Although her body does not respond as it used to, María knows she is a lucky woman. Controlled aches and pains, 68 years well lived and the sincere affection of her loved ones make all the difference for her.

That's what she thinks about while leaning on the balcony of her third-floor apartment, she observes the panorama. From there she sees Manolo pass by, the old man with the impeccable apartment and the extreme loneliness; made more acute now that the only granddaughter she had left here has been paroled. And he saw her flying, with a bag of promises that nobody could tell him, for sure, what meaning they had.

He also looks at Carmen as he watches her hang out the laundry almost with the breath of her 70-something years of life. She, a widow responsible for the care of her prostrate brother, makes ends meet thanks to the encouragement that faith gives her because not even the two checkbooks together are enough for food, imagine for soap to wash the clothes, electricity, water, and other things.

Armando, the nonagenarian who takes care of the children, is luckier. They take turns every 15 days to give him their full attention. Something like postponing everything else in their lives and anchoring themselves within four walls to watch him sleep, force him to eat and listen to him rant about themselves because, since Alzheimer's came to his days, they have never been taken into account again.

María knows that this is the reality of many people in Las Tunas. And, to understand it, she doesn't even have to sit and watch from the balcony. Even on television the other day she heard an expert say that the province has approximately 115,794 people over 60 years of age, that is, 22 percent of its total population. A notable increase over the previous year, they said.

TIRED YEARS

With the highest life expectancy in Cuba (79.83 years), the Balcony of the Cuban East is the ninth province with the most aged population in the country. Other data, all offered to 26 by the headquarters of the National Office of Statistics and Information (ONEI), confirm that the trend points to an increase in people aged 60 and over, while those of active ages (between 15 and 50) are decreasing.

None of this is new to Dr. Marisbelis González Rodríguez, head of the Elderly Section of the Provincial Health Directorate. "Family abandonment has increased in recent years. Many times relatives come here and tell you: 'Yes, he is my dad, but I am waiting for parole, go see if he has a nursing home for him'." And they leave them alone in the communities.

"In addition, she adds, as we are talking about an aging population, it happens that the caregiver is often another older adult and also needs support."

The expert stresses that all these conditioning factors and others lead to an increase in situations of disability. Then, she describes, patients become prostrate, have arthrosis, are dependent, and begin to suffer from ulcers and falls, very frequent ailments that leave hip fractures, with complex processes derived from these.

González Rodríguez refers that there are 20 institutions specializing in the care of the elderly in Las Tunas: 10 of these places are homes for the elderly (there is one in every municipality and two in "Amancio" and Majibacoa); four of them are certified and, therefore, have the highest rates and the best conditions in their care. "We have, he says, 10 grandparents' homes and it is very difficult for us to complete the income in this modality. The grandparents themselves tell you that the amount is very high, they pay 792.00 pesos per month, at a rate of 33.00 per day, but they receive breakfast, snack, lunch, afternoon snack, and lunch until Saturday at noon."

Listening to her and investigating the neighborhoods, we confirmed that the integral strategy for the attention of this population sector is working quite organically. Something that not only includes Public Health, with its active gear from Primary Care, but also the direct participation of the Sports Department in the grandparents' circles, the cultural activities organized in the institutions, and the material support of the Government in each area which, according to those in the know, is constant.

In the middle of the last decade, it was reported that a process of repair and maintenance of old people's homes and grandparents' homes was to begin in Las Tunas. At that time, the construction of new homes was foreseen, of which two would be located in the municipalities of Jesús Menéndez and Puerto Padre, where the largest number of elderly people in the eastern territory live.

However, the effects of the economic recession of these years hit hard the governmental social plans, and of the planned ones, only one could be built in the provincial capital, which opened its doors in 2020.

THE ROAD WE ALL TAKE

Ernesto Chávez Negrín, researcher of the Family Studies Group of the Center for Psychological and Sociological Research, predicts that before 2040, Cubans will massively reach retirement ages and in the following two decades, deaths will probably increase substantially. All this, he says, derived from the age structure of the population in which the necessary generational replacement has not been guaranteed since 1978."

This, in itself, is a warning of the great dilemma that, far from being foreseen, is already among us: Are our cities and development policies ready for the flood of contrasts that marks such a truth? Other investigations reveal different phenomena that further complicate the existence of an older adult.

Since the middle of the last decade, official data corroborated that the income of 91 percent of the Cuban population over 60 years of age depended, to a great extent, on the pensions they receive every month from the Social Security System. Seven out of 10 Cubans over 60 years of age said in the 2011 National Survey on Aging that in the future these pensions would be their most likely stable livelihood, but eight out of 10 considered them insufficient. Many seniors said they receive some financial assistance from family members inside or outside the country.

Subsequent changes in the sources of financing of pensions and social assistance, and then the inflationary effects of the monetary-exchange order that came into effect in 2021, were not enough to change the situation described above, or at least to recover their real purchasing power. On the contrary, the gap between the total contribution of employers and employees to the social security funds, as well as the expenditure finally made by the State to keep the entire Social Security System in the black, has widened. The result has been that both pensions and social assistance benefits continue to fall short of the needs of their beneficiaries, not so much in terms of their amount, but in terms of their real purchasing power.

Thus, in this country, a land where people grow old mainly as a couple and where up to three different generations live in the same house, it is a reality proven by science that income satisfaction decreases as age increases, which is why many elderly people continue to work to cover their basic needs.

Moreover, the wounds of the COVID-19 pandemic on them became evident as early as 2020. A team from the Center for Research on Longevity, Aging and Health and Cuban health care units, after analyzing them, suggested that many of the actions aimed at vulnerable groups during the pandemic, such as differentiated care, the extension of certificates for medicines and direct services in their homes, as well as the facilitation of procedures and online purchases "should be maintained and adapted to the new normality."

START WITH THE FAMILY

Patricia Arés, professor of Psychology at the University of Havana, emphasizes that loneliness deeply depresses older adults; even more so if it is due to the loss of the conjugal bond. Women, she says, tend to be more emotionally anchored in their offspring, while men under 80 years of age try to find a new partner. In Cuba, he says, many transitions after the separation of children are abrupt, going from living together at home beyond early youth to one imposed by geographic distance.

"The emigration of children is a painful process, especially when they already have grandchildren," she says. They are, she describes, traumatic detachments that leave an emptiness often associated with depression: "This feeling affects mostly mothers who are the ones who have configured, as part of their identity, the feeling of being necessary for the care they give to others."

The experts are very clear that the family is primarily responsible for the care of the elderly and regret that this is not always perceived as such by society as a whole.

Dr. Marisbelis Gonzalez anchors herself in the Family Code to be emphatic: "We have to make this document functional and assume it as a necessity. Grandparents cannot be seen as a burden, nor can they be excluded from making decisions that have to do with themselves or their environment. It is necessary to ensure that they live longer but with quality."

In his speech at the inauguration of his second term, Cuban President Miguel Díaz-Canel confirmed that demographic aging and high emigration remain among the main concerns of his government team. But this is an issue that does not only concern the authorities.

***

María, who surely is not going to read these lines because her eyesight is not good enough for the such small print in the newspapers or on her cell phone, is still engaged in her morning scrutiny from the third-floor balcony. She does not understand figures and academic analysis, but she would like to have a magic wand to help everyone, as her father did in the countryside, decades ago.

Someone looks up and shouts at her while waving his hand as a cordial greeting: "Viejuca, good morning, how are things going today?

She answers resolutely, moments before asking if the bread has been delivered. "Well, here, until God wills it."