Cuba faces the challenges of a graying population




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Cuba faces the challenges of a graying population

By Vanessa Bauza, South Florida Sun-Sentinel
October 9, 2003

HAVANA, Cuba, With her cane propped on the stoop behind her, 86-year-old Maria Rodriguez lays out tubes of toothpaste, packets of coffee and thermometers on the narrow steps of a run-down central Havana building along a busy boulevard.

After 30 years in the tobacco industry, she now supplements her $3.50 monthly pension peddling odds and ends to passersby.

Today's profits: roughly 25 cents.

It is a meager retirement, not unlike that of many other aging Cubans who spend their golden years counting pesos from small pensions and supplementing them with dollars from black market sales or remittances from relatives abroad.

Up and down the popular sidewalk, the faces of those trying to eek out a living hawking pens, cigarettes, soaps, lollipops or peanut-filled paper funnels are mostly elderly, snapshots of the fastest-growing sector of Cuban society.

Cuba's high life expectancy, averaging 76 years, combined with an extremely low birthrate and a steady stream of young migrants have created a graying boom which will make it one of the oldest countries in Latin America by the end of the decade.

Across the world, populations are steadily aging. The United Nations expects the number of people over 60 to triple in the next half-century to nearly 2 billion and urges even developed countries to address the implications for their pension systems and long-term care programs.

With Cuba 's social security system already straining under a stagnant economy, a significant elderly population creates challenges both in the immediate future and for a potential post-Castro transition to a market economy, experts say.

According to Cuba 's 2002 census, 14.7 percent of Cubans are over 60, a number similar to the older populations of Argentina and Chile . But by 2010, demographers estimate that figure will jump to 18 percent, surpassing many countries in the region. By 2025 one in four Cubans will be over 60 and by 2050 an estimated 40 percent of the island's population will be in their golden years with about 156 seniors for every 100 children, presuming no major demographic shifts, officials said.

"I can say in about 40 or 50 years, Cuba will not only be one of the oldest countries in Latin America , but in the world," said Juan Carlos Alfonso, director of the Population and Housing Census at Havana 's National Statistics Office.

Cuba sets its minimum, though not mandatory, retirement age at 55 for women and 60 for men, one of the lowest in the region. On average, those who reach 60 are expected to live another 20 years. That means Cubans spend a significant number of years depending on state-funded pensions.

Rodriguez and other elderly have limited options to supplement their livelihood.

"Sales are very bad," she said. "The police have told me to leave, but I sell what I can."

Rodriguez's home is a small room divided by a cardboard wall for privacy from her estranged husband who lives in the other half. Housing in Havana , after all, is at a premium.

She has no money to fix the patches of plaster that have fallen from the ceiling so on a recent rainy night a puddle of water spreads across her floor.

Across the street, Georgina Garzon, 73, sits in her doorway hoping a stream of school children walking noisily down the sidewalk will be enticed to buy her striped candies for a peso apiece.

A few blocks away Jose Navarro, 80, sells Granma and Juventud Rebelde newspapers from a yellow stool. He gets by thanks to his granddaughter, a hotel worker who lives on the island's eastern tip and occasionally sends $20 for food and medicine.

"Life is very expensive," said the former construction worker who receives a 100-peso monthly pension, about $4. "Some people make 400 pesos a month and they say that's not enough. Imagine me."

According to a 1997 study by Havana's Center of Psychological and Sociological Research, most of the 60 seniors interviewed said pensions either "do not cover minimum everyday needs or they only satisfy those (needs)" but do not allow for recreational activities. Although Cuba 's social security spending on the elderly and handicapped was five times greater in 1996 than in 1971, "the aging which is on the way will require greatly increased spending in this area in the future," the study said.

The rapidly aging population means economic recovery under a transition would also have to be accelerated, said Hans de Salas-del Valle, a research associate at the University of Miami 's Institute for Cuban and Cuban-American Studies.

"In strictly developmental terms, it's going to be an enormous challenge for Cuba ," de Salas-del Valle said. "You have the intrinsic challenge of going from a centrally planned economy to a market economy. Then you have the fact that this is a rapidly aging population."

Currently, Cuba 's social safety net provides free medical care, cheap meals at soup kitchens, subsidized housing and day centers for some elderly but many programs fall short of the demand.

In a country of 11 million people, Cuba currently has 14,453 "Grandparent Circles" that provide meals, entertainment and medical care for 658,000 seniors living at home. In addition, 10,815 elderly Cubans reside in 127 assisted living facilities.

"We seek to provide social integration and even provide certifications for the elderly to work," Roberto Dieguez said as part of "Day of the Elderly Adult," a program to raise awareness about assistance programs for the elderly on the island. Dieguez, who is an expert with the office of Elder Services and Social Work at Cuba 's Public Health Ministry, said the program also provides home nursing care, food, housekeeping and laundry services to nearly 95,000 other elderly Cubans.

In the upscale Havana neighborhood of Vedado, Casa de Abuelos, or "grandparents' home," boasts a sunny porch and spotless dining area. It provides up to 60 senior citizens with three meals a day for the equivalent of about $1 a month. An occupational therapist and social worker help women in the crafts workshop while the men play dominoes.

But this home is the only one of its kind in a municipality that could use at least five such programs, said an administrator.

Likewise, in central Havana , a former convent-turned-senior center provides meals for about 25 seniors and functions as a nursing home for another 40. The shared rooms are Spartan but clean and the menu is simple, often bland, generally consisting of rice, soup, eggs and occasionally a small piece of chicken or croquettes. Costs range from $1 to $2 a month. But again, social workers say the demand outpaces the available space. Despite the help seniors get at the center, some still sell their cigarette and coffee rations to buy medications that are often unavailable at state-subsidized pharmacies and must be bought on the black market.

In Cuba , most seniors still live with their children or other relatives, with only 9 percent living in group homes or alone.

As the sole caretaker of her blind 95-year-old mother and her mentally retarded daughter, Juana Rodriguez covers their medications, vitamins and fortified diet by renting a room in her Old Havana home to tourists for $20 a night. About a third of private entrepreneurs in Cuba are retirees and Rodriguez feels lucky the government approved her request to work in the coveted room rental business.

Without the extra income, her family's combined $6.50 monthly state assistance would never be sufficient, she said.

"If it weren't for the room rental we'd go hungry," Rodriguez, 58, said. "The pension doesn't cover my mother's needs. My great worry is that something will happen to me. She depends on me for everything."

Like all other Cuban families, they receive food rations each month, which include 6 pounds of rice per person, 1 pound of beans or peas, eight eggs, a pound of chicken and a pound of fish. Along with utilities and rent, the state-subsidized food costs only a few Cuban pesos. But rations generally only last a week or 10 days, leaving Rodriguez to buy higher-priced food for her family at the farmers' market or dollar stores.

Rodriguez has discarded the possibility of putting her mother, Giraldina, in a nursing home. "She talks about going to a nursing home and her hair stands on end," Rodriguez said. "She wants to die in her bed."

As more Cubans reach retirement age, government officials are counting on families to continue caring for them at home to keep costs down.

"The idea is to help families so the elderly can stay home," said Enrique Vega Garcia, director of Elder Services and Social Assistance at the Public Health Ministry. Adding soup kitchens, training more social workers to make house calls and creating flexible shifts to keep people at work beyond the minimum retirement ages could ease the burden for the elderly and their families, he said.

"The biggest challenge is for elderly people to associate growing old with health, to get them to the last stage of their life without a handicap," Vega Garcia said.

On the streets of Old Havana, Ramon Suarez Dominguez's biggest challenge is simply surviving. The 70-year-old receives the equivalent of a $2.50 monthly pension. He makes a little extra change by reselling plastic soft drink bottles that he picks out of Dumpsters. Lately, things have gotten worse. He hobbles along with a weak leg and the bottles are becoming harder to find.

"Sometimes I go two days without eating," he said. Still, he prides his independence over economic necessity.

"Sometimes I think I should go to a home for the elderly," he said. "But I don't want it to come to that."