Archive for January 4, 2008
The Ecological Footprint in Cuba
Recent media attention has focused on Cuba's legal framework for
environmental protection, the small "ecological footprint" of Cuba
relative to other countries, and the eco-friendliness of the Cuban
government. (1) A deeper analysis of the situation in Cuba reveals
that this characterization is not supported by the environmental
realities on the island.
According to the United Nations Environmental Program (UNEP), water
pollution in Cuba is a serious concern, particularly since there is a
marked lack of infrastructure to address the issue. Of the 2,160 main
contaminant sources recognized by UNEP, 1,273 or 59 percent, release
their pollution into the Cuban environment without any treatment
whatsoever. Another 433, or roughly 20 percent, receive limited but
inadequate treatment before being discharged. (2) This analysis
included agricultural sources of contamination, as well as industrial
and human waste.
Despite its clear importance to the citizens of Cuba, the treatment of
urban sewage in particular is extremely limited: only 17 or 18 percent
receives any treatment before discharge into Cuban waterways. (3) The
infrastructure of water and sanitation are beyond the breaking point
and are close to catastrophic failure. Havana's sewer system, which
was built almost a hundred years ago, has been due for major repairs
for almost five decades and is serving over two million citizens, well
beyond its design capacity of 400,000. (4)
The Cuban government has recognized this as a major environmental
problem on the island, conceding that "pollution in our ground and
marine waters has gradually aggravated…caused mainly by the deficient
state of the sewerage and its incomplete nature in the majority of
cases." (5) UNEP reported an approximate total of 341,716 tons per
year of organic material discharged into Cuban waters, equivalent to
the pollution generated by a population of over 22.3 million people.
It is worth noting that this level is twice the actual 2005 population
of 11.2 million. (6)
The effects of this system on the Cuban environment have been severe.
Cuban bays are widely recognized as being among the most polluted in
the world. (7) The Almendares River, which flows through Havana,
carries the untreated sewage of over 42,000 people directly to Havana
Harbor and coastal waters. (8) There has been evidence that in Havana,
an underground aquifer that provides 36% of the city's potable water
that runs directly beneath the polluted Almendares, represents a very
high risk of widespread drinking water contamination for the city. (9)
This is a phenomenon that is being replicated throughout the country:
it has been estimated that annually 863.4 billion gallons of
contaminated water finds its way into Cuba's rivers, much of it
industrial. (10) A recent study of the groundwater in Moa, usually a
naturally protected resource, concluded that a new water source for
the population of Moa must be developed quickly, as the present source
will be increasingly contaminated with heavy metals much of it from
the nickel industry in the medium to long-term. (11) Tourist
facilities have also exhibited insufficient treatment regimens, as
many either pump waste directly into the sea at some distance from the
coast, or use small oxidation pools, and release lightly treated water
into the ocean. (12)
Overdrawing of Water
Pollution is not the only serious problem facing Cuban water supply.
Cuba's water distribution infrastructure is crumbling, leading to
gross inefficiencies and tremendous waste. According to a study by the
Pan American Health Organization, the amount of water lost to leaks in
the system is truly alarming: in smaller cities of Cuba the
percentages range from 13 percent in Pinar del Río to 30 percent in
Manzanillo to 42 percent in Santa Clara. (13) It has been estimated
that of the 30 million cubic meters of water pumped into Havana every
month, 12 million are wasted. (14) This leads to an overdrawing
situation where extraction from the environment far exceeds the actual
volume that reaches the end user, creating undue strain on the water
resources of the island.
Despite these stark realities, a recent detailed analysis of the Cuban
environment concluded that water issues are not the island's most
endangered natural resource. While water-related issues were ranked as
four of the top five, the most troubled aspect was terrestrial
degradation, which included the effects on soil quality due primarily
to agriculture, mining, etc. (15) The widespread use of irrigation in
agriculture with poor drainage has caused a significant amount of
salinization of the soil, which leads to acceleration of erosion and
decreased crop yields. According to the United Nations, Granma
province suffers from a 20-40 percent reduction in crop yields due to
increased salt in the soil, while the province of Guantánamo has been
more severely affected with 10 to 70 percent reductions in yields.
(16) Salt-affected soil covers 14 percent of the national territory,
or approximately 1,000,000 hectares. (17) The cost of recovering these
salt-affected soils has been estimated at $1.43 billion. (18) This is
one of the main contributors to soil erosion which according to the
Cuban government, affects 60 percent of Cuba's territory, which has
given rise to serious concerns about desertification, or extreme
topsoil loss. (19)
The standard practices throughout the revolutionary period – including
decades-long neglect of infrastructure, virtually non-existent
pollution limits, and detrimental agricultural practices – seem to
have taken a significant toll on the Cuban environment. While some
recent "eco-friendly" policies, such as urban agriculture and reduced
use of pesticides, have caught the attention of many, they have mostly
been implemented due to shortages and lack of resources, and do not
seem to address the most pressing issues confronting the Cuban
ecosystem. The current situation does not seem to reveal a deep
commitment to environmental protection, and the challenges that will
arise from this use of resources should be of significant concern to
the Cuban government and the island's future.
1. See World Wildlife Fund's "Living Planet Report 2006,"
www.panda.org/livingplanet/ . The WWF recognizes that the criteria
used are limited and need to include a broader sample of data. Also
see "Castro the Conservationist" National Geographic,
2. "Integrating Management of Watersheds and Coastal Area in Caribbean
Small Island Developing States: Reporte Nacional, República de Cuba,"
United Nations Environment Programme (UNEP) , April 2001.
3. Berro, Carmen Terry, "Cuba: Technologies for Wastewater Treatment
and Disposal-Current Status and Performance", United Nations
Environment Programme (UNEP), 1998.
4. Sims, Holly and Vogelman, Kevin "Popular Mobilization and Disaster
Management in Cuba," Public Administration and Development, Volume 22,
2002, pp. 389-400.
5. National Environmental Strategy: Cuba, 1997. www.earthsummit2002.org.
6. Anuario Estadístico de Cuba 2005, Oficina Nacional de Estadísticas,
7. Maal-Bared, "Comparing environmental issues in Cuba before and
after the Special Period," Environment International, 2006.
9. Incremental Ecological Wastewater Treatment: The Havana Prototype,
University of Washington Urban Planning and Design, 2000,
10. Aguirre, B. and Portela, Armando, "Environmental degradation and
vulnerability in Cuba," 2000.
11. Candela, L. and Rodríguez, R., "Changes in groundwater chemistry
due to metallurgical activities in an alluvial aquifer in the Moa
area," Environmental Geology, July 2004.
12. Maal-Bared, 2006.
13. Pan American Health Organization (PAHO)/CEPIS, Assessment of
Drinking Water and Sanitation 2000 in the Americas, 2000. Available
14. Cepero, Eudel "Environmental Concerns for a Cuba in Transition,"
15. Maal-Bared, 2006.
16. Bio-Physical, Socio-Economic and Environmental Impacts of Salt-
Affected Soils, Food and Agriculture Organization, (FAO),
17. Extent and Causes of Salt-Affected Soils, FAO,
18. González-Núñez, LM et al., "Integrated Management for the
Sustainable Use of Salt-Affected Soils in Cuba," Universidad y
Ciencia, Volume 20, Number 40, pgs. 85-102, December 2004.
19. National Environmental Strategy: Cuba, 1997. www.earthsummit2002.org.
State of malnutrition in Cuban hospitals
Jesús Barreto Penié, M.D.
Received 8 June 2004; accepted 9 August 2004
We assessed the current state of undernutrition as observed in 1905
patients hospitalized in 12 Cuban health care institutions, as part of
a Latin American, multinational survey similar in design and goals.
We surveyed 1905 randomly selected patients from 12 Cuban hospitals in
a two-phase study. Patients' clinical charts were audited in phase 1,
the Subjective Global Assessment was used to assess patients'
nutritional status in phase 2. The study was locally conducted by a
properly trained team.
The frequency of undernutrition in Cuban hospitals was 41.2% (95%
confidence interval = 38.9 to 43.4), and 11.1% of patients were
considered severely undernourished. Statistically significant (P <
0.05) univariate relations were identified between undernutrition and
patient's age and sex. Nutritional status was a dependent of the
patient's instruction level (P < 0.05). Patients' nutritional status
was statistically associated with the presence of cancer and
infection. Undernutrition was highly prevalent among cancer patients,
no matter the stage of medical or surgical treatment. Undernutrition
became extremely frequent after surgical treatment in non-cancer
patients. High nutritional risks hospital services/specialties were
identified: geriatrics (56.3%), critical care (54.8%), nephrology
(54.3%), internal medicine (48.6%), gastroenterology (46.5%), and
cardiovascular surgery (44.8%). Malnutrition rates increased
progressively with prolonged length of stay.
A high malnutrition rate was observed among participating hospitals.
The design and inception of policies that foster intervention programs
focusing on early identification of hospital malnutrition and its
timely management is suggested to decrease its deleterious effects on
outcomes of health care in the participating hospitals.