dimanche 23 février 2020

LOVE OF THE LANGUAGE. ENGLISH! PLEASE NOTE IT IS SO EASY TO SPEAK IT BADLY

ENTOMOLOGY would have been one of the first words in my vocabulary that I could remember as a child. But what was the path to that knowledge?
What language did I listen to when I was born?
My mother was marooned in an erstwhile outpost of the Portuguese empire and the languages there would have been my first exposure.
There is a custom among my people to introduce the child to lifelong learning, when a venerable teacher comes to your house and writes letters on a blackboard and then you repeat after him, and after each letter or word, you are rewarded with a small bit of sweet, and the words: May your lifelong learning be as sweet as this.
I remember this distinctly, and I was three years old.
English entered my life with great force and I began a respectful love relationship with my language, which grew with time. Even to this day, I try to learn a new word a day, and hopefully retain in amidst the plasticity of my brain, with neurons developing newer and newer pathways each day, with accumulating knowledge.
The new words for this past week were: (some of them are not new but mostly they are)
Faff
Scroop
Fanfaconade
Jape
Whicker

I have to thank my friend Ross who at that time lived in Kuala Terengganu in Malaysia for the website.

Then entered THE ECONOMIST, I have been reading this magazine ever since I can remember, having grown an affection for it because of its fine English usage and rather wide coverage of world news, planetary in its reach. It is well written, less of a region-oriented prejudice (even though slightly anti-Israeli in its outlook which I can forgive) but gives you news coverage you cannot get in any of the major language newspapers around the world, one of which is my favourite The New York Times
In between universities I spent six months in New York and that is where the addiction to New York Times was born. Each Saturday evening, we would stay up late and be at the newspaper agencies around 2 AM on Sunday morning to snatch an issue of Sunday times, usually weighing a tonne! And the rest of the day was spent on reading the news, book reviews, analysis of the world as it rotated around its conflicts. Also, the Sunday morning treat of Lox und Bagel ..the Jewish soul food for the brain ..(before we knew omega-3 was good for your brain! Ha ..)
The Economist arrived in Australia, The New York Times in the USA but when and where did MONOCLE make an entrance?
Crisply written with Tyler Brule from the Financial Times fame at the helm, this is the magazine for the upscale, intellectually oriented but not averse to luxury styles and decoration and not to mention travel including accessories. I may have been reading it since its inception? In 2008, I was looking for it in Kuala Lumpur, for example.
So, when people ask, how to improve their English language skills, to learn new words, usage of English language in an elegant manner, I recommend the following.
Get yourself a good English language dictionary. Into the language you are speaking now. I have an electronic English-French dictionary, an English-Portuguese dictionary, but frankly I still prefer a hard copy of a dictionary.
Get yourself a copy of the Monocle magazine and you would need the rest of the month to finish reading it. The March issue is already out and what a great coincidence it concentrates on Austria, a little hidden gem of a country (outside the well-trodden Vienna of course), where I discovered good wines as well as chocolates and biscuits and not to mention magnificent mountain sceneries bordering both Slovenia and Italy.
Flip through, there are lots of little bits of information, a nice café in the back streets of Copenhagen, a little-known seamstress in the backstreets of Roppongi in Tokyo and the ways of the tribe of fire walkers in the islands of Fiji, was its Beqaa? Then buckle down with a cup of coffee or a nice glass of wine, Kim Crawford from Marlborough valley or a Carminere from Maipo valley would do for me. Savour one of the longer articles, leave the Monocle easily available in your house so that you can savour the snippets for the rest of the month.
(to have all these handy and ready in my house in Havana, Cuba is truly a luxury..adds to the beauty of living here in Cuba)

Both The Economist and The New York Times you can read on line. I read hard copies of them whenever I can, my travelling not permitting a regular subscription. I enjoy reading either of them, and I know that I will never feel lonely with The Economist or the New York Times besides me, because they invite you, tantalizingly, to feed the hungry neurons in your brain..

I read a lot of Travel magazines on line and off, and AFAR deserves a mention. Less commercial than the other glossier travel magazines (which glorify the unsavoury aspects of modern travel while absconding with the genuine experiences), I find it soothing to my traveler’s soul.

The last travel article I read was on Tristan da Cunha, an island I hope to reach one day, in my mind ever since I met a couple from the island during the days spent marooned in Funafuti.

L’Chaim. To Life
It is only just Noon in Havana, a bit too early for a tipple…
But it is time for Sunday Brunch in La Habana, Cuba
Crepe from Bretagne, Smoked Salmon from Maine, Cheese from California, a couple of eggs prepared lovingly by my Cuban sister..

Reminds what Omar Khayyam of Nishapur said in the 12th Century? 
Isn’t this the paradise we are all looking for? Do we need guides or religious figures or scriptures for us to get here?  No
But Humility, Gratitude and Compassion for yourself and Others
A book of Verse .. indeed.   In this case Monocle or The Economist
 PS
a friend of mine from Linz had asked me some questions about the English Language and I recommended that she buy Monocle magazine, imagine my surprise when I received this photo from her today.. MONOCLE is available in Linz!
and happily and no so paradoxically this issue March 2020 of MONOCLE is devoted to AUSTRIA ..

samedi 22 février 2020

DISEASE. ILLNESS SICKNESS. IS THERE A DIFFERENCE, ASKED A FRIEND

The normally Mediterranean-style climate of La Habana took a turn with the arrival of a cold front, a frente frio, from the North, The temperature dropped to 21C, the change was sudden and the rains and drizzles soon joined the fray.
I was at home, listening to some Persian Music and playing around with the computer, enjoying the wifi at home, when a friend of mine from Linz, sent a message: a language related question, what is the difference between Disease, Illness and sickness and when do I use them?


I was quite excited to answer the question. Brought me to two memories, when my friend and mentor, Medical Anthropologist, Dr Cecil Hellman was explaining the difference at the course in Brunel University and the second, trying to translate these concepts into Spanish when I taught a month long course in Medical Anthropology at the University of Havana. As there were not the exact translations, we had to settle for. Enfermedades, Sufrimiento y Padacimiento.  More important than the words, the concepts were important.

Most English speakers or Doctors will not be able to distinctly define these three states. Arthur Kleinman, a professor of Psychiatry and Anthropology was the leader in defining in context what ILLNESS DISEASE meant.
“Illness refers to how the sick person and the members of the family or wider social network perceive, live with, and respond to symptoms and disability. Illness is the lived experience of monitoring bodily processes such as respiratory wheezes, abdominal cramps, stuffed sinuses, or painful joints. Illness involves the appraisal of those processes as expectable, serious, or requiring treatment.”

Illness is thus the lived experience of the person, who may be a sufferer at this point and not yet a patient.
He has not yet presented to the doctor and the society he is part of, recognizes his sickness.

He then presents to the doctor who diagnoses the symptoms of his suffering, and objectifies them into a diagnosis, a DISEASE. In the western model, this objectification pries the person who is now a patient away from the society he is part of. He becomes a patient with a DIsease, thus set apart. He is to be CURED which emphasizes the body as a machine metaphor, excluding the social relationships and Healing is not considered at all.

In the indigenous communities that I work, the dichotomy of BODY-SOCIETY does not exist. The Lakota word for healing is WAPIYAH the concept is very similar to the word YOGA.. bringing or joining together, bring the patient back to being the person in the society he was in before.

In the island of Cuba, the curing part is done by the doctors, the healing part which includes emotional and spiritual aspects are done by psychologists, as well as the People working in the syncretic spirit religion of Cuba.
Only when the person receives the medical, psychological and spiritual counselling, then  he or she can be considered healed. Medications, procedures and Nutritional advice belong to the CURING mould, whereas Nutritional advice given in conjunction with emotional and spiritual counselling becomes a part of the Healing process
In spanish, both Disease and Illness are translated as Enfermedad, but we decided to explain the concepts using anthropology rather than biomedicine:
enfermedad DISEASE 
sufrimiento  Suffering or Sickness
Padacimiento. Illness 

Nice to get that message from Linz in Austrla..

vendredi 21 février 2020

SHABBAT SHALOM FROM LA HABANA, CUBA



I enjoy this surrealistic life in Havana, Cuba . We go to a Pharmacy and the attendant is very warm and helpful, but the answer to: Do you have ... such and such medication?, the answer is a pleasant NO.. Call us tomorrow and if something comes, we will let you know. The woman wanted some confidential advice (sorry to put it here), should she ask the man she plans to sleep with (not her husband) whether he would be willing to have a vasectomy, as she has a Latex allergy? 
Even Garcia Marquez couldnt come up with situations more bizarre and joyful than the ones we deal with every day with greatest of resilience and pleasure and laughter and mirth. the Miami Cubans who have more money and more luxuries are devoid of much of a good life and laugh and certainly far less innocent and more fraudulent. Of course not all Island Cubans are innovative and genuine and not all Miami Cubans are fraudulent and unhappy.

I had some endocrine colleagues over for dinner and my Cuban sister had prepared an excellent dinner: Lobster in Coconut Milk with relevant spices, three different kinds of salads, Organic Brown Rice, incredibly delicious Black Beans of her confection. No one could finish the dishes, especially as I was offering lovely Chocolate Cuban Ice-cream (one of the best and healthier tastes from Cuba).

Before the start of the dinner, I thought of my family in Haifa and Brussels, and thought of the little hands hovering over the candles and the shabbat prayers being said.
I had candles, a piece of bread (Lehem) and of course wine ( Kim Crawford from New Zealand).

Felt good to welcome Shabbat in this lovely island..I look forward to repeat these prayers in Quiberon, Miami, Budapest? in the coming months...

jeudi 20 février 2020

NOT DWELLING ON THE NONCONDITIONED. BUDDHA IN REAL LIFE

NOT DWELLING ON THE NONCONDITIONED

I am writing this from my flat in Vedado in La Habana, Cuba.
The life here seems almost ideal.
I woke up from a blissful sleep, to be greeted by warm messages on WhatsApp from friends.
I can listen to songs from Iran, most of them sounding nostalgic even though I do not understand the lyrics but I enjoy the music very much. It sets the stage for the day to come.
I have the book by Thich Nhat Hanh open on Mindfulness.

What does it mean, “not dwelling on the Nonconditioned”? (translated from the Chinese by Nhat Hanh)
He begins
The Bodhisattva contemplates the reality of Emptiness but does not take Emptiness as an object of attainment.

The mind wandered back in time. When we were Doctors in training, I used to discuss about the revolutionary movements around the world, wondering how as Doctors we could contribute to the welfare of the world.
With his normal Australian wit, one colleague quipped:
I am sure, when you become a revolutionary, you will demand your Cappuccino to be served?
When I became interested in International Medicine, everyone including professors used to say: it is for Christian missionaries!

You can practice something noble in reality but you do not have to make that your life’s objective or the peak of attainment.
The first country I truly got involved in International Medicine was Jamaica and the people I served were very poor and who lived in huts and house with corrugated iron roofs.. The idea of the international Medicine among my colleagues was such that they thought I lived with my patients in their homes. Wrong and romantic sort of an idea. In Jamaica I was feted and feasted and lived extremely well during my stays and got to know the island very well and enjoyed the stay.
At that time, I was also doing a certificate course in International Relations and I had some good teachers from whom I learned the intricacies of International Help, one of which was Elite to Elite to transfer. If you go to a poor country to work to volunteer, whether it is Jamaica or Namibia, the poor in those countries cannot help you, but the Elites of the country are glad to help and facilitate. In Jamaica, my clinic at a 250-year-old plantation was facilitated by the owners of the plantation who did it as a favour to workers past and present of the plantation. I was picked up and taken back to Kingston and a lovely lunch was provided and got to know the intricacies of life in a plantation. The drive there away from the main roads and through rugged and winding roads were of sheer beauty.

So, to enjoy non attachment or detachment in reality, one does not have to give up the realization of good things in life.

lundi 17 février 2020

SIMPLE THINGS TO PREVENT ENDOCRINE DISRUPTING CHEMICALS TO DISRUPT YOUR HORMONES

I am an Endocrinologist, a physician who studies the function and dysfunction of various hormones in our body. Most people would have heard of Oestrogen, Testosterone, Thyroid hormones at least, but there are plenty others. The most common chronic disease of our times, Diabetes, is caused by the dysfunction of a hormone, Insulin.
Many of these hormones circulate in minute amounts. PICOGRAMS in some cases, micrograms in others.
So it is only natural that outside chemicals (increasingly entering our lives in the modern society) even in minute amounts can disrupt the cycle of our hormones in our bodies and cause illness or disease.
there is a slew of diseases attributed to EDC endocrine disrupting hormones, including the one that attracted my attention many years ago, Attention Deficit Disorders.

It all had started many years ago as I was walking around the centre of the town of Johor Bahru in Malaysia on a day trip from Singapore. As I passed the Hindu temple, I noticed that they were having a book sale and of course that drew me in. There for the first time I encountered the publications of Consumer Association of Penang which was headed tirelessly for many years by Mr Idris Mohammed.. a remarkable man indeed, whom I met many years later..
My blog from that visit in 2012 is here 
https://medicoanthropologist.blogspot.com/2012/04/prophet-of-penang.html

This was the first time I read about Plastics and Toxicity and also the toxic substances coming into our diet through food manipulation and pesticides and herbicides among others. In 2004 all that was news and of course in 2020 we know about hormone fed cows and chicken and the antibiotic induced fatness in these animals 

what can we do?
This morning I read about 5 simple tips published by a practising doctor who would bring up these points to his points one at a time, giving them time to incorporate that into their lifestyle 

1. Mind your cookware. Nonstick pans contain perfluoroalkyl substances (best known as PFAS). Patients may have heard of the movie Dark Waters, which documents the consequences of industrial water contamination with PFAS. These chemicals have been shown to slow metabolic rate and promote the return of weight after a successful dietary intervention. Cast iron and stainless steel cookware are good alternatives. 
2. Open your windows and use a wet mop. Flame retardants and other persistent organic pollutants used in electronics and other products accumulate in household dust and can impair thyroid function. Using a wet mop will help to better rid the house of these pollutants. Patients should also be on the lookout when buying new furniture. A California law now requires disclosure when flame retardants are added to upholstery. 
3. Eat organic. Organophosphate pesticides are well-known thyroid disruptors, and multiple studies have shown their effects on cognitive potential. Some studies have suggested associations with an increased risk for cancer. Eating organic has become much less expensive because of growing market share, such that the big-box stores are displaying organic and conventional products side by side with competitive pricing. I focus on prioritizing organic leafy greens and vegetables, where pesticides are more likely to be ingested, and place foods like avocados, which have a protective outer rind, further down the list. 
4. Avoid canned foods. Bisphenols are estrogenic, antagonize adiponectin, and make fat cells larger. Studies suggest that stopping canned-food consumption can decrease bisphenol levels in urine as much as 90% or more. BPA-free cans are misleading in many cases because there are 40 or so replacement bisphenols. What little we know about one BPS suggests similar estrogenicity and toxicity to embryos, as well as persistence in the environment. A doubling of type 2 diabetes risk was also observed among adults with higher levels of BPS in their urine.
 5. Don't microwave or machine-wash plastics. Phthalates commonly found in food packaging can negatively influence lipid and carbohydrate metabolism, with exposure linked to increased weight gain over multiple years. The "microwave safe" label was intended for gross misshaping or warping.  reality is that the polymers break down at the microscopic level and get into food, and the noncovalently bound additives are mostly not tested
(thanks to the advice tabulated by the practising doctor published in MedScape and Endocrine Society)

Food which for centuries meant Sustenance, symbolized friendship and family and spirituality has become a Poison and we now have to protect ourselves against it.


samedi 8 février 2020

THERE ARE MANY FORMS OF SPIRITUAL HEALING AND IN JAPAN FOREST HEALING IS POPULAR

The first ever indigenous group that I worked with was a traditional group of American Indians who lived in their own little territory deep inside the USA.
I was completely naive about the cultural aspects of health care. Even in 2020, there are doctors who ask: what has culture to do with Health Care?
As I had not much to do after the clinic closed, I would wander into the homes of the people, where I was warmly received.
One of my earliest teachers was a well respected lady who taught me many things about nature and its ability to heal ones emotional, psychological and spiritual as well s physical dysfunctions.
One day after a fresh snow fall, as I entered her house, she asked me: Did you thank for the nice new snow fall? My western oriented education of man being superior to nature began to melt away during my stay with the tribe. 
At another time, she advised me to go and hug a tree when I am in any sort of confusion or hurt or any matter of un- wellness.

awkwardly i went out of her cottage and hugged a tree in the yard, and when I entered back to the cottage she also reminded me to listen to the trees as they do communicate with you. I have heard the connection one has with trees from many other tribes, and my friends in the Ticuna Tribe along the Amazon always wish me: May the spirit of the Forest go with you.
Many years later when I lost a colleague in an accident, one of the elders of another tribe advised me to take his favourite food and go in the shadow of the tree and release his spirit so that he can begin his journey.
While reading through the BBC information today, I was happy to read about the Forest Healing which has become very popular in Japan and also in many other countries 
Just having arrived in Miami, after a peaceful time in Cuba, one is made aware of how fragmented the life is in the Western world where there is no room made available for spiritual aspects of Healing..
I am fortunate to be working with Indigenous peoples of North America who have a healthy respect for what surrounds them. As a young Indians said to me: Listen carefully, doctor, you can hear the trees talking to you ..

Did I not hear that some years ago, somewhere else, from one of the earliest indigenous teachers I have been fortunate enough to have..


jeudi 6 février 2020

HEALTH CARE USING CERTAIN BUDDHIST PRINCIPLES


HOW TO IMPROVE HEALTH CARE IN THE USA USING BUDDHIST PRINCIPLES.  A NOTE TO THE DOCTORS

The Four Noble Truths
Buddha was preaching to the Monks
The contemplation of Mental Objects

Sathipathana Sutra
The Foundation of Mindfulness
The original in Pali, the sacred language

Buddha said
A monk knows
This is suffering, according to reality
He knows. This is the origin of suffering according to reality
He knows
This is the cessation of suffering, according to reality, he knows
This is the road leading to the cessation of suffering, according to reality

In the modern medical care, exemplified by the piecemeal, body as a machine model of USA, now exported widely to the rest of the world, SYMPTOMS feature predominantly in the ILLNESS the patient feels, that is translated by the doctor according to his intelligence and knowledge into a DISEASE
Illness is what the patient feels, Illness is not a physiological explanation
But Disease is objectification, bringing what is in the mind and the emotions of the patient into the body of the patient.
Thus, symptoms are treated and the reality is forgotten for a moment. Once the treatment is administered, very seldom do the doctor or even the patient enquire about what caused the symptoms.

To cease suffering, one has to know the origins of suffering and the path to the suffering. (the emotional and social aspects of ILLNESS) and then know the road to the cessation of that suffering (which is omitted in western medicine, but includes emotional and spiritual counselling)

In Lakota Language, the world for HEALING is wa pi yah , meaning bring together (much like the meaning of YOGA), to heal the patient, bring him back to the reality of his emotional and social world, most importantly to re integrate him or her into that reality.

A case to explain
A 29-year-old woman has pain in the right side of her “stomach” (My good friend and teacher Dr Cecil Helman had published an article about how ignorant the patients in his Family Practice were about the location of organs). The pain increased day by day, she travelled from the eastern part of the country to the capital. She was seen by a General Practitioner who said, you have gastritis and let us do an ultrasound, which was done. The patient left with no diagnosis, no treatment and no follow up.
The pain continued, she could hardly breathe, difficult to walk and she ended up in the emergency room of a teaching hospital, seen by a resident in Internal Medicine. He also suspected gastritis and did not alleviate her concern because she was feeling referred pain on her right shoulder. The area of pain was mostly over the gallbladder. The doctor did some blood tests, mainly to make sure that she did not have pancreatitis. She left still with no diagnosis and no treatment, with a note to call to make a follow up appointment.
Needless to say, no one had asked her about emotional and social and work situation.
She came to my house, limping and with a stomach very tender to touch.
I was with my sister who talked to her extensively, and found out the origin of her symptoms. I felt that she probably had a small ulcer or severe gastritis due to the reasons my sister had delineated.
So, we did the Cuban approach to Primary Care
Physical.  Diagnosis Severe Gastritis. Symptomatic treatment. Proton Pump Inhibitors such as Omeprazole or Pantoprazole (I had a bunch of them in my bag bought in India, the best source for reliable and cheap medications)
In the meantime, my sister had counselled her about the path to her suffering and was able to offer some good advice.
What was left for us to do was the spiritual aspect of healing or bringing her back to her reality: her work, her social relations, her love for her country.
A little cleansing ceremony was held in my house. She felt very good.
Day by day she called to report that her symptoms were being alleviated, we advised her on what to eat and what to avoid. She was emotionally feeling better having a taken a decision based on the path to her suffering and the spiritual cleansing had given her a sense of wellness and confidence.
All is well.



mardi 4 février 2020

OH MIGHTY AMERICA .. YOUR BLOCKADE DOES NOT AFFECT THE MIGHTY, BUT AFFECT THE HUMBLE POOR MARGINALIZED MIDDLE CLASS AND POOR PEOPLE


I am writing this from my flat in Vedado, Havana, Cuba while listening to Iranian music.

I have been thinking a lot about Iran and thanks to my friends inside Iran, I can feel the empathy for this land I have always loved, even though I have never visited it, having flown over it hundreds of times on Qatar Airways.

Why don’t you visit Iran? My friends inside and outside Iran ask me. My friends in Israel and USA would ask, are you mad even considering a trip to Iran, pointing out to the number of people jailed for being “spy” for CIA or Israel.. I have strong attachment to both USA and Israel; the two enemies Iran has sworn to destroy but their ageing technology like their ageing leaders would never be able to.

The frustration of the people, such a nice group of educated people, in my opinion the most educated and well prepared and westernized Muslim country, had to suffer under this backward vision of a theocracy which the entire world would decry. Not even the other many autocratic Muslim countries are so theocratic. Separation of the STATE and RELIGION occurred in the civilized nations about five hundred years ago, argued by philosophers such as Rene Descartes, I think therefore I am….
In the Muslim world we are still waiting for the world of a Descartes! The country that is ready to meet the Renaissance is IRAN.. and each day I am proud of my love for this country, so caught in the web of political intrigue and religious orthodoxy and liberal minded people.
A country which gave the world HAFEZ FERDOWSi KHAYYAM and the thousands of classic writers and philosophers and giants such as SHAMLOO and SHEGOYAN who could speak both German and Sanskrit!  Not to mention Makhmalbouf, Panahi, and films such as the Seperation..

IRAN would join the rest of us in the world stage but this is not the time to travel there and be falsely be accused of being an Israeli spy.

I began to write about IRAN and got carried away by the sadness I felt but I wanted to mention the effects of the BLOCKADE, I am sure the IRANIANS would feel it, not the Guards or the Mullahs or the Theocrats but the average IRANI.
That is the case here in CUBA. Which has withstood 60 years of blockade. The apologists for this draconian action by the USA including the Miami Cuban Americans would ask: but they can trade with others.. they do not know what an American Embargo or Blockade means. Right now, there are Gas for cooking for the population, Petroleum for the buses for the population are waiting in ports to be shipped to Cuba but USA has completely blockaded their arrival until Cuba gets its own ships at which time USA cannot stop the ships in the high seas.
These things are at a macrolevel, very soon, flights from the USA to Cuban towns outside of Havana including the popular charter flights would stop. Cruise ships cannot dock in Cuba if their itinerary includes a USA port even if it is a colonial one such as San Juan, Puerto Rico or US Virgin Island ports such as St John or St Croix. This has affected simple artisans who made a living selling handcrafts reminding the visitors of their short sojourn in Havana, whose trade was devastating, plunging them into further poverty.

Do you think the Government Officials are impacted? Do you think that people who receive millions of dollars from family members in the very same USA are affected? No..
Average Cuban, who gets up to go to work and has a family and has to see his children do well at school and those receiving pensions and are unable to work are affected. It is the unfortunate and the unluckiest ones are affected.
I am amazed that neither the politicians in the USA (whose sanity one questions) nor the average American cannot understand the devastating effects of this blockade…just simple, you cannot cook because the cooking gas containers have been blocked from entering Cuba by their government.

Those of us who love this country for intellectual and philosophical reasons rather than the political or ideological ones, the blockade is felt in a different fashion. I will give some examples

NEJM or the NEW ENGLAND JOURNAL OF MEDICINE is a prestigious medical journal read by all erudite doctors around the world. Every week they send something called NEJM Knowledge in which they present a case and give four possible answers. After brooding about the clinical presentation, you can click on one of the answers and it would open in another screen and give the explanation why your answer is right or wrong. It is truly a wonderful way to keep your medical wits about you.
Just guess what happened when I read the case of an 82-year-old woman who became incoherent after being put on Amitriptyline by her Family Practitioner, I clicked on my choice from the four possible answers: exchange Amitriptyline for Sertraline, another group affecting other parts of the brain.
This note appeared on the screen.
The country that you are accessing this from is not authorized to receive

I have an Amazon.com account with a USA based credit card and an USA address to ship to.
I wanted to buy a book, order it from Cuba, to be shipped to the USA address
When I clicked order now (it took me through the other steps)
You are not allowed to use this service.

Same story with apple.com or app store if you want to download an app. I have SPOTIFY music streaming but cannot stream it while I am in Cuba.

Cuba while being a Communist state, does not block any websites, unlike IRAN or many other countries including the friend of USA, CHINA.

If you think BLOCKADE of a nation such as CUBA and now IRAN affects only the sales of BOEING Planes or Refrigerators or big price tag items, you are wrong. It enters everywhere, makes the life of an average Cuban more difficult from Medications, trying to buy an airline ticket from here, the list goes on and on

So please do not be condescending of the 80 million citizens of Iran or the 11 million Cubans in the island

Listen to this proverb from the wisdom of the Native people of USA
Never criticize a man until you have walked a mile in his moccasins. He who is present at a wrongdoing and does not lift a hand to prevent it, is as guilty as the wrong doers. Great Spirit, help me never to judge another until I have walked in his moccasins. Listen or thy tongue will keep thee deaf.

This is attributed to the OMAHA (UmoNhoN) tribe with whom I have a long-standing relationship

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