[Marxism] Cuba exports health (Le Monde diplomatique)

Walter Lippmann walterlx at earthlink.net
Fri Aug 11 11:02:51 MDT 2006

The Bush administration now shrilly denounces "Islamic Fascism" 
around the world, and frames up Muslims in the United States on 
terrorism charges, as his little cousin Tony Blair does likewise
in the United Kingdom. Islamophobia has become quite the bugaboo
in the United States where fear of the unknown, whether foreign, 
or non-white, or others have long been building blocks for such
rightist campaigns as the anti-immigrant and anti-GBGT worlds.
It it any wonder then that someone who was seeking a world-view
to help explain, to himself and to others how a better world, a
world freed of racism, exploitation and violence, might turn to
Islam to express his consciousness? That is precisely happened 
with Malcolm X, and there is something which can be learned from
Malcolm's experience. When he bacame a Muslim, he didn't become a
fanatic. It simply was his religious practics, though it obviously
informed his activities as a revolutionary fighter as well. Here
in Cuba I knee-jerk hostility toward religion, probably something
related to the dogmatic style of Marxism practices in the Soviet
Union, was given up a long time ago. Note here the emphasais the
Cubans placed on the way their predominantly female medical staff
dressed when they went to provide care in Pakistan after last year's
earthquake in that Islamic country?

Walter Lippmann, CubaNews

WALL STREET JOURNAL today quoting U.S. President Bush:
"The recent arrests that our fellow citizens are now learning about 
are a stark reminder that this nation is at war with Islamic fascists 
who will use any means to destroy those of us who love freedom, to 
hurt our nation."

Le Monde diplomatique

August 2006


Cuba exports health

Some 14,000 Cuban doctors now give free treatment to Venezuela's poor
and 3,000 Cuban medical staff worked in the aftermath of last year's
Kashmir earthquake. Cuba has plans to heal those poorer than itself.

by Hernando Calvo Ospina

When Hurricane Katrina ripped through the southern United States in
August 2005, the authorities were overwhelmed and the governor of
Louisiana, Kathleen Babineaux Blanco, appealed to the international
community for emergency medical aid. The Cuban government immediately
offered assistance to New Orleans and to the states of Mississippi
and Alabama, also affected by the storm, and promised that within 48
hours 1,600 doctors, trained to deal with such catastrophes, would
arrive with all the necessary equipment plus 36 tonnes of medical
supplies. This offer, and another made directly to President George
Bush, went unanswered. In the catastrophe at least 1,800 people, most
of them poor, died for lack of aid and treatment.

In October 2005, the Kashmir region of Pakistan experienced one of
the most violent earthquakes in its history, with terrible
consequences in the poorest and most isolated areas to the north. On
15 October an advance party of 200 emergency doctors arrived from
Cuba with several tonnes of equipment. A few days later, Havana sent
the necessary materials to erect and equip 30 field hospitals in
mountain areas, most of which had never been previously visited by a
doctor. Local people learned of Cuba's existence for the first time.

To avoid causing offence in this predominantly Muslim country, the
women on the Cuban team, who represented 44% of some 3,000 medical
staff sent to Pakistan in the next six months, dressed appropriately
and wore headscarves. Good will was quickly established; many
Pakistanis even allowed their wives and daughters to be treated by
male doctors.

By the end of April 2006, shortly before their departure, the Cubans
had treated 1.5 million patients, mostly women, and performed 13,000
surgical operations. Only a few severely injured patients had to be
flown to Havana. Pakistan's President Pervez Musharraf, an important
ally of the US and friend of Bush, officially thanked the Cuban
authorities and acknowledged that this small nation in the Caribbean
had sent more disaster aid than any other country.

First medical brigade

Cuba set up its first international medical brigade in 1963 and
dispatched its 58 doctors and health workers to newly independent
Algeria. In 1998 the Cuban government began to create the machinery
to send large-scale medical assistance to poor populations affected
by natural disasters. After hurricanes George and Mitch blew through
Central America and the Caribbean, it offered its medical personnel
as part of an integrated health programme. The Dominican Republic,
Honduras, Guatemala, Nicaragua, Haiti and Belize all accepted this

Cuba offered massive medical assistance to Haiti, where healthcare
was chronically inadequate. In 1998 Cuba even approached France,
Haiti's former colonial power, with a proposal to establish a
humanitarian association to help the people of Haiti. The French
government did not respond (although, finally, in 2004, it sent
troops). Since 1998 Cuba has sent 2,500 doctors and as much medicine
as its fragile economy permits.

This free aid - the Cuban government funds the personnel -has been
effective. The willingness of the new barefoot doctors (1) to
intervene in areas where their local equivalents refuse to go,
because of the poverty of the clientele or the danger or difficulty
of access, has persuaded other countries, especially in Africa, to
apply for assistance.

Between 1963 and 2005 more than 100,000 doctors and health workers
intervened in 97 countries, mostly in Africa and Latin America (2) By
March 2006, 25,000 Cuban professionals were working in 68 nations.
This is more than even the World Health Organisation can deploy,
while Médecins Sans Frontières sent only 2,040 doctors and nurses
abroad in 2003, and 2,290 in 2004 (3).

The most seriously ill patients are often brought to Cuba for
treatment. Over the decades these have included Vietnamese Kim Phuc,
the little girl shown in the famous war photograph running naked
along a road, her skin burned by US napalm. Cuba also took in some
19,000 adults and children from the three Soviet republics most
affected by the Chernobyl nuclear accident of 1986.

In June 2001 the United Nations General Assembly met in special
session to discuss Aids. Cuba, with an HIV infection rate of 0.09%
compared with 0.6% in the US, made an offer of "doctors, teachers,
psychologists, and other specialists needed to assess and collaborate
with the campaigns to prevent Aids and other illnesses; diagnostic
equipment and kits necessary for the basic prevention programmes and
retrovirus treatment for 30,000 patients".

If this offer had been accepted, "all it would take is for the
international community to provide the raw materials for the
medicines, the equipment and material resources for these products
and services. Cuba will not charge and will pay the salaries in its
national currency" (4).

The offer was rejected. But eight African and six Latin American
countries did benefit from an educational HIV/Aids intervention
project which broadcast radio and television programmes, treated more
than 200,000 patients and trained more than half a million health

There are currently some 14,000 Cuban doctors working in poor areas
of Venezuela. The two governments have also set up Operation Milagro
(miracle) which, during the first 10 months of 2005, gave free
treatment to restore the eyesight of almost 80,000 Venezuelans,
transferring those suffering from cataracts and glaucoma to Cuba for
operations (5). More widely, the project offers help to anyone in
Latin America or the Caribbean affected by blindness or other eye
problems. Venezuela provides the funding; Cuba supplies the
specialists, the surgical equipment and the infrastructure to care
for patients during their treatment in Cuba.

So far no other government, private body or international
organisation has managed to put together a global medical programme
on such a scale or to offer such a level of assistance to those in
need of care. Operation Milagro's goal is to operate on the eyes of a
million people every year.

A few hours before he took up office as president of Bolivia in
December 2005, Evo Morales signed his first international treaty,
which was with Cuba, setting up a joint unit to offer free
ophthalmological treatment. As well as the national institute of
ophthalmology in La Paz, recently equipped by Cuba, there will be
medical centres in the cities of Cochabamba and Santa Cruz. Young
Bolivian graduates from the Latin American School of Medicine (ELAM)
will take part in the programme.

ELAM was founded in 1998, just as Cuba began to send doctors to the
Caribbean and Central America. It operates from a former naval base
in a suburb of Havana and trains young people of poor families from
throughout the Americas, including the US. There are also hundreds of
African, Arab, Asian and European students. Cuba's 21 medical
faculties all participate in training. In July 2005 the first 1,610
Latin American students graduated. Each year some 2,000 young people
enroll at the school, where they receive free training, food,
accommodation and equipment in return for a commitment to go back
home and treat their compatriots (6).

Really doctors?

Ideological considerations have inspired the medical and
ophthalmologic associations of some countries to launch a campaign
against this initiative. The review of the Argentine council of
ophthalmology, for example, questioned whether the Cuban
ophthalmologists really were doctors and announced that it was taking
steps, along with humanitarian NGOs, to fund a similar programme (7).

There was the same reaction in 1998 in Nicaragua, where, despite the
severity of the catastrophe caused by hurricane Mitch, President
Arnoldo Alemán refused to admit Cuban doctors. Similar reactions have
been seen in Venezuela since 2002 and now in Bolivia. Conservative
doctors, who prefer to specialise in diseases of the credit-worthy
and refuse to enter shantytowns, accuse Cuba's barefoot doctors of
incompetence, illegal medical practice and unfair competition.

In April 2005 the legal authorities in the Brazilian state of
Tocantins ordered out 96 Cuban doctors who had been treating the
poor. The state governor disagreed, but could do no more than
"recognise the professional bravery of the doctors who were welcome
here and whom we wish to thank".

The medical associations are afraid that if the Cuban medics bring
down prices or even offer some services free, medical treatment will
cease to be a profitable, elitist service. As each new doctor
graduates in Cuba, they intensify their protests and political

There is also a threat that diplomas obtained in Cuba will not be
recognised elsewhere. Excessive charges in Chile have prevented many
Cuban-trained doctors from validating their medical qualifications
there. But, as the BBC has pointed out, if Latin America's medical
associations persist in their opposition they risk losing the support
of populations deprived of access to health services, for whom the
project is a glimmer of light in the darkness (8). In the US, where
45 million people have no health cover and medical studies cost about
$300,000, a blockade forbids students to study in Cuba, threatening
up to 10 years' imprisonment and fines of up to $200,000.

Sceptics see the humanitarian aid offered by Cuba as a publicity
stunt, an investment to secure diplomatic support in the face of
continuing US hostility. They point out that when the UN Human Rights
Council was established in March 2006, Cuba was elected with the
support of 96 of the 191 UN member states, whereas Nicaragua, Peru
and Venezuela, where political opposition is legal, as it is not in
Cuba, were rejected.

But a western diplomat was prepared to recognise that Cuba's policy
of exporting doctors was an initiative which benefited so many people
that it should be applauded even by its political enemies (9).

Hernando Calvo Ospina is a journalist and the author of `Bacardi: the
Hidden War' (Pluto Press, London, 2002)

(1) This term originated in China around the time of the Cultural
Revolution and described farmers with basic medical training who
worked in rural areas.

(2) During 2005 the programme helped the most deprived areas of six
countries in Latin America and 20 in Africa. The staff delivered more
than half a million babies, carried out 1,657,867 operations and did
almost 9 million vaccinations.

(3) Financial report for 2004.

(4) Speech by the Cuban vice-president, Carlos Lage Davila,

(5) In the region, a cataract operation costs a minimum $600.

(6) The joint projects between the governments of Venezuela and Cuba
include one to offer free medical training to 10,000 Latin Americans
annually, not only in Cuban universities but also in an
infrastructure being set up in Venezuela.

(7) Periódico Informativo Oftalmológico, 37, Buenos Aires, 26
December 2005.

(8) BBC, 5 April 2001.

(9) Ibid.

Translated by Donald Hounam


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