STRANGLING CUBA : Does the embargo make sense?

At the pediatric unit of the Juan Manuel Marques Hospital in Havana, I watch an infant girl struggling for breath in an incubator; her little chest expanding and contracting, in out...in out. Two nurses are monitoring the child's life-support system. Thirty-four years ago at New York Hospital our newborn son was rushed from his mother's arms into an incubator to see if the infusion of pure oxygen would assist his labored breathing long enough for his own lungs to take over.

My son lived. At the window of the Havana pediatric unit, I pray a father's prayer for the life of the Cuban baby, struggling for breath, as my son did, in the incubator. What a miraculous machine! I later learn, on a tour of the hospital, that incubators and parts for incubators are in short supply, as are inhalers to treat asthmatics, parts for kidney dialysis machines, mammogram equipment, defibrillators for heart conditions, film for x-ray machines, and diagnostic equipment of all sorts.

Cuba's shortage of critical medical equipment can be directly attributed to the United States embargo, which is going into its thirty-eighth year and excludes, among other essentials, the importation of medicine and food. Cuban physicians currently have access to less than 50 percent of the new medicines available on the world market, and serious nutritional deficits, particularly among pregnant women, have led to an increase in low-birth-weight babies.

In a devastating indictment of U.S. policy against Cuba, the American Association for World Health (AAWH)-the U.S. committee of the World Health Organization-following a year-long study in 1997, concluded that "the embargo has closed so many windows that in some cases Cuban physicians have found it impossible to obtain lifesaving medicines from any source, under any circumstances."

In one instance, the AAWH reports, "Cuban cardiologists diagnosed a heart-attack patient with a ventricular arrhythmia. He required an implantable defibrillator to survive. Though the U.S. firm, CPI, which then held a virtual monopoly on the device, expressed a willingness to make the sale, the United States denied a license for it."

A Swedish corporation was recently prohibited from selling a sophisticated piece of medical equipment to Cuba because it contains a single filter patented under U.S. law. Dozens of other transactions between Cuba and foreign corporations, involving spare parts for x-ray machines from France, neurological diagnostic equipment from Japan, and parts to clean dialysis machines from Argentina are likewise prevented.

Until 1990, all Cuban women over the age of thirty-five received mammograms on a regular basis. Today, without adequate equipment, mammograms are no longer routinely given. In 1994 and 1995, the lack of x-ray film halted all mammograms in Havana.

During my tour of the Juan Manuel Marques Hospital, I learn of children continually vomiting from their chemotherapy treatment, a reaction that is normally minimized with a drug readily available in the United States but denied to Cuba, as are new medications for childhood leukemia and breast cancer.

Dr. Eduardo Sagaro, chief of oncology at the hospital, speaks of the "constant necessity of prescribing around the embargo," that is, "thinking in terms of alternative drugs or alternative methods, if what you prescribe is not available." At the Joaquin Alvabaran Surgical Institute in Havana, Dr. Miguel Arias laments the lack of medications such as "antibiotics, analgesics, IV's, as well as syringes, needles, surgical materials, and even oxygen."

A shortage of anesthetics and related equipment has forced a drop in the number of surgeries at Cuban hospitals from 885,790 in 1990 to 536,547 in 1995. Nonprescription drugs such as aspirin are not readily available, nor are disposable needles, necessitating sterilization.

According to the AAWH study, morbidity rates from water-borne diseases have doubled since 1989 because Cuba has been unable to purchase parts for the chlorinating system that treats 70 percent of the country's drinking water.

Ironically, Cubans are not the only ones being hurt by the medical embargo. In 1983, Cuba was confronted by a meningitis B epidemic. Within two years, Cuban medical researchers developed a vaccine. The AAWH now considers Cuba's meningitis B vaccine the most advanced in current production. When Smith Kline Beecham, an international pharmaceutical company, asked the Clinton administration, more than a year ago, for permission to test and possibly improve on the world's most advanced vaccine against meningitis B, their request was ignored.

Until the late 1980s, Cuba's inability to obtain U.S. medical and food supplies was largely offset by imports from the socialist bloc countries and Western Europe. With the collapse of the Soviet Union in 1989, and Cuba's loss of revenues, estimated between $4 to $6 billion annually, the embargo suddenly became extremely effective, particularly with the inclusion of two crippling pieces of legislation.

The Cuban Democracy Act, known as the Torricelli Act, for Robert Torricelli (D-N.J.), and lobbied for by wealthy anti-Castro Cuban Americans in Florida and New Jersey, was signed into law in 1992 by President George Bush. It prohibits foreign subsidiaries of U.S. companies from trading with Cuba. The Cuba Liberty and Democratic Solidarity Act (1995), known as the Helms-Burton Act for co-sponsors Jesse Helms (R-N.C.), and Congressman Dan Burton (R-Ind.), prohibits foreign companies from "trafficking" in American property nationalized by Cuba.

Since 1992, the United Nations General Assembly has consistently condemned the blockade against Cuba and called for the United States to rescind provisions of the embargo that violate both the UN charter and international law. The last vote in November was a scathing 157 to 2; the two were the United States and Israel.

In the June issue of Cigar Aficionado, Jesse Helms argues that "the real cause of the misery of the Cuban people is not the U.S. embargo"- it is Castro's regime. "The United States must continue the embargo to keep up pressure for change on the island, because if we don't give up our leverage by unilaterally lifting the embargo, Castro's successors will be forced to exchange normalized relations with the United States for a complete democratic transition in Cuba."

In response, Senator Christopher Dodd (D-Conn.) points out that "Cuba is not the only country in the world where government is not democratically elected and where full respect for internationally recognized human rights is lacking." As examples, Dodd cites China, Vietnam, and Russia as countries with which the United States has "no across-the-board trade or investment restrictions and there is no limitation on the freedom to travel."

In calling for repeal of all trade sanctions against Cuba, Dodd characterizes U.S. policy as one "that denies food to hungry Cuban children; that severely limits the availability of medicines and medical supplies to the Cuban people; that denies U.S. citizens the right to travel where they choose; that denies American children access to certain innovative and highly effective Cuban vaccines...."

The Clinton administration-having pursued and accepted campaign contributions from the anti-Castro coalition-recently announced moves to streamline the sale and donation of medicines to Cuba. "It's a charade," says the AAWH. "Donations from U.S. nongovernmental organizations and international agencies do not begin to compensate for the hardships inflicted by the embargo on the Cuban public-health system which is being systematically stripped of essential resources."

On April 29-the day after President Clinton announced that he would allow U.S. companies to sell food and medicine to Iran, Sudan, and Libya, but not Cuba-Dodd and Senator John Warner (R-Va.), along with Representatives Jose Serrano (D-N.Y.) and Jim Leach (R-Iowa), introduced bills in both houses to end the embargo on the sale of food and medicine to Cuba (S. 926 and HR 1644, respectively). The sponsors feel that the existence of identical bills "will allow the House and the Senate to work together to constructively change our nation's policy toward Cuba to a more humane one."

Brian Brown, a free-lance writer and Commonweal's publicist, recently returned from a two-week visit to Cuba with a delegation from Witness for Peace, which was there to assess the impact of the U.S. embargo on the Cuban people.