CU HIV-AIDS
29 Aug 2004

THE TORONTO STAR - (by Peter McKenna, an assistant professor in the Department of Political Studies at the University of Prince Edward Island in Charlottetown) - Revolutionary Cuba is hailed by some as a shining example of how to combat successfully the HIV/AIDS pandemic. Today, Cuba has an HIV infection rate of less than 0.1 per cent, in a region that has one of the fastest growing infection rates in the world. Not only have Cuban authorities virtually eliminated the transmission of the virus through blood transfusion and intravenous drug use, but they have also halted transmissions involving newborns at birth. In April 2003, Peter Piot, the executive director of UNAIDS, declared: "Cuba was one of the first countries to take AIDS seriously as a problem, and provide a comprehensive response combining both prevention and care." Of course, this was not always the case. Back in the mid-1980s, Cuba was widely condemned by the international community for its harsh treatment of AIDS sufferers. Indeed, it sought to isolate or quarantine people with HIV (remember the SARS outbreak in 2003?) in sanatoriums - far away from the "collective" population. Their sexual partners were subsequently traced and tested. Pregnant women and those who had travelled to Africa were also tested.

By the late '80s, however, Cubans were more knowledgeable about the epidemic, and they humanely allowed patients to leave the sanatoriums for extended periods of time. A few years later, the Cuban government introduced its ambulatory care treatment program, which enabled AIDS patients to choose between living within the sanatoriums or convalescing at home with family members. In Cuba today, people with HIV are guaranteed access to free medical care. And nobody can be fired from their jobs because they are carrying the virus. There is clearly a strong commitment on the part of the political leadership in Cuba to undertake a wide-ranging and comprehensive HIV/AIDS action plan - domestically as well as internationally, as part of Cuba's activist foreign policy. As early as 1983, Cuba had already set up a National Commission on AIDS, before any cases had even been diagnosed, to educate its 11 million people. Sex education programs were subsequently introduced in the schools and TV ad campaigns informed Cubans about AIDS and the need to promote safe sex. Over the years, the government began compiling a comprehensive database of those infected with HIV, along with their chain of sexual partners. While HIV testing is no longer compulsory, Cuban health authorities recommend it for pregnant women and those in high-risk categories. Those who do contact HIV are required to attend an eight-week education and drug support program in a sanatorium.

Last year, Dr. Byron Barksdale, the director of the American charity, Cuban AIDS Project, was quoted as saying: "I don't know if six weeks or eight weeks are the magic numbers, but that is certainly a longer time than is given to people in the U.S. who receive such a diagnosis. They may get five minutes' worth of education." Because of the 40-year-old U.S. economic embargo against Cuba, no anti-retroviral drugs were initially available on the Caribbean island. By 2001, however, Cuba's growing biotechnology sector was beginning to manufacture generic versions of several HIV/AIDS inhibitors. Cuba is now one of the few developing countries that actually provides its HIV/AIDS patients with a full supply of free drugs. From an international standpoint, Cuba has sent thousands of doctors and nurses to almost every part of the world to help in the valiant struggle against HIV/AIDS. In Botswana, which has the highest proportion of people living with HIV in the world, Cuban medical professionals work in several clinics and hospitals to treat AIDS sufferers and to offer suggestions for prevention. Two weeks ago, the Cuban government offered to train - at no cost - nurses and doctors from other Caribbean countries to fight the pandemic. More strikingly, Cuba has promised to provide anti-retroviral drugs to its Caribbean friends for a cost well below market prices. It won't be long before countries in Latin America and Africa will also come calling. This is even more impressive when you realize that Cuba is largely a poor, developing country locked in an undeclared war with its superpower neighbour only 145 kilometres away. As a comparatively rich and industrialized country, where is Canada's leadership on this critical issue?

Cuba's approach to the HIV/AIDS pandemic is a major success story. There is much that the rest of the world can learn from the compassionate Cuban experience. No one is saying that Cuba has all the answers to the AIDS epidemic. But as Nina Ferencic, a UNAIDS program development adviser for the Americas region, recently confided: "Cuba has lots of potential and lots to offer."

Granma International - Havana - All documentaries come out of an experience, a shock, a passion, an event. For Cuban filmmaker Belkis Vega her most recent work "began as a feeling of pain, of loss, of impotence." The artist wanted to transform that feeling "into something useful, that would make us reflect," and it became the documentary Viviendo al Límite (Living to the Limits). Vega, a successful documentary director with a extensive filmography, has said that a full awareness of HIV-AIDS, now a worldwide epidemic, came to her "with the loss of my best friend in 1998 and acquired project form in 2000." It is a fact that at times one needs to be really shaken in order to rationalize the coldest facts. Suffice it to say that the latest (2003) report from UNAIDS - the UN program aimed at coordinating efforts to combat the disease - states that there are 40 million infected people in the world, 2.5 million of them children.

According to the World Data Service and the Ministry of Public Health, 1,160 persons have died of AIDS in Cuba since 1986 (when the first case was discovered), and some 4,000 people are carriers of the disease. But the prevalence of persons living with AIDS on the island is the lowest in Latin America: 0.05% of the population aged 15 to 49 years. Doubtless the filmmaker would have been shocked at the prejudices and stigma that someone so close to her must have endured in addition to the terrible disease itself, before the tragedy of his death. Belkis Vega explained her project in the following way: "We are living in a century that was born under a terrible threat. That threat is called AIDS. For scientists or illiterates, the Acquired Immune Deficiency Syndrome is a major issue. A virus without a cure, without a vaccine, with a thousand and one faces. A virus that is advancing and becoming stronger day by day. A virus that any one of us could fall victim to tomorrow. Meanwhile, a kind of tacit conspiracy of shame and silence continues to accompany AIDS. People identified as HIV positive continue to be the object of rejection and discrimination." There have been many advances in Cuba. There is a whole educational program for those who do not have AIDS and for those living with it. But, without any doubt, there is a long way to go in that coexistence.

The documentary maker has explained that she asked herself a first question: "How to live with HIV-AIDS?" given that those who are infected face the certainty of a relatively close death. The questions increased. "What are their main concerns?" "Although they are socially marked by this kind of scarlet stigma are they capable of dreaming and loving? " "What is society doing for them and against them?" Then began an extensive investigation and a more pragmatic search, for funding. The filmmaker was advised by the National Center for the Prevention of AIDS and Sexually Transmitted Infections, and consulted with the Epidemology Directorate at the Ministry of Public Health, the Pedro Koiri Institute of Tropical Medicine and the AIDS sanatorium in Santiago de las Vegas. However, the most intense research consisted of the close to 60 interviews she had with people living with HIV and their families. Viviendo al Límite is finally the moving story of five infected Cubans: Yoire Ferrer, María Julia Fernández, Fernando Mederos, Kenia León and Carlos Borbón, who "had the courage to open their hearts to us," as the director said at the screening of the documentary at Havana's Chaplin movie theater.

Belkis Vega knew what she wanted to say and achieved it. It is not an informative film on how to avoid the disease. It is not a warning on the continuing number of people infected. She confines herself to the accounts of her five interviewees, their dreams and how they have managed to overcome their tragic fate. In order to do that, she also utilizes the so-called Spontaneous Theater - improvisations based on real testimonies - tied into psychodrama. It thus adds up to a conductor for the five, to follow their daily lives, and with those elements the actors (from the Teatro de los Elementos in Cumanayagua, Cienfuegos province) move onto their representation, inter-linking movement, text and poetry. The director has the virtue of achieving the fact that the film, structured on those five stories with a common theme, shapes their individualities and integrates dramatic representation with the purely documentary. The two complement each other. For Manuel Iglesias, the experienced editor who worked with Belkis Vega on this film, the argumental structure and the rhythmic style of this full-length feature are "very close to the canons of orthodox classical and academic cinema," and highly functional for a documentary like Viviendo al Límite, "transparent in its artistic and ethical proposals, totally clear in its catalyzing intentions on the sensibility of a society that in order to become steadily more human, needs to exorcise fears, stigmas and prejudices."

The idea for this film was made concrete by Vega in 2000, but it was not easy to make. The reasons were economic ones. Funding had to be sought and this arrived to a large degree thanks to the generosity of 98 Cuban visual artists who donated their works for this noble cause. Thus was born El arte por la vida (Art for Life) an exhibition hosted by the City Historian's Office and mounted in the San Francisco Convent's Salon Blanco in December 2002. Well-known and sought after artists such as Kcho, Moreira, José Omar, Bejerano, Zaida del Río, Nelson, Flora Fong, Mendive, Oliva, Choco and Sosabravo once again demonstrated their sensibility. Belkis Vega herself has explained that she also received funding from the UN Development Program (UNDP) "which allowed us to make two digital editions of the documentary: a 90-minute one for projection in movie theaters and another of 60 minutes for television." Likewise with support from the UNDP and help from the Cuban Film Institute, she noted, they were able to convert the video film in 35 mm for cinema. "We did that process in Mexico's New Art Digital as they gave us a quote well below the normal price as a contribution to the film." In any event, those were three years of intensive work for Belkis Vega, who wanted "to contribute in order that people living with HIV can encounter a better comprehension from society, insofar as they are human beings who still have their lives ahead of them and have the right to live them to the fullest."

Cinema, theater, photography (José Riera, Alejandro Pérez), music (Edesio Alejandro) and editing all unite to achieve the profound humanism of Viviendo al Límite, which obliges viewers to examine their prejudices and notes the urgency of comprehension, acceptation and respect for those people who are attempting with dignity to survive AIDS. Director and scriptwriter of documentary and fiction films, Belkis Vega has a respectable filmography under her belt, beginning in the 70s with Ustedes esta generación (You, this Generation); Seremos como el Che (We will be like Che) and La Política de la Traición (The Politics of Betrayal). The 80s were very fertile: Celia; Mujeres, simplemente (Women, Simply); Victoria; Cienfuegos en Septiembre (Cienfuegos in September); Con las milicias (With the Militias); Recordando (Remembering); España en el Corazón (Spain in Ones Heart); Días de Julio (Days of July); Mayombe; Fidelito; Huambo, Crónica de un crimen (Huambo, Account of a Crime; Operación Carlotta; María Luisa; Corresponsales de Guerra (War Correspondents, a documentary series in 3 parts); and Por si muero mañana (If I Were to Die Tomorow). Even in the difficult decade of the 90s, she managed to continue filming: Dame la Mano (Give me Your Hand); Por la Vida (For Life); Una gota en el mar (A Drop in the Ocean); Canción de Gesta (Epic Song); Siempre, la esperanza (Always Hope); La hora de la luz (The Hour of Light); Enigma; Quiéreme de este modo (Love me in This Way); Circo de la muerte (Death Siege); Del sueño a la poesía (From Dream to Poetry); A través de la nostalgia (Out of Nostalgia); Toledo judío (Toledo Jew); Recordar - Ernesto Lecuona (Remembering Ernesto Lecuona); Simplemente mujer (Simply Woman); Pensar con el corazón (Thinking with the Heart: Melba Hernández, Liuba María Hevia, Sara González, Harry Villegas, José Delarra, Arnaldo Tamayo, Sergio Corrieri, Jorge Fuentes and Reynaldo Muñoz); and Quintana, sinfonía de Compostela. Television viewers are indebted to her for The House of Bernarda Alba, El mensajero (The Messenger); and Santa Camila de La Habana Vieja. To date in this new century she has directed Secretas de la jungla (Jungle Secrets); Marcos bajo la piel (Marks under the Skin) and Viviendo al Límite.