"Cuban Health Care"
Don Fitz
Monthly Review Press, 303 pages
Eve Ottenberg
With Covid-19 roaring through the U.S., now is a good time to discuss Cuban health care. It's about as different from the American variety as possible. It is not for profit. It is socialized. It does not first resort to expensive medical technology. Its doctors live among the people, like in Haiti after the earthquake, not in luxury hotels, like American doctors. It does not rely on the thinking that there is a pill for every ailment. It is successful. Cuba has suffered 88 deaths from covid, and the 3408 infected people have not gone bankrupt receiving care. To repeat, that's because Cuban doctors and pharmaceutical entities are not in it for the money. Cuba's astonishingly good health statistics derive from its emphasis on preventive medicine, something not stressed nearly enough in the U. S.
Cuba's medical achievements have enabled it, for decades, despite devastating and criminal sanctions from the U.S., to send tens of thousands of physicians and nurses to poor countries across the globe. When covid slammed the world, Cuba was ready. Its medical brigades went to Italy, when that country was hardest hit, and its doctors received a standing ovation when they arrived in the airport. A medicine Cuba developed, interferon alpha 2b, showed so much promise with covid patients in China back in January that 45 countries have since requested it from Cuba. But there is no mention of this covid treatment in the U.S. media. Cuba, a small, relatively poor island country, has shared its medicines and its medical personnel – at great risk to their lives – with countries across the globe throughout the covid pandemic. This has led to a push for Cuban doctors to get the Nobel Prize. They certainly deserve it.
An incidental benefit of awarding Cuban doctors the Nobel would be breaking the conspiracy of silence about Cuba's remarkable medical successes. Don Fitz eloquently documents that conspiracy and the feats of heroism that it conceals, in his new book, "Cuban Health Care." "Since 1961, over 124,000 health professionals [from Cuba] have worked in over 154 countries," Fitz writes. "By 2009, in addition to 11 million people in their own country, Cuban doctors were providing medical care for over 70 million people." Like the U.S., Cuba has a 78-year life expectancy, but "spends only four percent per person of U.S. health costs." The Cuban infant mortality rate is lower than the U.S. one and half that of the U.S. black population, Fitz reports.
After its 1959 revolution, Cuba "eliminated polio in 1962, malaria in 1967, neonatal tetanus in 1972, diphtheria in 1979, congenital rubella syndrome in 1989, post-mumps meningitis in 1989, measles in 1993, rubella in 1995 and tuberculosis meningitis in 1997." Cuba had only 200 AIDS patients when New York City had 43,000. During crushing U.S. economic sanctions, Cuba achieved all this because of its uniquely rational health care model. Instead of reserving care only for the affluent few, as in the U.S., Cuba provides it to everybody, free. It does so through its family doctor program, begun in 1984.
In this program, each doctor and nurse team "included 600-800 [patients] within two to three square blocks in most cities and towns. The teams were required to see every patient at least twice a year…These new family doctors were…very different from the old general practitioners." The doctor and nurse team lives in its patients' neighborhood, often in apartments above the clinic. They frequently walk to patients' houses or apartments to examine them or treat them at home. Thus they know first-hand critical details about their patients' life-styles and illnesses. There is nothing impersonal about this medical system. And that's just within Cuba. Outside it, "52,000 Cuban medical workers [offer] their services in 92 countries," which is more than either the World Health Organization or "the combined efforts of the G-8 nations."
A media blackout hides these feats. And in some countries, hostile medical associations try to drive Cuban doctors out. "The conspiracy of silence surrounding the resounding success of Cuba's health system," Fitz writes "is egregious and it casts a doubt on the good intentions of" international health organizations. Fitz is too kind. This conspiracy reveals active, bad intentions. Those were never so fully on display as during Hurricane Katrina, when Cuba offered to send 1500 doctors to New Orleans. The Bush administration refused, revealing, as Fitz comments, that the U.S. preferred needy Americans to die than to accept help from Cuba and thus concede the superiority of Cuban medicine.
The same happened with Covid-19. As the lousy U.S. for profit health care system has led to over 175,000 deaths, Cuban medical personnel have travelled the world, saving lives. Just as they did after Chernobyl, when Cuba took in 25,000 Ukrainian patients and treated them gratis – for years. For many in the Global South, the only doctor they'll ever see is a Cuban doctor. And in these covid-ravaged times, Cuban medical workers risk their lives to save those of patients in other countries. For this alone, Cuban doctors deserve praise and recognition of their heroism. What better way than awarding them the Nobel Prize?