In Belgium as in Cuba, the first victims of coronavirus are the elderly. However, the elderly cubans fare much better than their Belgian counterparts in terms of health.
Of the 9212 deaths due to covid-19 recorded in Belgium on 21 May, one third were among over-85s (3175). In one-fifth of the cases, the victim were between 75 and 84 years of age. As a result, the virus has mainly affected the elderly, as evidenced by the dramatic figures in nursing homes, which reported 4695 of the 9212 deaths, or half.
In Cuba, on 22 May, there were 81 deaths due to coronavirus, including 2 foreign tourists (one Italian and one Russian). Again, most of those who died were in the 80-89 age group (25 deaths), followed by those aged 70-79 (21 deaths). Most of them already suffered from other health problems (hypertension, diabetes, chronic respiratory problems, kidney disease or cancer…). About 65% of patients were between the age of 20 and 59.
At a retirement home (“hogar de ancianos”) in Santa Clara, Villa Clara province, 60 people (residents and staff) were diagnosed with coronavirus. Two died there. Santa Clara also has the highest number of positive cases (135) of the entire island. However, this situation in the Santa Clara nursing home is by no means comparable to the thousands of deaths recorded in nursing homes in the United States, the United Kingdom, Spain or Belgium.
Few deaths, high survival rate
While 80% of victims of covid-19 in serious or critical condition die worldwide, in Cuba, 80% survive, Ángel Guerra Cabrera observes in a column in the Mexican newspaper La Jornada.
How did Cuba achieve these good results? Through prevention, strict containment measures, generalized (preventive and curative) monitoring of (potential) infections, innovative medicines and good cooperation between all stakeholders.
Children and people over the age of 85 should be kept confined. General practitioners or nurses systematically roam their neighborhood to check the residents’ state of health. They are assisted by thousands of medical students. Day centers are closed and visits to nursing homes are restricted.
Besides the purely medical teams, the committees for the defense of the revolution and other organizations also play a role in the fight against the pandemic. For example, the Centro Felix Varela – our partner, to whom we have been targeting the benefits of our Easter campaign for several years – literally maps groups at risk in neighborhoods, but also helps to run errands for people who need them.
Cuba spends 27.5% of its GDP on health and well-being (social assistance), compared to an average of 2.2% for the region and the 6% recommended by the WHO.
The resources of the country, strangled by a persistent American blockade and even harder than before, are however limited. As a result, certain products are reserved for the most vulnerable. At one point, everyone over 65 was able to go and pick up a packet of detergent and detergent (a “modulo”) at the “bodega” (shops where you can do your shopping using the notebook rationing). If suddenly there is no more milk anywhere, it is because it has been given first to children and nursing homes.
What role do older people still play in society?
In his carte blanche entitled “The Malthusians of the corona”, the Cuban chronicler Julio Martínez Molina wonders about Belgium where “the government asked the doctors not to bring the elderly and ‘the weakest’ infected to the hospital by covid-19 “. And we bet he probably hasn’t heard of the proposal by Belgian economist De Neve to impose an additional tax on retirees to pay for the corona crisis …
Like the children, in Cuba, the elderly are given special attention. The aging of the population is an important factor on the island, where 20% of the population is over the age of 60. In 2030, it will be 30%. Average life expectancy is 78 years and, as in Belgium, the birth rate is relatively low (1.7 children / woman, whereas it should normally be 2.1 to ensure the renewal of the population ).
Care for the elderly is an integral part of a national plan to improve their well-being, which includes physical and mental health, food, sport and culture, and even continuing education. It is not uncommon for retired teachers and professors to continue teaching enthusiastically and many older people graduate (university).
In 2000, at the instigation of the CTC union, the University of Havana opened the first course for the elderly. Between 2004 and 2005, 40,000 seniors studied across the country, and more than 7,500 teachers taught on a voluntary basis.
In the medical field, there are multidisciplinary geriatric assistance teams made up of a specialist doctor, a nurse, a social worker and a psychologist, all graduates in community geriatrics and who support the general practitioner.
Whereas in 1982 Cuba had no geriatric service, they are now present in more than 34 hospitals. There is now a geriatric service for 7,000 elderly people.
There are day centers (casa de abuelos) and retirement homes (hogar de ancianos). The number of day centers increased from 74 in 1998 to 293 in 2019.
Finally, “círculos de abuelos” (groups of grandparents) are also organized in the communities. Seniors – especially people with Alzheimer’s, who receive special attention – can go there to participate in all kinds of activities.
They were created around 1980 to serve as a social fabric in the neighborhoods. The elderly gathered there, accompanied by a gymnastics teacher, a social worker, the nurse and the general practitioner, in a park, hospital or on the beach to move together or do other activities.
A 1991 survey, in which 200 participants were interviewed at the start and after one year of participation, showed that their health had improved considerably: they had better control of their chronic diseases (arthritis, hypertension, diabetes, asthma), had needed less medication and felt better about themselves (suffered less from loneliness and depression). Other studies have confirmed the beneficial effect of these circles.
The day centers offer physical, psychological and social rehabilitation services, socio-cultural and recreational programs, sports activities and personal care. They are open from 8 a.m. to 5 p.m.
The country has some 155 nursing homes, which accommodate just under 9,000 residents. They are mainly intended for people who have no family or whose family cannot take care of, or for people who have serious social problems.
To have access to day centers and rest homes, it must be requested from the local services of the Ministry of Health. The request can be made by the person himself, by his general practitioner or by an organization. We then review the candidate’s priorities and socio-economic situation.
There is a cost to stay in a rest home or day center. Costs of personnel, food, medicine, electricity, fuel, non-medical equipment, maintenance, etc. for a care home represent 5600 pesos per month. The resident pays 7% of these costs, or 400 pesos. When the person concerned does not have sufficient resources for this, the government covers part or all of this cost. Almost 18% of residents (and their families) pay the standard rate, while the remaining 80% receive partial or full compensation from the government.
All of this clearly shows that Cuban society cares for its elderly and that the coronavirus will not kill thousands of people there prematurely, as is unfortunately the case elsewhere in the world.