CHAPTER II. REPERCUSSIONS OF THE EMBARGO ON THE MOST SENSITIVE SOCIAL SECTORS

2.1 Repercussions on health and food

The sectors of public health and food have been prioritized objectives of the embargo policy.  

PUBLIC HEALTH

Between May 2009 and April 2010 repercussions on the public health sector totalled 15 million 200 thousand dollars. 

The economic toll is due basically to the necessity of acquiring medicines, reactives, spare parts for medical equipment, instruments and other consumables in far away markets and on many occasions with the use of intermediaries, thus increasing the prices.  

Added to the above is the suffering and desperation that this situation caused on patients and their families, seeing that they cannot count on having the best medicine for an illness and on many occasions, at the moment it is needed, in order to save a life.  This pain can never receive be given a dollar value. 

Among the many examples describing the damage caused in the sphere of health during the period referred to, we include the following:

• The Institute of Oncology and Radiobiology cannot use Radioactive Iodine plates for the treatment of children and adults suffering from retinoblastoma (congenital tumors growing on the retina) since they cannot acquire these since they can only be bought in the US.  This technology is mostly used for the treatment of children since it permits treatment of the tumor on the retina, saving vision in the affected eye and the appearance of the face.  Faced with this shortage, the only alternative is to remove the eye and in some cases both eyes, a procedure which, besides being invasive, carries with it severe limitations for the lives of the patients.

• This institute has approximately 1600 patients per year who are affected by the impossibility of acquiring the refills for Philips Tomography. Of these patients, 250 face serious difficulties in the planning of their radiotherapies.  Not having this technology means that the imprecision rate of the treatment increases from 3 to 5 % and the radiotherapy services are adversely affected since the limits and forms of the tumors cannot be precisely determined. 

• Cuba has no access to Temozolamide (Temodar), specific cytostatic medicine for use in tumors of the central nervous system (gliomas and astrocytomas). This disease affects approximately 250 patients every year, and of these around 30 are children.  Use of this medicine would significantly increase survival and quality of life for the patients, since the medicine has very few adverse effects and can be relatively easily administered in comparison with other medicines. 

• Cuba is denied the right to acquire non-ionic iodine contrast, a product that has a bearing on the quality of imaging studies of patients with tumors.  Use of this medicine would increase the efficacy of diagnoses and there would be no risk of allergic reactions to the contrast which on occasion has very serious results.

• Cuban hospitals are deprived of the possiblilty of obtaining the reactive SILANE, sold by Sigma, which is used to adhere histological sections to slides for special techniques in immunohistochemistry and hybridization.  Without this reactive one cannot process malignant tumors and other infectious diseases, something that prevents the application of modern techniques that are necessary for diagnosis, prognosis and treatment of these diseases.    

• The Hermanos Ameijeiras Hospital, in Havana, cannot make tomographic studies on more than 5,000 patients, particularly the Angio-TAC, something that is vital for the study of cerebrovascular diseases due to the non-compliance of Phillips in supplying the spare parts for two tomographs.
  
  
• Cuba is also prevented from acquiring consumables and medicines related to organ and tissue transplants.  Medicines such as cyclosporine and tacrolimus that prevent rejection by the transplanted organ or tissue cannot be bought by our country. 

Cuban children continue to be the innocent victims of the US embargo policy against Cuba.  

• The “William Soler” Pediatric Cardio-centre was included in the year 2007 by the US Treasury Department into the category of “Rejected Hospital” and so it has conditions placed on it for the sale of products and the acquisition of these is refused unless they comply with the demands placed on them. This situation has involved an endless number of repercussions on carrying out different surgical techniques due to not being able to acquire certain materials suitable for children on the American market, such as better quality vesical and tracheal probes, catheters and stents, etc.

• Cuban children are denied the use of the Amplatzer device which is manufactured in the US, made from special materials to avoid organic rejection.  This device is used for the percutaneous closure of the intra-auricular communication (closure of the defective opening between the aorta and pulmonary arteries, a procedure known as interventionist catheterism) avoiding open heart surgery which besides being risky frequires intensive care and a three week recovery period.

4 new cases of children waiting for operations have been added to the list from previous years:

1. María Fernanda Vidal, 5 years old, Havana, HC 680347.
2. Cyntia Soto Aponte, 3 years old, Havana, HC 668739
3. Mayuli Pérez Ulboa, 8 years old, Ciego de Avila, HC 691064
4. Lianet D. Alvarez, 5 years old, Camaguey, HC 04110975335 

• The American company ABBOT is forbidden to sell Cuba the medicine called Sevofluorane, a general inhaled anaesthesia agent, having rapid induction thus making it ideal and the best product for anaesthesia induction for children, and at the same time, an excellent myocardial protection agent for episodes of ischemia in patients who have been anaesthetized for revascularization. Other generic medicines having inferior quality and adverse effects on the patient such as Levosimendan are manufactured by the same company and so also cannot be acquired by Cuba.  

FOOD

During the period we are analyzing, conditions under which Cuba had to make fundamental purchases of foods from American companies remained onerous and difficult.

The US government continues to set up obstacles for such purchases and there has been no action made to carry out these sales in accordance with the norms, channels and regular practices of international commerce.  

In June 2009, the US International Trade Commission published a report on the agricultural sales to Cuba where it was recognized that among the factors limiting commerce between the two countries were: the difficult payment conditions for Cuban importers; additional warehousing costs or extended stay costs affecting Alimport due to bureaucratic roadblocks; the complicated and slow process of obtaining licences for the exporters who need to travel to Cuba; travel restrictions on Cuban negotiators; penalization by US laws of the foreign vessels that dock in Cuban ports and purchases made by the Cuban government from certain countries for geopolitical reasons.  The Commission supposes that an eventual lifting of financial restrictions and bans on travel by Americans would cause an increase in US agricultural sales to Cuba that would be between 924 million dollars and one thousand 200 million dollars, something that would signify between 49% and 64% of the total agricultural purchases by Cuba. 

The following examples illustrate the situation:

• ALIMPORT, the company which imports foods, had repercussions to the effect of 102 million 900 thousand dollars because of “Risk Country”, banking and financial costs dealing with payment instruments.  If the funds had been available, we might have acquired 337,000 tons of wheat or 451,000 tons of corn or 109,000 tons of chicken at average prices in 2008. 

• According to information from the US Department of Agriculture Service of Economic Research, in 2009 this country imported more than
  3 million 82 thousand TM of raw sugar, of which 1 million 370 thousand TM was under quota. Since Cuba didn’t have access to the preferential and futures market of New York, during the period we are analyzing it had repercussions of close to 49 million USD, taking into account the current volumes of production and exports of our country.   

• Without access to the US market, The Union of Beverages and Soft Drinks is forced to import the aging barrels for rum from European markets; for this purpose it had to spend an additional $ 284,700. 

• The impossibility of access to the US market for Cuban rum, especially the leading brand of Havana Club, means that no less than
  2 million 200 thousand crates of rum have not been sold which, calculated at the average invoiced price for Havana Club International in 2009, represents an economic repercussion of 87 million 300 thousand dollars.

• The embargo adversely affected rice production, delaying receiving fertilizers and pesticides in time for the planting of this cereal, and this signified that 6,000 hectares were not sown in the cold campaign of
  2009-2010 with a repercussion of 24,700 tons of wet rice, representing 12,400 tons less for consumption.  Importing that same amount meant that the country had to spend 7 million 500 thousand dollars

• Pork production has been adversely affected for approximately
  23 million 400 thousand dollars due to geographic relocation of its commerce, transportation, lack of external funding, and the oft-repeated increase in insurance because of risks involved in doing business with Cuba.