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And they managed to achieve that despites the unjust US-embargo. Shame on you, capitalism! Boooooooooh!
Wrong. The embargo did it - not them.
In Cuba you've got a country where the heavy majority of people (excluding the ruling elite) don't have access to the kinds of products that tend to produce an environmental impact. If you aren't allowed to buy much of anything, than your "environmental footprint" goes down. Its pretty simple really. There are plenty of countries that would have a similar (or much lower) footprint, but they are excluded from the rankings because of "quality of life" - which in many ways is related to stability. If anything, Cuba's strongly governed.
For good about Cuba: The health care system has proven very effective - the numbers are quite good.
Of course, because of the limits in options they provide, there is still a "blackmarket" going on for treatment.