Cuba’s renowned health care system has a blind spot: It is failing people with mental illness. The island nation has the highest rates of suicide and depression in the Americas. Writing for the Virginia Quarterly Review, Lygia Navarro skillfully weaves the stories of individual Cubans with a broader perspective on the government’s refusal to acknowledge the dramatic suicide rates and the prevalent prescription drug abuse. She exposes secretive lives without exploitation and pays homage to the setting with telling descriptions.

An excerpt:

After days of talking about mental health and black-market meds, one afternoon Mirta stops me midconversation. She can tell from my questioning that Cuba’s passion for sedatives is something of an anomaly. Do Americans take sleeping pills? she asks. I do not want to offend her, and say carefully that it isn’t as common there, and is stigmatized by the stereotype of unhappy housewives downing bottles of Valium. Mirta laughs. The possibility of falling over the precipice is all around her—almost everyone she knows takes sedatives. “Because people know that they have to get up and start all over again. This has been going on for so long here in Cuba that if someone doesn’t take sleeping pills, that’s abnormal.” Both she and Alejandro are uneasy about their underground pharmacist’s corruption in profiting off people like them. But they keep buying.

The more I talk with health workers and Cubans hooked on sedatives, the more I am convinced that the government has strategic reasons for making meprobamate available primarily on the black market. With no aboveground market or statistics, who knows how many tablets are produced or how many Cubans consume them? If meprobamate were conveniently available in pharmacies—and more affordable than on the black market—how many more Cubans would rush to drug themselves? And, the question ultimately is, how afraid is Havana of its citizens unsedated?

(Thanks, Untold Stories.)

Immersion journalism requires writers to throw themselves into the thick of things, spending months and even years with their subjects. (Think Truman Capote’s In Cold Blood, or more recently, Barbara Ehrenreich’s Nickel and Dimed.) It’s a genre not without criticism—some fret about lost objectivity, while others dismiss it as “stunt” journalism—but its unique merits shouldn’t be overlooked at a time when deflated budgets increasingly deny writers opportunities to do deep reporting.

For one, the story that emerges is often different than the one a writer sets out to find. Lee Gutkind, founding editor of the journal Creative Nonfiction and a contemporary master of immersion journalism, tells Fresno Famous about working on his latest book, Almost Human: Making Robots Think.

“Almost all of the cutting-edge research, software writing, and engineering is being done by people, mostly men, and a few women, under 25 years of age. I was stunned by that,” Gutkind says to the Fresno Bee-owned website. “I thought I was going to go meet all these people who look like me, with gray hair. You know, Einstein-like characters….”

You might go into an immersion with a particular idea, Gutkind explains, but after a few months, you have a new one—or a variation on the original. “If you spend another year or two, your idea sophisticates and focuses even more,” he says.

It’s not to say that all writers ought to (or can) adopt an immersion model, but Gutkind’s statement does nudge at a dilemma haunting the general journalistic pursuit of objectivity in an era of quashed resources:

If a beleaguered writer, strapped for time or cash or both, “parachutes” in on a story and spends only limited time with the subject (be it person, place, or thing), then the window for maturing comprehension slams shut. Whether we’re talking about jumping directly into the fray or reporting from the sidelines, without time to make discoveries, vet assumptions, and evolve perceptions, isn’t a writer destined to deliver a story closer to what he or she expected to find in the first place? And isn’t that its own kind of subjective slant, in the end?

Compare that hypothetical to immersive, time-drenched work like Dave Eggers’ What Is the What. Eggers, one of Utne Reader’s 50 visionaries, and Valentino Achak Deng, one of the Lost Boys of Sudan, spent three years working closely together to complete what evolved into a fictionalized autobiography—written by Eggers in Deng’s voice.

“It was not until six months ago that I saw the book in the form of a whole book,” Deng says in an interview on his foundation’s website. “It was very strange how [Eggers] envisioned events through my eyes. Because we had spent so much time together by that time, it is not surprising that he could guess my thoughts.”

The men’s close relationship roils the traditional tenets of objectivity—but the resulting book, which many consider a masterpiece, couldn’t have been produced any other way. Among various reasons, “because Valentino was very young when many of the book’s events took place, there is no way he can recount his life with a degree of detail necessary for a compelling nonfiction book,” McSweeney’s FAQ explains. In its fictional hybrid state, What Is the What is more truthful than the truth.

That might not make it an objective tale, but then what is the pursuit of objectivity other than the pursuit of truth—a straining toward some kernel of certainty, untainted by overt bias or agenda? Books like What Is the What chart a course toward a compelling new way to tell the truth: one armed with facts, but also rendered with intimacy, subjectivity, and slowly-developed insight. When lack of resources pinches much of the writing overtly aiming at objectivity, it may be time reevaluate what kinds of stories are really cutting to the heart of their matters.

Utne Reader contributor—and extremely well traveled journalist—Andy Isaacson dropped us a welcome line today: Isaacson recently had been in Kenya, where he met Abebe Feyissa, an Ethiopian refugee living in the Kakuma Camp and author of “Traveling Souls,” an essay about camp life that we excerpted in our Sept.-Oct. 2008 issue.

“I came across the article online while I was searching for Kakuma,” Isaacson writes. “I then visited the camp, last week, and found Abebe Feyissa. We spent several hours together over a couple days, talking and walking around the camp. I took him to the camp’s only cyber cafe so that he could see the article on Utne’s website—I wanted him to know where his words are reaching.”

Feyissa is an interesting, thoughtful man, writes Isaacson. “His predicament—he’s been in the camp for 17 years, and will not be leaving in the foreseeable future—was rather saddening.” All the same, we were heartened to hear that Isaacson had visited him.

During his month-long journey to Kenya, as it turns out, Isaacson also spent some time with U.S. president elect Barack Obama’s grandmother. Read his pre-election story on Slate, and then check out Isaacson’s account of post-election jubilation for U.S. News & World Report.

Isaacson’s previous stories for Utne Reader concerned indigenous medicine, the social significance of tea, and better design through biomimicry.

Image courtesy of Andy Isaacson.

The events, and often even the non-events, of the 2008 election season have spawned a growing group of die hard political junkies, whose habit for constant information about Obama, McCain, and Palin (sorry Biden) is nursed by the legions of reporters and bloggers working the 24-hour news cycle. But with less than a week remaining in the horserace, what’s actually worth reading? Here’s a brief, and by no means comprehensive, guide to political writing for the home stretch.

First, a few from the New Yorker: Particularly fit for mention on this blog is James Wood’s “Verbage” essay, detailing the Republican Party’s “deep suspicion of language.” A thorough piece on Senator Chuck Hagel, a Nebraska Republican, is an antidote to the hyper-partisan tone that is sure to dominate the campaign’s last throes. And an essay from David Sedaris is likely the only place you’ll find the choice in this election compared to choosing between chicken or a “platter of shit with bits of broken glass in it” on an airplane.

From last Sunday’s New York Times, Frank Rich’s column may help ease the anxiety of Obama supporters worried that racism will decide this election, arguing that “white Americans are not remotely the bigots the G.O.P. would have us believe.”

In the blogosphere, Politico’s Jonathan Martin and Ben Smith seem to require little sleep. Their blogs are updated almost constantly and are two of the greatest information sources for full-fledged election addicts. (They also prove that it is possible to be too informed.) But Politico does stellar reporting too. This week one piece that stuck out explained McCain’s negative media coverage with detailed and self-reflective treatment, which I haven't seen done elsewhere.

Looking back a bit, Michelle Cottle’s blog post, “Spare Me Your Reverse Snobbery,” for the New Republic remains one of my favorite rants of the season, and though it was published in late September, it's still relevant. So is the year-long perspective offered up by Alec MacGillis in a recent piece for the New Statesman, which thoughtfully chronicles the reporter’s time on the campaign trail with Obama, beginnning with the Iowa primary last fall.

If you need laughs more than thoughtfulness at this stage, Wonkette will surely deliver. They’re snarkier than Sarah Palin and refer to John McCain by the pet name Walnuts. What more could you want?

Add your suggestions to the list in the comments section below.

At the Lalgadh Leprosy Hospital in Nepal, amputations and skin grafts are routine procedures. Caregivers see a dozen new patients every day, with many more returning for continued treatment. With this sort of bustle, it’s surprising that we don’t hear or read more about the disease. Enter Conor Creighton, who wrote a provocative, vividly detailed essay for Vice magazine about his trip to the hospital. With Steve Ryan’s accompanying dramatic photos, the captivating account leaves no doubt in our minds that leprosy is as real and gruesome today as it was in the days of Moses.

Creighton tenderly describes Bakumari, “a tiny woman with short gray hair and frail limbs that poke out from under her sari like the branches of a blackthorn tree.” In 14 years with the disease, Bakumari's eyelids have disintegrated, robbing her of sight. She’s lost most of her toes. The worst part is that she has no way of protecting herself from further damage, having lost all sensory capabilities in her extremities.

Creighton captures the horror of the disease, both physically and socially. Called a neglected disease by the World Health Organization, leprosy carries a stigma in many countries, leading to negligent medical attention from doctors who simply turn people away at the first sign of infection. The most disheartening aspect of knowing that this seemingly archaic disease exists in the 21st century is that it's very easily cured if treated properly: A six-month schedule of medication, although physically brutal, flushes leprosy bacteria from the body. Creighton’s essay is an eye-opener, fluidly told, effortlessly carrying the weighty importance of reengaging people with the appalling realities of the forgotten disease.