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To Thrive in Cuba, One Needs to Be an OT

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One of my second-year graduate students, Sarita Streng, has travelled to Cuba seven times to study dance and to direct and produce a documentary film about Cuban-style salsa dance called "La Salsa Cubana" (www.facebook.com/LaSalsaCubana). She once said to me, "Most everyone in Cuba has to be an OT."

When I had the opportunity to visit Cuba last summer I saw repeated evidence supporting her statement. Living day to day in Cuba requires adaptation; strategic, creative income generation; and ongoing problem solving. Working together is a common practice to overcome daily life challenges.

The average salary in Cuba is reportedly $20 a month, whether you are an unskilled (e.g. street sweeper) or skilled worker (e.g. health professional). I was told health professionals across specialties (OT, PT, nurse, doctor, etc.) make the same salary. While this seems unsustainable, one has to take into consideration the subsidies provided by the socialistic government, which include free healthcare, education including university studies, and subsidized housing and food.

However, most workers have to find multiple means of making money. The driver for Sarita's film was a family-practice doctor who drove a cab in the evenings and on weekends. While driving, he never forgot his job as a doctor, often providing care to people, offering medical advice and always taking his basic medical kit with him.

When Sarita worked on her low-budget film in Guanabacoa, Cuba, she needed access to film equipment that was not easily available. The Cuban dancers in the film helped her improvise. For example, when there was no electric in the town, the dancers hooked her equipment up to a bread truck for power. When she and the crew needed a dolly for a smooth, panned shot, the dancers tied the camera to a bicycle pedaled by an elderly man. When an overhead shot was needed and there was not a high enough ladder, the dancers found a home with a beamed ceiling and made a human pyramid to help the cameraman get on a beam to shoot from above. None of these adaptations took much energy or thought-for Cubans, a "can do" attitude is part of daily life.

Another example of adaptation is the retention of American cars (estimated to be 60,000), all purchased before the Revolution in 1959. Standing on any given street in Cuba is better than attending an antique car show in the U.S. Beautiful, well-cared-for Fords, Chevrolets, Cadillacs and Chryslers drive by in assorted brightly painted colors with shiny ornate chrome. Often on the side of the road a man can be seen underneath his car fixing his showpiece. Due to the U.S. embargo, parts are not available so Cubans must improvise every tool and hand-make every part, adapt household products or use Soviet car technology to repair their vehicles. With this ingenuity these cars have certainly outlived their intended lifespans!

Little is thrown away. Sarita saw cardboard toilet paper rolls used as women's hair curlers, razors being resharpened, beer bottles turned into drinking glasses, diapers made from flannel sheets, and fans made from the metal paddles of old Russian washing machines. People take their own bags, boxes and bottles when shopping. Many things that are readily thrown away in the U.S. are repaired or used for parts. Those doing the repairs are not specialists; most Cubans just know how to fix things.

Cubans also need to adapt to secure food their families. One needs to negotiate several types of economic markets. One might be able to purchase a piece of ham outside a small farmers' market through the black market, indicating the product may be stolen. Other goods (rice, sugar, beans, oil, salt, etc.) are distributed at neighborhood centers through the subsidized market. The government provides ration books, but these do not always guarantee products as at times there are food shortages. Families might purchase fruits and vegetables (often of limited variety) at a nearby market using the local currency (CUCs). Or a family might grow most of the food they need.

While life in Cuba may be challenging, there are many things we can learn from our neighboring country. Sustainability is part of their lifestyle, which is a sharp contrast to our "throwaway" society. Close contact with multiple generations of family members living under the same roof brings richness to all, especially the children. Living without multiple commercial distractions and technology interruptions can be liberating. Most Cubans do not have excessive possessions, so they immaculately care for and value what they have. The Cuban people's resiliency, strength of character and living-in-the-moment attitude are admirable.

Terry K. Crowe, PhD, OTR/L, FAOTA, is a professor in the department of pediatrics (division of occupational therapy) at the University of New Mexico in Albuquerque. She has worked in Argentina, Bangladesh, Cambodia, Mexico, Thailand and Vietnam, and travelled in 51 countries around the world. Reach her at tcrowe@salud.unm.edu.


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