Wednesday, Feb. 10th 2010.
I recently went to the Intensive Care Unit (ICU) of the Mt Hope Hospital to visit a friend and I became somewhat geographically disoriented. I was first greeted by a Nigerian doctor, then a Filipino nurse, a Cuban doctor, and later an Indian physician.
I asked the very polite Filipino nurse to call the consultant in charge of my friend. He was not in the hospital but she called one of his junior staff. Soon after a young and pleasant UWI-trained doctor, very recently qualified (but working in the ICU?), arrived. However she did not know who I was and indeed she had never heard of me at all. But why should she? Look, I was told that a young college student once looked at a photograph of Eric Williams and asked if he was Ellis Clarke! So who is me!
Now, a few days ago a newspaper headline ’More Cuban health workers coming’ attracted my attention, but before I go into that I think the country should know something about the Cuban healthcare system. After the revolution in 1959, half of the country’s 6,000 doctors fled the island (but many well-qualified doctors and scientists remained). In addition, the US embargo severely reduced the availability of medical technology and medication. The new government immediately promoted medical education as part of a national project to revamp the healthcare system. Education is free for medical students, but as a rule Cuban medical students and doctors must contend with a lack of modern equipment and often certain diagnostic tools which are taken for granted in developed countries.
According to international medical journals, Cuba has about 33,000 family physicians and specialisation in family medicine is a requirement for more than 97 per cent of the medical graduates. Over the years the number of medical and nursing schools and training centres for health technicians rapidly increased, so much so that Cuba’s ratio for physicians and nurses per 10,000 population is even higher than in the United States. Cuban health outcomes also match or surpass those in high-income countries as reflected in low infant, child, and maternal mortality rates. Cubans also have one of the world’s highest life expectancies of 77 years. There is also a Latin American School of Medical Science in Havana which attracts thousands of students from around the world but applicants must make a commitment to return to their communities and those who do not speak Spanish have to take intense courses in the language. In fact, I was recently told by a consultant colleague in Barbados that Barbados has sent a few of its doctors to be trained in Cuba!
But although Cuba has had to struggle for years with a US blockade, it has nonetheless developed a significant biotechnology and pharmaceutical industry. A comprehensive research policy supports the health sector’s development and its biotechnology research has led to novel diagnostic tools and recombinant vaccines against hepatitis B, meningitis B, and haemophilus influenza type B. In fact in 2005, Cuba provided cancer treatment technology for a new biotech company in China. There is also local production of diagnostics and drugs, including antiretroviral drugs for HIV/AIDS and drugs for cancer. By the way, its rate of HIV/AIDS is one of the world’s lowest.
Interestingly, there is no private care or private hospitals for Cubans, but whereas the Cuban healthcare systems lacks essential medication for its own citizens, it offers excellent healthcare to foreigners in exchange for dollars. In fact, hospitals for foreigners always have the latest equipment and drugs!(This is the opinion of this author who never life in Cuba, nobody in Cuba is lack of health support because they are not tourist, even they can have second, third and so many phisicians opinion as they want and have the opportunity inside the system to have attention in any hospital of the island, the designed clinics and hospital for tourist are more "luxury" and "speedy" than the normal one for cubans in some particular cases, thats true, but they never are not so much over the clinical attention than a normal cuban can get by himself with the support of the family and phisicians, I have experience about, recently, by the family of my wife, farmers, still living in Cuba. An is very easy to probed in the real life, any cuban who travel have any kind of disease, they are very healthy and any of them overweigth, that is a particular true in Miami Airport in 2009 with about 37, 000 young cuban, very healthy and strong who left the island to lived in United States and some in Spain and Mexico.Note of the blogger, Gualterio Nunez Estrada, to this article)Now, Cuba has more doctors per capita than any other country: 70,000 for a population of 11 million, and the supply of doctors eventually came to exceed the domestic market. Doctors are not paid much in Cuba (some make less than US$40 a month) and in the 1970s the Cuban regime started to make money from its low-paid doctors by using bilateral service contracts and various money-making strategies. Since 1998, thousands of Cuban doctors have worked in 27 countries and they make an extraordinary humanitarian contribution to the world’s poor populations. The revenue goes directly towards the Ministry of Public Health’s budget and is then invested into the public health system. Indeed, the export of Cuban physicians to Third World countries has benefits both for developing countries and for Cuba since it also siphons off doctors who might otherwise be unemployed.
But the question has been frequently asked, why does Castro send so many of his doctors abroad? There are many reasons, one of which is to trade services for goods that Cuba would not have otherwise. For example, about 15,000 Cuban doctors and dentists currently work in Venezuela while President Hugo Chavez supplies Cuba with subsidised oil.
Apropos this, central to Chavez’s health policy is a project in the neighbourhood of Caracas. The programme, which is popular among Venezuela’s poor, brings Cuban doctors and other medical services to the most remote slums of Venezuela. It has not, however, been without its detractors. The Venezuelan Medical Federation (akin to our T&T Medical Association) has criticised the appointment of Cuban doctors to high-ranking positions, and protests have taken place in Caracas by Venezuelan medical staff, who (justifiably or not) fear that Cubans are a threat to Venezuelan jobs. So what’s new!
To be continued on February 24