My friend Joel leans over in the darkened movie theater as the opening credits roll and whispers “I know this story; I know the muchacho who this is about.”  We are watching the Cuban film Boleto al Paraiso (Ticket to Paradise) at the Quad Cinema on 13^th St. in New York City.  The film is being shown as part of the Havana Film Festival.  Joel and his partner have driven up from Washington D.C. where he now lives to spend the weekend.

I didn’t really know much about Boleto, but everyone in Havana had been talking about it when I was there for a month in January.  The director, Gerardo Chijona, has a long history of very successful and popular films in Cuba that take a humorous look at the foibles and contradictions of Cuban society (Adorables Mentiras or Adorable Lies is probably his most well known).  But it was clear from the first frame of Boleto al Paraiso that this film was not made with a light touch and would force us to look at some uncomfortable realities.  Boleto is based on the true stories of a group of marginalized youth in Cuba in 1993.  At the time, everyone who tested positive for HIV in Cuba was required to live in a residential hospital or sanitarium and these young people believed that life would be easier for them there.  Like ripping a band aid off a raw wound, the film exposes an underside of Cuban society in those difficult years, and confronts issues that are not often explored in Cuban cinema:  sexual abuse, illicit drug use, prostitution, alcoholism.

Eunice, the young and innocent protagonist of Boleto, is a high school student in a small provincial town when we first meet her, suffering sexual advances from her widowed father in silence until one day she takes flight.  With no where safe to go, Eunice is drawn to Alejandro, a young man who is part of a group of young frikis and makes her way to Havana with them.  (“Frikis” are the self-named long-haired, grungy, disaffected hippie/punk rockers of Cuba).   On the streets of Havana, they live on the margins of an underground rock culture, sharing food and sex, sleeping on beaches and under bridges, and sticking together with fierce solidarity. As their lives spiral downward and they are pushed further to the edge,  Alejandro tells  them about a place where they can live in peace—well-cared for, fed and housed—and be free to live their lives as they choose.  That paraiso is the AIDS Sanitarium, and their boleto or ticket to this paradise is infection with HIV.  In a heart-breaking series of scenes, these desparate young Cubans set out to intentionally infect themselves through sexual contact with a friend who is HIV positive and living in the Sanitarium.  Eunice initially flees from this horrifying solution, but eventually she too is caught in the web of despair.

Joel, his partner and I left the Quad Cinema in silence.  We wandered the streets of Greenwich Village for several hours before we were able to shake the storm of emotions that the film had created.  Joel, who left Cuba in 2001, had lived through the early years of the epidemic in Cuba and was a founding member of the AIDS Prevention Group.  Though he never lived in the Sanitarium, he knew some of the young people on whose lives this film is based.  I too had a personal encounter that had opened my eyes to this phenomenon. 

In 1996 I lived in Cuba for six months and worked at “Los Cocos,” the AIDS Sanitarium in Havana.  For the first time, people living with HIV/AIDS were going to share their stories in public, and I was working with Cuban psychologists and health educators to prepare them.  One day I led a workshop called “Telling Our Stories.”  We sat on hard metal chairs in the worker’s cafeteria, and each participant was asked to respond to a question on a folded piece of paper pulled from a cap that we passed around the circle.  Ricardo, a tall man with a shoulder length hair and a dramatic handlebar mustache, became very agitated when he unfolded his question, “No puedo contestar, he said.  “I can’t answer this question.”  And then he scraped his chair back and abruptly left our circle.  Later I found the paper he had left behind on his chair with the question left unanswered:  What prevention message can you pass on to others based on your own personal experience?  Ricardo didn’t return to the group that day or the next.  After several days had passed, I grew worried and went to look for him in the large building, much like a college dorm, where he lived in a tidy single room.  It was then that he told me his story and why he could not respond to the question. 

Ricardo showed me a picture of two little girls, about a year apart, dressed in blue and white school uniforms with ribbons in their hair.  “My daughters,” he told me.  “I had my two beautiful daughters.  I was married.  I was working.  Then everything began to fall apart.”  Ricardo described a year in which his marriage ended and he had to move out of his apartment.  He had no permanent home, which is common after divorce due to Cuba’s severe housing shortage, and was crashing with friends.  Then he lost his job.  With no place to go and no real support from family members, he became depressed.  His sister with whom he was very close had been diagnosed with HIV and was living in the Sanitarium. He visited her frequently and noted that she seemed to be living well—she had a nice home, a good diet and lots of support.   As things deteriorated in Ricardo’s life, he saw a way out.  He wanted to be with his sister.  So he bought contaminated blood and injected himself.  Several months later he tested positive for HIV and came to live in the Sanitarium. 

Ricardo’s story was almost beyond my comprehension.  To feel so desperate and alone in the world that the only solution is to inject oneself with a deadly virus---how could I begin to understand that?  I had read stories about young roqueros injecting themselves in the New York Times and other U.S. periodicals but had dismissed them as anti-Cuban propaganda.  But by that time I had come to understand a term that was used to describe people who lived on the margins in Cuban society.  Una vida disorganizada (a disorganized life) was a catch phrase that I heard often and seemed to cover every type of marginalized behavior in Cuba.  In the Sanitarium life was relatively free of the expectations that shaped Cuban life on the outside---the high value placed on being a productive, contributing member of a collective society was tempered on the leafy paths of Los Cocos.  Gay couples lived openly together, transvestites were free to dress in any way they chose, punk rockers flaunted their anti-authoritarian styles without fear of harassment or censure.  The virus somehow erased the need to conform.  But was this reason enough to intentionally acquire it?  Did these young Cubans not understand that they might pay with their lives?  In the film, Alejandro tells them not to worry, that a vaccine or a cure will be discovered soon.

The Cuban Ministry of Health acknowledges that there have been cases of self-injection, but it’s hard to get a firm statistic.  When I interviewed a representative in 1996, he told me 12 cases had been confirmed, but I heard stories of many more.  Dr. Jorge Perez, a former Director of the Sanitarium, addresses the issue in his memoir  

SIDA: Confesiones A Un Medico (AIDS:  Confessions to a Doctor, published in 2006 and soon to be published in English).  In fact, the stories he tells in his book inspired Boleto, according to the closing credits of the film.  In an interview on the Miami Herald blog, the filmmaker Chijona credits his friend Dr. Perez with bringing the stories to him.  That interview also mentions 60 young teens who were infected in this way, and goes on to say that Chijona and his team visited 40 survivors as part of the research for the film.  The filmmaker comments about what he learned:   “It was a combination of inexperience, ignorance, innocence and abusive violent families. The country was collapsing. Those kids felt all doors were closed to them. They saw no way out. Now nobody would look for that exit. They’d leave the country – maybe open a new business.  Cuba is no paradise, but it is not collapsed now like it was in 1993.” 

In January of this year, I visited Cuba for a month, doing research for a book I am writing that explores the intersection of AIDS in my personal and professional life and my work in Cuba (working title:  Unfolding: A Memoir of Forbidden Travel, AIDS and Healing in Cuba).  At a small park in Santiago de las Vegas, the neighborhood on the outskirts of Havana that is home to the Sanitarium, I met Ireni, Ricardo’s sister, for the first time.  “We were like twins,” she told me.  “So close, like twins.”  And it’s true she looks like a smaller, more feminine version of him.  We were standing together at a display of Proyecto Memorias, the Cuban AIDS quilt, and Ireni was reading me the poem she had embroidered on Ricardo’s panel.  He died several years ago after a long illness.  Later that day we had a longer conversation and she confirmed much of her brother’s story. 

I often compare my efforts to try to understand life in Cuba to peeling away the layers of an artichoke.  Each layer of spiny leaves reveals another, but the knowledge of the sweet fleshy heart that will be uncovered at the end keeps me peeling.  Trying to understand why young teenagers in Cuba would deliberately infect themselves with HIV was wrenchingly difficult for me, but it helped stretch my understanding of this epidemic in a very different social and political context.   The film Boleto al Paraiso peels away one more layer of the artichoke.  The images are still haunting me, days after I emerged from the theater, blinking in the bright sunlight of an April afternoon in New York.

Special Note:    Boleto al Paraiso, which was made with the support of ICAIC, the Cuban Film Institute, has yet to be shown in Cuba but has been entered in several international film festivals.  The Havana Film Festival NY ends this Saturday, but Boleto will be shown again on May 22^nd as part of CINE Cuba at BAMcinematek in Brooklyn (http://www.bam.org/view.aspx?pid=3022).