by Will Podmore
The Special Period officially ended as the economy recovered. Between 1996 and 2000, it grew by 3.9 per cent per head a year. By 2005, Cuba had recovered its pre-crisis GDP. In 2006, it introduced its own hard currency. Tourism, biotechnology and the scientific and medical services sectors had all contributed. By 2013, real national income per head was 40 per cent above 1990’s level. The Cuban working class could only do all this because it held state power.
Internationalism
In 1999, Hurricane George devastated Haiti, followed by Hurricane Mitch, which destroyed much of Honduras and Nicaragua. More than 60,000 people lost their lives. Cuba, along with many other countries, sent doctors to help the survivors in all three countries.
After a month, most other aid agencies left, but the Ernesto Che Guevara Cuban Medical Brigade stayed in Haiti, as agreed with the government. It comprised 575 doctors and health professionals and operated the same Integral Health Programme, based on the Cuban domestic model, as the Cuban brigades in 62 other countries. It covered 70 per cent of the Haitian population.
The work of each unit started with a comprehensive analysis of people’s health, the risks to health and the resources available. Then each unit took measures to provide clean drinking water, to improve diet, sanitation and sewage disposal, and to visit every house in the area. This would usually be the first time that most Haitians had ever seen a doctor. On their visits, the doctors saw every member of the household and made basic health checks. They then organised various ‘circles’ for the elderly, pregnant women, adolescents and children, to discuss and identify risks and find solutions. Some medical problems required surgery, but other problems were solved by measures as basic as exercise, the use of condoms, prenatal examinations and better family hygiene.
The brigades mostly comprised young people, many of whom studied together in the same medical school, along with some experienced professionals, specialists in internal medicine, orthopaedics, surgery, paediatrics, gynaecology and obstetrics. They provided health care to the people of Haiti despite the personal risk of malaria and dengue and the two-year absences from home. They were also committed to their country, to the Cuban revolution and to their union. In the corner of every brigade house there was a ‘patriotic corner’, with their flag and items reminding them of Cuba. But they maintained strict political neutrality in Haiti.
Part of the agreement with the Haitian government was that young people from the poor areas where the Cubans were working would be educated as doctors and health professionals, to return to these areas to work for at least three years. As they were all being educated in the Cuban model, it was hoped that they would develop the same revolutionary professionalism as the Cubans.
Between 1999 and 2007, the Cuban Medical Brigade sent 1,000 doctors, nurses and other personnel to Haiti. They conducted almost 15 million patient visits. Life expectancy rose from 54 to 61 and the rates of maternal death, infant mortality and child mortality were all reduced by more than half, resulting in a verified saving of 81,856 lives. Haiti’s President Jean-Bertrand Aristides, a former Catholic priest, said that there were stars in the sky and on earth – those on the earth were the Cuban doctors.
After Haiti’s 2010 earthquake, the US Navy treated 871 patients and performed 843 surgical operations in seven weeks. In the same period, the Cubans treated 227,443 patients and performed 6,499 operations.9 In 2010, the organisation ‘Project Censored’ called ‘Cuba Provided the Greatest Medical Aid to Haiti after the Earthquake’ one of the year’s ‘outstanding stories ignored by the US corporate media’.
Cuba gave medical aid to many other countries too. 14,000 Cuban aid workers, mostly medical, worked overseas in the late 1970s, mostly in Latin America and Africa. Otto Reich, Bush’s representative for Latin America and a former organiser of anti-Cuban terrorism, threatened US intervention in Venezuela because of the growing number of ‘military-style’ Cubans in the country. Castro responded that the doctors were there at the invitation of the Venezuelan government and that if the US government would replace Cuba’s 10,169 doctors in Venezuela with American doctors, Cuba would gladly withdraw them.
In the areas of Ghana where Cuban medical professionals worked, infant mortality was cut from 59/1,000 to 7.8/1,000. After the Pakistan earthquake of 2005, Cuba sent 2,465 medical workers, including 1,430 doctors. Almost all the other aid teams left after five weeks; Cuba’s stayed for eight months, treating more than a million people and leaving behind 32 fully-equipped field hospitals. In 2014, Cuba mobilised 461 doctors and nurses to West Africa, the largest medical contingent of any country, to help in the fight against Ebola.
By 2009, 38,000 Cuban health workers, including 17,000 doctors, were working overseas. By 2010, Cuban health workers had performed more than 2.2 million operations, assisted 768,858 births and vaccinated more than 9.2 million people.10 By 2012, surgeons working on Cuba’s Operation Milagro had performed free eye surgery on more than three million people in 34 countries.11 They restored the eyesight of more than a million people, including that of one of the Bolivian soldiers who had killed Che Guevara. Cuban medical staff had provided 745 million free medical consultations. They had cared for more people (more than 70 million) and had saved more lives in the developing countries (1.5 million) than all the G-8 countries, the World Health Organisation and Médecins Sans Frontières put together.
Since 1959, Cuba has provided free medical education for 52,000 people from 130 other countries. It has helped to set up ten medical schools in other countries. In 1999, Cuba set up the world’s largest medical school, the Latin American Medical School, with more than 8,000 students from countries in Asia, Africa and Latin America. Most were from working class and peasant families and half were women.12 It educated more health workers from other countries than did all the G8 member countries combined.
Cuba was the only country in the world’s history to create a WHO-validated, six-year course of medical education, with no fees and with full food and board, for adequately-schooled people from anywhere in the world who could not afford medical school in their own country. The graduates’ only commitment was to return to their home countries and provide medical care to those who could least afford it. By contrast, in Zambia, only 50 of the 600 doctors educated there since independence were still working there in 2008.
Giving medical aid had been a basic principle of the Cuban Revolution from the first, flowing from its belief that medicine is not a business but the right of every citizen and the duty of every doctor. Cuba has done more to aid underdeveloped and developing nations than any other country in the world.
Working class democracy
Two decades after the crisis that followed the collapse of the Soviet Union, the Cuban working class was still in control. The dictatorship of the proletariat still meant democracy for the workers, the direct application of power and control by Cuban workers. Cuba is, constitutionally, a ‘socialist state of workers’. There were no capitalists apart from foreign entrepreneurs in mixed companies and a few clandestine workshop owners.13 As the 19th Congress of the Cuban trade union congress, the Central de Trabajadores de Cuba (CTC), stated, “the principal conquests of the Revolution have been preserved, first of all, the political power of the workers.”14
This meant that workers as the ruling class were not to be treated as just labour power. So Cuba decided not to compete with other countries in a race to the bottom by offering low-wage workers to foreign companies. Instead it would invest in its people’s skills, especially in health care, education, biotechnology, medications and other high-value goods. The saving of material resources and a more productive workforce had to be the key sources of this investment. So Cuba needed better organisation and better education and technical skills. As workers improved their skills, they increased productivity, so fewer were needed to carry out particular jobs. Workers could then be redeployed to other areas of work to develop new lines of production and to upgrade th
eir skills. This would again raise productivity and workers’ skill and educational levels, in a virtuous circle.
So Cuba re-engineered its economy, developed a new Labour Code and debated the nature of the future workforce. The new task was to move from crisis management to restoring normal working practices, including full use of the working day. It meant modernising management under Cuban standards, professionalising administration and re-drafting workers’ legal rights and responsibilities. It also meant addressing the distribution of incomes.
So the people consulted, as they had in the earlier workers’ parliaments in which workers and unions had a complete veto. 1.5 million proposals on job descriptions and redeployment, health and safety, productivity, incentives and salaries were discussed and voted on at more than 20,000 workplace meetings.
Those moving out of the direct state sector were from over-manned sections and those services that should not be maintained by the state, such as hairdressing. All were offered full pay in higher education, skills training or new areas of work like small-scale manufacturing and repair workshops. New areas of work also arose from the economic integration with other countries through ALBA. This required novel relations with private capital in those countries as joint companies were developed on the island. But Cuban workers decided the regulations governing these ventures, insisting that the people would decide, not market forces.
Yamil Eduardo Martinez, a young trade unionist, said, “Sections of the western, hostile, media are claiming that these changes are a retreat from socialism. In fact, they are about making our economy more efficient so that we can develop further in health and education – with the public sector not having to directly manage everything. One thing we really want to do is to raise agricultural production, so in a world of uncertain food security we can be as close to being self-sufficient as possible.”15
So at all stages, workers were in control. Unions initiated laws; trade unionists sat in the National Assembly and participated in ministerial decision-making. Legislative proposals affecting workers were always referred to the unions for their agreement or criticism.
In 1995, the unions rejected a draft law to allow foreign companies to directly employ Cuban workers on their own terms. The unions insisted that those workers must be employed through a state agency and under Cuban labour laws. In the 1990s, the unions defeated a proposal to raise the retirement age. In 2002, the radical restructuring of Cuba’s biggest industry, the sugar industry, followed negotiations with unions and meetings with all its 900,000 workers. 207,000 went to new jobs, or to ‘study as a form of work’, or to early retirement with enhanced pensions; none was discarded.
Resolución No. 8/2005 provided that no worker could be dismissed through redundancy, redeployment or temporary lay-off. Any such had to be negotiated with the unions and management had to pay the worker 100 per cent of his or her salary for a month, then 60 per cent until an alternative was agreed. This would be either another job, with training if necessary, or ‘study as a form of work’, with workers keeping their salaries and employment rights. In 2008, in conditions of full employment, this proposal was revived with improved pension rates and another CTC mass consultation exercise was launched. 3,085,798 workers met in 85,301 workplace assemblies to discuss the proposals: 99 per cent voted for the changes.
The drafting of new employment laws involved detailed and extensive consultation with the CTC. And, for implementation across workplaces, the laws explicitly required the agreement of unions and of the monthly workers’ assemblies. Resolución No. 9/2007 specified managerial responsibilities for health and safety, required written health and safety policies and workplace health and safety manuals, listed hundreds of hazards to be addressed and restated the role of unions in all aspects of health and safety policy. As a result, recorded workplace accidents fell from 8,280 in 2002 to 6,015 in 2007 and fatal accidents fell more rapidly, from 111 to 47.16
Cuba also had the world’s best programme of community-based disaster preparedness.17 During the three devastating hurricanes Fay, Gustav and Ike that hit Cuba in 2008, causing $8 billion worth of damage, the working class worked selflessly and collectively to repair the damage and to care for those who lost homes and property, under the slogan ‘every human life is sacred’. The Cuban Civil Defence Authority took responsibility for the population in such events and guaranteed to save all lives if people and organisations did as instructed. In Cuba seven people died. When visiting British health workers expressed their condolences during their visit, they were respectfully told that the seven had died because they ignored instructions from the Civil Defence Authority. When the same three hurricanes hit neighbouring Haiti, more than 1,000 people were killed.
In 2010, unions accepted some dilution of the 2005 rights. The right of redeployed workers to take up ‘study as a form of work’ with their salary and continuity of employment retained or to enhanced early retirement (as in the sugar industry restructuring in 2002) was no longer available as of right, though they remained options in practice. Temporarily redeployed workers would no longer have the right to continue to draw their original salary if it was higher than the salary in the job to which they were redeployed. Earnings-related salary protection would be paid at 100 per cent of salary for a month, then at 60 per cent for the next one to five months for those with 10 to 30 years’ service. Thereafter welfare benefits in cash and kind were available, subject to regular household income and availability-to-work assessments.18
As the economy recovered, modest salary increases across the board followed, with the minimum wage more than doubled and minimum pensions tripled. In April 2008, the minimum monthly pension was raised again, by more than 20 per cent to 200 CUP, and social security payments were raised by 20 per cent. In 2012, the economy grew by 3.1 per cent.
People’s Power
People’s Power was piloted in the province of Matanzas in 1974 and set up nationally in 1976. Cuba held competitive elections for delegates to its municipal assemblies, in which the people, not the Communist Party, proposed the candidates.19 There were usually four to seven candidates, never fewer than two. There was no campaigning for or against any candidate; negative campaigning was not allowed. There were no electoral promises or bribes or funding. There were no lobbyists to promote private interests over the general good. 20
Delegates were unpaid and their work was on top of their regular work, so Cuba had no caste of professional politicians. The delegates did not represent themselves or parties; they had to act in the interests of the whole people. Delegates had to live in their electoral districts and had to account to their constituents at all times. The constituents formally instructed the delegates and had the right to recall them at once at any time. The delegates held weekly and six-monthly meetings to report back to their constituents, who held them to account.
This system was not perfect, but it worked. For example, in June 1978 in a passionate debate in the National Assembly, delegates raised the matter of housing repair, a matter of great concern when 80 per cent of Cubans owned their own homes. In response, the government’s 1979 plan put 70 per cent of the monies for building into housing repair and maintenance and Cuba doubled the number of houses built every year.21
Cuba’s 169 municipal and 14 provincial assemblies met at least twice a year. Since 1993, there have been direct elections to the provincial assemblies and the National Assembly. The National Assembly met twice a year, for two days each time. It had ten permanent commissions. The people were sovereign, so their elected delegates worked to ensure that the people participated as much as possible in making the laws. This was a key part of democratising the country.22
In 2007, 5.1 million Cubans participated in meetings to discuss what reforms they wanted and they made 1.3 million proposals. In 2011, in preparing for the 2011 Party Congress, 8.9 million people attended 163,000 meetings and generated more than three million suggestions. This was democratic central
ism in action, where the Cuban people consulted together, then decided policy.
Cuba persistently sought to keep high standards of behaviour. All those in leading positions and their families were expected to live in a manner no different from other people. Those found guilty of corruption were punished severely. Cuba did well on the World Bank and Transparency International scores of corruption. A thorough US-sourced study which set out to show the extent of corruption in Cuba ended by confirming the extent of the efforts to contain it.23
Cuba’s 1992 Constitution banned discrimination based on race, skin colour or sex. Its Article 44 said, “men and women have equal rights in the economic, political, cultural and social realms and in the family.” In 1994, the Federación de Mujeres Cubanas [FMC] had 3.6 million members, 82 per cent of the adult female population. It was the largest organisation in Cuba and the largest women’s organisation in Latin America. It helped to improve women’s health, education, legal rights and rights at work. National control of the economy and the government’s policy of encouraging women’s work brought women more independence, professional opportunities and social mobility.2424
The FMC’s 1985 Congress successfully called for more childcare centres, more provision of contraception, better sex education and more emphasis on the need to share housework, in line with the 1975 Family Code which required men and women to share household duties and child care. By 1996, Cuba had 1,156 childcare centres. The FMC also organised voluntary health workers into programmes of screening for cervical cancer. It helped to find absconding fathers to assist them to support and legally recognise their children. It arranged care and subsidies for children in need. The country also had a network of shelters for victims of domestic violence and child abuse.