On July 11, thousands of people took to the streets across Cuba in protest, expressing grievances that had been building over nearly a year and a half of pandemic-induced struggle and frustration. The primary issue at hand was the food supply shortage that had grown increasingly dire over the course of the island’s COVID-19 outbreak. Most Cubans were calling for their basic needs to be met; wait times to get basic commodities and household items were growing longer and island-wide medical short- ages exacerbated conditions at already overwhelmed hospitals in provinces such as Matanzas that were struggling to deal with a COVID-outbreak brought on by the spread of the Delta variant.

While protesters criticize the government’s management of the economy and COVID-19, most Cubans are not denouncing socialism or calling for U.S. intervention. The overwhelming majority of Cubans are pointing to the lack of access to basic goods, which has been largely due to the nearly six-decade-long U.S. blockade of the island.

“Cuba lives in a situation of scarcity that didn’t start with COVID,” Dr. Davel Milián Valdés, a specialist in general surgery and family medicine at the University Hospital Calixto García, told The Indypendent. “There was a big mass of the population that considered the economy their main problem.”

Milián Valdés describes the Cuban Revolution as an ongoing process that is aimed at building stronger systems for the benefit of the Cuban people. “The majority of those of us who are on this island, we are with the revolutionary process. I think that absolutely all of the people on the island as well as a major number of those who are outside the island are against the blockade,” he said. “We’ve been in the process of institutionalization since the revolutionary outbreak of the ‘50s, which had its culmination in ‘59. Little by little, these institutions are advancing towards a better Cuba, a more organized Cuba, a Cuba for all Cubans.”

The COVID-19 pandemic has further highlighted the devastating implications of the economic sanctions on the healthcare system during a global crisis — and beyond. Since 1962, the U.S. has continuously imposed an embargo on Cuba that prohibits trade between the two countries. In the 1990s, the U.S. globalized the embargo by imposing penalties on trans-national corporations that do business with both the U.S. and Cuba. While the severity and type of sanctions have waxed and waned, the U.S. has never lifted the restrictions completely.

Former President Trump imposed 243 new sanctions on Cuba during his time in office, including restrictions on remittances from Cuban Americans to Cuban family members, commercial and private travel to the island and the rum, tobacco and oil industries. He also declared Cuba a state sponsor of terrorism, a categorization that only also applies to Iran, North Korea and Syria. The decision came after the Obama administration had removed Cuba from the same list as part of his policy of rapprochement. In the six years since Obama’s decision, Trump’s State Department could not point to a single act of terror sponsored by Cuba. President Biden has made no move to reverse this measure.

Following the July 11 protests, Biden also announced plans to impose sanctions on individual Cuban government officials. Right-wing Cuban exiles in Florida have called for military intervention on the island — a move Cubans and hundreds of individuals worldwide have openly denounced. In an open letter to Biden that appeared as a full-page advertisement in the Times on July 23, 400 people, including scientists, artists, academics and activists, called on the U.S. to lift all sanctions on Cuba.

“Our foreign policy was very deliberate and intentional in all the steps it has taken over the years in enforcing a situation of despair in Cuba,” said Dr. Samira Addrey, a U.S.-raised graduate of the Latin American School of Medicine (ELAM) in Havana, Cuba and the program coordinator for the Interreligious Foundation for Community Organization (IFCO) medical school project.

Despite the targeted U.S. campaign against Cuba, the country has been successful in maintaining its commitment to public health. The government has long and heavily invested in its biotechnical sector and developed vaccines in response to numerous disease outbreaks, starting with a response to a spike in dengue fever cases in the 1980s.

Cuba still continues its legacy of medical solidarity campaigns, primarily that of the Henry Reeve Brigade, a Cuban group of medical professionals established by Fidel Castro in September 2005 with the mission of international medical solidarity, deployed worldwide

during major health crises, such as the Ebola epidemic. According to Global Health Partners, as of December 2020, Cuba had carried out 53 international medical brigades and sent 3,700 health care workers to over 40 countries during the pandemic.

The island’s national response to the pandemic had been planned months ahead of its first COVID cases (two Italian tourists) in March 2020. For months afterwards, the island was in lockdown and heavily restricted travel and non-essential movement. Hospitals were established for COVID patients, and separate institutions were created for contacts of COVID-positive people.

Milián Valdés told The Indy that doctors, medical students and even university students on non-health care paths became involved in what is called pesquisa, monitoring of the spread of COVID-19 on a grassroots level by going from door to door in neighborhoods to check in on households and possible transmissions of the virus.

And yet, the blockade has significantly hampered the Cuban healthcare system and prevented it from reaching its intended potential, Milián Valdés said. “One can find signs of the blockade in the daily life of every Cuban and in practically every one of the functions of a hospital institution,” he said.

Cuba’s drug regulator, the Center for State Control of Medicines, Equipment and Medical Devices, recently approved the three-dose Abdala vaccine and is soon set to approve another candidate, Soberana 2, both with reported efficacy rates of above 90 percent. Approximately a quarter of Cuba’s 11 million people have received at least one dose of a vaccine.

“Despite all of the setbacks that this pandemic has put on the island, and especially the blockade, it’s incredible,” Addrey said. “These vaccine candidates are a huge hope for a lot of the developing countries that will never get access to the Big Pharma vaccines.”

However, as the pandemic continues, shortages of over-the-counter medicines and syringes, which are needed for vaccinations, are preventing Cuba from being able to carry out its healthcare vision.

“The hardest blow for my comrades right now is medication shortages,” Addrey says of her medical colleagues who are working in Cuba hospitals. “Sometimes even saline has to be rationed, or surgeries have had to be canceled because there’s no antibiotics for pre-op or post-op. It’s ridiculous.”

In response, solidarity groups in the U.S. and around the world are organizing to send emergency shipments of syringes and other medicines and medical supplies to Cuba. Humanitarian organization Global Health Partners organized with other U.S.-based groups — such as The People’s Forum, Democratic Socialists of America, CODEPINK and others — to send 6 million syringes to Cuba, with support from thousands of people in the U.S. The first shipment of two million syringes arrived in Cuba on July 17 and shipments of medical aid are also expected to come from countries including Mexico and Russia.

As Cuba continues to administer vaccine doses and carry out its mission of medical solidarity for its own people as well as those of other countries experiencing vaccine inequities, its healthcare system remains a reflection of its values of universal healthcare as a human right and the collective well-being of the Cuban people.

“The pandemic has reinforced my commitment to my people,” Milián Valdés said. “We will come out of this better and stronger because of all the processes that will be subsequent to the protests of July 11 with better capacity to see ourselves from the inside, to see our problems and to reach solutions with our own efforts.”

Quotes from Dr. Davel Milián Valdés have been translated from Spanish.

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