The Militant (logo) 
Vol.63/No.42       November 29, 1999 
'Health system in Cuba is based on solidarity'  
BOSTON — "The health-care system in Cuba is internationalist in its core concept. It is based on solidarity with our own people and with other communities in the world," said Dr. Alfredo Portero Urquizo, speaking at Roxbury Community College (RCC) here November 4. Portero is the director of the International Medical Cooperation Unit in the Ministry of Public Health in Cuba.

In a two-week tour of the Boston area, Portero addressed more than 600 people on seven campuses and spoke before seven community organizations and health agencies.

In Boston he spoke at Harvard University, Tufts University, Boston University Medical Center, and the University of Massachusetts. He also spoke at Yale University in New Haven, Connecticut, and Trinity College in Hartford. The tour was organized by the Student-Faculty Cuban Medical Doctor Tour Committee.

At the RCC event, attended by 60 people, Portero was joined at the podium by Dr. Jorge Pérez, the director of Cuba's Instituto Pedro Kouri. Pérez presented a slide show that explained Cuba's program for the treatment of people with AIDS.

Dr. Paul Farmer of the Harvard Medical School also spoke. Farmer is the director of Partners in Health, an agency based in Cambridge, Massachusetts, that organizes health-care projects in Haiti and Roxbury, a mostly Black community in Boston. Pérez was in the United States through an invitation by Farmer.

Portero described Cuba's medical care system and its international medical brigades. "Cuba maintains one medical care system," he said. It is accessible to all Cubans regardless of sex, religion, or political belief and it is free of charge, "whether you need an aspirin or open heart surgery."  

Gains of Cuban revolution

Cuba's prerevolutionary health system treated the wealthy and well-connected, while leaving the vast majority with little or no attention. After workers and farmers took power in Cuba in 1959, ousting the U.S.-backed dictatorship there and opening the first socialist revolution in the Americas, half of the country's 6,000 doctors left.

New generations of youth, motivated by a social system that puts human needs ahead of private profits, responded to the need for replacements. Today Cuba has 66,000 physicians and a total of 350,000 health-care workers.

Cuba's infant mortality rate, which was officially 60 deaths per 1,000 live births in 1959, stands at 7.1 per 1,000 today. That figure is slightly higher than the national average in the United States, but lower than in many large cities and rural areas here.

Cuba has one family doctor per 180 people, and maintains a medical school in each province of the country. Diseases resulting from malnutrition, poor public sanitation, and unhealthy water sources, which are major causes of death in other underdeveloped countries, are unknown in Cuba. The leading causes of death in Cuba are cancer, heart attacks, and high blood pressure, Portero said.

This has been accomplished despite the economic embargo maintained on the island by the United States for close to 40 years. Portero estimated the trade ban, which denies Cuba medicines and equipment that contain any U.S.-manufactured or patented component, has cost more than $60 billion in medical costs alone.

"No international medical collaboration [by Cuban doctors] took place before 1959," Portero noted. The revolutionary govern-ment's medical aid abroad began with an emergency response to a 1960 earthquake in Chile. The first regular internationalist assistance program was established in Algeria in 1963.

Since then, 39,780 volunteers have worked in 80 different nations in the Caribbean, Latin America, Africa, and Asia. Today, 2,652 serve in 56 nations, Portero said.  

Internationalist medical aid

He described the "Integral Medical Aid Plan," initiated by Cuba following Hurricanes Mitch and Georges that devastated parts of the Caribbean and Central America last year. More than 30,000 people died in those hurricanes and their aftermath. Portero said, "The media talked a lot about the destruction of Mitch, but they are silent about the chronic hurricane of malnutrition and diseases that take as many lives every year."

To fight this "chronic hurricane," Cuban volunteer doctors are going to the most remote areas of the countries affected to provide medical relief. At the same time young people from those countries are receiving training in Cuba to become doctors who can eventually replace the Cuban doctors.

Currently there are 429 Cuban doctors in Haiti as part of this program, and the number will be increased to 800 by the end of this year. The host countries provide housing, food, and no more than $100 per month "pocket money" to the medical workers.

Portero noted that Cuba has few material resources to use on these projects. The Cuban government has challenged governments with far more resources to provide medicine and equipment to supplement Cuba's contribution of volunteer medical workers.

He described how the Nicaraguan government at first rejected Cuba's offer of aid following the hurricanes, claiming that poor Cuban doctors just wanted to eat Nicaragua's food. A flood of protests by needy Nicaraguans forced Managua to reverse its stand. "And this time, we sent food as well as doctors," Portero pointed out.

To train doctors from other Latin America countries and the Caribbean, Cuba has established the Latin American School of Medical Science in Havana. Currently it has nearly 2,000 students. Portero stressed that these students are selected by their own governments. The education is completely free, including room and board. The only cost to the student is travel to and from Cuba.

Cuba has expanded the Integral Medical Aid Plan to parts of Africa and recently opened the first medical school in the history of the African nation of Gambia, Portero reported.

During Portero's visit, the Haitian Consulate in Boston held a reception and press conference for the Cuban doctor. Consul Andrine Constant thanked Portero for the medical aid Cuba is giving Haiti.

A highlight of the tour was a meeting of 20 people at the public library in Lawrence, Massachusetts. This meeting, conducted in Spanish, was organized, chaired, and publicized by textile workers at Malden Mills.

Alberto Guerrero Lara, a member of Union of Needletrades, Industrial and Textile Employees Local 311, explained after the program why he helped organize the meeting. "It is a show of solidarity with the Cuban people and it clarifies many lies about the revolution," said Guerrero. "I believe this type of activity should happen more often."

Martin Boyers is a member of the United Auto Workers. Sarah Ullman, a member of the United Transportation Union, contributed to this article.  
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