Attachments
CONTEXT
Hurricane Melissa made landfall in southeastern Cuba on 29 October 2025 as a Category 3 hurricane, bringing winds over 195 km/h and rainfall above 400 mm and causing severe flooding, river overflows, and widespread damage to housing and essential infrastructure across Santiago de Cuba, Granma, Holguín, and Guantánamo (1–7). Approximately 735,000 people were evacuated prior to landfall — including elderly individuals, children, people with disabilities, and pregnant women — and more than 3 million people were exposed to hurricane conditions (2,8,9). Although evacuation numbers declined in the following weeks, displacement persisted into mid-December 2025 (10). Over 215,000 homes were damaged and 1,860 educational institutions were affected, while disruptions to health, water, telecommunications, and electricity systems significantly reduced service capacity (10). Power outages constrained water treatment and safe storage, increasing risks of waterborne diseases and limiting the functioning of health facilities (10). Agricultural losses affecting approximately 185,000 hectares and an estimated 40% of national vegetable production further strained food systems (5,9).
These impacts have intensified public health vulnerabilities and service delivery constraints. Cuba relies on food imports for over 80% of its supply, and hurricane-related agricultural losses have reduced domestic production capacity (11,12). Transport limitations and disruptions to the rationing system constrain food access, particularly among vulnerable populations dependent on social protection mechanisms (11,12). Disruptions to water systems increase the risk of waterborne diseases (10), while weakened environmental control conditions may elevate the risk of arboviral transmission. Approximately 5 million people live with chronic illnesses requiring continuous care and medication, including 16,000 patients requiring radiotherapy and 12,400 undergoing chemotherapy (13). Individuals dependent on electrically powered medical equipment or stable cold-chain systems face heightened vulnerability (13). Maternal and child health services have been affected, with more than 32,000 pregnant women facing increased risks due to reduced access to obstetric ultrasounds and limited transportation for obstetric emergencies (14). Delays in routine childhood vaccination schedules place approximately 61,830 children with special health care needs at increased risk (14). Reduced referral capacity and delays in access to emergency and specialized care further elevate health risks (13).
Since December 2025, limitations in energy availability resulting from reduced fuel supply have introduced additional constraints across multiple sectors (15) which has been intensified since the beginning of 2026. Given Cuba’s dependence on imported fuel and centralized distribution systems, energy supply disruptions have affected electricity generation, transportation, food production, water supply, and health service delivery (15). Restrictions on high-consumption diagnostic services, including Computed Tomography (CT) scans and certain laboratory technologies, have increased reliance on basic-level care, while mitigation measures such as solar panel installations remain limited in scope (13). Fuel constraints have reduced ambulance services and referral capacity, and public transportation networks have been scaled down, further limiting access to health services and employment (13). Delivery of clean water, medical care, food, and humanitarian assistance has been disrupted in several areas, including provinces still recovering from Hurricane Melissa (15–17). Reduced diesel allocation under the February 2026 Energy Contingency Plan has affected agricultural activity and cold-chain reliability, contributing to spoilage of perishable foods and increased food safety risks (11,12).
Taken together, hurricane-related infrastructure damage and ongoing limitations in energy availability are exerting cumulative pressure on health service delivery, access, and recovery efforts. The overlapping and compounding effects of infrastructure disruption, food insecurity, service constraints, and reduced reliability of energy services have increased the fragility of the public health situation and may heighten risks across the population in the months ahead.