Healthcare

Fidel Turns 87 and Cuban Medics in Haiti Put the World to Shame

Well written and insightful, by retired Cuban- American Prof. from University of New Mexico, and a scholar on Cuban affairs, Nelson P. Valdés. See below for Cuban Medic story.

Nelson Valdes, August 13, 2013 http://www.progresoweekly.us/20130813-fidel-turns-87/

fidel

Today, August 13, Fidel Castro became 87-years-old. He has been out of power since he got very ill in 2006 and retired in 2008. Seven years have gone by. We were told by the world mass media that Raúl Castro did not have the wherewithal to rule. And yet, there has been no political or social challenge to the successful transition. Indeed, Cuba has been more stable than many countries in Europe. Moreover, the influence and expansion of ties with the world have increased. And Raul Castro might even have more legitimacy than expected.

Contrary to expectations Fidel is doing fairly well too – considering his age and medical problems. What is remarkable is that a charismatic leader lived long enough and managed to transfer his power and authority to institutions. This is unheard of, sociologically speaking. Typically, charismatic rulers died and then others had to figure out the new regime.

The expected scenario promoted by the mass media, U.S. and European think-tanks and foreign governments was: quick death, power struggle at the commanding heights of power, civil war, possible U.S. intervention and a return to the ancient regime. None of these happened. The anti-Castro futurologists did not see much of the future while they hammered us with reference to Cuba as a Caribbean Jurassic Park and Fidel as the dinosaur in chief.

How come talking heads, editorial writers and wishful thinkers were so wrong about a post Fidel or a post Castros’ Cuba?

One basic reason is that attention has not been paid to the real developments in the island. Wishful thinking and lies dominated the debate. Second, there has been no reference, then or now, to the fact that Cuba has institutions, a history and a political culture. Thirdly, the critical framework exhibited by the average Cuban was interpreted to mean the decline and crumbling of the “totalitarian system” by outsiders. It was assumed that open criticism was not allowed. Yet, Raul Castro often calls upon the people to openly criticize what needs to be changed.

Although it has been acknowledged that the Cuban Americans are one of the mainstays of the Cuban economy through remittances; the implications have not been fully understood or appreciated. Thus, the very people who were assumed to be the opponents have been a major factor in stabilizing the island’s society.

Indeed, the Cuban government is so confident, that now Cubans are allowed to freely travel abroad – something that the American citizen is not afforded in return. Moreover, the social characteristics of the past economic political refugee has morphed into the economic migrant who refuses to break ties with the country of origin.

What does it all tell us?  We were wrong about assuming that the Cuban political system was simply depending on one man’s personality while the millions of Cubans were sheepish.  We assumed that we understood the reality and dynamics of the social, economic and political system – yet, not a single prediction by specialists and journalists have stood the test of time

The institution of the Cuban family does not seem to recognize the political and ideological boundaries that were assumed. Moreover, many in the U.S. assumed that the world shared the views and expectations of U.S. politicians and policy makers on what to do about the Cuban government; today not even the conservative government of the Popular Party in Spain sides with the U.S., nor does the European Union. The yearly votes at the United Nations demonstrate this error.

In fact, Cuba has further advanced in its ties with left, center and conservative governments in Latin America and elsewhere. Cuban medical and educational assistance programs have gone as far as Vanuatu and east Timor.

Just several weeks ago the Cubans were invited to Suva, by the secretary general of the Pacific Islands Forum. Cuba is a leading member, as a partner promoter, of economic and social development in the region. Cubans, in fact, are invited to aid the Pakistanis, the Saudis, the Hondurans and even European nations that want to deal with the issue of illiteracy. The Yo Si Puedo program is found in more than 30 nations, including Mexico and Australia.

But what about Fidel?

Fidel continues to have a dual influence – among the general public and within the institutions that hold power. Does he favor one group against another? Doubtful. From 1959 into the 21st century the Cuban revolution went through many and different phases.  But Fidel led all the twists and turns. Consequently, if necessary, one can always find a comment or statement in favor or against: centralization, material rewards, opening or closing something, for or against egalitarianism. Whichever faction, his name will be used to legitimate it.

Are there differences between the two brothers? Even before 1959 there has been a division of labor between Fidel and Raul. One relied on mass mobilization, charismatic speeches and agitation. The younger brother, on the other hand, had the responsibility of organization, the day-to-day education of revolutionists and cadres – and later bureaucrats. One dealt with the general public and mass organizations; the other was concerned with organizations, division of labor, command and control, efficiency.

Each one needed the other. The new Cuba that is emerging seeks efficiency, productivity. And the preservation of social and national gains.

Fidel Castro has managed to represent as well as integrate the thoughts of José Martí and Simón Bolívar – 19th century revolutionary leaders. The Cuban revolutionary, with the aid of many, shaped a foreign policy and national movement around the fundamental concept of national sovereignty, yet devoid of any self-centered nationalism. This unique form of national self-determination incorporated other countries on an equal footing. In fact, national sovereignty and solidarity had precedence over ideology. Cuba has aided countries, despite the economic and political differences they may have.

Today Fidel might comment on contemporary matters but he does not enunciate or make policy – foreign or domestic. Surprisingly, he maneuvered well into a transition without upheaval or trauma.  When he dies it is highly doubtful that there will be any major upheaval; except a large funeral with Cubans sharing their feeling with representatives from every country and corner of the world.

Neither the German sociologist Max Weber, who wrote on charisma, nor the CIA,

that tried to assassinate him, ever envisioned such an outcome. In 2007 Saul Landau wrote, “Fidel exudes the same sense of astute practicality – a devastatingly cold grip on reality – combined with a seemingly inexhaustible optimism.” [1] More recently Landau added that Fidel’s “courage, and his determination to change vocations from chief of state to wise writer” is unique and inspirational. [2]

[1] Saul Landau, “Filming Fidel: A Cuban Diary, 1968″ Monthly review (New

York), August 2007.

[2] Marta Rojas, “An interview with Saul landau” Progreso Weekly (Miami),

September 8, 2010.

——————————

Cuban Medics in Haiti put the World to Shame

Nina Lakhani, Sunday December 2010. The Independent.

http://www.independent.co.uk/life-style/health-and-families/health-news/cuban-medics-in-haiti-put-the-world-to-shame-2169415.html

They are the real heroes of the Haitian earthquake disaster, the human catastrophe on America’s doorstep which Barack Obama pledged a monumental US humanitarian mission to alleviate. Except these heroes are from America’s arch-enemy Cuba, whose doctors and nurses have put US efforts to shame.

A medical brigade of 1,200 Cubans is operating all over earthquake-torn and cholera-infected Haiti, as part of Fidel Castro’s international medical mission which has won the socialist state many friends, but little international recognition.

Observers of the Haiti earthquake could be forgiven for thinking international aid agencies were alone in tackling the devastation that killed 250,000 people and left nearly 1.5 million homeless. In fact, Cuban healthcare workers have been in Haiti since 1998, so when the earthquake struck the 350-strong team jumped into action. And amid the fanfare and publicity surrounding the arrival of help from the US and the UK, hundreds more Cuban doctors, nurses and therapists arrived with barely a mention. Most countries were gone within two months, again leaving the Cubans and Médecins Sans Frontières as the principal healthcare providers for the impoverished Caribbean island.

Figures released last week show that Cuban medical personnel, working in 40 centres across Haiti, have treated more than 30,000 cholera patients since October. They are the largest foreign contingent, treating around 40 per cent of all cholera patients. Another batch of medics from the Cuban Henry Reeve Brigade, a disaster and emergency specialist team, arrived recently as it became clear that Haiti was struggling to cope with the epidemic that has already killed hundreds.

Since 1998, Cuba has trained 550 Haitian doctors for free at the Escuela Latinoamericana de Medicina en Cuba (Elam), one of the country’s most radical medical ventures. Another 400 are currently being trained at the school, which offers free education – including free books and a little spending money – to anyone sufficiently qualified who cannot afford to study medicine in their own country.

John Kirk is a professor of Latin American studies at Dalhousie University in Canada who researches Cuba’s international medical teams. He said: “Cuba’s contribution in Haiti is like the world’s greatest secret. They are barely mentioned, even though they are doing much of the heavy lifting.”

This tradition can be traced back to 1960, when Cuba sent a handful of doctors to Chile, hit by a powerful earthquake, followed by a team of 50 to Algeria in 1963. This was four years after the revolution, which saw nearly half the country’s 7,000 doctors voting with their feet and leaving for the US.

The travelling doctors have served as an extremely useful arm of the government’s foreign and economic policy, winning them friends and favours across the globe. The best-known programme is Operation Miracle, which began with ophthalmologists treating cataract sufferers in impoverished Venezuelan villages in exchange for oil. This initiative has restored the eyesight of 1.8 million people in 35 countries, including that of Mario Teran, the Bolivian sergeant who killed Che Guevara in 1967.

The Henry Reeve Brigade, rebuffed by the Americans after Hurricane Katrina, was the first team to arrive in Pakistan after the 2005 earthquake, and the last to leave six months later.

Cuba’s constitution lays out an obligation to help the worst-off countries when possible, but international solidarity isn’t the only reason, according to Professor Kirk. “It allows Cuban doctors, who are frightfully underpaid, to earn extra money abroad and learn about diseases and conditions they have only read about. It is also an obsession of Fidel’s and it wins him votes in the UN.”

A third of Cuba’s 75,000 doctors, along with 10,000 other health workers, are currently working in 77 poor countries, including El Salvador, Mali and East Timor. This still leaves one doctor for every 220 people at home, one of the highest ratios in the world, compared with one for every 370 in England.

Wherever they are invited, Cubans implement their prevention-focused holistic model, visiting families at home, proactively monitoring maternal and child health. This has produced “stunning results” in parts of El Salvador, Honduras and Guatemala, lowering infant and maternal mortality rates, reducing infectious diseases and leaving behind better trained local health workers, according to Professor Kirk’s research.

Medical training in Cuba lasts six years – a year longer than in the UK – after which every graduate works as a family doctor for three years minimum. Working alongside a nurse, the family doctor looks after 150 to 200 families in the community in which they live.

This model has helped Cuba to achieve some of the world’s most enviable health improvements, despite spending only $400 (£260) per person last year compared with $3,000 (£1,950) in the UK and $7,500 (£4,900) in the US, according to Organisation for Economic Co-operation and Development figures.

Infant mortality rates, one of the most reliable measures of a nation’s healthcare, are 4.8 per 1,000 live births – comparable with Britain and lower than the US. Only 5 per cent of babies are born with a low birth weight, a crucial factor in long-term health, and maternal mortality is the lowest in Latin America, World Health Organisation figures show. Cuba’s polyclinics, open 24 hours a day for emergencies and specialist care, are a step up from the family doctors. Each provides for 15,000 to 35,000 patients via a group of full-time consultants as well as visiting doctors, ensuring that most medical care is provided in the community.

Imti Choonara, a paediatrician from Derby, leads a delegation of international health professionals at annual workshops in Cuba’s third city, Camaguey. “Healthcare in Cuba is phenomenal, and the key is the family doctor, who is much more proactive, and whose focus is on prevention … The irony is that Cubans came to the UK after the revolution to see how the NHS worked. They took back what they saw, refined it and developed it further; meanwhile we are moving towards the US model,” Professor Choonara said.

Politics, inevitably, penetrates many aspects of Cuban healthcare. Every year hospitals produce a list of drugs and equipment they have been unable to access because of the American embargo which prevents many US companies from trading with Cuba, and persuades other countries to follow suit. The 2009/10 report includes drugs for childhood cancers, HIV and arthritis, some anaesthetics, as well as chemicals needed to diagnose infections and store organs. Pharmacies in Cuba are characterised by long queues and sparsely stacked shelves, though in part this is because they stock only generic brands.

Antonio Fernandez, from the Ministry of Public Health, said: “We make 80 per cent of the drugs we use. The rest we import from China, former Soviet countries, Europe – anyone who will sell to us – but this makes it very expensive because of the distances.”

On the whole, Cubans are immensely proud and supportive of their contribution in Haiti and other poor countries, delighted to be punching above their weight on the international scene. However, some people complain of longer waits to see their doctor because so many are working abroad. And, like all commodities in Cuba, medicines are available on the black market for those willing to risk large fines if caught buying or selling.

International travel is beyond the reach of most Cubans, but qualified nurses and doctors are among those forbidden from leaving the country for five years after graduation, unless as part of an official medical team.

Like everyone else, health professionals earn paltry salaries of around $20 (£13) a month. So, contrary to official accounts, bribery exists in the hospital system, which means some doctors, and even hospitals, are off-limits unless patients can offer a little something, maybe lunch or a few pesos, for preferential treatment.

Cuba’s international ventures in healthcare are becoming increasingly strategic. Last month, officials held talks with Brazil about developing Haiti’s public health system, which Brazil and Venezuela have both agreed to help finance.

Medical training is another example. There are currently 8,281 students from more than 30 countries enrolled at Elam, which last month celebrated its 11th anniversary. The government hopes to inculcate a sense of social responsibly into the students in the hope that they will work within their own poor communities for at least five years.

Damien Joel Suarez, 27, a second year from New Jersey, is one of 171 American students; 47 have already graduated. He dismisses allegations that Elam is part of the Cuban propaganda machine. “Of course, Che is a hero here but he isn’t forced down your neck.”

Another 49,000 students are enrolled in the El Nuevo Programa de Formacion de Medicos Latinoamericanos, the brainchild of Fidel Castro and Hugo Chavez, who pledged in 2005 to train 100,000 doctors for the continent. The course is much more hands-on, and critics question the quality of the training.

Professor Kirk disagrees: “The hi-tech approach to health needed in London and Toronto is irrelevant for millions of people in the Third World who are living in poverty. It is easy to stand on the sidelines and criticise the quality, but if you were living somewhere with no doctors, then you’d be happy to get anyone.”

There are nine million Haitians who would probably agree.

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