HIV/AIDS in Cuba: representation and reality  

Apropos the film El acompañante.

Whoever has visited for some reason the Los Cocos Sanatorium for HIV/AIDS seropositive persons, between Santiago de las Vegas and El Rincón, on the southern tip of Havana, will have difficulty in forgetting it. It is the type of experience that accompanies you throughout your life. That’s what happened to me after I went there several times, between 1993 and 1994, as a guest to the literary workshop that was being held there.

The literary workshop, which later would be called La montaña mágica (The Magic Mountain), was an initiative by several professionals interned in the sanatorium, promoted by three specialists in literature of the Houses of Culture of Boyeros and Arroyo Naranjo: Ana María de Rojas, Lourdes Zayón and José Ramón Fajardo. But, more than a literary workshop, it was a forging of friendship and human growth in a universe still unknown by the majority of the Cuban population.


Almost four decades since its appearance, AIDS continues being something which no one wants to know about, an accursed disease. And like in all fields with limited knowledge, there are more than enough prejudices, stereotypes and stigmas, as well as the meanings that mask it.


To unmask the enormous charge of meanings and metaphors that throughout history the “accursed” diseases have dragged on, prestigious U.S. writer Susan Sontag wrote a long essay: “Illness as Metaphor” (1978), which she accompanied a decade later with “AIDS and Its Metaphors” (1988). In the latter she pointed out that it’s always worthwhile to question the very old process, apparently inexorable, through which illnesses acquire meanings (replacing the most rooted fears) and inflict stigmas….


The first cases of HIV/AIDS in Cuba were detected among the military and Cuban health and construction collaborators who were in Africa, but the first case that became public through the press was that of a set designer who passed away in 1986. This is how the daily Granma reflected it in an editorial note:


“In the early morning of last Thursday a Cuban citizen died victim to AIDS. It is the first confirmed case of this disease in our country. According to all indications, this person, who was a set designer by profession, contracted the disease in New York to where he had travelled for questions related to his work in 1982…. A systematic study is being made of the relations and contacts of possible carriers, and measures are invariably being taken to instruct them about the risk of contaminating other persons and to isolate them if possible.” (Granma, April 26, 1986)


Compared to that item, Doctor Jorge Pérez Avila, the Cuban scientist with the greatest knowledge about the subject, in an interview with writer Miguel Angel Fraga, seropositive since 1992 and interned in the mentioned sanatorium – then headed by Pérez Avila – until 1997, said the following:


“It was not until 1985 that a person who had been in Africa and didn’t know what was wrong with him, knocked on the door of my office…. That person was the first seropositive case diagnosed in Cuba. We did his report in the Institute of Tropical Medicine. We called his wife and did a diagnostic test and it came out positive, we went to the Public Health Ministry and we told the deputy minister that we had detected the first two cases of AIDS in Cuba. I’m talking about November 1985.” (Miguel Angel Fraga: En un rincón cerca del cielo, Valencia, 2008.)


That testimony is almost the same as the one in Jorge Pérez’ book, published two years before: SIDA: Confesiones a un médico, Havana, 2006, where he collects his long experience and dedication to the subject. Both books are the most specific and precise sources of information about the vicissitudes of HIV/AIDS on the island since its beginning. Fraga’s book contains the testimony of doctors, nurses and psychologists at the sanatorium, in addition to interviews with patients, family members and even with a very peculiar figure: the companion.


Precisely that figure is the protagonist in the new cinema representation where HIV/AIDS is at the centre of the narration and Los Cocos sanatorium becomes the principal set. We’re talking about the Cuban film El acompañante (The Companion), by director Pavel Giroud.


The first sanatorium for HIV/AIDS seropositive persons was created in April 1986 as a healthcare institution directed by the Armed Forces Ministry. In 1989 it passed on to the Public Health Ministry. The actions of El acompañante take place during the period when it was headed by the military. For almost a decade all detected cases of HIV/AIDS were obligatorily interned in the sanatoriums, subsequently similar centres were opened in other provinces.


During the first months of the sanatorium, the patients were not allowed to leave the institution, they could only receive visits. A system of bimonthly passes began in 1987. For those passes they had to be accompanied by a worker who had to observe their behaviour and report on it. After some time, if their behaviour was irreproachable, a commission would give them the condition of warrantor: they were freed of the companion and they enjoyed their weekend freedom.


Like all works of fiction, the mentioned film allows itself licenses in its representation of the companion. It is a metaphor that overflows the space of the sanatorium and enters that of sports. Just like the combatant Daniel has lost his freedom because of his condition as HIV positive, boxer Horacio is sentenced for doping: he will be shut away as a companion. But, with evident cynicism, the military that heads the sanatorium tells him he shouldn’t see it as punishment.


Both characters, the combatant and the boxer, went from being heroes to villains according to the decisions of power in their respective fields. The reaction of the first is to escape from the imprisonment; that of the second is to train in secret to recover his sports shape and be a champion again. They mutually back each other in their aims and a friendship flourishes. A cinematographic narration of excellence is structured based on the growth of that friendship.


During the press conference in the Fresa y Chocolate room at the end of the film’s exhibition, someone asked if the companions really existed. Someone from the production team answered that they did, though not precisely that companion. In the aforementioned book by Miguel Angel Fraga, the companion that offers his testimony said:


“I started working in the sanatorium on March 1, 1989…. My first outings with the patients were very shocking but revealing. I got to know things that I never imagined existed and others, which I knew of from reference, which I never had had the opportunity to experience…. I can tell you that this job is not valued as it really should. The companion is the most relegated worker of the institution…. I continue with it because a love the work I do and I’m very identified with the patients…. That’s why many of them prefer me and want to go out with me, because we don’t look like patient and companion but rather like two friends. I try to make their problems mine. And the thing is that I think that from the moment in which we go out together, we both have to trust each other…. My personal experience has been enriched a great deal; for me the sanatorium has been like a school where one gets prepared for life.”


Let’s hope that this real companion sees the film, because he will see a beautiful recognition of his work. Though, like almost all of us who went to the sanatorium for working purposes, I had obtained the most valuable: the human experience. (2016)


Un comentario

  1. Bob McCormick

    IHe escuchado excelentes elogios por su trabajo y me gustaría visitar el sanatorio y conocer al Director para discutir la historia de la epidemia de VIH / SIDA en CUBA.
    Llegaré a CUBA en la tercera semana de marzo y me gustaría mucho hacer una visita al sanatorio y agradecería una reunión con el director, el personal y los clientes del VIH.
    Muchas gracias.
    Robet McCormick

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