HAVANA, Apr 2 (IPS) - The bars are not visible from outside.
At a glance, the solid buildings of one of Cuba's main prisons
merely have rectangular openings in the concrete walls to
allow air to flow.
Few people who are not part of the Cuban penitentiary system
have been allowed to visit the inside of Combinado del Este,
the men's prison located 20 km outside Havana.
Nor are the doors normally open to journalists or
international observers at the National Hospital for
Prisoners, inside the fenced compound. The hospital receives
the infirm from several other prisons in Cuba.
"We treat all of the patients equally. All we know is the name
and the details on the clinical record. Nothing more. Nothing
about where they come from, their sentences, or the crime
committed," said doctor Aurelio Gonz�lez, director of the
As for medications and other hospital supplies and equipment,
he told IPS that the institution faces "the same limitations
as in the rest of the country: no more, no less."
Gonz�lez received a group of more than 40 members of the
foreign press on Thursday who were invited on a tour of the
compound, along with delegates to the First Cuban Congress on
The forum organised by the Ministry of Interior, which met
Mar. 29-30 in parallel to meetings on nursing and natural and
traditional medicine in Cuban prisons, was also open to the
national and foreign press.
This unusual open-door attitude comes just weeks before the
vote by the 53-member United Nations Commission on Human
Rights on a resolution critical of the socialist-run island's
The resolution condemns the Cuban government's crackdown on
dissidents in March and April 2003. After swift trials, 75
human rights activists and journalists were handed long prison
Responding to complaints from some of those inmates' families,
Cuban Foreign Minister Felipe P�rez Roque said on Mar. 25, "It
is false that they are victims of cruel, inhumane or degrading
But the families and human rights groups like Amnesty
International insist that prisoners are mistreated and
humiliated, and receive poor nutrition and little medical
The last prison visit by the accredited foreign press in Cuba
was 14 years ago. The objective of that tour was to observe
the conditions in which several dissidents were being held.
This time, reporters were not allowed to speak with any of the
dissident inmates, but did have access to other prisoners in a
hospital ward, and to 20 more who were participating in a
training course for nurses offered by the prison.
"It's a good profession. We are barely getting started and
already I feel different," nursing student Joel Perez, 26,
told IPS. He is serving a 15-year sentence for armed robbery.
When he completes the programme, he will receive a diploma
like anyone graduating in the Cuban education system. He will
be able to work as a nurse in the National Hospital for
Prisoners and, once he is released, he will be qualified to
apply for a nursing job in any hospital.
The Cuban government's initiative to "turn prisons into
schools" entails several types of training courses for
inmates. The stated aim is to ensure their reinsertion into
society when they have served out their sentences.
In addition to nursing, there are courses in physical
education and in technical areas. The inmates who work in the
prisons receive wages.
"The problem is not getting in (to the prison). The problem is
knowing how to be out," Nereida Pacios, one of the
penitentiary medicine congress delegates, told IPS.
If it weren't for the bars that separate the rooms from the
hallways, the guards, the silence and the overwhelming
solitude of the long corridors, the prison could be any other
hospital in Cuba.
The equipment in the prison's three operating rooms and in the
anaesthesiology area are the latest models available.
"The volume of people arriving here has declined because now
all of the units (prisons) have their own medical posts. We
are seeing 15 to 20 patients per day," said doctor Carlos
Hernias are the most common reason for surgery in the prison,
and pneumonia is the most frequent infection, according to the
The Cuban prison system has 15 health programmes under way,
including testing for tuberculosis and sexually transmitted
diseases, and providing immunisations and nutritional
Infection with HIV, the precursor to AIDS, is not a serious
problem amongst the prison population. Inmates who test
positive for the virus are transferred to special facilities.
According to lieutenant colonel Juan Pe�a, who is also a
physician, there are three health institutions in Cuba for
prisoners who are HIV positive. "The capacity of the one in
Havana is 200 people, but I don't know how many are there
now," he said.
Some 40 km from Combinado del Este is the Western Prison for
Women. There, the medical personnel are training inmates as
In the prison's medical unit and in the maternity ward, also
open to the foreign press for a visit of about two hours, two
or three assistants could be seen working alongside every
nurse or physician.
The number of pregnant women who gave birth in the prison grew
from 18 in 2000 to 48 in 2003. The babies live with their
mothers in the prison's maternity block until they reach their
"Here, the children are born into good hands," said Yaima
Leal, one of the 15 mothers living in the unit along with nine
All of the births take place at institutions of the national
health system. No maternal or infant deaths have been
reported. The average birth weight is 3.5 kilos. The mothers
are encouraged to nurse their newborns for the first six
The data made available during the First Congress on
Penitentiary Medicine indicate that there is one doctor for
every 200 inmates and one nurse for every 100.
The government does not publish statistics on the Cuban penal
population, but the opposition Cuban Commission for Human
Rights and National Reconciliation (CCDHRN) estimates it to be
in the "tens of thousands", which is relatively high for a
country of 11.2 million people.
Although none of the experts consulted by IPS offered numbers,
it is widely held that there has been a notable increase in
the prison population since the Cuban Penal Code was modified
in the late 1990s.
A study of prison systems by researchers Elsa Azaola and
Marcelo Bergman estimates that the Latin American prison
population grew 56.4 percent between 1992 and 1999. Only
Venezuela was excluded from the investigation.
They found that Brazil had the worst prison overcrowding in
Latin America. For Cuba, prisons are estimated to be 75
percent over capacity, which experts consider moderate
compared to the prisons in other countries.
"The conditions are improving somewhat in the prisons.
Treatment is more human. We are gathering data about the
situation. There is an effort to improve treatment," Elizardo
S�nchez, president of CCDHRN, told IPS.
At the same time, the rights activist -- who has spent time
behind bars himself -- considered the visit organised for the
foreign media "a propaganda manoeuvre" of the government with
an eye to the vote on Cuba by the U.N. Commission on Human
Rights in the next few weeks.