Journey to the Land of the Sweets in Dance Connection’s ‘The Nutcracker’ at MCCC’s Kelsey Theatre Dec. 15-17

No holiday season is as sweet without “The Nutcracker.”  Join Clara, the Nutcracker and the Sugar Plum Fairy for Dance Connection’s family adaptation of the timeless Tchaikovsky classic at Mercer County Community College’s (MCCC’s) Kelsey Theatre.  Dates and show times for this magical production are: Friday, Dec. 15 at 7 p.m., Saturday, Dec. 16 at 1 p.m. and 4 p.m., and Sunday, Dec. 17 at 1 p.m. and 4 p.m.  Kelsey Theatre is located on Mercer’s West Windsor campus at 1200 Old Trenton Road.

Even the youngest theater goers will enjoy this fully-narrated, one-hour ballet set to the famous Tchaikovsky score. Dolls and sweets come to life, mice and toy soldiers do battle, and snowflakes dance in a snow covered forest. It’s abridged and yet complete – with a large cast danced almost entirely by children and teens in beautiful costumes and scenery full of warmth and wonder.  At the conclusion of the show, children and parents are invited up on stage to meet their favorite characters, who will be available to sign autographs. 

Dance Connections (formerly known as New Jersey Youth Ballet) is based in Hillsborough, NJ. It was founded in 2007 by David Kieffer, who has extensive experience as a teacher, dancer and choreographer.

Tickets for “The Nutcracker” are $16 for adults, and $14 for seniors and children. Tickets may be purchased online at www.kelseytheatre.net or by calling the Kelsey Box Office at 609-570-3333.  Kelsey Theatre is wheelchair accessible, with free parking is available next to the theater.  For a complete listing of adult and children’s events, visit the Kelsey website or call the box office for a brochure.

Even if they belonged to higher social classes, most women throughout history have been enslaved by men. Until recent times, women throughout Europe, the Middle East and Asia were unable to have any influence over the political, religious or cultural lives of their societies. They couldn’t own property or inherit land and wealth, and were frequently treated as mere property themselves. In some countries they could be confiscated by money lenders or tax collectors to help settle debts; in ancient Assyria, the  punishment for rape was the handing over of the rapist’s wife to the husband of his victim, to use as he desired. Most gruesomely of all, some cultures practised what anthropologists have called ritual widow murder (or ritual widow  suicide), when women would be killed (or kill themselves) shortly after the deaths of their husbands. This was common throughout India and China until the twentieth century, and there are still occasional cases nowadays.

Even in the so-called 'enlightened' society of ancient Greece — where the concept of democracy supposedly originated — women had no property or political rights, and were forbidden to leave their homes after dark. Similarly, in ancient Rome women unable to take part in social events (except as employed 'escort girls') and were only allowed to leave their homes with their husband or a male relative.

In Europe and America (and some other countries) the status of women has risen significantly over the last few decades, but in many parts of the world male domination and oppression continues. In many Middle Eastern countries, for example, women effectively live as prisoners, unable to leave the house except under the guardianship of a male guardian. (There are many Saudi Arabian women who have only left their houses a handful of times in their whole lives.) And when — or if — they do go outside, they are obliged to cover themselves from head to toe in black, leaving them in danger of vitamin deficiency and dehydration. They have no role at all in determining their own lives; they are seen as nothing more than a commodity, property of the males of the family, and as owners, the men have the right to make decisions for them. Their male owners have the right to have sex with them on demand too. In Egypt, surveys have shown that the vast majority of men and women believe it is acceptable for a man to beat his wife if she refuses sex.

There have been attempts to explain the oppression of women in biological terms. For example, the sociologist Stephen Goldberg suggested that men are naturally more competitive than women because of their high level of testosterone. This makes them aggressive and power-hungry, so that they inevitably take over the high status positions in a society, leaving women to the more subordinate roles. This is hogwash. Women are and can be more competitive than men. Testosterone should not be used as an acceptable excuse for bad behavior.

However, in my view the maltreatment of women has more deep-rooted psychological causes. Most human beings suffer from an underlying psychological disorder, which is called ‘humania.' The oppression of women is a symptom of this disorder. It’s one thing to take over the positions of power in a society, but another to seemingly despise women, and inflict so much brutality and degradation on them. What sane species would treat half of its members — and the very half which gives birth to the whole species — with such contempt and injustice? Despite their high level of testosterone, the men of many ancient and indigenous cultures revered women for their life-giving and nurturing role, so why don’t we?

The oppression of women stems largely from men’s desire for power and control. The same need which, throughout history, has driven men to try to conquer and subjugate other groups or nations, and to oppress other classes or groups in their own society, drives them to dominate and oppress women. Since men feel the need to gain as much power and control as they can, they steal away power and control from women. They deny women the right to make decisions so that they can make them for them, leave women unable to direct their own lives so that they can direct their lives for them. Ultimately, they’re trying to increase their sense of significance and status, in an effort to offset the discontent and sense of lack created by humania.

No one wins when men continually do this to women in business. 

Buena Vista Social Club

As Cuban revolutions go, it was an entirely peaceable uprising – but its impact could not have been more profound. On the release of the Buena Vista Social Club™ album in 1997, few outside the specialist world music audience initially took much notice of the record’s elegantly sculpted tunes and warm, acoustic rhythms. Then something extraordinary occurred. The album was spectacularly reviewed by a few discerning critics, but although their words of praise did Buena Vista’s cause no harm, they cannot explain what subsequently happened. Good reviews create an early surge in sales, but unless it’s a big pop release sustained by an expensive TV advertising campaign, the established pattern is that interest then slowly tails off. Instead, Buena Vista’s sales figures kept steadily rising week by week, building almost entirely by word-of-mouth until it achieved critical mass: all who heard the record not only fell in love with Buena Vista’s irresistible magic, but were then inspired to play or recommend the album to everyone they knew. It was one of those rare records that transcended the vagaries of fad and fashion to sound timeless but utterly fresh. Once you heard it, you had to have a heart of stone not to be swept away by the music’s romantic impulses and uninhibited exuberance.

 That its impact had made waves, far beyond the specialist world music audience was soon self-evident. Buena Vista went on to win a Grammy and its crossover success persuaded the cclaimed director Wim Wenders to make an award-winning feature film about the phenomenon.s Nick Gold, whose World Circuit label released the record, put it :

“Buena Vista was a once-in-a-lifetime thing. We knew we’d made a special record but nobody could have imagined how it would take off.”

The record’s success launched what can only be described as Cuba-mania, helping to inspire a thousand salsa dance classes and Cuban-themed bars on every high street. At its peak, it seemed that you couldn’t move without hearing Buena Vista’s potent, captivating soundtrack : in coffee shops and mojito bars and even department stores and elevators songs such as Chan Chan, Dos Gardenias and Candela came to accompany our daily existence. Suddenly, Buena Vista was not so much a record as a brand, albeit one based on musical quality rather than marketing hype. Even Salman Rushdie, in his New York novel Fury, paid tribute to its all-pervasive power, describing the long, hot days of 1998 as “that Buena Vista summer”.

On the album’s release, Nick Gold had hoped that, given a fair wind, Buena Vista might ¬-Today the album’s global sales stand at over eight million, making it the biggest-selling Cuban album in history. As one critic put it, Buena Vista has become “world music’s equivalent of The Dark Side of the Moon

Yet few could have predicted this iconic success when the veteran musicians who recorded Buena Vista assembled in the run-down Egrem studio in Havana in 1996. They weren’t even a formal group, but a loose collective, spanning several generations and assembled more-or-less spontaneously for the occasion. Indeed, the group that came together was in essence an accident: the original intention had been to make an experimental hybrid record bringing together African and Cuban musicians, but the African musicians failed to turn up because of visa problems. In fact the original idea had been to record not one but two albums. The first was Juan de Marcos González’ dream project – an album celebrating the continued vitality of Cuban music’s golden age – the 1940’s and 1950’s. He hand-picked and recruited a multi-generational big band which he called the Afro Cuban All Stars and in a week they had recorded their brilliant debut album ‘A Toda Cuba le Gusta’ (‘All Of Cuba Likes It’). The following day recording of the Mali – Cuba collaboration album was due to start, but as the Africans were unavailable World Circuit’s Nick Gold, American Producer Ry Cooder and band leader Juan de Marcos were forced to improvise.

The veteran pianist Rubén González, who didn’t own a piano at the time had been persuaded out of retirement by Juan de Marcos for the All Stars album. Not that it took much coaxing: despite his years of inactivity, his playing was on fire and so eager was he to get to the piano that every morning when the janitor turned up to unlock the studio doors, he was already waiting outside. The singer Ibrahim Ferrer, who was scraping a living shining shoes and selling lottery tickets, was also rescued from obscurity – and proceeded to sing his heart out. Eliades Ochoa the great guitarist and singer provided the rural roots from Santiago. Omara Portuondo was recruited as the company’s leading lady and the rich, resonant voice of the 89 year-old Compay Segundo provided a link with Cuba’s deepest musical past. “He knew the best songs and how to do them because he’d been doing it since World War One,” as Ry Cooder noted.

Yet this stellar line-up of singers was only part of the story. Behind them were some of the finest musicians Cuba had to offer, including the bassist Orlando ‘Cachaíto’ López, who provided the heartbeart, trumpet player Manuel ‘Guajiro’ Mirabal, who added the flair, and Barbarito Torres the virtuoso laoud player. In the space of two weeks World Circuit’s Havana recording blitz produced not only the Afro Cuban All Stars and the Buena Vista Social Club™ albums but also the debut solo album by Rubén González.

When they had finished recording, Ry Cooder knew that he had been privileged to be part of a unique musical experience. “This is the best thing I was ever involved in,” he said prior to Buena Vista’s release in June 1997. “It’s the peak, a music that takes care of you and nurtures you. I felt that I had trained all my life for this experience and it was a blessed thing.”

In Cuba, he noted, he had found the kind of deeply rooted musical context that he had been searching for all his life. “These are the greatest musicians alive on the planet today,” he enthused. “In my experience Cuban musicians are unique. The organisation of the musical group is perfectly understood. There is no ego, no jockeying for position so they have evolved the perfect ensemble concept.”

Following the recordings, the musicians hit the road and extensive tours were undertaken by Rubén González, Ibrahim Ferrer, the Afro Cuban All Stars, Eliades Ochoa, Omara Portuondo and Compay Segundo. The original line up of the Buena Vista Social Club made three triumphant concert appearances; two at Amsterdam’s Carré Theatre and the final legendary show at New York’s Carnegie Hall. The latter was filmed by Wim Wenders as the climax of his successful documentary also named “Buena Vista Social Club™”, and the concert recording was released ten years later as “Buena Vista Social Club® at Carnegie Hall”. Over the years World Circuit has continued to travel to Havana recording acclaimed albums by Ibrahim Ferrer, Omara Portuondo, Rubén González, Cachaíto López, Guajiro Mirabal and Angá Díaz, who had been an integral part of the Afro Cuban All Stars.

Sadly, several of the group’s aging stars, including Compay Segundo, Rubén González and Ibrahim Ferrer are no longer with us. But the timeless, magical music that created the Buena Vista legend lives on. Omara Portuondo has been extremely busy having recorded two albums, one with Brazilian star Maria Bethania and a solo album due for release in autumn 2008; her tours continue to sell out concert halls around the world. Juan de Marcos González is ever active: working on musical productions in Mexico and forming a new edition of the Afro Cuban All Stars. Eliades Ochoa embarks on a new European tour in the autumn of 2008 and has been working on material for a new solo album. Cachaíto López, Guajiro Mirabal, Aguaje Ramos, Manuel Galbán, Amadito Valdés and Barbarito Torres are touring the world to great acclaim as part of the Orquesta Buena Vista Social Club.

The House That Castro Built

During a recent trip to Cuba I stayed at a home that was owned by Fidel Castro. It was a beautiful home. The current owner has acquired a license to rent some of the rooms of his home out, as part of private enterprise initiatives in Cuba. He had to sign a 5-year contract. Each room he rents out he must pay the government 35 CUC a month. ($35 USD) He has relationships with 5 agencies. These agencies work to do the logistics for Americans, Europeans and other to travel to Cuba. These agencies pay the home owners a nondisclosed amount. They are their guarantee to have the rooms filled. Any profit the homeowner makes, they must pay 10% to the government as well.  Recently, President Trump has created some very tough restrictions for Cuba. This same homeowner’s business is now in jeopardy.  There were 20 Americans who were slated to stay at his home. They cannot get Visas to come. He is stuck. He is still required to pay the 35 CUC per room/month to the government, where there are people there or not.  He has four more years to his contract. The government will not give him a break. They depend on the USA for their visits.

In order for this homeowner to leave Cuba to visit the USA, it’s not easy for him either. He has to go to the immigration office for a meeting to try to get a Visa. The meeting costs $160 CUC. This cost may not get him a Visa. In the event, he has to return to try again, it’s another $160. So, the Cubans are now trying to go through Columbia to get Visa’s to come to America. This creates enormous expense for them.

Their success is evidence of a growing Cuban middle class with disposable income. With the increase of private enterprise, President Obama’s relaxation of restrictions on US travellers and the introduction of Airbnb to Cuba in 2015, more tourist money has been going directly into the hands of the people instead of into government-owned hotels and restaurants. Private business owners are making incomes that far exceed anything they could earn working for the state.

Their success is evidence of a growing Cuban middle class with disposable income. With the increase of private enterprise, President Obama’s relaxation of restrictions on US travellers and the introduction of Airbnb to Cuba in 2015, more tourist money has been going directly into the hands of the people instead of into government-owned hotels and restaurants. Private business owners are making incomes that far exceed anything they could earn working for the state.

After years of stagnation, Cuban entrepreneurship has changed and grown dramatically.  Regulations governing entrepreneurship were liberalized significantly in October 2010, notably allowing the hiring of employees.  Official attitudes about it changed from indifference to encouragement.  The number of Cubans employed in this sector increased 145 percent, from 157,371 in October 2010 to 385,775 today, representing about one in 13 workers. 

Most important, the purpose has changed.  In the past, when no thought was being given to changing the socialist model, entrepreneurship seemed to be viewed as a necessary evil, of marginal importance to the economy.  It is now viewed as a strategic necessity for a government that is determined to cut costs and boost economic output by reducing government payrolls and expanding the private sector.  For every new person employed as an entrepreneur, the government counts one more job created, one more stream of tax revenue, one more household with higher income, and one less household in need of the universal food subsidies that it aims to eliminate.

Entrepreneurship, in Cuba called trabajo por cuenta propia, or self-employment, is the most visible manifestation of economic reforms undertaken by President Raul Castro since he took office in 2008.  The entrepreneurs, called cuentapropistas, are operating their new businesses on the streets of every city and town.  State media are covering this sector amply and, in a new twist, favorably.

But the new entrepreneurs are only part of the reform plan, which is being developed and implemented according to a blueprint approved by the Communist Party in 2011.  To reach major economic objectives involving job growth, productivity increases, improved government finances, and reduced incentives for young Cubans to emigrate, a larger “non-state” sector of the economy has to develop, one that will need to include larger and more complex businesses than those that today’s entrepreneurs are creating.

The situation was similar at labor ministry offices in the provincial capital of Sancti Spiritus, where an official said that 720 licenses had been issued in the first two weeks of the new policy.

Public response to the new policies was strong because of the government’s new disposition to issue new licenses again, and because they in fact expanded opportunities for entrepreneurship:

• Licenses are now available in 181 lines of work.

• To bring entrepreneurs in from the black market, licenses may be granted to those without a vinculo laboral, i.e. those with no current workplace.

• Previously, only restaurants and small food-service operations such as sandwich stands were permitted to employ assistants.  The new regulations permitted employees to be hired in 83 lines of work, and later they were changed to allow employees to be hired in any line of work.

• In private restaurants, the seating limit was increased from 12 to 20 and later to 50.  Prohibitions on serving beef and shellfish were ended.

• “Housing, rooms, and spaces” may be rented to entrepreneurs for use as places of business.

• Entrepreneurs may now have licenses for more than one line of work.

• Unlike before, entrepreneurs may work anywhere, not just in the municipality in which they were licensed. 

• Instead of being restricted to selling to individuals, they may now sell goods and services to state entities, foreign companies, and cooperatives.

• A June 2012 article in Granma discussed the ways in which government entities in Artemisa are contracting “brigades” of carpenters, painters, bricklayers, and other construction workers to fix a stadium, cafeterias, and other public buildings.  A local official praised the “speed and quality” of their work.

• Entrepreneurs must pay income tax.  The first 10,000 pesos of income, an amount that equals approximately twice the average salary paid in the state sector, is tax-exempt.  The top marginal rate is 50 percent.  Expenses totaling up to 40 percent of gross income may be deducted from taxable income (the previous limit on deductions was 10 percent).  In addition, there is a sales tax, a public service tax, and a tax per employee hired, all deductible from income tax.  The tax on hired labor is explained as necessary “to avoid concentrations of wealth.”

Finally, there is a contribution to social security, which entitles entrepreneurs to disability and maternity benefits and monthly payments upon retirement.  Taxpayers can vary the amount they contribute, and benefits will depend on the amount contributed.

• In May 2011, these policies were eased to favor job creation over tax collection.  The tax per employee was suspended for businesses with fewer than six employees, taxes were reduced and deductions increased in some occupations, and businesses were allowed to close for repairs more easily and for longer periods, suspending their licenses and their tax obligations.

Beyond the new regulatory treatment, other government actions evidence a change in attitude toward entrepreneurs and a desire to see the sector grow rather than simply subsist.

With the new policies governing entrepreneurship, a retiree in rural Pinar del Rio province said, “The only people not working are those that don’t want to.”  That’s an exaggeration, but an easy one to make given the appearance of so many new businesses across Cuba.

The block of Havana’s Neptuno Street between Aguiar and Amistad Streets is a good example.  It is near areas frequented by tourists, but it is not a tourist spot and its businesses cater to Cubans.  Many new businesses were in operation during a June 2011 visit.

A retired house painter sold herbs for medicinal, religious, and culinary uses from his front step, paying 150 pesos per month tax and earning, he said, a modest supplement to his pension.  He was fixing up a bedroom upstairs to rent to foreigners, but he was waiting for the “right moment” to start that business.  The room rental, he believed, would be “the only way to get my head above water.  When I marry again it has to be to a foreigner too.”

Nearby, a babalawo (Santeria priest) ran the Ile Ogdara religious articles shop, with a cafeteria alongside.  He pays 2,000 pesos per month to rent the space, and one month into the business he expected to do well.  Next door to him, a shop sold religious clothing.

A few doors away, a woman took advantage of the new regulations to take out two licenses, so she could sell party supplies and music CDs in the same premises.  With a combined monthly tax bill of 450 pesos, she was clearing between 1,000 and 1,500 pesos per month.

Across the street, the Gran Via store is a place where the government rents space to 15 individual entrepreneurs for 30 pesos daily.  Businesses included jewelry and watch repair, sales and repair of shoes and sandals, sale of wickerlike patio furniture made by the vendor’s husband, and more.  “Much of this was hidden before,” one repairman said, “and now people are coming out in the open.”

For the barber in Santa Maria del Rosario, the change came in May 2011; he lost his state salary and his life became both more complicated and more lucrative.  He pays 993 pesos per month to the state to cover rent, utilities, and taxes.  That works out to about 40 pesos per workday, so he has developed the habit of setting aside that amount each day – and on a typical day, he says, that leaves about 80 pesos for himself.  He acquires supplies completely on his own without difficulty, he says, including the electric clippers that friends bring him from the United States.  His prices: ten pesos for a regular haircut, 20 for a “styled” cut, ten for a shave, all to the sound of reggaetón played through an I-pod blaring through two small computer speakers on the windowsill.

A similar change is taking place in state taxi companies.  A Cuba taxi driver explained that in 2010 his company stopped paying his salary and started renting him his taxi for a flat $42 per day.  He keeps the taxi at his home, pays for gas and repairs, charges in convertible pesos, and keeps his profit.  Interviewed in June 2011, he was not yet sold on the new system because his earnings vary so much between high and low tourism seasons.

What does the experience of converting the smallest barber and beauty shops into private entities tell about the government’s task ahead?  First, the pilot projects and limited scope indicate the slow, cautious pace of the reform process.  Second, these are examples of reductions in state sector payrolls that do not involve layoffs, but rather the conversion of state jobs to private jobs on the spot.  The move to create private non-farm cooperatives will likely repeat these traits.

A local official said the number of entrepreneurs renting rooms in their homes had jumped from 200 to more than 400.  The local tourist hotel on a hillside just out of town has only 78 rooms.

A recent economics graduate had just opened a gallery on the main street to sell art and photography.  She does business in a sheltered porch and interior room that she rents from a retiree.

On the main street: room rentals, several cafeterias, ice cream stands, vendors of imported trinkets and housewares, pizza makers, and new private restaurants.  Several taxi drivers had started business in recent months; one also rents a room in his home and is fortunate enough to be listed in Lonely Planet. 

New restauranteurs worried about competition and many employ promoters who approach visitors to drive business their way.  The owner of one new restaurant on the main street, El Colonial, said about 15 new private restaurants had opened in the past six months.  Subsequent visits showed that some restaurants off the main street had closed.

But entrepreneurs alone are not likely to generate one million new private sector jobs under current rules.  Those jobs, combined with further reductions in the public-sector workforce, can potentially eliminate a fiscal deficit that has already declined from 6.9 percent of gross domestic product in 2008 to 3.8 percent last year.

In Cuban discussions of economic policy – in academic journals, public debates, Catholic church magazines, and state media – there is no shortage of ideas for policies to spur the expansion of the private sector.

When it comes to entrepreneurship, the most common suggestion is to treat the sector as an “infant industry” by reducing taxes to promote growth until the sector matures.  Other suggestions are to do away with the list of 181 permitted lines of work and instead to allow entrepreneurial ventures in any line of work except those that the state may reserve to itself, and to allow professionals to work as entrepreneurs in the field for which they were trained.

However, the potential for far more substantial job growth lies in the creation of private non-farm cooperatives.  In this area, policies have yet to be defined except in general terms.

The economic policy blueprint adopted in 2011 by the Communist Party stated that private cooperatives will be formed “as a socialist form of collective property in different sectors…integrated by persons who join together contributing goods or labor….and assume all their expenses with their income.”  A briefing document circulated as layoffs were beginning in 2010 noted dozens of potential business lines for cooperatives, including services to municipal governments, and singled out five general areas: agriculture, construction, construction materials, transportation, and food production.

The lack of entrepreneurial opportunities for Cubans with advanced professional and technical skills means that Cuba is failing to take full advantage of the investment made in their education and foregoing their potential contribution to economic development: innovation, competitiveness, export growth, job growth, and reduced incentives for young Cubans to emigrate.  Many of the new entrepreneurs, such as those re-selling housewares brought to them from relatives abroad or selling copied music and movies on disc, have created jobs and pay taxes but otherwise contribute little to development.

The Cuban people are surviving in a situation where they are supposed to die. What are the sanctions supposed to do? Why is an embargo being done?  Somebody wants to make an example of them.

What are we doing to Iraq or Gaza? These situations weren't put on against socialism, they were all put on because the proper model is the poor making the powerful richer,  so the poor can have trickle down.  The main way we can help Cuba is to stop keeping them in isolation. For example, let people from here go visit without all this rigmarole.

I just spent a week in Cuba where I was given access to unique individuals. These individuals are residents of Cuba who shared their stories. They allowed me to attend their medical appointments to enter the hospitals. There are few modern myths that have been debunked as frequently yet have been accepted as incredulously as the idea that Cuba has a superior (or even adequate) health care system. Articles have been written since the 1960s debunking the nonsensical claims about health care in Cuba and yet it is invariably the issue that is trotted out to show how socialism can actually be effective.  These appointments I attended were heartbreaking.

If you get sick on a cruise ship or are an American in Cuba, who gets sick, your health care experience is distinct.  These are hospitals that the regular Cuban citizens are not permitted to go to, only foreigners can. For foreigners, who can pay with hard currency.  In Havana can receive pretty decent healthcare. However, if you need any advanced imaging you will have to take a flight to Mexico to do so. Many medical device manufactures have donated  MRI, CT and other devices to the hospitals. However, they are boat anchors now. There is no money to service them so they sit rotting in their suites. A primary selling point of socialism is that everyone is treated equally regardless of class or ability to pay. But in reality, socialism keeps the inequality of capitalist systems and merely spreads the misery to more people. Outside of Havana, the hospital conditions are inhuman.

In America doctors are well compensated for their years of training and experience. Although the pay varies based on such factors as specialty and region of the country, the average physician in the US earns $472,000 a year. In most countries, of course, doctors are not paid nearly as well. In Hungary doctors earn an  annual income of $12,000, while in many regions of China the salary is half that amount, about $5,000 a year.

But, Cuba is near the bottom of the least when it comes to compensating health care professionals. Doctors in Cuba earn somewhere between $30 and $50 a month ($360 to $600 a year). At the high end, doctors with two specialties can earn as much as $67 per month.

These salaries do not match the cost of living in Cuba. It’s quite expensive to live in Cuba.  A young doctor would have to work for more than a week just to afford a gallon of milk (average cost is $7).  If he doesn’t have such expensive taste he can go forgo the dairy for cheaper fare: a pound of potatoes only cost about one day’s wage (90 cents). Physicians have a territory, like a paperboy. They are assigned a neighborhood to knock on doors to go and see families. They go in and give vaccines (Cuba is ahead of many countries as it pertains to vaccines), give prescriptions and assess the overall health of the community, proactively.

In Cuba, medication for hospitalized patients is free, but all outpatient medications have to be paid for out-of-pocket. And all medications (even aspirin) require a prescription. There are also no private pharmacies (except on the black market) so you have to get your Tylenol at a state-run pharmacy. That is, if you can find one.  With a population of 11 million, and more than 2 million in Havana, there are only 2pharmacies presumably located on the island.

The first was situated in a residential neighborhood in Havana. It was large yet incredibility rundown, just like its surrounding area. The narrow shelves lining the pharmacy were bare bones, giving the impression that the store was going out of business. The space focused strictly on pharmaceuticals; there were no cosmetic, greeting card, health and wellness, or candy aisles.

In comparison, the second farmacia we visited near the Ciengage de Zapata Biosphere Reserve—a 3-hour bus ride from Havana—was no larger than a backyard storage shed. Dressed in a white lab jacket, a female pharmacist manned the Dutch-door prescription window, counseling a patient who stood on the sidewalk. Her female assistant sat at a card table with a cardboard box containing filled prescriptions.

Not surprisingly, the shortages allow health care workers to supplement their income on the black market. Some doctors, nurses and cleaning staff smuggle the medicine out of the hospitals in a bid to make extra cash.

The doctors are underpaid, the system is unequal, and the hospitals are horrific. But at least they can take credit for having a low infant mortality rate, right? Actually, there’s more to be said for that statistic.

You might suspect a story behind this respectability — and you are right. The regime is very keen on keeping infant mortality down, knowing that the world looks to this statistic as an indicator of the general health of a country. Cuban doctors are instructed to pay particular attention to prenatal and infant care. A woman’s pregnancy is closely monitored. There are numerous maternity only hospitals all over the country. They are significantly run down and close to inhuman conditions.  The regime manages to make the necessary equipment available.  And if there is any sign of abnormality, any reason for concern — the pregnancy is “interrupted.” That is the going euphemism for abortion. The abortion rate in Cuba is sky-high, perversely keeping the infant-mortality rate down.  Cuba's annual induced abortion rate persistently ranks among the highest in the world, and abortion plays a prominent role in Cuban fertility regulation despite widespread contraceptive prevalence and state promotion of modern.

There is one aspect of Cuba’s health care system that seems to produce results: preventive care. The foundation of Cuba’s preventative health care model is for family doctors to oversee the health of those in their neighborhoods. But there’s a catch.

In Cuba when you hear “The doctor will see you now” it often means in your own home. And you don’t have a choice about it.

Imagine your doctor knocking at your door to give, not just you, but your whole family an annual health check-up.  As well as taking blood pressure, checking hearts and asking all sorts of questions about your job and your lifestyle, this doctor is also taking careful note of the state of your home, assessing anything which could be affecting the health of you and your family. These doctors are assigned a territory in the town, like a paper route.

Chances are the doctor is not just checking to see if you’re hiding Twinkies in the pantry, but will be reporting other findings to the local magistrates.

Cuba has a thriving Black market in medicine.  Friendships are carefully maintained with several doctors so a seller will have no problems obtaining enough prescriptions to support their  business.

People will sell medications at vastly inflated prices, but shortages in state-run pharmacies mean that many people have no choice but to turn to black market entrepreneurs.  Massive corruption throughout the Cuban health system means that this double-tier system is common across the country.

Although medicines are officially sold only through government pharmacies, prescriptions are routinely siphoned off to obtain remedies that are then resold on the streets for far higher prices.

As doctors are only paid up to 1,600 Cuban pesos (65 US dollars) each month  - barely a living wage - most need to find some way to subsidise their income. All Cubans know that doctors have thousands of needs and life challenges corrupt even the most honest. You may even find your physician driving a rickshaw or cab to make ends meet.

The best selling medicines on the street are salbutamol inhalers for treating asthma, the tranquiliser meprobamate, the painkiller ibuprofen and vitamin C in tablet form.

Topical treatments such as the anti-bacterial ointment gentamicin, skin cream triamcinolone and antifungal lotion clotrimazole are also in high demand.

Products such as these officially cost 0.65 Cuban pesos but are sold for ten pesos on the black market.

Beta-blockers such as atenolol and the anti-inflammatory analgesic dipyrone were in particularly high demand on the black market. A strip of dipyrone is sold in a pharmacy for 0.70 Cuban pesos; on the street it costs five Cuban pesos.

This year 60 medicines were affected by problems with raw materials and the withdrawal of some suppliers. Other medicines are sourced from far away, leading to production delays.

Of the 857 medicines that make up the state’s basic medicine supplies, 269 are imported from different countries, primarily from very distant markets like China, India and some European countries, and have a supply procurement cycle of between 60 and 90 days.

Last November, the minister of public health announced new control measures to try and stamp out the illicit sales.

All doctors were limited to issuing 100 prescriptions a day, each identified by a numeric code.

To prescribe a medicine a physician must see the patient and give them a prescription. Now no one can have blank prescriptions that haven’t been filled in which could be taken to a pharmacy falsifying the doctor’s name and the medicine.

In addition, the doctor’s name and signature on the prescription must be legible and accompanied with instructions on how to take the medicine.

But the practice is proving hard to end, considering that the black market involves all levels of health care staff, from pharmacy workers up to doctors. Worst affected are people who rely on these medicines, mostly of whom are elderly people. When we went to see the family doctor and he prescribed a family member a cortisol cream. We went to buy it at the pharmacy and were told that there wasn’t any.  This is the normal thing that happens.  However, in the corner of the pharmacy there was a man selling it for ten Cuban pesos. The same thing happened when a family took their child to the doctors to have their eyes tested. It was identified that he needed glasses. They were told that no glass was available to male the glasses. However, if they paid them 10 CUC they would meet them on the corner in an hour and would have the eye glasses. I don’t understand why the government doesn’t have enough for people´s needs but there are people selling it outside.

 Want some paprika-infused chorizo sausage? How about a bit of buffalo mozzarella? Or maybe you just need more cooking oil this month, or a homemade soft drink you can afford on paltry wages. Perhaps you are looking for something more precious, such as an imported air conditioner or some hand-rolled cigars at a fraction of the official price.

In a Marxist country where virtually, all economic activity is regulated, and where supermarkets and ration shops run out of such basics as sugar, eggs and toilet paper, you can get nearly anything on Cuba’s thriving black market — if you have a “friend,” or the right telephone number.

A raft of economic changes introduced over the past year by President Raul Castro, including the right to work for oneself in 178 approved jobs, has been billed as a wide new opening for entrepreneurship, on an island of 11 million people where the state employs more than four in five workers and controls virtually all means of production.

In reality, many of the new jobs, everything from food vendor to wedding photographer, manicurist to construction worker, have existed for years in the informal economy, and many of those seeking work licenses were already offering the same services under the table.

And while the black market in developed countries might be dominated by drugs, bootleg DVDs and prostitution, in Cuba it literally can cover anything. One man drives his car into Havana each day with links of handmade sausage stuffed under the passenger seat. A woman sells skintight spandex miniskirts and gaudy, patterned blouses from behind a flowery curtain in her ramshackle apartment.

Economists, and Cubans themselves, say nearly everyone on the island is in on it.

“Everyone with a job robs something. The guy who works in the sugar industry steals sugar so he can resell it. The women who work with textiles steal thread so they can make their own clothes.

Some make their living as a “mule,” ferrying clothes from Europe to Havana for sale at three underground stores. These people end up in jail for his activities.

Merchandise flows into the informal market from overseas, but also from the river of goods that disappear in pockets, backpacks, even trucks from state-owned warehouses, factories, supermarkets and offices.

There are no official government statistics on how much is stolen each year, though petty thievery is routinely denounced in the official press. On June 21, Communist party newspaper Granma reported that efforts to stop theft at state-run enterprises in the capital had “taken a step back” in recent months. It blamed managers for lax oversight after an initial surge of compliance with Castro’s exhortations to stop the pilfering.

Criminal and corrupt acts have gone up because of a lack of internal control. An extensive study by Canadian economist Archibald Ritter in 2005 examined the myriad ways Cubans augment salaries of just $20 a month through illegal trade — everything from a woman selling stolen spaghetti door-to-door, to a bartender at a tourist hot spot replacing high-quality rum with his own moonshine, to a bicycle repairman selling spare parts out the back door. He and several others who study the Cuban economy said it was impossible to estimate the dollar value of the black market.

One could probably say that 95 percent or more of the population participates in the underground economy in one way or another. It’s tremendously widespread.  Stealing from the state, for Cubans, is like taking firewood from the forest, or picking blueberries in the wild. It’s considered public property that wouldn’t otherwise be used productively, so one helps oneself.

Cubans even have a term for obtaining the things they need, legally or illegally: “resolver,” which loosely translates as solving a problem. Over the decades it has lost its negative connotations and is now taken as a necessity of survival.

Turning to the black market and informal sector for nearly everything is so common that it has become the norm, with little or no thought of legality or morality. When legal options are limited or nonexistent, then everyone breaks the law, and when everyone breaks the law, the law loses its legitimacy and essentially ceases to exist.

There is evidence, however, that Castro is persuading at least some black market operators to play by the rules and pay taxes. In the last seven months, more than 220,000 Cubans have received licenses to work for themselves, joining about 100,000 who have legally worked independently since the 1990s. Of those, some 68 percent were officially “unemployed” when they took out their license, 16 percent had a state job and another 16 percent were listed as “retired,” according to statistics on the government Web site Cubadebate.

Many of these jobless and nominally retired people were likely making ends meet by working in the informal market, and even the former government workers were probably connected in one way or another.

You have to find a way to survive.  A Cuban residents  monthly government ration card plus their meager salaries only covered two weeks’ worth of food. They often sit in the pa and think, ‘What can I do?’”

Some will even begin bicycling around town on Sundays, renting out bootleg DVDs of the latest Hollywood films, which others had downloaded from the Internet.  They defend their decisions to turn to the black market to put food on the table.

Physicians are required to stay in their roles for a minimum of two years. IT is only then that they can migrate to another higher paying job, such as a cab driver, shoe shiner, etc.

How do we help them?