HAVANA — When New York’s Cardinal Timothy M. Dolan and a group from the Archdiocese of New York visited Cuba in February, they spent quite a bit of their mission trip doing what a lot of volunteers and staffers at Catholic organizations on the island do: visiting, encouraging and caring for the elderly.

It’s becoming a critical service on the island as Cuba’s birthrate plummets, economic pain from sanctions and a struggling economy has sent the island’s youth and the middle-aged to far-off lands, leaving a big hole in the care of a growing and aging population. In just a few years, by 2025, the percentage of islanders over age 60 is expected to grow to 30 percent.

Already, with more than 20 percent of Cubans age 60 or older, Cuba claims the title of being the “oldest” nation in Latin America in terms of its population.

Economists have long speculated what this will mean for the future of the island since there are no replacements for workers, therefore little to fund a pension program as the elderly settle into retirement.

But the burden isn’t merely economic. With family members leaving the island, nonprofits, including many Catholic organizations, have had to step into the role once reserved for offspring, grappling with the care of the growing number of elders in an environment of scarcity.

In the city of Camaguey, in eastern Cuba, there is a center for the elderly called Centro Monsignor Adolfo Rodriguez, named after the first archbishop of the Archdiocese of Camaguey. At the center a small group of women religious of an order founded by the Italian St. Camillus de Lellis — and whose charism is to care for the sick — smile at and comfort some of the permanent residents and those who arrive for daily physical therapy or a dose of medicine.

“He ran too much in his youth,” said Dolan as he made a joke Feb. 9 with a man receiving therapy for his legs at the senior care center. Though it took 13 years to build, it’s become an indispensable facility to provide care the elders of the area otherwise wouldn’t receive, said Archbishop Wilfredo Pino Estevez of Camaguey.

Much of the facility was funded with money from abroad, from lay Catholic Camagueyans who wanted to give back to their hometown, he said.

On the other end of the island, Dolan continued to spread good cheer, hugging and joking Feb. 10 at the Santovenia Home, where the Sisters of the Abandoned Elderly, along with staffers and Catholic volunteers, tend to seniors who have been abandoned by family.

While some of the seniors’ care is funded by the government, the Catholic congregation absorbs a lot of the costs of their care, food and medicine, and like many Catholic organizations, the sisters depend on donations from abroad to keep their doors open.

The same is true for Caritas Cuba, said Maritza Sanchez Abillud, the organization’s director, addressing the donations from Germany, the U.S. and other places that help staffers carry out their mission.

She spoke with the cardinal about the work of her organization, not just providing daily necessities to elders via 11 diocesan Caritas offices on the island, but also in helping some of them recognize their worth in society, even though they might be poor, can no longer work, have a meager pension and have in some cases been left behind by families who have emigrated.

“Caritas has the mission of trying to listen to the cry of the poor, not only when it comes to material needs but also to the liberation of the person, his or her human development,” she told the group from the Archdiocese of New York visiting Feb. 10.

Caritas Cuba, the humanitarian and social services arm of the Catholic Church on the island, operates much like Catholic Charities in the U.S., caring for the most vulnerable populations in Cuba, including children at risk, the sick and disabled, men and women living with HIV or AIDS as well as helping victims of natural disasters.

But its largest and growing client population has become the elderly. With harsh sanctions from the U.S. and its threats against countries doing business with Cuba, even getting basic food such as eggs can be a challenge, much less securing medicine to help with the innumerable ailments afflicting Cuba’s elders.

Caritas staff and volunteers can go to the store to try to buy basic foods, but the only thing to be found sometimes is an empty shelf, Sanchez said. Each day there is less and less on the shelves and what food or material is left is expensive, she added.

What medicine Caritas can provide comes from other Catholic organizations such as Catholic Relief Services, whose support also allows them to provide a basic meal, laundry services as well as programs to keep up the spirits of a population prone to depression or a lack of self-worth as they see their family abandon them along with the island.

With a growing number of clients and no physical space to accommodate them all, “we have to be creative, despite the scarcity,” Sanchez said. Sometimes volunteers allow their homes to be used as gathering places to host workshops to teach the elders basic self-care but also to remind them “to live life to the fullest.” But even that is affected by emigration, Sanchez said.

Sometimes the volunteers, like the family of the elders, end up leaving Cuba permanently, too, Sanchez said, taking with them a critical and priceless resource for the elderly poor on the island: Compassion.

“In America, we advocate for the poor (to the government),” Dolan said to Sanchez during the February visit to the Caritas headquarters in Havana, and asked whether that was a possibility in Cuba.

“We’re talking about two different realities,” Sanchez answered.

Though there is an opportunity for dialogue with the government, she said, scarcity affects the entire island.

“We try to do what we can,” Sanchez said. “But we simply don’t have institutions.”

Though it’s a difficult task and the “hemorrhage” that is immigration will continue to affect the care the elderly receive, the work of the church will continue, said Sanchez, but not without help from outside or above.

“Without the Holy Spirit, it’s impossible,” she said.

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