Hawaii and Cuba, both islands in tropical regions, are at risk for Zika. Cuba, surrounded by dozens of other countries in the Caribbean and Latin America that have already had cases and outbreaks, is particularly vulnerable.

Hawaii recently had its first cases — involving people who had been traveling abroad. Cuba, meanwhile, has remained one of the only vulnerable countries in our hemisphere tocompletely avoid Zika cases. How is this possible?

Cuba has performed aggressive door-to-door mosquito spraying. It is using 9,000 soldiersin the spraying to decrease the mosquito species that spreads the virus. Cuba is about 42,500 square miles, or 10 times larger than the Big Island.

In Hawaii, meanwhile, spraying has been much more limited. This means Zika will likely come to Hawaii, and people may die. Why has a developing nation with extremely limited resources been able to conduct much stronger public health strategies than the state of Hawaii in the richest country on Earth?

While I’m writing this article, numerous other places in our hemisphere are recording their first Zika cases — one in Missouri, 16 in Florida.

Cuba remains one of the last places in the Western Hemisphere free of Zika. The fact that it is also one of the poorest places in the hemisphere, and one with almost no trade relations, means that its efforts are even more impressive. We could learn a lot from them.

Cuba has always taken public health seriously. It did with the HIV virus, and always had one of the lowest rates for HIV in the entire world. How did it accomplish that? By offering free testing.

Hawaii has not taken the Zika threat seriously, just as it failed to do with dengue. The result will inevitably be sick people, and perhaps deaths. And it could spread even further because of what we know about Zika’s capacity to spread via sexual activity.

The question remains: Why haven’t we sprayed more?

It becomes a question of motivation and awareness. Why should a country like Cuba be leading the world in public health efforts?

It is a shame that our government does not learn lessons from our past, or from the good work of other places. Hawaii should have sprayed the entire state.

Our stubbornness could cost lives. We ought to demand that our government explain its inaction. What excuse could it possibly have?

It seems that every time there is a public health threat in Hawaii, the state does nothing. Officials just throw their hands up in the air and hope that nothing serious happens. It is why there have been hundreds of dengue cases, and why there may be hundreds of Zika cases.

It is embarrassing when a country as wealthy as America fails so comprehensively in matters like this. We know the biology of Zika. We know how it spreads. We know that it can be prevented through spraying, as Cuba has thoroughly demonstrated.

It is like our government does not care about the welfare of its citizens. Is it our arrogance and ego and recalcitrance that prevent us from doing something simple like thorough spraying?

Our attitude seems to be: Let’s just wait and see what happens. Anybody with any intelligence will know exactly what will happen. The same as happened with dengue.

We have an opportunity to prevent Zika from taking hold in Hawaii. All we have to do is follow the lead of Cuba. Is that so hard? In this case, it doesn’t take a public health expert or fancy equipment or tons of research. Buy the chemicals, pay people to spray, go spray. Then people won’t get sick and die.