"Despite assassination attempts and international isolation - especially after the collapse of the Soviet Union - Castro has clung on to power and remains the world's longest surviving head of state. Meanwhile his people will risk almost anything to flee, and the country continues to decay. In 2003 seventy-five dissidents were imprisoned for up to eight years for daring to speak out against the regime. They have concrete slabs for a bed, eat food that would 'make a pig vomit,' and use lavatories that 'regurgitate their fetid contents around the clock.' On the other hand, Cuba has an efficient and generous welfare state and health system."