With a gathering storm of uncertain change looming on Cuba’s horizon, preparations are being made in the upper echelons of power, both in Washington and Havana, for the next phase in the history of Cuba. Speculations abound regarding successors, the prospects for a democratic transition, and the possibilities of violent conflict or civil war. In light of the dire circumstances of the present day, and the instability that these possible scenarios may bring, the need for external aid seems a common thread that runs through all probable developments in Cuba’s near future. As an important component of a crucial period in the country’s development, the success or failure of this aid effort may have tremendous ramifications on Cuba’s future. An efficient response will give Cubans a vision of positive change and of a better tomorrow, while an ineffective effort may confirm many fears concerning change while consolidating the power of former regime members.
The Bush Administration’s Commission for Assistance to a Free Cuba recently published a report1 that, among other aspects, addressed some issues that may face a humanitarian aid response in Cuba, most notably the importance of organization among USbased non governmental organizations (NGOs) and Cuban-Americans interested in assisting in such an effort. This paper looks to contribute to the groundwork laid by the Commission’s report and to help guide the preparations for a humanitarian response to Cuba in two areas: suggesting issues of concern in present day Cuba that merit deeper investigation and preparation by aid planners, and proposing a potential framework for the effective organization of Cuban Americans and other potential contributors in the United States.2
CUBA: ISSUES OF CONCERN FOR HUMANITARIAN PLANNERS
Water and Sanitation
The system of water distribution in Cuba is in serious disarray, and is a particularly vulnerable area of the island’s infrastructure. With its central importance to the health and well-being of the population, water issues represent a clear area of concern. According to the National Institute of Hydraulic Resources, the Cuban government ministry overseeing water concerns, virtually all urban Cubans (98.3 percent) enjoy water service. Of these, the vast majority, or 83.5 percent, have a domestic connection, with another 14.8 percent having easy access to water, a technical term which implies a water source within 300 meters of the home.3 Despite these impressive numbers, the reality of water provision in urban Cuba is very different. One Cuban government water administrator anonymously confirmed a common approximation that Havana loses approximately 30 percent of the water pumped to the city to leaks.4 This, unfortunately, is not a problem that is limited to the capital. Leakage in urban water systems is a tremendous concern throughout Cuba, with leakage rates ranging from 13.3 percent in Pinar del Río, to 30 percent in Manzanillo and Camagüey, to an alarming 42 percent in Santa Clara.5
Poor pumping capacity also limits the number of hours that water is available through these connections. While the Pan American Health Organization (PAHO) cited the national average at approximately twelve hours a day, the figure varied from sixteen hours in Bayamo to eight hours a day in Pinar del Río and Santa Clara.6 In a rare moment of honesty, a government employee responsible for the municipal aqueduct for Pinar del Río gave a frank and revealing testimony of the state of urban water service. He confessed that no area of the city receives an adequate supply of water, citing the poor condition of the pipe network, poor electrical service for pumping, and the tremendous waste due to leaks.7
Contamination has proven to be a concern, and raises questions about the ability of the Cuban government to combat these issues.8 During the onset of the “Special Period,” the population receiving chlorinated water service declined from a reported 98% in 1988 to 26% in 1994.9 During the first week of July 1994, only 13% of Cuba’s 161 municipal water systems were treated with chlorine. The public health repercussions were not far behind: mortality from diarrheal disease rose almost threefold, from 2.7 per 100,000 in 1989 to 6.8 in 1993. In areas without chlorination, over 200 Cubans suffered from an outbreak of Guillain-Barré syndrome, an affliction that is often a secondary consequence of enteric infections. 10 The chlorine supply eventually stabilized, and by July 1995, 87% of the municipal water sources were chlorinated. 38 While this was undeniably a consequence of economic instability, there are signs that the shortcomings of the system may be more troubling. Despite the restoration of chlorine stocks and a slowly recovering economy, the number of water- borne outbreaks nearly tripled in 1996, and peaked to over 160 in 1997, after the restoration of chlorine stocks. According to a report by the Chilean Ministry of Health, in comparison to the 1993-1995 period (widely recognized as the most severe of the Special Period), the number of outbreaks of disease traced to water supply was significantly higher in 1996-2000.11
Sixty-five percent of water responsible for outbreaks of disease was deep groundwater,12 which is usually protected from contamination, and may speak to another area that warrants consideration: the inadequate water treatment practices in Cuba, which may be significantly compromising water sources. In the capital, this is compounded by the fact that virtually half of the city of Havana relies on a sewer system built almost a century ago to accommodate 400,000 residents.13 With the capital’s population at approximately two million, it is evident that this represents a serious public health risk. Water supply contamination is not an isolated issue, but one of critical concern that affects the entire island. The National Inventory of Point Sources of Pollution reported in 1998 that only 54 percent of the main polluting sources had any wastewater treatment facility; the others released wastewater into inland and marine waters untreated. Even more disturbing, from a public health perspective, is the revelation that only 17- 18 percent of urban sewage receives any treatment before being discharged.14
After a thorough examination of the Cuban water and sanitation systems, the Pan American Health Organization (PAHO) came to some strong conclusions that are of value to any planning of humanitarian assistance to Cuba. According to PAHO, “…the levels of quality of the water and sanitation services in the area of health and its extensions, is a call of alarm concerning the sustainability of the health indicators Cuba has achieved.”15 This, of course, is the assessment during a period of complete political stability; these services, and the public health environment they support, are in serious danger of deterioration or collapse in a period of political upheaval or uncertainty.
Many, including PAHO, contend that in light of the dire water situation in Cuba, incidence of waterborne disease and related illnesses should in all probability be much higher, were it not for the grassroots strategy of the Cuban model of public health, which focuses on prevention and community health education. Looking at the situation through the lens of humanitarian planning, this could either be seen as a useful ally or merely as a patch for deeply disconcerting and widespread structural shortcomings. Having knowledge of basic health practices disseminated at the community level, is a great boon to aid efforts, and this system of local doctors may prove extremely helpful in a crisis of political upheaval if it can operate without the political structure that created it, a possibility that unfortunately is far from certain.
Regardless, there is very little disagreement that the infrastructure and the services are woefully inadequate, and the advantages of the preventative model may simply not be enough, nor sufficiently sustainable. PAHO echoes this concern, stating that “even if the effects of the sanitary deficiencies caused by the low levels of water and sanitation services are reasonably attenuated by the Cuban model … this is done at a cost that at times exceeds available resources.”16 Even more distressing is the observation that this grassroots system “does not achieve the same effect during outbreaks of transmittable disease, specifically those carried in water.”17 While the preventative model may have been helpful in mitigating serious conditions, it has resembled plugs in a leaking dam; it is simply not enough to confront the myriad of problems and concerns, particularly in a period of political upheaval and uncertainty. Under those conditions, the disruption of the limited water and sanitation services that exist is a viable possibility, and one that may very well become a serious public health concern.
These realities are troubling and have relevance for assistance planning. Therefore, any humanitarian aid framework, while recognizing and perhaps utilizing available advantages of grassroots public health mechanisms, should focus on gathering of information regarding water and sanitation in Cuba and the preparation of plans that include contingencies for water-related emergencies.
Cuba’s present food situation has been gaining international attention and should be a cause of considerable concern. Notable nutritional deficiencies, problems in distribution, and serious consequences of the dual economy have all complicated food security for many Cubans. This is particularly unsettling with the recognition that these conditions are manifesting themselves in a time of stability. With the tumultuous changes that may accompany a succession or transition of power, the situation may deteriorate further. Even in the unlikely event of a smooth democratic transition, the threat of rapid dollarization or inflation of food prices, which has been seen in the transition experience of other countries, could seriously compromise Cuban food security. For all these reasons, any assessment of assistance must analyze in detail the precarious food situation in Cuba.
Nutrition: The ration system, an integral part of Cuban society since its inception in 1962, has significantly deteriorated, and has proven incapable of meeting the basic needs of the population. The monthly allotment given through the ration card is clearly deficient, and is recognized to provide goods that last between eight to ten days.18 This makes securing a food supply an urgent and time-consuming activity for most Cubans. With an average salary hovering around 260 pesos, or US$10, the ability to meet these needs is precarious and often uncertain. An external evaluation of the efforts of the European Commission Humanitarian Aid Office (ECHO) in Cuba verified this potential crisis through the eyes of European NGOs with first-hand knowledge of the island. The study reported “wide consensus … that in Cuba [there] currently exist important pockets of humanitarian needs and the most vulnerable people (basically those excluded from the dollar circuit), suffer an extremely precarious situation in humanitarian perspective.”19 The nutritional effects of this reality, particularly upon those without the lifeline offered by access to dollars, are becoming increasingly apparent.
The Food and Agriculture Organization estimates that 13% of the Cuban population was chronically undernourished in 1998-2000.20 The United Nations’ World Food Program, in conjunction with the Physical Planning Institute (IPF) and other Cuban government bodies, found serious deficiencies in dietary intake in Cuba’s five eastern provinces. According to these findings, the average diet in this region provided less than 80% of the minimum levels of proteins, less than 50% of fats, and insufficient vitamin and mineral intake for sustained health.21 At the level of fat intake reported, the absorption of fat-soluble vitamins (such as A, D, E, and K) becomes difficult. These vitamins contribute to growth, strong bones and teeth, healthy skin, and defensive blood clotting. Protein consumption was notably deficient, with levels varying between 75% and 88% of the recommended daily intake of 72 grams.22 The diet in the region tends to have a disproportionate amount of total calories from carbohydrates, and virtually no fruits or vegetables. These are recognized signs of poor diet quality and the UN warns that this low level of protein consumption can limit growth, immunity, as well as hormone and enzyme production.
Perhaps the most common food-related public health problem in Cuba is iron-deficiency anemia, primarily seen among pregnant women and small children. Approximately 50% of breastfeeding children 6-11 months of age and 30% of children one to three years of age are anemic,23 as well as 40% of women in the third trimester of pregnancy and between 25% and 30% of women of child-bearing age.24 This is a serious situation by any standard, and one that may have significant long-term consequences in the physical and cognitive development of rising generations in Cuba.
Distribution: The concept of access, rather than availability, as central to food security was pioneered by Amartya Sen, and profoundly influenced the discussion of, and strategic response to, famine and other food related crises.25 Global experience responding to nutritional disasters has reinforced the hypothesis that food crises are often generated by fluctuations in price and poor distribution. While it seems unlikely that Cuba would resemble many of the case studies that focus on the Indian subcontinent or sub-Saharan Africa, there are indications that shortcomings in distribution and vulnerabilities to fluctuations in price, particularly in a transitional period, may warrant investigation.
The inefficiencies in Cuba’s food distribution system are well documented. Courageous reporters who funnel information out of Cuba regularly inform of food problems that can be attributed to breakdowns in the supply chain. Reported problems include food spoiling in storage facilities, farmers’ produce rotting at the farms while waiting to be collected, citizen complaints regarding the food available for purchase, products that show evidence of poor quality and age (such as moldy meat products and rotten eggs).26 This is second page news to most, but it reveals fundamental flaws of the utmost importance to those focused on humanitarian concerns in Cuba. The primary question regarding food distribution for humanitarian aid planners is, are these shortcomings the result of inefficiencies of state central planning or of deficiencies in infrastructure? While it seems clear that both are important contributors, the extent to which the latter, more tangible, concern is relevant, may be significant in a humanitarian response. If the lack of spare parts or fuel play a major role, there may be an opportunity for an effective and non-intrusive intervention: supply of spare parts, fuel, vehicles, and other equipment as necessary.
Price may also be a concern, particularly due to the tremendous market distortions in Cuba. As was seen in the transition experience in Eastern Europe, rapid economic liberalization may create an upward pressure on prices of basic goods. For instance, Bulgaria experienced a 300% increase in food prices immediately following the liberalization of prices. As a result, the average family spent 47% of wages on food, compared to 36% in the 1980s.27 At present, estimates of the average Cuban family’s expenditure on food range from 66% of monthly income to over 100%.28 In light of these present realities, a marked increase in prices may create limitations of access that often are the catalysts of food emergencies.
While the face of future change in Cuba remains veiled, certain aspects seem highly likely, perhaps the most likely opposition to drastic change from those expressly benefiting from, or ideologically committed to, the present regime. This is a pivotal point in any discussion of aid, as the perception of foreign assistance by this population will be perhaps the most important variable in the calculus of physical security for aid supplies and personnel. If assistance is seen as an intrusion of Cuban sovereignty or a prelude to invasion, there may very well be a serious threat of violent opposition to aid efforts. This is not an uncommon occurrence in humanitarian assistance, and Cuba, unfortunately, shows aspects of a uniquely unstable environment that should give planners every reason to believe that a violent response will accompany any sizeable intervention. The rhetoric of the Cuban government, the mass military training of the populace, and the huge stores of materiel for the purpose of mounting a massive mobilization of the population, make the likelihood of some Cubans engaging in clandestine operations to derail humanitarian efforts very high. These components of the Cuban landscape are all chilling realities that may threaten aid efforts and which should be closely monitored.
“The War of all the People”: Of particular concern to any foreign involvement in Cuba are the preparations in place by the Cuban government to mobilize civilians in resistance. The provision of aid to the island may be portrayed by those with a vested interest in maintaining the status quo as a threat to national security and sovereignty, endangering the aid effort and its personnel. This military doctrine, the “War of All the People,” is a major component of the security landscape of Cuba and may be the primary threat to humanitarian efforts.
The concept of “the War of all the People” arose in the early 1980s, as a response to more aggressive policies of the United States towards Cuba and increasing signs of Soviet unwillingness to aid Cuba in the event of military invasion. Adapting the strategy utilized in the defense of Vietnam, the government formed an elaborate system that integrates civilians into the active defense of the country, creating a framework under which, according to the Cuban Armed Forces (FAR), “in the event of an armed imperialist aggression against the country, each citizen … would have a place, a means, and a manner to participate in defense.”29 Castro left no ambiguity concerning the goal of this campaign:
Each cadre of the party, of the state, of the armed forces; each officer, each combatant, each citizen, and each youth, will be able to do what he is supposed to do in every circumstance. The enemy will face our combatants in each square meter of our valleys and mountains, on each street, in each block, in each house of our cities.30
The organization of this effort is centralized in the Territorial Defense System (TDS), which coordinates the efforts of all aspects of Cuban society towards defense. Geographically, the TDS claims to divide the country’s 169 municipalities into over 1,400 “defense zones.” There have also been claims that the physical territory has been altered to support defensive operations, with thousands of projects carried out across the island. These efforts include defensive positions for use in combat, as well as tunnels and protective structures for troops, armament, evacuation shelters, economic targets of opportunity, and strategic reserves. Beginning in 1980, the FAR began training Militias of Territorial Troops (MTTs) to bolster the manpower that could be brought to bear in a defensive situation, and these militia are under the jurisdiction of the FAR. Presently, the Institute of International Strategic Studies estimates the troop strength of these militias at approximately one million. 31 Others who may not be fit for typical military service have been organized into Production and Defense Brigades (BPD), which are small groups focused on production and support, civil defense, and maintenance of internal order. Perhaps the most troubling personnel in the TDS are those who have received training in one of Cuba’s training facilities for Special Forces. These individuals are trained to “operate independently behind enemy lines.” The Cuban government claims to have trained over 100,000 people in these tactics, from active and reserve personnel to civilians.32
Many will dismiss these figures as the colossal bluff of a country with a severely depleted military. The numbers are most surely inflated, and many Cubans—most likely the vast majority—are interested in change, and will not risk their lives for the present system. While these criticisms may be legitimate, the concept of the “War of all the People” should nonetheless be a source of concern for humanitarian aid planners.
The mentality of entrenchment that the government has continually thrust upon the Cuban people whenever a more aggressive U.S. foreign policy has been implemented may have found some receptive ears. There are also many who have a vested interest in the present system, some of whom may see their own survival linked to that of the revolution, such as members of the repressive structure that has kept internal order for years in Cuba. And while the vast majority most likely are either not interested in defending the status quo, or have become immune to the constant droning of the government’s rhetoric, this is largely immaterial. The fact that there are huge numbers of Cuban citizens with rudimentary military training, stores of weapons, and detailed plans with rendezvous points, defensive positions, and the like, makes the likelihood of some violent response extremely high.
Even in the best case scenario of a smooth transition to a government interested in democratic reform, there is still a high risk of this potentially violent plan being implemented independently in small cells throughout the country. Recent experience in Iraq has shown that small contingents of armed men can wreak havoc and hamper efforts for democratization and peace. But while the efforts in Iraq appear to be more or less the actions of a spontaneous movement, in Cuba, these militias are already organized, and have been for years. The training of civilians at Special Forces facilities should be of particular concern. This training is surely imparted only to individuals with revolutionary credentials. Therefore, those with the most dangerous training may also be the ones least likely to accept a significant political change, and foreign aid may easily be equated with political change.
This equivalency of aid and change is an important point in the analysis of physical security, and one that has been passionately debated in the humanitarian community. For years, the safety of humanitarian workers has been ensured by the perception of their neutrality in political affairs and impartiality as to who receives assistance. With aid to Cuba expressly tied to political change, the shroud of neutrality becomes difficult to maintain, and aid workers may be seen by opponents to change as legitimate targets.
One final note regarding security concerns that may face humanitarian assistance efforts in Cuba focuses not on concerted attacks on aid workers themselves, but on the deterioration of the general security landscape. The internal security system, which utilizes citizens as watchdogs over their own neighbors, has created enormous tension among the population, even at the neighborhood level. Once it is perceived that this system has collapsed, or that its enforcement has become ineffectual, there may very well be violent reprisals. Revenge killings or other outpourings of years of subdued frustration could become a reality, and may seriously hamper efforts at maintaining stability and order.
Psychological Aspects and the Importance of Dignity
If and when humanitarian assistance is provided in Cuba, it will no doubt be during a critical period in Cuba’s history, a potential turning point. Most on the island have no knowledge of any other system other than the strict confines of revolutionary Cuba, and have systematically received an inflammatory, confrontational message regarding the United States, democratic ideals, and, of course, the Cuban exile community. For many, this interaction will be their first opportunity to make their own judgment regarding the people and ideas that had been officially vilified for so long. Regardless of its size or scope, this aid enterprise may be of inestimable importance to the future of Cuba, as in a number of ways, it may set the tone of things to come in the minds of many Cubans on the island. The psychological impact of assistance is just as crucial of a component as the satisfaction of physical needs, and may prove to have a much more lasting effect on the trajectory of Cuba’s future.
While there seems to be a very strong interest in change among Cubans on the island, the prospect of a dramatic transformation of the fabric of society and daily life is a very intimidating proposition for many. The provision of humanitarian assistance to Cuba will most likely be a testing ground in the minds of many Cubans of what is to come. As a result, it is imperative that the aid effort also convey a sense of positive change, and aid planning may choose to meet relief goals in ways that are emotionally significant to the Cuban people. For instance, a food distribution program through the dollar stores, which are out of reach for many, or community meetings in hotels previously off limits to Cuban citizens, would not only satisfy the physical needs of the population, but would also have profound meaning and provide a glimpse of a better future. Due to the serious privations that Cubans have had to cope with for years, a better future must also reflect a rapid and tangible improvement in living conditions. Public services, such as garbage collection, water and electricity, should be high priority and high profile components of reconstruction.
One of the primary psychological components of this change will undoubtedly be the ownership of the process by Cubans on the island. This is crucial to understand, particularly in the Cuban context, with exiles returning to the island and struggling with their own emotions and interpretations of what is happening and what should be done. The humanitarian aid effort in Cuba, and especially the Cuban- Americans involved in that process, must be very careful to work with, and not for, their counterparts on the island.
UNITED STATES: ORGANIZATION OF CUBAN-AMERICAN AND U.S. NGOs
One of the possible benefits a transition in Cuba would enjoy is a deep pool of talented and committed personnel, with a personal interest in the success of Cuba’s political shift and in her free and prosperous future. The Cuban exile community, in its epicenter in Miami and in numerous enclaves throughout the world, has long shown an interest in assisting Cuba in a post-Castro recovery. The recently-released report of the Presidential Commission for Assistance to a Free Cuba33 recommends the formation of what it calls a “Foundation for Assistance to a Free Cuba,” to help organize the efforts of Cuban-American organizations and individuals with U.S. NGOs and other sources of support from the United States into a coordinated, unified response. The importance of this cannot be overstated: the success of Cuban- American participation in any provision of humanitarian assistance to Cuba will rely in no small part to the amount of organization and preparation taken beforehand. While this may be recognized by many, a tangible, centralized plan to harmonize efforts for effective humanitarian assistance in Cuba has not yet surfaced. The following is an explanation of the importance of consolidating and avoiding an ad hoc, piecemeal response, as well as the presentation of a possible chapter-based framework, in the hope of stimulating discussion of a better model, or of its implementation to organize the Cuban-American community in the provision of assistance in the future.
The Invariable Waste of Precious Time
Well-publicized emergencies often are burdened by misguided outpourings of charity. This phenomenon is so common that it is often referred to by aid professionals as the “second disaster.” Many private individuals and companies respond to news of emergency by cleaning out their closets, medicine cabinets, or warehouses, with indiscriminate donations of clothing, food, medicines, and other goods, without a clear understanding of the situation at hand and the needs of the affected. Stories abound of inappropriate and unsolicited packages with items of limited value to a response: from sweatshirts for tropical regions hit by hurricanes, to small appliances with parts missing, to goods with instructions in English for non-English speaking recipients. The logistical burden of sorting, packing, storing, and disposing of these items diverts precious aid personnel from more pressing issues that are directly facing those in need.
Due to their perishable and potentially dangerous nature, donations of medical supplies and drugs in particular can be problematic for aid workers and can tax resources. During hostilities in Bosnia and Herzegovina in the early 1990s, it has been estimated that approximately 17,000 metric tons of unusable or irrelevant medicines were being stored in warehouses and medical facilities throughout the region. The cost of transporting these medicines cost the aid effort approximately $8.5 million and another $34 million to destroy them.34 In the wake of the 1988 Armenian earthquake, 5,000 tons of medicines and medical supplies, worth an estimated $55 million, were sent, an amount that far exceeded need. Fifty aid workers worked for six months to get a clear picture of what had been sent, and the results were not promising: 8% of the drugs had expired on arrival and another 4% were destroyed by weather conditions. Of the remaining medicines, only 30% were easily identifiable, partially because most were labeled by brand names unfamiliar to Armenian medical personnel, and only 42% were relevant to the type of emergency situation that prompted the donation.35
While at the U.S. Office of Foreign Disaster Assistance, Andrew Natsios described the severity of the problem, stating that “the biggest waste of precious time we must invariably deal with in every disaster visible to the public is unsolicited, inappropriate and unneeded relief commodities. Educating the American public to channel their admirable humanitarian instincts into more productive routes remains one of our most serious challenges.”36 This is a situation that can be avoided through public education campaigns, particularly in the closely-knit Cuban community in the United States, that can disseminate information quickly.
Avoiding Another Mariel
While the close proximity of a large percentage of the Cuban-American community to the island should prove to be a logistical advantage, without prior planning and coordination it may instead be a tremendous bane to efforts to fulfill basic needs on the island. The temptation to visit the island, the feelings of wanting to tangibly contribute to aid efforts, and the realistic ability to do so using private boats and other means of transport, has the potential to spark a response similar to the Mariel boatlift, with thousands of Cuban-Americans traveling to Cuba with small amounts of goods and supplies. This indiscriminate humanitarian visitation is simply not an effective way to respond. The assistance these individuals will be able to provide will be small in comparison to the confusion such piecemeal method would provoke. The coordination of aid flights or flotillas, in coordination with the proper authorities, such as the U.S. Coast Guard, the Transportation Security Authority, U.S. Customs, and others, will ensure an orderly, targeted, and effective response.
Framework for Organization
The tangible aspects of disseminating these concepts and coordinating the efforts of a large community spread throughout the United States are daunting. What follows is a suggested organizational model for the coordination of humanitarian aid to Cuba based on the recommendation of the Commission for Assistance to a Free Cuba to create a “Foundation for a Free Cuba” to centralize aid efforts. It is based on a chapter model that is utilized by numerous NGOs and will hopefully provide some guidance to the crucial components of an effective response: communication, organization, and coordination.
The chapter system framework would build on existing organizations and citizen groups in all major areas of the Cuban diaspora in the United States: Miami, New Jersey, Washington D.C., Los Angeles, and so on. The community in these areas would each form a chapter. These bodies would begin taking stock of the resources, talents, and expertise that each community has to offer as well as educating their respective communities about the issues that will help or hinder an effective response to Cuba’s future needs. A computerized network of participating organizations would keep communication efficient, including a central database of affiliated groups. An electronic monthly or quarterly newsletter would keep the entire system informed of events, best practices, and opportunities for further collaboration. Each chapter may look different, depending on the resources and strengths of the community, but all would include a number of crucial components. A brief description of duties may help give a fuller understanding of this framework:
NGO Liaison: The NGO Liaison would coordinate established Cuban-American NGOs and other local organizations interested in assisting in Cuba. As many Cuban-American NGOs have limited experience in humanitarian assistance operations, the NGO Liaison would facilitate the partnering of these organizations with more established NGOs with international experience, a recommendation put forth by the present USAID Administrator in his influential assessment of humanitarian assistance to Cuba.37 Taking this step early would ensure that Cuban- American organizations, which have numerous advantages in providing aid to Cuba, would be prepared. The NGO Liaison would also help organizations that are not already registered with USAID through the registration process, a crucial step for federal funding and recognition. In past responses, NGOs that were not registered were delayed in their deployment because of paperwork that had not been filed beforehand. This is a setback that can easily be avoided by organization and mobilization of interested parties.
Community Liaison: The Community Liaison would be the point of contact for private financial and in-kind donations. This individual would maintain a database of private volunteers and/or groups in their area interested in making contributions. In order to avoid the issue of inappropriate donations, the Community Liaison would also set up a locally implementable system, such as a hotline, to give information regarding necessary supplies and what to avoid donating after an on-the ground assessment has been done in Cuba. A type of registry or other agreement with local merchants could also contribute to effective donations.
Training: The training component is of vital importance, as many organizations in the Cuban-American diaspora are relatively unfamiliar with responses of this nature, and training could provide a basic understanding of central humanitarian issues. This could most easily be done in conjunction with, or primarily through, the local Red Cross chapter or other large NGO with international experience. This more formal training would complement the practical lessons that partnering, mentioned above, would provide. Issues covered should include the following minimum standards in disaster response (the Sphere Project):
• Issues related to neutrality, impartiality, and other humanitarian concepts.
• Cuban sovereignty and the importance of supporting Cubans on the island.
• Best practices: targeted vs. unhelpful aid, monitoring and evaluation, etc.
• Challenges: security, mental health, collaboration with Cuban counterparts, others.
• Organizational concerns: funding, documentation, administrative issues.
It is very important to note that this training would not be sufficient for NGOs with little humanitarian assistance to engage in large-scale aid efforts. Many Cuban-American NGOs may be most effective through teaming up with organizations with more experience and utilizing their advantages in the field in a collaborative effort.
Public Affairs: Public Affairs would focus on the coordination of an information campaign to educate the local Cuban-American and wider community concerning responsible collaboration. Some of these points have already been mentioned: no indiscriminate donations of inappropriate items, no ad hoc response reminiscent of Mariel, support of the Cuban population on the island, among others. It is imperative that this information begin to enter the public consciousness long before the crisis presents itself. Regular forums, town hall meetings, radio and television programs, and other local public arenas should be utilized to begin the discussion and educate their communities.
The National Council: The Council would be the central body of the organization. It would include three representatives of each chapter, a representative from the short-term assistance and planning team proposed by the Presidential Commission’s Report, a representative from the Office of Foreign Disaster Assistance—the branch of USAID that will most likely be involved should a response take place—and other parties of interest. It would help facilitate information sharing between chapters, as well as between the entire network and other parties, such as USAID and other government agencies, Interaction, the national alliance of NGOs, and others. It would also oversee and impose strict policies to promote transparency, as the integrity of the organization will surely be questioned by those with a stake in the regime and by its ideological supporters.
This paper has brought out some issues to help guide the discourse and inform preparations both for operations on the island and for mobilization of resources in the Cuban-American community and the larger United States. They include:
• Maintain rigorous vigilance over the quality of water supply. To the extent possible, collaborate with the existing grassroots monitoring system.
• Expand water truck, garbage collection, and other sanitary services to an acceptable level.
• Begin infrastructure reconstruction as soon as possible; these systems face imminent collapse.
• Compile information regarding the extent of contamination of water sources.
• A nutritional assessment, particularly outside of the well-documented region of Eastern Cuba, is necessary, including a look at the possible secondary effects of the present diet.
• A deeper understanding of the supply chain is indispensable. The probability of food shortages due to production limitations is rather low. With the possible exception of areas in Eastern Cuba, food aid in the classical sense will most likely not be needed, merely a second-tier intervention which would focus on the elimination of bottlenecks and other limitations in distribution.
• Investigate the real need for spare parts, fuel and other equipment.
• Compile information regarding the liberalized produce distribution system and find ways to support its efficiency and expansion.
• Compile information regarding the specifics of the national defense plan, from recent arrivals, exiled military personnel and other sources.
• Prepare security plans with NGOs and other potential actors.
• Clarify the distinction between humanitarian aid providers and the U.S. government.
• Recognize the psychological impact of the aid effort. Creatively plan the response to convey positive change.
• Understand and reinforce the importance of Cuban ownership of the process and the supporting role of aid practitioners.
• Organize the vast resources of the Cuban-American community and others willing to contribute in advance.
• Educate and train these communities on effective and ineffective ways to support and contribute to aid efforts.
A chapter in Cuba’s history is closing; how it will end remains to be seen. Despite the hopes and desires of many, a smooth transition to a more humane, more efficient government is far from certain; a succession of power and a slow process of transformation may be on the horizon, or merely a change at the helm. While the present political landscape yields few clues regarding the future, the inability of the general populace to reliably fulfill their basic needs shows a clear point of concern for those focused on the humanitarian aspects of a transition in Cuba.
The provision of humanitarian aid to Cuba and the mobilization of the vast resources of the Cuban community outside the island are two components that may very well play important roles in Cuba’s near future. If this aid becomes a necessary aspect of future change, it will be an intricate and challenging operation whose perceived success or failure may have significant repercussions for the transition. A perception of the effort as a benevolent show of support, devoid of political or economic interest, will go far to overcome antagonisms, both real and imagined. Due to the importance and complexity of this response, those interested in participating must begin planning and organizing as soon as possible. This paper is by no means a definitive work, but an effort that hopes to focus the discourse on areas of evident concern and guide the organization of Cuban-Americans and others looking to aid in writing Cuba’s next chapter.
1. The full report is available at http://www.state.gov/p/wha/rt/cuba/commission/2004/c12237.htm.
2. The Institute for Cuban and Cuban-American Studies (ICCAS) is actively contributing to the humanitarian preparedness effort in a future Cuba. For more information, see the proceedings from the ICCAS Seminar held January 2004 in Washington, Eric Driggs and Georgina Lindskoog, eds., Humanitarian Aid for a Democratic Transition in Cuba, ICCAS, University of Miami, 2004.
3. Pan American Health Organization (PAHO)/CEPIS, Assessment of Drinking Water and Sanitation 2000 in the Americas, 2000. Available at: www.cepis.ops-oms.org
4. “Water scarce in areas of Havana,” CubaNet News, April 1, 2004.
5. PAHO/CEPIS, 2000.
6. PAHO/CEPIS, 2000.
7. “Fourteen city neighborhoods have no water service,” Victor Rolando Arroyo, CubaNet, June 18, 2001.
8. For more information on environmental issues in Cuba, see Eudel Cepero, “Environmental Concerns for a Cuba in Transition,” ICCAS, University of Miami, 2004.
9. Richard Garfield, “The Impact of the Economic Crisis and the US Embargo on Health in Cuba,” American Journal of Public Health, January 1997.
10. Richard Garfield, 1997.
11. Chilean Health Ministry, Resultados de la vigilancia de las enfermedades transmitidas por alimentos en Cuba, from a presentation given at the National Epidemiological Workshop, November, 2001. http://epi.minsal.cl/epi/html/presenta/Taller2001/ BROTES_CUBA_93-00.ppt
12. Chilean Health Ministry, 2001.
13. Holly Sims and Kevin Vogelman, “Popular Mobilization and Disaster Management in Cuba,” Public Administration and Development, Volume 22, 2002, pp. 389-400.
14. Carmen Terry Berro, Cuba: Technologies for Wastewater Treatment and Disposal-Current Status and Performance, United Nations Environment Programme (UNEP), 1998.
15. PAHO, 2000.
16. PAHO, 2000.
17. PAHO, 2000.
18. James Ross, “Realities of Food Security in Cuba,” in Driggs and Lindskoog, 2004.
19. Carlos M. Artundo and Maurice Coenegrachts, Evaluation of the Humanitarian Aid in Favour of the Cuban Population 1999-2000, May 2000.
20. Food and Agricultural Organization (FAO), The State of Food Insecurity in the World 2002, 2002.
21. World Food Program (WFP), Food Aid to Women and Children in Eastern Cuba, 2001. See also WFP and Instituto de Planificación Física, Análisis y Cartografía de la Vulnerabilidad a la Inseguridad Alimentaria en Cuba, 2001.
22. World Food Program, 2002.
23. John Gay Rodríguez, et al, “Anemia nutricional en un grupo de niños aparentemente sanos de 2 a 4 años de edad,” Instituto de Nutrición e Higiene de los Alimentos, Revista Cubana de Alimentación y Nutrición, 16(1), 2002, pp. 31-34
24. PAHO, “Country Health Profile: Cuba,” Health in the Americas, 1998.
25. Amartya Sen, Poverty and Famines: An Essay on Entitlement and Deprivation, Oxford University Press, 1983. 26. Among many others: “Medicines spoil in storage in Cienfuegos,” CubaNet, August 31, 2000, “Potato crop doesn’t meet quota standard,” CubaNet, December 16, 2003, “En mal estado cuota de leche para niños,” CubaNet, December 18, 2003, “Dañan las ratas leche en polvo destinada al comercio,” CubaNet, February 1, 2004, “Se pierden en el campo 350 quintales de tomate en Isla de la Juventud,” CubaNet, February 9, 2004.
27. Nancy Cochrane and Shannon Reid Hamm, “Bulgarian Retail Food Markets in Transition,” Global Food Markets, May 1996.
28. See Susan Archer, “How Cubans Survive,” US Interest Section, 2003; and Minor Sinclair and Martha Thompson, Cuba: Going Against the Grain, Oxfam America, June 2001.
29. “La doctrina militar de la Guerra de Todo el Pueblo.” http://www.cubagob.cu/otras_info/verde_olivo/ la_doctrina_militar_de_la_guerra_de_todo_el_pueblo.htm
30. Fidel Castro, Speech on the 30th Anniversary of the Attack on the Moncada Garrison, July 26, 1983.
31. Institute for International Strategic Studies, The Military Balance, 2003-2004.
32. “La doctrina militar.”
34. Patrick Berckmans, et. al. “Inappropriate Drug Donation Practices in Bosnia and Herzegovina, 1992-1996,” New England Journal of Medicine, Volume 337, pp. 1842-1845, 1997.
35. World Health Organization (WHO), Guidelines for Drug Donations, revised 1999.
36. Andrew Natsios, U.S. Office of Foreign Disaster Assistance, “Disaster Response: When Good Intentions Aren’t Enough,” Interaction, 1990.
37. Andrew Natsios, “Humanitarian Assistance During a Transition in Cuba,” in Irving Louis Horowitz and Jaime Suchlicki, eds., Cuban Communism, 11th Edition, 1998.