|Ride to the beach in 1950s style. Trinidad, Sancti Spiritus province.|
Along the way I had an opportunity to speak with a psychologist about the practice of psychology in the country. For what it's worth, here's a bit of a summary.
Since shortly after the revolution in 1959, Cuba has been relatively isolated due in part to the Cuban government’s policies and partly to the United States embargo that remains in place, with some minor shifts, to this day. US citizens are still restricted in their ability to travel to Cuba, but the rest of the world (particularly Canada) has made it into a middle-league tourism destination.
In recent years Raul Castro has begun the process of economic and social reform, perhaps in recognition of the fact that the economy has not prospered under the communist system. For decades Cuba was supported by the former Soviet Union until it fell (precipitating what the government called the “special period” starting in 1991 during which the economy virtually collapsed). More recently it has relied on other allies – notably Venezuela and China – to keep afloat.
In terms of exports and material wealth of its citizens Cuba has not done well, though the US embargo has paradoxically muddied the cause for this, enabling observers (and the government) to attribute economic problems to US policy rather than to the command economy. Some of the Cuban citizens I spoke with suggested that the primary effect of US policy had been to unite the country under the Castro government, supporting the very situation that the policy was supposedly intended to disrupt.
Health and Education
|Not the best accommodation, apparently.|
On at least some aspects of the social front, Cuba has done markedly better. The arts occupy a prominent position in Cuban society, and appear to be supported more than in either Canada or the USA.
Cuba, like Canada and most “first world” nations other than the US, has a socialized medicine system that covers all citizens. Unlike Canada, dental care is also included free of charge.
Infant mortality rates are correspondingly low: in the most recent 5-year period reported by the UN, Cuba beats Canada by one spot, while the USA sits 8 positions down the list (just behind Lithuania, just ahead of Belarus).
In life expectancy Cuba does not do so well, sitting at 37th (78.5 years) on the UN list for 2005-2010, behind Canada at 11th (80.54 years) but still ahead of the USA at 40th (77.97 years).
|Young revolutionaries on school trip, Camaguay.|
Traveling across Cuba one constantly sees packs of children in school uniforms in the early mornings and late afternoons, and seldom during school hours. A 3 or 4-room school I visited had a “computer lab” but was equipped with only a few fairly antiquated machines.
Psychology in Cuba
|Sr B, with almost certainly unnecessary confidentiality.|
He repeatedly waved his hand saying “no problem” but I’m still not entirely sure he knew what a blog was. Access to the internet is quite restricted in Cuba, though it has been showing signs of opening up a bit recently. Consequently, let’s just call him Sr B.
Treatments are largely psychotherapy-based. We did not have time to get into the details of technique, but it seemed that basic counseling practices formed much of what was done. Much of the work is family-based, and Sr B described home visits that would be carried out to see how patients lived and got along with other family members.
Psychologists, like other professionals in Cuba, appear to be dedicated to their work. They labor at challenging jobs despite extremely limited remuneration. Psychologists and physicians make an average of 20CUC (about $20 CDN or US) per month (yes, per month) – plus some perks involving housing and childcare – along with the universal ration card that allows citizens to purchase some basic foods for sharply reduced rates.
This rate of pay is double what some workers make, but still only allows a very basic life, even with the low prices in the Cuban economy. The real money comes from any job outside government employment, or a job with a government agency that allows for tips (the very best job, multiple people told me, was taxi driver). Consequently, many professionals moonlight at jobs that provide private income. The desserts at one restaurant were baked by a local physician, and the casa I stayed at in Baracoa was run by a dentist, who made breakfast for guests before heading off to the clinic for the day.
I’d been briefed by other travelers that books, clothes, and other supplies were extremely welcome throughout Cuba, so I gave up my Canadian Psychological Association t-shirt and with some embarrassment handed over a copy of my assertiveness book, which I had narcissistically packed and which he enthusiastically (and perhaps somewhat politely) received.
|Recently restored square, Havana.|
If I go back, which I may – Cuba is a beautiful country and the casa particular system allows for a kind of mixing with local people that you seldom get anywhere in the world – I will look up Sr B again, perhaps with some advance warning so that I can get more of a sense of practices in his country.
|You can watch the change coming.|
Cuba is changing fast. Under Fidel's brother Raul, the economy is opening up in a hurry and the next ten years look like they will be startling for Cuba's citizens. It was only a little over a year ago that hundreds of thousands of private businesses were permitted to start up. Just three weeks before my visit the international travel restrictions were significantly relaxed. Havana's streets are torn up and being repaved as we speak.
Talking with people I heard the same refrain over and over: "Cuba needs to change. But right now it's changing too fast." There is a real fear of a Russian-style collapse and a race to kleptocracy-style capitalism that will provide much-needed cash but sacrifice the real gains Cuba has made over the past 50 years. They want to keep their successes: their education and healthcare systems, the sense of equality, the care for the poorest in the society. Can they do it?