[Sandokan]

Cholera in Cuba: Notice to Protect U.S. Travelers
http://ctp.iccas.miami.edu/FOCUS_Web/Issue200.htm

Sherri L. Porcelain*
CTP Issue 2000, September 3, 2013

The Center for Disease Control and Prevention (CDC) is the leading U.S. government agency with the mission to protect and secure the health of Americans at home and abroad. CDC also functions as a key informational source, for clinicians and travelers, providing up to date facts and advice about health issues both nationally and internationally. Yet, CDC has not posted a notification about cholera in Cuba for summer 2013, even though other countries and the Pan American Health Organization (PAHO) have confirmed the vibrio cholerae bacterium infecting international travelers visiting Cuba this summer.
CDC refined their travel announcements on April 5, 2013, with the purpose to clarify both health risks and precautions: (1)

Level 1: “Watch” is a reminder to use precautions when traveling to a specific destination;

Level 2: “Alert” to recommend applying enhanced precautions;

Level 3: “Warning” to avoid any non-essential travel to a specific country.

Cholera is one of the oldest reportable diseases along with the plague and yellow fever. Under the International Health Regulations (IHR), the regulatory arm of the World Health Organization, the rapid spread of cholera has a long history. Cuba’s decaying infrastructure of poor water, sewage, sanitation and housing conditions coupled with heavy rains and international medical missions, makes cholera ripe for rapid spread.

Recent laboratory evidence confirmed that travelers carried more than their luggage home from Cuba. In the past two weeks:

August 14, 2013: PAHO reports that Italy, Venezuela and Chile cases support previous rumors and pleas from dissidents that cholera continues to spread in Cuba. (2)

August 20, 2013: U.S. Interests Section in Havana issued a cholera health warning. (3)

August 23, 2013: PAHO reports additional information that Spain, Germany and Netherlands confirmed cholera from returning travelers from Cuba, and identified cholera in provinces of Havana, Santiago and Camaguey. (4)

August 27, 2013: Juan Tamayo, Miami Herald reporter, interviewed a New York teacher hospitalized in Cuba for six days. The Cuban-American was stricken with cholera, along with other family members, after eating at a state-owned restaurant. (5)

August 29, 2013: European surveillance reports that the 40-year-old male who spent a two-week vacation in Cuba, arrived home to Tieste, Italy in July with cholera and severe renal failure. He was hospitalized for 10 days and has recovered. (6)

The latest PAHO surveillance reports 163 cases of cholera in Cuba for the year 2013; however, it is not clear how many cases are linked to this summer outbreak, and little epidemiologic details are presented. The Italian case study provides important epidemiologic evidence, identifying the likelihood of fresh seafood as the infected food source and the Havana waters as a possible point of concern. (7)

No one is questioning the active and vigilant epidemiologic surveillance of infectious diseases in Cuba. Conspicuously, it is this evidence- based research that does not mirror the government’s lack of transparency in reporting.

We know that cholera re-emerged in Cuba, after a century’s absence, prompting CDC to issue a travel advisory for Cuba in July 2012. Shortly after, the Cuban government reported no more cases of cholera.

New scientific and epidemiological evidence this summer revealed European, Latin American, and U.S. travelers visiting Cuba were infected with cholera. Does anyone believe that the recent cholera outbreak started with international visitors from Italy, Venezuela or Chile this summer?

Cuban dissidents, independent journalist, and Promed mail (8), working under the auspices of the International Society for Infectious Diseases, have tried to engage the international community- and expose a fact that the 2012 Cuban cholera epidemic did not vanish so quickly. Cholera never does so in countries with poor infrastructure.

Unmistakably, we cannot depend upon an early official notification from the Cuban government. Therefore, we must rely on the international scientific evidence and U.S. government’s responsiveness to disseminate travel advisories.

The U.S. Interests Section announced a cholera warning for Cuba on August 20, 2013. However, the CDC, whom I highly respect for both their excellent research and up-to date- information sharing about global public health issues, has yet to release a “watch” notification. While on June 19, 2013 CDC announced a cholera watch for Haiti and Dominican Republic. Based upon the evidence, risks and precautions necessary to avoid cholera in Cuba, I would assume a cholera travel health notice is warranted from CDC.

Notes
1) Center for Disease Control and Prevention (CDC) Traveler’s Health Notice.
http://wwwnc.cdc.gov/travel/notices. Accessed August 31, 2013.

2) Pan American Health Organization (PAHO). Epidemiological Update. Cholera, August 14, 2013. http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&gid=22575&Itemid.
3) U.S. Interests Section, Havana Cuba, Security Message-Cholera Outbreak. August 20, 2013. Accessed August 20, 2013.

4) PAHO, Epidemiological Update, Cholera August 23, 2013. http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&gid=22752.

5) Juan Tamayo. Cuba reports more cholera among foreign visitors. Miami Herald, August 26, 2013. http://www.miamiherald.com/2013/08/26/3587434/cuba-reports-more-cholera-among.html.

6) M Mascarello, M L Deianam C Maurel, C Lucarelli , I Luzzi R Luzzati, Cholera with Severe Renal Failure in An Italian Tourist Returning from Cuba, Eurosurveillance, July 2013. Volume 18, Issue 35, August 29, 2013. http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20572.

7) Ibid

ProMed mail post. International Society for Infectious Diseases.http://www.promedmail.org.
_________________________________________________
*Sherri Porcelain is Senior Lecturer of Global Public Health in World Affairs & Senior Research Associate at the Institute for Cuban and Cuban-American Studies, University of Miami. Professor Porcelain is currently writing a book on U.S. Foreign Policy and Global Health: The Nexus of Infectious Diseases.

Cuba’s Public Health Ministry, on July 2012, declared that the cholera outbreak have been control. The real fact is that Cuba is turning into another Haiti, and the Castroit corrupt regime is in charge of the whole mess.

[Sandokan]

Exposing a shady cover-up in Cuba
http://www.washingtontimes.com/news/2013/mar/21/exposing-a-shady-cover-up-in-cuba/

The truth about dissidents’ killings confronts the U.N.
By Jose R. Cardenas - Thursday, March 21, 2013

More than 60 dignitaries and pro-democracy advocates from around the world have signed an open letter to U.N. Secretary-General Ban Ki-moon requesting that the world body conduct an investigation into the tragic deaths of Cuban dissidents Osvaldo Paya and Harold Cepero in an automobile accident in July 2012. It’s the least anyone can do.

The letter was prompted by a tour of European capitals by Paya’s daughter, Rosa Maria, and the blockbuster revelations by Spanish political activist Angel Carrameo, who was with Paya and Cepero at the time of the accident. Now out of Cuba, Mr. Carrameo went public with the truth that the accident was caused by a Cuban state security vehicle that rammed the car in which they were riding, forcing it off the road into a tree. The two Europeans survived, but Paya and Cepero, sitting in the back of the car, were killed.
Since Paya’s death, his family has maintained the Castro regime was behind his death, which is hardly surprising to anyone with a sober understanding of the nature of that government. However, the regime moved quickly to silence Mr. Carrameo and another European activist who was present, Aron Modig, by setting up a kangaroo court, in which they were held responsible for Paya and Cepero’s deaths.

The regime’s machinations fooled no one, except the legions of Castro regime apologists who have aped the party line from the get-go: that unprompted by anything, the car that Mr. Carrameo was driving spun out of control on a lonely country road.

Mr. Carrameo was convicted by a Cuban court of “vehicular homicide” and sentenced to four years in prison, but the quiescent Spanish government, playing along with the farce, nevertheless managed to persuade the Cubans after several months to allow him to serve out his sentence under house arrest in Spain. Both sides underestimated the power of human nature to want to speak the truth.

After witnessing the abuse heaped on Paya’s daughter in Europe by pro-Castro mobs, Mr. Carrameo said he finally decided to speak out, despite death threats and the “nightmare” that his life had become. He said he “could not hide the truth any more” because “the most important thing for me is that the Paya family always has defended my innocence, when they are the most injured by this tragedy.”

Mr. Carrameo’s testimony once on free soil is a dismal reminder of the Cold War, in which he recounts a Kafkaesque nightmare of druggings and intimidation by Cuban authorities to ensure his complicity in this Big Lie that he was responsible for the deaths of Paya and Cepero. He was held incommunicado in a dark, roach-infested prison cell without a working toilet. He said he was subjected to constant threats and was told that his account of what happened on that lonely road had not happened and “that I should be careful, that depending on what I said, things could go very well or very badly for me.” He was then presented a statement for him to sign admitting his culpability, saying his “speeding” caused the accident.

Mr. Carrameo, who said he still suffers from memory lapses owing to the unknown drugs he was given by the Cuban authorities, said he thought going along with the charade was his best chance of getting out of Cuba — which, ultimately, proved to be the case.

Given the United Nations‘ historical indulgence of the Castro regime, it is not likely that it would ever conduct any investigation of the Paya affair, which is a tragedy in itself. Individuals like Osvaldo Paya represented the future of Cuba, and only a few of them come along every generation. He was independent, beholden to no one, and rock-sure of his principles. He found an unusual strength in the rightness of his cause that allowed him to be unintimidated by the Castros’ thuggish ways.

Sadly, it is more likely that the deaths of Paya and Cepero at the hands of Cuban state security will be quietly swept under the carpet. That’s because their deaths are mortal threats to the current propaganda campaign that Cuba under Raul Castro is “reforming,” and that the United States should normalize relations with the country as a result. The killings of dissidents thus present most inconvenient facts to those dogged policy critics who will stop at nothing to have the United States recognize that brutal dictatorship. That’s why it is up to decent people to keep Osvaldo Paya’s and Harold Cepero’s memories alive for the sake of Cuba’s future.

Jose R. Cardenas was acting assistant administrator for Latin America at the U.S. Agency for International Development in the George W. Bush administration and is an associate with Vision

The UN should be investigating, since so many dignitaries have requested the investigation. The MSM is have not been paying the necessary attention to the tragic deaths of Cuban dissidents Osvaldo Paya and Harold Cepero. But of course the UN will no more address this than they will address other atrocities around the world.

[Sandokan]

Cayman Islands prepare for more Cuban migrants
[url]http://www.miamiherald.com/2013/06/06/3437447/cayman-islands-prepare-for-more.html
[/url]
By Juan O. Tamayo
jtamayo@ElNuevoHerald.com
Posted 6/06/2013

Facing a potential increase in the flow of Cuban migrants, authorities in the Cayman Islands are reviewing their preparations for an exodus and policies on denying assistance and repatriating the Cuban migrants.

“There are questions about human rights issues for the Cubans,” said Deborah Bodden, staff manager at the independent but government-appointed Human Rights Commission in the British territory 125 miles off Cuba’s southeastern coast.

Some Cayman officials believe the number of Cubans spotted recently in Cayman waters has been growing, apparently because of fears that U.S. immigration reforms will make it harder for them to enter and stay in the United States.

But others say the sightings always rise at the beginning of the summer, when the seas are calmer and the tides and winds push the Cuban boats toward Honduras, from where the passengers try to travel by land to the U.S. border with Mexico.

The numbers are not large by any means. About 26 Cubans were spotted in two boats in April. Only seven Cuban boats were sighted in Cayman waters in all of 2012, nine in 2011 and three in 2010.

Yet, the Cuban migrants are indeed a nettlesome issue for the Cayman Islands, a peaceful banking haven and tourist destination with a population of 57,000.

Under a Memorandum of Understanding (MOU) signed with Havana in 1999, Cayman authorities and residents cannot assist the boats — with food, water or boat repairs — and must repatriate almost every Cuban who set foot there.

Boats that are considered safe can sail on. But Cubans in unsafe vessels, and those who simply want to get off are put in an immigration lockup in Grand Cayman Island. They can apply for political asylum, but virtually all are rejected and flown back to Cuba.

Of the 1,200 Cubans who arrived in the Cayman Islands during the “Rafter Crisis” of 1994 — when Fidel Castro allowed more than 35,000 Cubans to take to the seas — only 20 received political asylum.

Gary Wong, a deputy chief immigration officer in the Caymans, told the Reuters news agency that Cubans who reached the British territory recently have repeatedly mentioned the growing concerns about the U.S. Congressional efforts at immigration reforms.
Under the U.S. “wet foot, dry foot” policy, Cubans intercepted at sea are repatriated while those who set foot on dry U.S. land gets to stay — and obtain permanent U.S. residency after just one year under the Cuban Adjustment Act.

Havana residents say Cuba was swept by rumors earlier this year that those benefits might be cut back. The migration hubbub apparently was also amplified by the Cuban government’s decision to ease restrictions on travel abroad by its citizens as of Jan. 14.

Bodden told El Nuevo Herald last week that the Human Rights Commission added the Cuba issue to an ongoing review of the Caymans’ overall migration policies due in three months, after receiving “inquiries from the public and officials.”

Police detained one man last month when he vociferously complained that authorities were blocking a crowd gathered at a Cayman Islands dock from delivering assistance to a boat with about 30 Cubans aboard that was standing just off the dock.

Cayman residents left cases of bottled water and fruit juices by the shore, but managed to deliver sunglasses to the migrants, according to witnesses. The boat sailed on.

The Caymans government, meanwhile, has revived a mass migration management committee organized several years ago when large numbers of Cubans were arriving, according to Wesley Howell, deputy chief of the Internal and External Affairs Portfolio.

“It is looking at contingency planning for another mass influx of migrants, whether from Cuba or Haiti or elsewhere,” Howell told CayCompass.Com, a Cayman news outlet.

If you want to know how well the "reforms" of the totalitarian Castroit regime are working out for the Cuban people, just ask the authorities of Cayman Islands, Cuba's southeastern coast close neighbor. The Caymans government said that “is looking at contingency planning for another mass influx of migrants, whether from Cuba or Haiti or elsewhere.” There you have the answer.