Yale Bulletin and Calendar

January 21, 2000

Volume 28, Number 17

U.S. embargo causing health crisis in Cuba,
says physician

The U.S. embargo against Cuba has contributed to several public health catastrophes, among them an epidemic of blindness due to a dramatic decrease in the supply of nutrients, a Yale physician says.

There also have been epidemics of infants ingesting lye, which is used when soap is not available, and an outbreak of Guillain-Barre syndrome, a form of paralysis associated with water contamination due to lack of chlorination chemicals, says Dr. Michele Barry, professor of medicine and public health and director of the Office of International Health at the School of Medicine.

"The embargo against Cuba is one of the few embargoes that includes both food and medicine and it has been described as a war against public health with high human costs," Barry wrote in an article published Jan. 18 in the Annals of Internal Medicine.

"Although curtailments of individual liberties and privacy by the Cuban government may seem as an abridgement of personal freedom, we as health care professionals have a moral duty to protest an embargo which engenders human suffering in Cuba to achieve political objectives," she says.

Secretary of State Madeleine Albright wrote a commentary on U.S. embargo policies in the same issue of the publication in response to both Barry's article and a related position paper prepared by the American College of Physicians-American Society of Internal Medicine.

Barry says she visited Cuba in February of 1999 with the Social Science Research Council. Her last visit had been 15 years earlier, as a lecturer.

"During this current visit, I was struck by profound changes that have occurred to a health care system once considered the preeminent model for developing countries," she says.

The U.S. trade and aid embargo against Cuba, which began in 1961, was tolerable until the Soviet bloc crumbled -- as did its aid to Cuba -- in the late 1980s, contends Barry. The situation was worsened, she says, with passage of the Cuban Democracy Act of 1992, which prohibits foreign subsidiaries of U.S. companies to trade with Cuba.

Among the resulting public health "catastrophes" Barry cited were: more than 50,000 cases of optic and peripheral neuropathies in 1992-93 due to scarcity of food; an epidemic of the narrowing of esophageal passages in toddlers who inadvertently drank liquid lye; and an outbreak in Havana in 1994 of Guillain-Barre, a neurological syndrome often resulting in temporary paralysis, which is caused by contaminated water left unpurified due to a lack of chlorination chemicals.

"My position is that we need to be aware of the hidden sequelae of what may seem to be a very reasonable sanction, but might actually affect health," Barry says. "Medicine, food and water purification materials should be exempt from any sanctions. There absolutely needs to be development of a neutral agency that can monitor the health effects of sanctions."

-- By Jacqueline Weaver

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