ethnobotanical practices as resistence to the politic, social and cultural challenge in Cuba

WHY CUBANS PREFER SANTERIA YERBATEROS TO FAMILY MEDICINE
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Do the Cubans opt for Santeria and Yerbateros who are unprofessional physicians because the official health sector in Cuba is incompetent?
The island of Cuba is a socialist nation that believes in bringing people together in many ways. One of the strategies the Cuban government has used is family medicine where between 120 and 150 families are treated by a family doctor who is found in the neighborhood and is always available for the patients. It is a puzzle that even with doctors who work closely with their patients most Cubans would prefer to use unprofessional physicians (Yerbateros) who use medicinal plants and Santeria. The main reason most Cubans prefer not to be attended by the family physicians is because they are politically influenced, and their primary duty is to protect the interest of the leaders and not the patients’ needs. The second reason that has affected family medicine is the economic ban placed on Cuba by the US in the year 1961 which led to the fall of the Soviet Union in the 1980s.1 The US embargo negatively impacted the Cuban formal health sector, and the citizens started to use alternative ways such as Santeria and informal physicians who use medicinal plants to address their health problems rather than depend on family medicine.
Cuba has undergone so much transformation after the Soviet Union collapsed and the US ban on trade with Cuba and political influence has significantly affected the family medicine.

Cubans have a social, medical program but rather ignore the family physicians and instead use unprofessional physicians and Santeria to address their health needs. There are many professional doctors, but the formal health sector in Cuba has been greatly politicized hence affecting this system. Family medicine is facilitated in Cuba where each health facility is expected to serve between 120 and 150 families and the physicians being available for their
patients all day long. Family medicine creates a social structure that enables the doctors to know all their patients in a personal way and interact in a social and professional way. From that relationship you expect Cubans to stick to family medicine but rather they opt for Santeria and Yerbateros. Family doctors work in a way to protect the interest of Cuban leaders and, therefore, most of their acts are against the expectations of the citizens who prefer to be attended by unprofessional individuals. Family doctors are politically backed, and therefore, the Cubans cannot report any unethical practices involving the physicians. Citizens will, therefore, prefer to be treated by unprofessional physicians who have got no political influence.
Politics highly affect family medicine, and the physicians are expected to collect data about the political affiliation of each household they are supposed to treat. Political data about patients is recorded on the medical forms that the doctors use. It is challenging to open totally up to the doctors with medical surveys incorporating politics. In the ethics of medicine, the physician should only deal with a patient professionally and, therefore, seeking to know the patient’s political standpoint is breaking the doctor code.2 The political interference negatively impacts the physicians who are in the field for professional reasons. Monitoring what every household stands for politically interferes with their privacy and lowers the level of trust between the physicians and the patients. Political influence on family medicine creates tension between patients and their designated physicians because they could act as political informers hence Cubans prefer to be treated by unprofessional physicians who are not interested in knowing the political stand of a person.
Family medicine is further influenced politically because the political aspirants use the physicians to mobilize households during political rallies. Family doctors have created a good relationship between them and the locals because they can freely interact and share meals, political leaders use this relationship to their advantage. Family doctors run silent campaigns for politicians and try to get many people to back the politicians. On average, every doctor treats a minimum of 120 households which implies that if a politician influences many doctors, then there is a possibility of having numerous supporters during elections. The family doctors also happen to give speeches during political rallies so as to support Cuba against its enemies.
Political influence will determine which medical conditions the physicians will pursue. The family doctors do not deal with medical situations that are pressing rather they have to deal with what the leaders think is important. In the past, sanitation, proper waste disposal, and mosquito eradication were carried out efficiently in Cuba but due to the political influence, some things happen in the wrong way. Most areas in Cuba face a health hazard because waste is improperly disposed of, mosquitoes are not killed, and sanitation is poor just because these issues do not interest the leaders.3 Doctors should look for ways to deal with such dangers that wait to befall Cubans, but not much can be done with the political influence.
Most Cubans will seek medical attention from friends or relatives just to avoid the family medicine centers. Some patients want a revolution on how the politics control the medical sector, and the only way to do it is to seek alternative medical advice. The Cuban politician tends to advocate for abortions when fetal development is impaired, by doing this the infant mortality rate is maintained. Every physician has a duty to protect the Cuban revolution by making sure the
health goals are achieved, one of the objectives is a low infant mortality rate that is lowered by making sure all abnormal pregnancies are terminated. This practice is unethical and, therefore, most pregnant women will prefer to seek medical attention from friends and relatives rather than the official medical centers where they could be told to terminate their pregnancies. There is a tendency for Cubans to receive pharmaceuticals from friends and relatives in the US hence they do not have to visit family doctors. Most of the individuals do not have knowledge of the drugs they are dealing with, but they will share the medical products with friends and use them to treat ailments they are not meant to address. In one instance, some woman took Ganostin thinking it was Gastrosin to her sister to treat stomach problems. Sharing pharmaceuticals is a dangerous practice that could place many lives in danger but Cubans would rather share medicine or seek medical advice from other people rather than visit the family doctors.
Cubans operate home gardens where they can plant food and medicinal plants. The government influence on the cost of food and the family medicine has caused many Cubans to opt for measures that work best for them. The home gardens act as sources of cheap food and medicinal plants rather than use family medicine that is highly influenced by the politicians.4 Home gardens are ways of the Cubans to protect themselves from economic exploitation in the acquisition of food that is expensive and also from the family doctors who favor the politicians. It is observed that most home gardens have a high percent of medicinal plants that could be an indication that the Cubans prefer treating themselves rather than the politically influenced family doctors.
The USA embargo on Cuba, which started in the year 1961, has negatively affected the health system in this socialist nation because it could not access raw materials needed for the
production of pharmaceutical goods. Cuba also experienced significant financial losses after the embargo hence it became a challenge to acquire medical products for the lack of currency. The US ban on Cuba has had a catastrophic effect on the health system due to unavailability of drugs and proper diet. Studies related to the US embargo have shown that a decline in nutrient intake, inadequate food supplies and excessive tobacco use on the island contributes to health conditions related to the optic system hence causing blindness.5 Diseases such as tuberculosis and HIV did not worry most of the Soviet Union citizens because they were worrying about how to survive. In one case, over 250 children were infected with HIV because physicians recycled injections while administering vaccines.
The formal health sector in Cuba has been impacted negatively by the politics and the US embargo of 1961 which contributed to the collapse of the Soviet Union in the 1980s. Cubans came up with measures such as Santeria and Yerbateros to deal with the problems in family medicine. Ethnobotany has been promoted by the unprofessional physicians who use medicinal plants to treat patients. The most widespread religion is Santeria; it originated from Catholicism and Oricha religion of the Yoruba’s who were brought to Cuba during the slave trade era between the years 1510 and 1886. Most Cubans observe Santeria because it represents their origin and therefore in following this religion they people are keeping their socio-cultural practices together.6 The Santeria is also viewed as a revolution movement against the formal health sector that has been highly politicized. In Santeria, there is no political influence, and
therefore, you do not have to feel forms that show the political stand of your household rather you worship and find a form of spiritual and physical healing.
Santeria and ethnobotanical practices have gained so much popularity in Cuba rather than family medicine because of the political, economic and socio-cultural influences on the formal health sector. Family medicine is one of the best strategies to treat patients because they have a personal touch with the physicians. However due to the outside forces such as politics that control family medicine practices, many Cubans will prefer Santeria and medicinal plants.7 The Cuban health sector was affected by the US ban and pharmaceuticals were not available, so the Cubans thought of the Green Revolution and started using the Santeria and ethnobotany that was cheap and readily accessible. Most Cubans have home gardens where they can plant herbs that they use for treating ailments and for cultural purposes rather than use family medicine. Family medicine has been significantly affected by economic practices, politics and socio-cultural practices making the Cubans opt for Santeria and use of medicinal plants.
 
Notes
Barry, Michele. “Effect of the US embargo and economic decline on health in Cuba.” Annals of internal medicine 132, no. 2 (2000): 151-154.
CONCHA‐HOLMES, AMANDA D. “Cuban Cabildos, Cultural Politics, and Cultivating a Transnational Yoruba Citizenry.” Cultural Anthropology 28, no. 3 (2013): 490-503.
Volpato, Gabriele, Daimy Godínez, and Angela Beyra. “Migration and ethnobotanical practices: The case of tifey among Haitian immigrants in Cuba.” Human Ecology 37, no. 1 (2009): 43-53.

Lefever, Harry G. “When the saints go riding in: Santeria in Cuba and the United States.” Journal for the Scientific Study of Religion (1996): 318-330.
Hirschfeld, Katherine. “Sociolismo and the Underground Clinic: The Informal Economy and Health Services in Cuba.” Cuba in Transition 16 (2006): 335-350.
Buchmann, Christine. “Cuban home gardens and their role in social–ecological resilience.” Human Ecology 37, no. 6 (2009): 705-721.
Moret, Erica. “Afro‐Cuban Religion, Ethnobotany and Healthcare in the Context of Global Political and Economic Change.” Bulletin of Latin American Research 27, no. 3 (2008): 333-350.
Bibliography
AMANDA, CONCHA‐HOLMES. “Cuban Cabildos, Cultural Politics, and Cultivating a Transnational Yoruba Citizenry.” Cultural Anthropology 28, no. 3 (2013): 490-503.
Christine, Buchmann. “Cuban home gardens and their role in social–ecological resilience.” Human Ecology 37, no. 6 (2009): 705-721.
Erica, Moret. “Afro‐Cuban Religion, Ethnobotany and Healthcare in the Context of Global Political and Economic Change.” Bulletin of Latin American Research 27, no. 3 (2008): 333-350.
Gabriele, Volpato, Daimy Godínez, and Angela Beyra. “Migration and ethnobotanical practices: The case of tifey among Haitian immigrants in Cuba.” Human Ecology 37, no. 1 (2009): 43-53.
Harry, Lefever. “When the saints go riding in: Santeria in Cuba and the United States.” Journal for the Scientific Study of Religion (1996): 318-330.
Katherine, Hirschfeld. “Sociolismo and the Underground Clinic: The Informal Economy and Health Services in Cuba.” Cuba in Transition 16 (2006): 335-350.
Michele, Barry. “Effect of the US embargo and economic decline on health in Cuba.” Annals of internal medicine 132, no. 2 (2000): 151-154.