As an aside, travel doctor is a great gig. Your patients are upbeat rather than under the weather. You are not exposed to illnesses. Since treatment is generally not covered by insurance, payment is direct rather than dependent upon a convoluted bureaucracy.
Health Insurance
Because of the Embargo, your American health insurance plan will neither cover, nor reimburse, for health care expenditures in Cuba. Although medical coverage is free for Cubans, uncovered visitors will be required to pay in cash. Fortunately costs are very low by US standards.
You will read that proof of insurance is mandatory in Cuba. That may be so, but no one asked us for such proof. If required to have insurance, a Cuban company, Asistur, will provide it for about 3 dollars per day. You may also buy a travel health insurance reimbursement or medical evacuation policy online. Check with your airline to see if health insurance is included with your ticket.
Insects
Even if malaria isn't prevalent at your destinations, mosquitoes may be. For some that means DEET, and repeat. I detest the odor and feel of DEET.
Instead I recommend a two-prong solution. Picaridin is rated as effective as DEET, but is neither smelly nor sticky. Sawyer and Cutter are two brands. Ideally use a twenty percent concentration. But, in the words of Ron Popeil, “wait there’s more.” Spray your clothes with Permethrin. Sawyer is a popular brand. It will deter mosquitoes for up to six washings. This is a much cheaper solution than purchasing insect repellent clothing, which usually relies on the same ingredient.
Because of regularly scheduled spraying, mosquitoes are less of a problem than in most tropical countries.
What to Pack
One of the inviolate mathematical rules of travel is the inverse relationship between the length of your trip and the amount of clothes to pack. Don't take two weeks worth of clothes for a one-month trip. Four to five days worth will suffice. Packing light will also prevent weight surcharges for flights.
Most casa particulares will do your laundry for a price of 3 to 8 dollars for a large load including ironing and folding. For emergencies, bring some dry detergent for hand washing. For men, order some quick drying underwear for the trip. The main brand is Exofficio, which is available from Amazon and many other providers. Made primarily of nylon, a pair will dry over night.
Pack hot weather clothing. Bring comfortable walking shoes. For rain bursts bring an umbrella or a lightweight raincoat. You will have no need for anything fancy. Skip the sport coat or the cocktail dress. Bring sunscreen and as mentioned above, mosquito protection.
Bring a bathing suit for daytime dips, and a flash light for the, sometimes dark nighttime streets and paths. Bring toilet paper for when nature calls and your casa particulare is too far away to hear. Bring plastic cups for juice stands.
Bring any and all medication that you might need. If you use glasses, take a backup pair. Take sunglasses and a hat for the sun. Make a photocopy of your passport and bring extra passport photos. Pack, or carry, a secure way of holding your money and passport. I use a travel pouch that hooks to a belt, or in my case, suspenders. Two top brands are Eagle Creek and Lewis N. Clark. Bring a camera and enough memory chips.
Most importantly, bring a sense of adventure.
Overseas Flights
Although this may change by the time you read this, as of June 2016 there are only charter flights from the US to Cuba. The cheapest, and best flights, are by way of Mexico City. Think of Interjet, as Southwest Airlines with more legroom, assigned seats, and a free alcoholic drink. In economy, seat pitch, the distance between seat rows, is among the highest of any airline, at 34 inches. The round trip flight from Mexico City to Havana is $300, including the 25 dollar Cuba exit fee.
Mexico City is worth at least a few days. It has some of the best museums and restaurants in North America. Be sure to enjoy the smoky complexity of a margarita made with mescal.
Selecting Accommodations
The first choice is between hotels, and the Cuban equivalent of B&Bs, casas particulares (“CPs”). In most cases the choice will be made for you. Most better hotels are fully booked long in advance by tour groups. But that is just as well. Cuban hotels are government owned. They tend to overcharge, and underdeliver. As an added negative, the hotels are filled with tour groups.
In Cuba price is seldom a consideration. Most CPs cost between 20 and 30 CUCs per night. All are required to have AC and a private bathroom, but always double check. CPs vary far more than a 4-star hotel. Living with a family is great, except when it isn’t. With the average Cuban salary standing at about 20 CUC per month, income from renting rooms is a windfall. Owners will go to great lengths to make accommodations hospitable for tourists.
The two best tools for selecting CPs are www.tripadvisor.com and www.cuba-junky.com. Tripadvisor is self-explanatory. We all use it. Cuba Junky offers reviews and general information. But the value is in their app that costs 5 dollars. The app includes the phone numbers and email addresses for most of the listed CPs. With extremely rare exceptions, this is the only way to make a reservation. I will of course provide such information for recommended CPs.
If you book through www.airbnb.com, you may be able to make a deposit. However, you will pay a significant premium over the cost of booking directly with the CP.
The old saw is that the three most important things in real estate are location, location, and location. Accommodation selection in major cities is much the same.
Once you have selected a few possible CPs, study location. This is important and complex. You must factor in your priorities and the nature of the city. Swimming back through your data dip, proximity to one or more of the following will be most important: historical sites, shopping, restaurants and food stalls, drinking and nightlife, public transportation, a tranquil area, or a good view. Conversely, you will avoid unsafe areas (fairly rare), and hopefully, you will want to avoid tourist ghettos. Roughly half of the CPS we booked were up one and sometimes two flights of stairs. So double check if you have mobility issues.
Remember Cuba is a cash economy. In most cases, you will be unable to make a deposit. To ensure your reservation is held, reconfirm and keep in contact. At each stop, have your CP call you next casa to reconfirm and, if you are arriving by bus, arrange for pickup at the bus station. If a CP is unable to fulfill your reservation they will find you comparable accommodations.
In the chapters to follow I will explain the rationale behind each accommodation choice.
Beds
Bed being repaired in Trinidad
The picture above is of a bed being restored. With Cuba’s limited resources, cars are not the only things restored, repaired or repurposed. Standard mattresses are about 6 inches deep, resting on wood slats. If they are fairly new or you lack heft, you won't feel the slats. You will want to bring many things back from Cuba. Beds are not one of them.
In reviewing CPs, I will let you know if bedding is worse or better than usual.
When to Go
The coolest and driest months are November through March. These months, along with summer vacation months of July and August, are the busiest. Shoulder seasons are April (other than around Easter) and October. October is part of hurricane season. I usually prefer to travel in shoulder seasons and chose April and part of May.