CARACAS, Venezuela ? In his monthlong fight against cancer, Venezuelan President Hugo Chavez has placed utmost importance on secrecy, carefully offering only scraps of information about his condition.
Now, as he begins planned chemotherapy in Cuba, Chavez appears to have found the perfect place where he can tightly guard details of his illness and keep the prying eyes of the news media far away.
The Venezuelan leader first underwent surgery in the island nation on June 20 to remove a cancerous tumor from his pelvic region. He returned Saturday night, saying he would be starting a "second phase of treatment."
Typical of the cone of silence Chavez has lowered over his health problems, he hasn't said how long the chemotherapy is likely to last, and there was no immediate confirmation from either Cuba or Venezuela that the treatments had in fact begun.
Chavez, 56, had said he would begin the treatments in Havana on Sunday to ensure cancer cells don't reappear. He has also said he has been open about the details of his medical condition.
Maria Teresa Romero, professor of international studies at the Central University of Venezuela, said controlling information about his illness is important for Chavez to maintain both his hold on power and an image of strength at home.
"The secrecy, the trust is assured" in Cuba, she said, "which is something that wouldn't be assured if he were treated in Brazil, for example, or here in Venezuela. It would be much more difficult to keep secret everything they are going to do him."
Paul Webster Hare, a former British ambassador to Cuba from 2001 to 2004, said Chavez is likely receiving the same sort of protections and accommodations that ailing Cuban leader Fidel Castro himself would expect. Hare was also the deputy head of mission for the British Diplomatic Service in Venezuela from 1994 to 1997.
"Everything there will be arranged as if a member of the Castro family were being treated ? strict secrecy, encrypted communication with Venezuela, transport, etcetera, just as if a favorite son had returned," Hare said.
"Just as there is no accountability for the subsidies that Venezuela provides Cuba, the political relationship is based on shared commitments and understandings between the leaders that are never subjected to institutional scrutiny."
On top of that, Hare said, "non-Cuban specialists could be more easily flown in to Havana than in the countries with a free and inquiring media."
When Fidel Castro himself was gravely ill in 2006, a Spanish surgeon, not a Cuban, treated him.
One of the few messages that emerged from Chavez by early afternoon Sunday came via his Twitter account, where one of three notes offered congratulations for the start of the ALBA Games in Venezuela, an athletic competition involving countries in the left-leaning Bolivarian Alliance bloc.
"From my trench, battling for life, I congratulate the entire homeland for the marvelous inauguration of the ALBA Games! We will live!" the message said.
Chavez has been treated by a team of Cuban and Venezuelan doctors since doctors removed a cancerous tumor that Chavez said was the size of a baseball. He hasn't said what type of cancer he was diagnosed with nor specified where exactly it was located, saying only that it was in his pelvic region.
Government officials have deferred to Chavez to provide the information he chooses about his prognosis, while opposition leaders have demanded that the president come clean about what exactly his medical condition is. Three days before he left for Cuba, Chavez acknowledged for the first time that he expected to undergo chemotherapy or radiation treatment.
The Venezuelan leader also revealed on Saturday that his foreign minister, Nicolas Maduro, had traveled to Brazil in recent days to look into a proposal by Brazilian President Dilma Rousseff, herself a cancer survivor, for him to be treated at a hospital in Sao Paulo. He didn't say whether that option was still being considered, or whether it had been a possible alternative to treatment in Cuba.
Romero noted that when Paraguay's president, Fernando Lugo, recently underwent cancer treatment in Brazil, the hospital provided regular medical reports on his condition. Details have also been released about the type and location of Lugo's tumors and his chemotherapy process.
"In this case, it would be a risk from the Venezuelan government's perception to have (Chavez) in a place that wouldn't guarantee ... the secret about the entire treatment process that is being carried out," Romero said.
Cancer patients regularly undergo chemotherapy in Venezuela, and Chavez didn't offer a detailed explanation of his reasons for returning to Cuba before he departed for Havana.
"Evidently, the president feels much more confidence in the circle ? not only medical, but also political ? that he has around him in his allies in Cuba," said Asdrubal Mendez, a Venezuelan political analyst. "There's an issue of trust. One always wants to be with whoever is closest ideologically, also from an emotional point of view."
While regular health briefings would be expected in similar circumstances in many other countries, some world leaders have kept a tight lid on their medical tribulations.
In France, for example, the health of presidents has long been shrouded in secrecy. The public didn't learn of President Georges Pompidou's bone marrow cancer until after he died of it in 1974. There were rumors of health problems throughout much of the 14-year tenure of President Francois Mitterrand, who ordered his doctor to systematically falsify his health bulletins. He died of prostate cancer just months after leaving office in 1995.
U.S. President Franklin D. Roosevelt kept his polio semi-secret during his presidency. And more recently, the government of North Korea has divulged few details after reports emerged that leader Kim Jong Il suffered a stroke in 2008.
Nor has Cuba ever said officially what condition afflicted former President Fidel Castro in July 2006, though it was widely reported to have been complications involving the intestinal ailment diverticulitis. Returning to the public eye two years later, Castro said he had been "at death's door" but did not give details on the illness.
Still, some suggest Chavez's decision to be treated in Cuba may be motivated simply by an interest in maintaining continuity in his treatment after his surgeries in Cuba.
"Since he was treated in Cuba, it makes sense to return to return to the island for chemotherapy," said Miguel Tinker Salas, a Latin American studies professor at Pomona College in Claremont, California.
Footage on Venezuelan television showed Chavez arriving at the airport in Havana on Saturday night, where he was greeted by Cuban President Raul Castro.
Cuban state media published a brief report on Chavez's arrival and a photo of the two presidents, but left out medical details. During Chavez's previous visit, Cuban officials said privately that it was up to Chavez's government to release any information.
Chavez has insisted on retaining most of his responsibilities while in Cuba and has said he would use an "electronic signature" involving an eight-digit personal code that will allow him to remotely approve government measures.
"Whether in Havana, Moscow, Washington, Buenos Aires, you sign electronically and the security is also totally protected so that there can't be a false signature or anything," Chavez said during a televised Cabinet meeting in Caracas before his departure.
As to his treatment, Chavez said medical checks since his surgery have found that "no malignant cell has been detected in any other part of my body." He said there is always a risk cancer cells might reappear, "and therefore there's a need to attack hard through chemotherapy."
On the outskirts of Havana on Sunday, some Venezuelans in a group of about 250 who came for medical treatment under a government accord said they were praying for Chavez and hopeful for the leader's recovery.
"Cuba is a brother country," said 21-year-old Nestor Vazquez after he attended Mass. "I imagine the president feels like he's at home here. Also he knows there are good doctors."
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Associated Press writers Peter Orsi and Anne-Marie Garcia in Havana and Patricia Rondon Espin in Caracas contributed to this report.
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Ian James on Twitter: http://twitter.com/ianjamesap
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