Cuba’s double troubles
Our hemisphere’s oldest nation is facing a demographic challenge of epic proportions: How to care for a rapidly aging population while boosting a stagnant birth rate to revitalize economic activity.
HAVANA — At 67, struggling against the challenges that come with aging and a meager pension, Raquel, an engineer who in her own words was “formed by the Revolution,” survives by sifting through garbage every day in search of recyclable products.
Hands that at one time drew plans and measured distances now pick up cardboard, cans and other discarded containers.
“My life is a struggle from the moment I wake up,” Raquel said.
“My last name? For what? And I don’t want any photos. I have children, and I once had a life. I don’t want people talking about me,” she said after agreeing to tell her story.
Digging through garbage as a way to make a living was not part of Raquel’s plan but she is not alone. Many within the island’s growing aging population are struggling with survival in the twilight years.
Cuba has become the oldest country in the Western Hemisphere, according to official figures, amid an accelerated process that has even surprised specialists who had not expected the phenomenon to become apparent until 2025.
Facing a pension system that is increasingly nonviable, a harsh economic recession and an expected impact on social services as a result of the aging population, the island is confronting one of the biggest challenges of its history, experts say.
Demographic catastrophe
Almost 20 percent of Cubans are now over the age of 60, and the fertility rate stands at 1.7 children per woman of child-bearing age. To counter the aging population, the fertility rate would have to rise to 2.4 children per woman of child-bearing age. Cuba’s economically active population shrank for the first time in 2015, by 126,000 people.
“The population aging that is affecting the country leads to a significant increase in public spending as well as a drop in the population of the fertile age, which in turn leads to a decrease in the fertility rate,” said Juan Valdes Paz, a Cuban sociologist who has written several books on the issue.
Valdes said no government can be prepared for the kinds of demographic problems that Cuba now has.
“If there’s no harmony between demographic progress and economic development, the latter is impacted,” he said.
Government spending on public health per capita in 1999 was 21 percent lower than in 1989, according to economist Carmelo Mesa-Lago. Official Cuban figures show that category of spending dropped from 11.3 percent of the country’s Gross Domestic Product (GDP) in 2009 to 8 percent in 2012.
Although Raquel is retired, government pharmacies do not subsidize the medicines she needs for her diabetes and hypertension. State socialservice programs do not serve elderly Cubans who live with relatives or other presumed caretakers.
“I get a pension of 240 pesos a month,” said Raquel, the equivalent of less than $10. “From that money, I have to pay 50 pesos for the Haier refrigerator the government forced me to buy and 100 pesos to buy my medicines.”
Assistance evaporates
Cuba has about 300 daytime centers for the elderly and 144 nursing homes, with a total capacity of about 20,000 clients. Officials have acknowledged that a significant portion are in terrible shape, and many elderly prefer to go into one of the 11 homes across the country run by religious orders. They operate thanks to foreign assistance, like the Santovenia asylum in the Cerro neighborhood of Havana.
The state-run day-care centers charge 180 pesos per month and the nursing homes charge about 400 pesos. Social Security subsidizes the payments when socialservice workers determine that the clients cannot afford to pay those fees.
Cuba once had one of the most generous and broadest socialsecurity systems in Latin America. But that was largely possible because of the massive subsidies from the Soviet Union, calculated by Mesa-Lago at about $65 billion over 30 years.
“Although the pensions were never high, there was an elaborate system established by the state to facilitate access to food and other products at subsidized prices,” said the economist.
After the Soviet subsidies ended in the early ’90s, pensions remained at about the same level but their purchasing power collapsed. In 1993, a retired Cuban could barely buy 16 percent of what he could afford in 1989. By the end of 2015, the purchasing power of retirees remained at barely half of what it was when the Soviet Union collapsed and Cuba entered into the so-called Special Period.
Raquel is a product of that reality.
“It bothers me when I hear talk of the good services for the elderly,” she said. “I don’t get any subsidies because I live with my son, his wife and my two grandchildren. But they have their own expenses and can’t afford to also pick up all of mine.
“I need new dentures,” she added, “and if you don’t give the dentist a little gift, they take months or come out bad.”
Other elderly residents on the island echoed Raquel’s sentiments.
“We are two old people living alone, we have no one overseas, so we receive no remittances,” said Andres, a former cartographer who lives with his wife, Silvia, in the central city of Cienfuegos and now sells homemade vinegar and other products to make ends meet. “It’s very hard to get old and live off a $10 pension when four drumsticks of chicken cost $5.
“Last year I was awarded with a lifetime achievement recognition at work and then I was laid off,” he said. “I was already retired but continued to work because we could not live on my pension.”
Drastic cutbacks
After Fidel Castro left power in 2006, following a health emergency, the Raul Castro government began drastic cutbacks in social-security benefits under the rubric of “the elimination of gratuities.” Of the 582,060 Cubans who were receiving social assistance benefits in 2006, such as disability or special diet funds, the number was slashed to 175,106 by 2015.
Castro also removed several products from the highly subsidized ration card, such as soap, toothpaste and matches, forcing everyone to pay far more for those products when they bought them on the open market.
The government has launched some new programs for the elderly. The Sistema de Atencion a la Familia (System to Help the Family), for example, allows more then 76,000 lowincome elderly to obtain food at subsidized prices. That’s a tiny number compared to Cuba’s elderly population, estimated at more than 2 million in a nation of about 11 million.
Some elderly Cubans also receive assistance from churches and nongovernmental organizations.
“People see me picking up cans, but they don’t know I was a prize-winning engineer and that I even traveled to the Soviet Union in 1983,” Raquel said.
After retirement, she had to find other ways of making ends meet. She cleaned the common areas of buildings where military officers lived near the Plaza of the Revolution until she got too old to handle the work.
“They wanted me to wash the windows of a hallway on the 9th floor. That was dangerous, and I was afraid of falling. I preferred to leave, even though they paid well,” she said.
Raquel was earning 125 pesos (about $5) per week — more than half her monthly pension of 240 pesos.
Raquel said she sells the empty recyclable containers she collects to state enterprises but would love to be able to sell them to a private company, instead, to avoid bureaucratic problems and delays. In the patio of her home, she has created a homemade tool to crush the empty cans she finds on the streets.
The work can be profitable but competition is stiff and physically tougher for the elderly and disabled who have to wait in long lines to sell their products at state enterprises or pay someone else to hold their spot in line.
“In January I made 3,900 pesos on beer bottles. But I paid 500 pesos to hold my spot in line because I can’t just lay down on the floor while I wait,” she said. “Aluminum also pays well. They pay 40 pesos for a sack of cans. It’s eight pesos per kilogram.”
Cuba does not have official statistics on poverty.