Cuba's Epidemic of Blindness: How Yankees Solved Castro’s Medical Mystery

In 1991, the Soviet Union collapsed, and one of the casualties was Cuba, which lost its primary source of fuel and food, leading to an economic crisis and famine called the ‘Special Period’. Not long thereafter, cases of blindness began to appear, beginning in the western villages and spreading across the island, eventually afflicting approximately 50,000 Cuban citizens. Fidel Castro mobilized all his country’s resources, creating a team of 1,000 top scientists to find the cause and cure of the epidemic. After a year of diligent research, the team concluded that the epidemic was an optic neuropathy caused by a virus. But despite trying numerous anti-viral therapies, the cases of blindness continued to increase.Castro now realized that he must seek help from other countries. He remembered the US-based outreach program, Project Orbis, that had recently visited his country, and he contacted them to ask if they might identify a leading American scientist to come and help solve their medical mystery. Dr. Jim Martone, who was working with Orbis at the time, immediately thought of his friend, Dr. Alfredo Sadun, a professor at the University of Southern California and a world authority on diseases of the optic nerve. Sadun agreed to do what he could, and the two doctors, along with Sadun’s technician, flew to Havana. They had only been there for a short time before Sadun recognized that the epidemic, although clearly an optic neuropathy, was not caused by a virus. The Cuban scientists were indignant at being told they were wrong, and a tense, hostile situation ensued. Castro invited a Nobel laureate in virology to come and settle the matter, and he confirmed Sadun’s suspicion.The scenario remained contentious, as the Orbis team continued their search for the true etiology of the blindness. Using epidemiologic methods, recommended by Martone, a major part of the puzzle was discovered to be the Cuban’s dietary deficiency, including the vitamin folic acid. However, Sadun contended that there had to be an additional factor, and continued investigation revealed that factor to be high levels of methanol in homemade rum, which requires folic acid for detoxification. Castro accepted Sadun’s theory and instituted a nation-wide dietary supplement program of folic acid and other B-vitamins that eventually eliminated the epidemic, ending a major chapter in Cuba’s history. This is a story of medical mystery, ingenious problem solving, tense international intrigue between competing scientists and even humorous moments, such as Castro’s flirtation with Sadun’s technician. But most importantly, it is a significant chapter in the history of our medical heritage that deserves to be told. Read more