The economic downturn that has been a hardship for Americans has had a greater impact on the elderly in Cuba, who increasingly struggle to fend for themselves, according to members of a Miami-based charitable foundation. "It is a well-known fact that the people in Cuba have been suffering extreme poverty as part of their daily living for decades, and the conditions are currently worse than ever," said Fernando Garcia-Chacon, a Coral Gables resident and president of the Cuban Association of the Order of Malta, which supports mission projects and charitable outreach in several Caribbean and Central American countries as well as in Miami. Financial hardship in the Miami area translates into worse hardship in Cuba, where many depend on cash remittances from family abroad to help making ends meet. Cubans with no such outside help are finding it hard to put food on the table with Cuba's local economy in stagnation. "People with relatives in Cuba know these facts and they want to give something back to these poor communities," said Garcia-Chacon, born and raised in Havana, whose family founded a small town named Santa Maria del Rosario in the outskirts of Havana. They also were active members of the Knights of Malta for many generations. In 2011 especially, the Malta Knights and Ladies explored firsthand the situation of the elderly and poor in towns throughout Cuba. For Garcia-Chacon, the pilgrimage was his second trip back to Cuba since leaving in 1961. "In Cuba, the elderly are very poor, same as everyone else in the island." he said. "Our soup kitchens are for people 70 years of age or greater, and of course there is a lot of turnover." Only very impoverished seniors can access these programs, he said, which offer breakfast and lunch five days a week, he said. "At times, we also send them away with food for the weekend. When possible we have a place for them to watch television, play dominoes or provide a simple service like a haircut."The association is hoping to find a means to double the number of senior citizen support centers in Cuba, including a medical component to support medical care for elderly with diabetes. In late October, the association will host its annual White Cross Ball, with Honduran Cardinal Oscar Rodriguez Maradiaga, president of the Rome-based Caritas Internationalis, as guest of honor.