On July 11, thousands of Cuban citizens took to the streets in what has become the largest wave of anti-government uprisings there in three decades. Armed with signs bearing slogans that harkened back to the communist government’s origins during Fidel Castro’s 1959 rebellion — Libertad (freedom); Patria y Vida (homeland and life), a play on Castro’s oft-invoked patria o muerte (homeland or death) — protestors demanded change from a half-century of repression amid rampant food shortages and a surge of COVID-19 cases.

Opportunities and Necessities

A wave of emotion came over me as I watched these protests on TV and spoke with family and friends. I grew up in Cienfuegos, a rural Cuban city of low hills and clay dirt roads, and I consider myself fortunate to have been able to immigrate to the U.S. when I was 7. While I benefited from the myriad educational and professional opportunities available to me in Florida, my former elementary school classmates back on the island were less fortunate. Some became doctors, though they received meager salaries and faced vast difficulties working in Cuba’s chaotic public health system. Others, despite years of education, have been unable to find jobs anywhere except in tourism, an industry now in rapid decline. All of them are worried about necessities I often take for granted here. They worry about what they and their family members will eat the next day, and about safety from whatever repressive action they might face if they’re caught saying something against the government. There’s a common refrain they tell me: No tenemos nada. No food in grocery stores. No access to jobs. No syringes or medications at hospitals.

Two of my family members recently died of COVID-19 in an urban public hospital. Young and without prior medical issues, they suffered from pulmonary complications as drug shortages prevented staff from providing even basic pain medications that would have made them more comfortable. While some estimates place Cuba’s vaccination rate at around 70%, this belies the lack of vaccine access in rural areas, where many older adults — including my great-grandmother — reside.

Pushing for Change

The protests went beyond COVID-19. They spoke to issues of repression and free speech, exemplified by the government’s swift blockage of internet access throughout the island after the protests began in an effort to curb grassroots organizing. My friends and family members who protested put their lives on the line as plainclothes police, masquerading as civilians, threw people in jail and beat them. I felt compelled to write to governors and senators throughout the U.S. to advocate for a bill providing Cubans free internet access, and I was thrilled when it passed in mid-August — though I question how much of a difference this will make.

Now in my fourth week of anatomy as a medical student, my days are occupied by cadaver dissection and mapping arteries and innervations. I feel guilt and remorse at times, as I think about the people I know back home and what I might be able to do to help them. But I also feel pride. I think of how my aunt and uncle, who became doctors in Cuba, had to study their anatomy textbooks under the nearest street lamp since they couldn’t afford electricity at home, and I feel grateful for the sacrifices my family made so that I can now study at Johns Hopkins. I think of my relatives who support the communist government and admire the fact that despite our political differences, we still manage to get along.

And I think about how the worsening situation on the island hasn’t stopped people from helping one another. Whether they agree with the government or not, health care professionals are doing everything they can to care for their patients — working longer hours and in conditions of significant resource scarcity.

These actions reaffirm my commitment to serving others through medicine. They reaffirm my identity as Cuban, and they reaffirm my hope that between patria y vida and patria o muerte, we’ll choose life.


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