Cochabamba, Bolivia – As Latin America becomes the new focal point for the devastating spread of Covid-19, Cuba stands virtually alone in having saved its population from the dramatic health and societal collapse seen across most of the region. At the other extreme is Bolivia, where the coup regime is using the trauma of mass graves and corpses in the streets – the fruits of its own inaction – as an excuse to ban elections. A close look the divergent results of the two countries gives an insight into how two opposing ideological models have shaped the situation that Cuba and Bolivia find themselves in today.
The two countries have roughly the same population of about 11 million and were among the last in the region to see their first imported cases. Covid-19 arrived in Bolivia on March 10th; it hit Cuba the following day. The similarities end there.
At the time of writing, Cuba has yet to see a single medical professional or child die from the virus, and has a total of 2,495 cases. Meanwhile, Bolivia had 1,825 cases of Covid-19 just in the last 24 hours, adding to a staggering national total of 68,281 infections. Cuba has suffered 87 deaths from the virus while Bolivia has suffered a whopping 2,535.
The number of tests carried out is a core component of any Covid-19 strategy, if those who are presenting symptoms or are carriers of the virus are not able to access tests, then it makes tracing and isolating impossible. So far, Cuba, a blockaded country, has carried out 247,203 tests. In Bolivia, where the coup regime has complained that such tests are expensive to acquire, only 134,769 have been carried out.
This is an extraordinarily low number in comparison not just to Cuba, but to immediate neighbors like Peru, which has carried out 2 million tests. Instead of buying tests, Bolivia’s incompetent government purchased 500 faulty ventilators at inflated prices. This corruption scandal forced the country’s Health Minister Marcelo Navajas to resign after just a few miserable weeks on the job.
The strengths of Cuba’s socialized health system are well known. Figures from the World Health Organization show that the island has the highest doctor-patient ratio in the world, with 8.4 per 1000 of the population, compared to just 2.6 in the United States. The infant mortality rate in Cuba is 4 per 1000 live births, the same as the UK and Denmark. Meanwhile, the US stands at 6 per 1000.
These statistics alone are a testament to Cuba’s general preparedness for the challenges of Covid-19. But beyond its superior public health system, Cuba’s concrete pandemic prevention strategy has been far more advanced than that of most around the world.
Ariana Campero was the former Minister of Health in Evo Morales’ government between 2015-2018 and served as Bolivian ambassador in Cuba, where she lives today. She detailed for me the prevention system that sets Cuba apart from Bolivia and other neoliberal governments in the region: “Unlike Bolivia, Cuba has had a real plan, most importantly in its active search for cases through primary healthcare provision. An example of this is how the nurse assigned to our neighborhood comes by our house every single day to check that no one is presenting symptoms or has had contact with anyone who’s been abroad recently, or any change of circumstance that would expose the family to Covid-19.”
While Cuba’s early measures allowed its government to run a properly functional track and trace operation, the Bolivian coup regime sat on its hands as Covid-19 inched toward its borders. Don Fitz, a leading academic expert on Cuba’s health system, explained to The Grayzone, “The only reason that Cuba’s tracking system has worked is that the Coronavirus Plan for Prevention and Control was implemented on March 2, 2020.
Within four days, it expanded the plan to include taking the temperature of and possibly isolating infected incoming travelers. These occurred before Cuba’s first confirmed Covid-19 diagnosis on March 11. Cuba had its first confirmed Covid-19 fatality by March 22, when there were thirty-five confirmed cases, almost one thousand patients being observed in hospitals, and over thirty thousand people under surveillance at home. The next day it banned the entry of nonresident foreigners.”
Conversely, Bolivia has almost no discernible strategy. Following the coup against Evo Morales in November 2019, Bolivia focused instead on purging its public sphere of anything that could be remotely connected to Cuba. The new government formally broke off diplomatic relations and expelled the 700 Cuban medical professionals stationed here.
While Bolivian health ministers once sought to emulate Cuba, the coup government of Jeanine Añez turned to the private sector and appointed Marcelo Navajas, an owner of an elite private clinic in the upper class south side of La Paz, as health minister just as Covid-19 cases began to surge. The ideological divergence handicapped the country as it careened into the current health crisis.
Before the coup, Cuban doctors were running entire hospitals in working class urban and rural areas of Bolivia. Today, those clinics are still empty. The government claims to have plans to open one of the clinics in La Paz, but said nothing of the others. I visited a former Cuban clinic in the working class ‘Valle Hermoso’ district in the city Cochabamba, the establishment was home to 143 Cuban doctors providing free healthcare to the community. When I visited the area in January 2020, the gates were locked and the only information was a handwritten sign reading, “There is no service. There are no doctors. There are no nurses.”
Today, more than four months since the start of the pandemic, the clinic’s gates are still closed. María Rodríguez, Valle Hermoso resident, explained to local media in June how her husband had been receiving long-standing treatment for pulmonary fibrosis at that Cuban hospital, but is now unable to access any service at all since the pandemic hit. “We were told that it would only be closed for a short time,” Rodríguez said, “that they just needed to hire new staff. We had to go to the ‘Hospital del Sur’ to continue with the treatment. It was ok there, but a week ago when I went, they didn’t even let us in because they said everything is full…they don’t want to treat him anywhere.”
The closure of the Cuban clinics is a particularly bitter twist now that Bolivia’s privately driven health system is falling apart at the seams. The largest hospital in Cochabamba declared itself ‘collapsed’ over a month ago. In neighboring Quillacollo, one doctor spoke anonymously to Kawaschun News, where I am employed, revealing that though staff hadn’t been paid since March, they are still expected to perform 24 hour shifts, at times they’ve had to leave dead bodies on the floor of the hospital without any material with which to wrap them. As public health is neglected, private clinics are seeking to turn a profit off the pandemic. Thanks to government inaction, clinics are charging Covid-19 patients up to $3000 per night for a hospital stay, then charging again, at inflated prices, for each medication used during that stay.
Where the state has failed, local authorities have done what they can, but are hamstrung by austerity measures that starved municipalities of government funding. This is a policy that began after the coup and before the pandemic. Alvaro Ruiz (MAS), Mayor of Uriondo and President of the Federation of Municipal Associations (FAM Bolivia) told The Grayzone, “There are projects in water, health, education that are now paralyzed because the central government has cut local authority budgets. We can’t allow our people to go backwards and lose the social gains made thanks to the work and coordination under Evo Morales”.
Matilde Campos (MAS), Mayor of Shinahota, in the Chapare region, echoed Ruiz’s points, complaining the austerity policy has affected their ability to respond to Covid-19. “As municipalities, we’ve been abandoned,” the mayor told The Grayzone. “The government doesn’t have any initiative, they haven’t even bought any ventilators for the hospitals in this region. Total inefficiency”.
Rather than holding the new government to account for this disaster, Bolivia’s corporate media has blamed Cuban doctors and the country’s pre-existing health system instead.
Leading the attacks has been Jhanisse Vaca Daza, US-linked regime change operative who now has a weekly column in the right-wing newspaper Pagina Siete. She condemned the MAS for praising Cuba, commenting, “Luis Arce (MAS candidate) asked the central government to accept the help of Cuban doctors. This follows a long line of praise for the Cuban health system that should be questioned. If you listen to testimonies of activists who manage to leave the island, the stories about the lack of resources in Cuban hospitals are horrendous.”
In order to suppress the Covid-19 mortality rate, the issue of medicines is vital. The US economic blockade on Cuba is an obstacle in accessing imported medicines. However, the island has spent decades developing a first-rate biotech industry. The state initiative was launched during Fidel Castro’s period in the presidency, when the Center for Genetic Engineering and Biotechnology was founded to carry out world leading research. The center was complimented by a wider network of state-run production that now manufactures the vast majority of the medications used in the country, as well as 300 products for export.
The Cuban-made Interferon-AlfaB2 has proved to be a lifesaver. Cuba began producing Interferon in 1981 to combat Dengue fever. Since then, the drug has come into international demand. Its effectiveness against coronaviruses was first demonstrated during the 2003 SARS outbreak; it is now being exported by Cuba to 72 countries to help fight the symptoms of Covid-19. Cuba currently has a mortality rate of just 3.77 compared to 5.71 throughout Latin America.
Ariana Campero points to Cuba’s biotech sector as a key to reducing deaths among those who are hospitalized. “It’s an example of the futurist vision of Comandante Fidel,” the Bolivian diplomat said. “This project of producing medicines within Cuba started decades ago. That futurist vision has helped save countless lives now. Not just with Interferon, but there’s now another medicine that’s been developed here, CIGB-258. It’s only very recently been authorised for trial use on patients in a critical state, but it’s showing very good results. All these innovative medicines are developed here and follow all WHO standards and protocols.”
Despite its contribution to global health, the only factor impeding further growth in Cuba’s health sector is US sanctions, which places innumerable obstacles to stop commercialization and research.
In Bolivia, where the US offers full-throated support for the coup regime, doctors’ associations have become increasingly desperate about the regime’s failure to provide adequate medications. In the Amazonian department of Beni, one of the worst affected regions, the medical college has formally asked the state to import Interferon Alpha B2, but the request has fallen on deaf ears.
The medicine shortages have forced desperate Bolivians to turn to herbs and forgotten ancestral medicine. The primary ingredients used in these remedies include eucalyptus, ginger, honey and a plant called Huira Huira. These elements contain medicinal properties and have been used for generations in rural indigenous communities. Huira Huira can help with respiratory problems, for instance, and ginger boosts the immune system.
However, these solutions are only experiencing a revival because of the government’s near-total abdication and incompetence. Leonardo Loza, a union leader in the Tropico of Cochabamba has been helping to distribute medicinal plants to the communities he represents, but told The Grayzone he was forced to do so because the central government has abandoned his community. “I remember these medicines when I was a child,” Loza told The Grayzone, “but as our people started rising out of poverty we all began going to the pharmacy and buying those medications, most of us have forgotten how to even prepare these remedies. But now we’re forced to learn this again.”
With the government absent, indigenous unions are inviting elders with medicinal knowledge to give workshops at local union halls. One workshop I witnessed in Central Litoral in the Municipality of Villa Tunari featured instructions on how to make a therapeutic syrup from ginger, onion, garlic and honey.
Mayor Matilde Campos is one of a number of local mayors sponsoring these efforts, but emphasises that they arisen from necessity: “It’s due to a lack of conventional treatments. Where did the initiative of medicinal plants come from? It has come from the population, from citizens, and so we’re supporting them as a municipality because the municipalities are with the people. The government is with the IMF and the United States.”
It is not yet clear if these remedies actually produce results against Covid-19. There are testimonies such as those of 55 year old David Pascual, a neighbor of mine in the Tropico of Cochabamba, who was ill with Covid-like symptoms for 35 days. For much of that time he had very serious respiratory problems and complained that his brain ‘stopped working’. Unable to find a test, he decided to treat himself with natural remedies including boiling ginger with Coca Cola.
When I asked Pascual why he hadn’t gone to a hospital during such a severe stage of the illness, he replied: “Those (natural) medicines are the way I was cured of Covid-19. It took a while to work, but it was worth it. I didn’t go to a doctor or the hospital … I don’t trust them, I’ve heard lots of stories recently about negligence that results in deaths and also, they don’t even have any medicine there anymore. What’s the point of going?”
David is in good health now and is back at work on his plot of land, picking coca and mandarins. But his DIY solutions are a far cry from Cuba’s impressive biotech industry, whose products have undergone clinical trials in Wuhan and have shown to be effective in strengthening the immune system and reducing inflammatory proteins that lead to complications in Covid-19 patients.
The strain on health systems is not the only crisis caused by the pandemic. As Nash Landesman reported for The Grayzone, total lockdown measures imposed in many Latin American countries threaten to starve the masses of workers that subsist off the informal economy, depending on a day’s labor for basic provisions.
The economic crisis has already begun for both Cuba and Bolivia, who have each adopted quarantine measures to varying degrees. However, there’s a vast difference in how the two nations have approached the economic question during the last four months. In Cuba, those under lockdown have been receiving 60% of their salary to help with the cost of living.
In contrast, Bolivia’s government has presided over the mass impoverishment of its own population through a strict implementation of lockdown, coupled with an almost total absence of any support for the millions who’ve lost their income.
Figures from the CELAG think tank show that 38% of Bolivians have lost the entirety of the earnings, while 52% have lost part of their earnings. Just 8.5% responded that they had not been affected by the neoliberal-style lockdown policy.
The only measure the Bolivian coup regime has introduced to soften the blow is a one-off payment of 500bs (70 USD) for every citizen over 18 unable to earn a living during the pandemic. Needless to say, in a country where the minimum wage is over $300 per month, $70 has hardly been enough to last four months.
Bolivians have taken to the streets to protest against the hunger and impoverishment facing the majority of the country. In mid-May almost every region was gripped by marches that spread from El Alto and Potosi in the Andes to Cochabamba in the valleys to Yapacani and San Julian in the Eastern department of Santa Cruz.
One protester in the working-class district of K’ara K’ara (Cochabamba) described the desperation that led the community to break quarantine: “We’re tired, we don’t know what to eat. What we want is to go back to work immediately. We want to be able to bring home at least a piece of bread for our children, because the payment this government gave us is nothing, it’s already run out…the banks (loans) are pressuring us, we still have to pay for basic services, we still have to pay for water.”
The pandemic has wrought vast destruction, particularly in Latin America where health systems have crumbled upon impact. That Cuba has avoided the scenes of dead bodies lining the streets and collapsed hospitals is a historic victory for its socialist model. Its approach has saved countless lives at home while sending 2000 well-trained doctors abroad to fighting Covid-19 in 28 different countries.
In Bolivia, meanwhile, where an unelected, US-backed regime has abandoned the model that Evo Morales employed to lift millions out of extreme poverty, the bodies continue to pile up.
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