Bad Medicine

 A couple of weeks ago I had occasion to go to the local CVS pharmacy to make some purchases, my first time entering such a store in over a year. Kim had sprained her ankle, and was in need of some anti-inflammatory pain reliever. I went into CVS and made my way to the pain reliever aisle, and quickly realized that I am not over the re-entry culture shock of coming back to the US after an extended time in Cuba. Back in Matanzas, if a pharmacy by chance had a pain reliever in stock (which it usually did not), there would only be one variety. Here, we have dozens of varieties, and I stood there somewhat paralyzed in front of so many options. I was reminded of a line from a Wendell Berry poem— "In plenitude too free." I finally did the sensible thing and called Kim to see whether she needed ibuprofen or naproxen sodium or acetaminophen or aspirin or  magnesium salicylate tetrahydrate or some combination of these, and whether she wanted tablets or capsules or cream or powder. On my way home I was listening to NPR; it was a story about a new med coming on the market to help wean people off their addiction to opioids, as communities across the US have become awash in Oxicodone. We are a surplus culture, and we have gotten good at creating demand.

Meanwhile, I check in on my various WhatsApp groups every day to communicate with my Cuban family, and among the various messages and topics, there is always an urgent appeal for a much-needed medication that is nowhere to be found. Occasionally there will be cause for gratitude, as someone else in the group will have the med in question and the grassroots people's pharmacy works. Sometimes, as in the case of an older adult whose Parkinson's prescription has run out, or a young woman suffering excruciating menstrual cramps,  the people's shelves are bare as well. 

It's shameful to live and be a part of a country that demands surplus for its own and scarcity for its neighbors, as we continue to double down on a blockade that disrupts the supply chain of raw materials and lab supplies for Cuba's world-class pharmaceutical industry. I've had people question this, saying that they thought medicines were exempt from the embargo. ¡Ojalá! (If only!). The fine print of the embargo reads that while US-based pharmaceutical companies can do business with Cuba, the stipulation is that they have to have an in-country inspection system to ensure that their meds are not being used for purposes of torture. And what about other countries, like Germany or Canada; can't they supply the Cuban pharmacies? ¡Ojalá! Other fine print sections of Helms-Burton speaks to intellectual property, so that if any medication or equipment has 10% or more US-based intellectual property in its makeup, the company is not allowed to freely do business (without the onerous stipulations). Given the global nature of everything, there's not much coming out of a German company's laboratory that doesn't rely on at least 10% of research coming from a Stanford or Chapel Hill or some other tier-one lab in the US.  

Around the same time all this was swirling around in my head, I got a WhatsApp message from a pastor in Matanzas saying he'd heard of an Italian company, Globestar, that has an office in Miami and was able to ship meds to Cuba via a third country. I checked it out, called the office, and sure enough, they can ship boxes with up to 22 pounds of over-the-counter meds. We collected a boxful and sent it off by 2-day Priority Mail at the USPS. Ten days later it arrived at our friend's home in Miami (apparently it wasn't high on the Priority list), and he drove it over to Globestar, only to find that they had moved locations and wouldn't be re-opening until May 17. Kim called the Globestar office to see how long it would take the box to get to Cuba once we sent it on the 17th, and the answer was 30 days. Globestar's third country must be on the other side of the globe, via a slow boat. Meanwhile, in the land of the free we continue to strategize on how to get our surplus drugs into the veins of the populace, and in Cuba my senior adult friend with Parkinson's continues to suffer from uncontrollable tremors and my young adult friend is forced to tolerate intolerable monthly pain.