Society - MAHAMAG Magazine beyond boundaries

Cuba : Health Revolution

Ever since 1959, Cuba, despite its limited economic resources, has been building a very effective health system. The educational system of Cuba has been able to produce more physicians per capita than any other nation. In 2007 Cuba had one doctor for every 155 citizens, compared to 1 for every 330 in Western Europe, and one for every 417 in the United States.

Today, the vision of Che Guevara who as a young Argentine medical graduate had ventured to Guatemala, hoped to contribute to revolutionary change, has finally been realized. Cuba and its doctors have made a tremendous commitment to “solidarity” on the international level.

The experience of the newest reflection of Cuba, in concert with the people of other nations, like Africa, Latin America, and the Caribbean, in transforming the training of doctors, nurses, and other health professionals. They are also delivering medical care to poor populations, which, in the past seldom received any attention at all. This dynamic notion, planted by Che Guevara and others at the beginning of the Revolution, has taken decades to develop, finally come to fruit. Thousands of doctors are capable of practicing and teaching revolutionary medicine, and they are putting this “weapon” to good use. In 2003, this positive force was deployed on a massive scale in order to aid the Bolivarian Revolution in Venezuela.

A strike by the Venezuelan Medical Federation to create a total breakdown in medical service, was in vain. The mayor of the Libertador, sought to directly hire Venezuelan doctors to form a new community medical network. Within a few months, hundreds and more Cuban doctors

arrived in Caracas to add their skills to the new network of family care. The experiment was so successful that the Venezuelan government decided the pilot program, (called Barrio Adentro (inside the barrio)), to be duplicated nationwide. Its effect in history has a grand health care revolution.

What made the Cuban health delivery system exceptional in those years is their commitment to the service. The emphasis on various preventive measures in health programs reached almost all citizens.

Author and Doctor STEVE BROUWER lived in the mountains of western Venezuela from September 2007 to May 2008, wrote about the participation of rural Venezuelans in the Bolivarian Revolution. “In the community I lived in, a settlement of about 125 campesino families where no one spoke English, most residents had never attended high school and almost no one had been near a traditional university. Yet there are eleven young women and men from these families enrolled in a demanding six-year medical program that will graduate them”.

In 1984–85, Cuba decided to keep improving its health system by adopting the program called Medicina General Integral (Comprehensive General Medicine), which created family medicine teams, comprised of one doctor and one nurse, that were designated to serve every neighborhood in the country. By 2004, the teams served more than 99 percent of all Cubans, with each team having a small neighborhood of 120–150 families under its care.

During the 1990 decade, the Cuban economy sank into a severe depression due to the collapse of its major trading partnership with Russia & Eastern Europe.

There was a severe shortage of medicines and medical equipment, exacerbated. The introduction of medical establishment developed by Che Guevara helped to overcome this crisis. The Cuban medical universities managed to graduate 38,000 physicians during the 1990s, four times the number produced during the 1970s. By the beginning of the twenty-first century, Cuba decided to use its modest economic gains to promote a “revolution within the revolution,” a process of restoring socialist values that had been under such distress during the Special Period. The renovation of facilities that served all citizens was given priority, particularly community medical offices, the neglected polyclinics and hospitals, and public schools.

By 2007, Cuba was boosting health statistics, such as an infant mortality rate of 5.3 for every 1,000 live births and an average adult lifespan of 77 years, that placed it in the top ranks in the world alongside rich, industrialized first world nations. The extraordinary number of physicians in this small nation, 72,417 as of 2007, has allowed Cuba to mobilize thousands of medical professionals (including nurses, dentists, and medical technicians) who are willing to go anywhere in the world to provide disaster relief and treat poor populations who do not have access to adequate health care. Revolutionary Cuba has always been willing to do this in the spirit of international solidarity.

Ever since 2005, the Escuela Latinamericana de Medicina (Latin American School of Medicine- ELAM) in Havana has been graduating 1,500 to 1,800 foreign students per year from its six-year program. Medical students come from Guatemala, Haiti, and Honduras, as well as forty other countries in Latin America, the Caribbean, and Africa.

When indigenous ELAM graduates from Honduras return to their native Garifuna region on the Mosquitia Coast, they are slated to get post-graduate residency training from Cuban specialists and a handful of Honduran doctors who have decided to participate with them. This enables the graduates to serve their own people in new hospitals.

In 2000 Fidel Castro told the Cuban people that the ability of their nation to survive and maintain its revolutionary independence depended on being willing to fight and win “a Battle of Ideas.” He emphasized that “Our consciousness and the ideas own by the Revolution throughout more than four decades have been our weapons. Revolution means being treated and treating others like human beings.” Cuban minister of culture, Prieto explained in 2004, that this renewal process was so important, not just for Cuba

but for the whole world. He insisted that there was an alternative to “capitalist development.” in contrast to the stupidity, barbarity and the law of the strongest that today intends to impose itself worldwide, we try to defend the idea that another world is possible.”

“We believe,” said Prieto, “that what should be globalized, are not bombs or hatred but peace, solidarity, health, education for all, culture, etc. That is why, when our physicians go to help in other countries, although their mission is to work for medical attention, they are also bearers of our values and our ideas of solidarity. This is the essence of the Battle Ideas.”