To categorically affirm that “Cuban women are letting their hair go grey” is, without a doubt, an uncertain generalisation; however, the reason to say this is not sensationalist, its aim is for it to be a call to attention regarding a “phenomenon” that, though isolated, can be seen especially in the immense majority (or immense minority…?) of Havana artists, writers, journalists and cultural promoters…; beautiful women, some of them very beautiful in the recent past and still today, who are in the so-called third age.

Traditionally in the world – and in Cuba as part of it – the human tendency has been to hide the inevitable aging and persons from one or the other sex start using, because of a functional need or to have an agreeable physical aspect according to the established beauty canon, prostheses, eyeglasses, partial or total dentures, dental, hip or other silicon stylistic implants or facelifts, walking sticks, wheelchairs….

 

Nowadays, without leaving out the inevitable aids and substitutions, it seems that a gap has opened among the women who use keratin or highlights in their hair, tattoo their eyelids and eyes, increase the size of their lips or other parts of the body and those who opt for a natural or apparently natural style: grey hair in a “daring” or not short haircut; clothes that “slim” those who are overweight or that “augment” the ones who are too slim.

 

Many prefer going to the gym (traditional low- or medium-intensity exercises, aerobics….), Tai Qi or Yoga, and refuse to wear “invisible” girdles like Cuban women with a rather comfortably off economy used to do years ago, in the 1950s and even way before then (one must not forget the corsets of yesteryear), together with the nylon stocking, perhaps because of the heat or because their agendas are full of activities and an acceptable and even excellent, but comfortable, presence is better, because in addition there are no other camouflaging clothes on the market or they are very expensive for the average domestic economy, that is, if there is an average domestic economy at present. It must not be ruled out that a group of women does exist who gladly pay for a “girdle,” no matter how expensive for the diminished finances of Cubans, and they do not hesitate in asking some family member residing abroad for one.

 

A decisive cause lies in the genesis of the triumph of the 1959 Revolution, when the so-called women’s liberation and their growing and active participation in the political and social life was increasingly more committed and hierarchically high, while the shortage of many products and the establishment of rationings – through ration books for the purchase of food, clothes, footwear, etc. – made it impossible to dedicate much time to “frivolities”.

 

It should be taken into account that in this initial period of emancipation it was very important to be devoted to collective work and personal growth instead of caring for their aspect. However, those were the years in which Cuban women replaced the mascara with shoe polish, and for eye shadow used colour pencil scrapings mixed with a cream that could well be even a deodorant of the only and national trademark, Fiesta.

 

Old clothes were transformed, very fashionable shoes were made; a poor imitation of those sold “on the ration book” in Primor – a network of shoe shops, one establishment per province – for the purchase of women’s footwear for special occasions, like when girls turned 15 or for weddings. The handmade shoes were made over those which fell into disuse by lining the deteriorated by time leather with a satiny cotton fabric; the barrio cobbler’s inventiveness to make some money or to be in fashion in the case of the female consumers.

 

Cuban women, turned into comrades, continued distinguishing themselves for their elegance and rhythmic way of walking that, it seems, is a thing of the past (I’m referring to “wiggling” their hips);not only among those who are aging but also among the young women. That swaying must have been lost during the frequent mobilisations in agriculture, or the hurrying imposed in modern societies; though, in comparison, in Cuba the dynamics is still slower, when in the first world and even third world countries people live hastily.

 

People are constantly running, a constant “I have no time”; when women return tired from work they stay at home, they socialise increasingly less and consume increasingly more, perhaps not just because of the demands of the market in its broadest sense, but rather due to the contagious pace, as if it were an epidemic, of modern times, which Charles Chaplin saw from the silver screen without malice, anticipated and masterfully, as corresponds to cinema.

 

Cuba, it must be noted, does not classify in that pattern of an excessive routine, accompanied by a sort of closed-circuit home existence, favoured by the Internet in general and its market in particular. The stressing agents on the island are the material difficulties of all type that affect daily life. Cubans live in a depressed, underdeveloped scenario or that belonging to the euphemistic group of “developing” countries. There is also an unprecedented aggressiveness in society and a crisis of education (not of the educational system) in general.

 

Times change

 

The present time seems to be a time of male transformations on a global level, the island included: well-outlined eyebrows using different hair-removal methods, eccentric haircuts and strident hair dyes, unthinkable only a few years ago. There are no barriers in what women and men can do and use in terms of the “creation” of a chosen physiognomy.

 

There are many questions, and the answers are also many. Without a scientific foundation it could be said that, in any case, those attitudes reflect a possible declaration of freedom, of a very particular affirmation of who is or wants to be in their exterior and/or interior;an affirmation of the Ego, in the framework of tendencies that are in use.

 

Nowadays, some Havana publicly known women, like Miriam Socarrás (former hostess of the Cuban mecca of the corporeal ideal of women, especially mestizas, in the internationally famous Tropicana Cabaret; actress); Lizette Vila (musicologist, documentary maker, promoter from the centre she heads, Palomas); Soledad Cruz (journalist, writer, former diplomat); Juanita García (poet); MarianelaDuflar (PR)…, have, among others, chosen to let their hair go grey.

 

Those who still do not dare, dye their hair anash blond that takes them closer to the grey tone, somehow imposed by a fashion that doesn’t stop being optimistic, in Cuba as well as in other countries, among them Chile, where middle-class upwards women are the ones who, in an act of “bravery,” go to the beauty parlours wanting to show off a daring, rejuvenating cut, to take the step and be “trendy”. The poor ones, who do not have the money for this, let their hair go grey with no other alternative. They don’t even have the liquidity to buy something more necessary, for health and aesthetic reasons, like dentures.

 

In Cuba the motivations are diverse. Some women note that they have always liked grey hair, but they couldn’t let their hair go grey because of professional reasons; that it is absurd to try to deny a real fact like aging. For others, the decision passes through the high prices of beauty parlours (which is common in many countries), or a feminine (feminist?) position: “I don’t have to be beautiful, shapely…. I’m like this. I accept myself. I love myself and I am happy, satisfied, with that woman I am now,” almost always based on the patriarchal inequality.

 

Meanwhile, one must not forget that the island’s dentistry, ophthalmology and aesthetic surgery or of another kind, like the rest of the medical services, are free.

 

A complete denture costs 20 Cuban pesos, five less than a peso of the freely convertible currency (CUC). Bifocals cost less than 60 pesos; progressive eye glasses less than 100 in the state-run opticians’ in Cuban pesos. There are some, also state-run (which are a minority), that charge only in hard currency. Medicines are sold at ridiculous prices; some of them bought through a card that guarantees the necessary amount for the month of persons suffering some chronic diseases: cardiovascular, hypertension, diabetes, asthma….

 

The problems and the context

 

That acceptance of a natural aspect in a visible amount of public women is not only a fashion (though it also is) but rather the real fact that in the country 20 per cent of the population is over 60 years of age and, in the near future, a third will be senior citizens. Today the amount of elderly is greater than that of children and adolescents. According to the 2014 census, out of a population of 11,238,317 resident inhabitants, the persons over 60-64 years of age include 304,442 women and 284,875 men. The figure of more than 65 years of age is rising to 1,551,421.

 

Meanwhile the zero to 14 year population is made up by 675,427 persons (347,838 girls and female adolescents and 327,584 boys and male adolescents).

 

The reasons for the asymmetry are, among others, the reduced birth rate, the increased life expectancy (life expectancy is 79 years of age) and the emigration of young males and females.

 

The problem strongly arose in the academic circles toward public opinion and was included in the agenda of the Council of Ministers, which in October 2014 approved a policy to deal with, albeit belatedly, the complex demographic panorama, which includes encouraging pregnancies.

 

Even though the desired age indices are not reached – which needs not just a demographic strategy but also liquidity and time -, the public health authorities are now insistently warning about the dangers of early maternity and paternity among adolescents, as well as the risks for women over 40 and their children. It is a sort of crossroads between population and repopulation; between aging and the birth rate; between the depressed economy and the need for a great deal of costly investments to make the life of senior citizens easier.

 

Let’s imagine an aged society. Who will be in charge of defence, industrial and agricultural and livestock production, of services? How does a country develop with a much smaller number of young people than the average of adults of the second and third age? How can that scenario be for everyone, the young and the elderly…?

 

It is inevitable to stop asking how, with what liquidity, the State will introduce the changes at the pace required to revert the situation, as well as the policy drawn out in 2014, when the obstacles of the so-called special period of the 1990s, a consequence of the fall of the Berlin wall that left the country without 85 per cent of its foreign trade, is still perceptible and when it is on the threshold of a transition due to the still new, but above all vague relations with the United States, only two years from when President Raúl Castro hands over the country’s leadership, the so-called leadership of “the historics”, to another young generation, of persons born in 1959 or later.

 

It is interesting that today the term of “third age” is spoken of and “old age” is avoided because it is supposedly disparaging. Or, I note, because without beating around the bush we place ourselves in an environment that is actually not the ideal one but rather a very complex social reality for which countries are not prepared and actions are behind. The island included.

 

Here and there the government did not foresee the actions to be decided on for the consequences and requirements that were being seen in the population censuses of a commendable higher and growing life expectancy, creating the conditions for the quality of life of an age group going through all types of vulnerabilities.

 

This real panorama, which seems bleak (and is, in my opinion, bleak) is seen however by the scientific community with good eyes, not just on the island: it is an indicator of increased life expectancy.

 

We could place at the tip of the problem Cuba, a poor, third world country (but with undeniable social advances); and on the other Germany, which has one of the most solid economies in Europe and better programmes for the care of the elderly on a world level.

 

Cuba: its characteristics

 

In both cases, the governments and the scientific community cannot avoid the challenge imposed by population aging, irreversible in the short- and mid-term and which has to be assumed while strategies are drawn out and actions are taken at a forced march, which should be at full speed, so that society adapts, in the least possible time, to the desirable indicators.

 

In the Cuban case, the living conditions of the elderly (without making comparisons with other third world societies of Latin America and other continents) are way behind, despite the free medical care, the economic aid to the poorest persons, who don’t have a pension and family protection; the creation of grandparents’ centres; of canteens (one per barrio) subscribed to the Family Care System (SAF), which also includes cultural performances in those places once a month and access to university education, also free, among others.

 

Every year the number of pensioners increases and a desirable and necessary growth of the labour forces does not take place, as is easy to infer.

 

In the recent past the State increased the pensions of retired persons. The minimum is 200 Cuban pesos, which is insufficient if the high cost of food is taken into account, disproportionate compared to the purchasing power of the majority of persons and the fact that the country functions with two currencies and many of the basic food products are acquired in CUC or, for some time now, their equivalent in pesos. (One CUC is equal to 25 Cuban pesos.) Pensions continue being meagre, especially for those living alone and not receiving remittances from abroad, despite the social palliative measures.

 

A mop to clean the floor costs 20 Cuban pesos; a package of four rolls of toilet paper has almost become a luxury product: more than one CUC or 25 Cuban pesos.

 

These and other products have to be purchased in CUC because they are not included in the diminished ration card, though they are essential.

 

The basic food basket, rationed by the monthly per capita “ration card”, includes: seven pounds of rice; 10 ounces of beans (almost always black); one pound of white sugar and one pound of brown sugar; half a pound of oil; one package of coffee of 115 grams; one kilogram of salt every three months; one package of spaghettis of 100 grams seven times a year; a box of matches. Also sold on the ration card, also per capita, are a pound of chicken and half a pound of chicken or fish more for persons suffering from diabetes or high cholesterol, in addition to a bag of powdered skimmed milk or not, according to the case. After turning seven, instead of milk children receive soy yogurt (one bag of 100 grams one day yes one day no); five eggs, half a pound of minced soy meat that is alternated with the same amount of mortadella. These products do not cost more than 40 Cuban pesos (less than 2 CUC), since they are prices subsidised by the State.

 

It is due to the basic food basket that it is affirmed that in Cuba no one goes hungry. (Poverty, let’s say, is shared.)

 

At present, the government is remodelling the Homes for the Elderly, whose numbers are – and was previously noted – way below the growing needs and the access availabilities are too low (there are only 143 in the entire country).

 

The precarious state of sidewalks and streets; the presence of architectural barriers; the poor lighting in the streets; the scarce fluid collective transport, without thinking about other comforts (needs?), like platforms to help the elderly get on and off the bus with or without a wheelchair; the food that is not always appropriate for the nutritional requirements of those age groups, are still problems for the Cuban State that, inevitably, has to resolve them in the shortest possible time, without the backing of a solid economy.

 

The principal causes of death among the population older than 60 are those diseases proper of advanced ages: heart diseases, malignant tumours and cerebrovascular ailments. Male mortality is higher in relation to those causes, except for cerebrovascular diseases, in which the mortality levels are slightly higher in women.

 

These and other indices oblige the educational authorities, together with those of public health, to increase the number of specialists in geriatrics, neurology, psychiatry and psychology.

 

Alzheimer’s. A growing threat

 

Faced by the fact that life expectancy is increasing in numerous countries, the policy will necessarily have to change and contemplate other ways of thinking and acting. It will be necessary to form a new generation of experts, also set to become responsible for that different society -a society that will be threatened, in addition to the previously mentioned diseases, by a delicate state of mental health and the subsequent loss of faculties.

 

It will be necessary to prepare the people and the families for the interferences produced and which will be produced by the gradual loss of higher cerebral activities, known as dementia, among which the most well-known is Alzheimer’s. (It should be specified that dementia has different causes and it is not always Alzheimer’s, though popularly all of them are called that.)

 

Before reaching that state people start forgetting things, have disorders in understanding, language and behaviour. They are signs of a cognitive deterioration which should not be overlooked since they are “problems that affect the elderly and are inevitable.”

 

There are some curable dementias; others, those of neurocognitive disorder, are still not curable.

 

The presence of advanced dementia has tripled worldwide in the last 60 years: 47 million persons suffer or can suffer from this and it is probable that the figure will increase twofold in the next 20 years.

 

This is a situation that will not only affect the rich countries.

 

Ten per cent of the persons who are over 60 years of age suffer from some type of dementia; 1.4 per cent lives with dementia. By 2040 that amount can reach 2.7 per cent.

 

The impact is economic and social. Dementia is one of the principal handicaps. There is no room for doubt that urgent measures are required to face the problem based on a multisectorial perspective.

 

The world is living a peculiar moment. It will have to pay attention to the protests of mother earth and to reduce – if not eliminate – all the risk factors for its disappearance. Moreover, the physical and mental health of persons has to be protected. The fate of nature and human beings is at play.

 

Thirty per cent of the dementias can be changed if healthy lifestyles are adopted. (Hypertension, diabetes, a sedentary lifestyle…have to be avoided.) The cornerstone of prevention is education and rehabilitation.

 

Cuba has a programme and a strategy to face dementia, as well as research protocols. But the problem is global and the solutions are or should be in the hands of everyone, rich as well as poor countries, and they must all also contribute to the development of new technologies to get to know the persons more prone and with a high risk of suffering dementia.

 

The higher life expectancy is an achievement that demands, unalterably, urgent changes to the interior of society, more or less developed, wherever the population lives the most. Cuba included.

 

In a desirable scenario, with a more solid economy, thanks to tourism, the production and marketing of cutting-edge medicine for diabetic feet, against cancer and heart attacks, among others, the country could surmount its demographic dynamics in better conditions, especially if the blockade is lifted and the future generations of leaders continue and even improve the social achievements. (2016)