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Judi Lynn

(160,542 posts)
Mon Oct 27, 2014, 04:35 PM Oct 2014

What’s So New About Cuba’s Medical Internationalism?

What’s So New About Cuba’s Medical Internationalism?

by Mateo Pimentel / October 21st, 2014


Fidel Castro, 88-year-old revolutionary hero and anti-imperialist icon, recently published in the Cuban daily Granma that his island nation would readily cooperate with the US to wrestle Ebola. This is not the first gesture of goodwill that Cuba has made toward the US regarding cooperation, either; rather, it is one of many invitations to solidarity that happen to echo across an icy political tundra spanning years of embargo. Perhaps the newest aspect of Cuba’s long-lived medical internationalism is that, in 2014, it yet defies decades of imperial embargo. Cuba’s international medical mission yet survives Yankee economic terrorism, and does so with an outstretched hand for partnership! Other than Cuba’s remarkable magnanimity that persists well into the 21st century, there is little new about Cuba’s maverick ethos of serving the Third World and its public health.

Despite unimaginable economic hardship, Cuba has had no qualms with proffering (and actually sending) America its vital resource: human capital. Facts amassed within the last few years are worth revisiting, especially given that the size of the Cuban population is a decimal of US numbers, and that Cuba’s financial capability does not compare with America’s. Consider the following:


◾For more than 40 years, Cuban doctors have worked abroad, and Cuban hospitals have received patients from around the world.
◾Cuba has had more than 30,000 health care personnel (19,000 physicians) in over 100 countries.
◾Cuba has sent medical teams to Chile, Nicaragua, and Iran, responding to devastating death tolls and destruction caused by earthquakes.
◾An emergency medical team of almost 2,500 Cubans treated 1.7 million people affected by the 2005 Pakistan earthquake alone.
◾Cuba has sent medical personnel to El Salvador to assuage the outbreak of dengue fever, donating more than 1,000,000 doses of meningitis vaccinations to Uruguay after an outbreak there.
◾Cuba sent medical task forces to Iraq during the Gulf War (which remained there after international relief organizations left); it sent medical crews to the beleaguered peoples of Kosovo, too.
◾Cuban medical personnel went to Guyana in 2005, to aid in flooding, and also to Paraguay so as to work with infectious diseases and epidemiology.
◾Nearly 100 Cuban doctors worked in Botswana in 2005, combating the HIV/AIDS pandemic.
◾Cuba has also offered thousands in medical staff to work with HIV/AIDS in sub-Saharan Africa.

The foregoing list in no way exhausts Cuba’s extensive history of medical internationalism. Again, it goes without saying that Cuba’s medical endeavors are decades old. It has been an enduring, if unofficial, pillar of the Cuban Revolution.

More:
http://dissidentvoice.org/2014/10/whats-so-new-about-cubas-medical-internationalism/
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Wellstone ruled

(34,661 posts)
1. What a shame we have a embargo in place
Mon Oct 27, 2014, 04:48 PM
Oct 2014

against this little country. Because the CIA and the Mob were pissed when Fidel who was a asset of our CIA,turned and went left on them. Remember Eisenhower and Dulles refusing to meet with Castro and the outcome is Fidel said screw you I'am going Russian. Right Wing politics of hatred was in full blown flower in the fifties.

Judi Lynn

(160,542 posts)
11. Wingers have hated Democrats for ages. They despised Franklin D. Roosevelt, as he did so much good
Thu Oct 30, 2014, 01:52 AM
Oct 2014

for the suffering poor after the depression, creating jobs to get the people back to work who had lost EVERYTHING. They knew that he could be re-elected until he was a very old man, and he probably would have, had he not succumbed during his fourth term, to his illness which had been destroying him.

(As you probably know already, high-ranking Republicans also conspired to spring a coup upon F.D.R., at one time, trying to engage a former Marine officer Smedley Butler to lead it for them, which he flat-out refused.)

That's when they legislated TERM LIMITS suddenly for the U.S. President, as soon as FDR died in office, although the Founding Fathers had never placed limits on the number of terms a President might serve, considering the person the people voted for would always be the country's legitimate decision each election.

Good case of the filthy right-wing trying to force its dirty, selfish wishes upon the population. One of far too many.

They are hateful people.

By the way, Eisenhower was the one who had set in motion the Bay of Pigs invasion, having sent Cuban "exiles" and others to train for it in El Salvador or Guatemala (can't remember, but it's available to locate in a search) well before John F. Kennedy was elected.

broiles

(1,367 posts)
2. While I admire Cuba's humanitarianism, I not too sure
Mon Oct 27, 2014, 04:50 PM
Oct 2014

of the quality of Cuba's doctors. I fell in Nicaragua and went to a private clinic to have my head sewn up. The Cuban doctor didn't seem to know what she was doing and the nurse, a local, took over. While this is an admittedly small sample it did make me question the overall quality of Cuban medical care.

Judi Lynn

(160,542 posts)
3. We've had DU'ers who were treated by Cuban docs both in their domestic (for Cubans) offices
Mon Oct 27, 2014, 05:21 PM
Oct 2014

and in the offices designated for Cuban tourists and they have taken the time to post their experiences, and both sides of Cuban medical treatment got very positive reviews from them.

I've also read comments from other posters at the old CNN US-Cuba relations message board, and read the same kind of experiences there.

Cuba has been known internationally for decades for its physicians.

Cuba also has an international program, accepting poor students from many countries, including the United States, to train young medical students, provide housing and food, as well, with the agreement they will go back to their home countries and devote an agreed period of time working with and for the poor of their countries who cannot afford to pay ordinary doctors for their own treatment.

As US graduates have asserted, after graduation, it's a once in a lifetime opportunity they cherish. Example:


A Dream Come True: Cuba’s Free Medical School
By Kayce T. Ataiyero

HAVANA – Ever since she was five years old, Chasiti Falls has known two things: She wanted to be a doctor and she wanted to travel the world. But dreams aren't free in America. They often require money and resources – things that Falls didn't have.

"I always had that aspiration that I was gonna go somewhere and it just led me," Falls said. "You follow the yellow brick road and you see the wizard at the end."

Latin American School of MedicineAs fate would have it, Falls' wizard showed up a year ago on a street corner in her hometown of Atlanta. A man pulled her over and handed her a flyer on the Medical School Scholarship Program at the Latin American School of Medical Sciences in Cuba. It was just the ticket the 30-something mother of one needed to change her life. Suddenly, a woman who had never set foot outside the United States found herself 90-miles offshore in Havana, with her American dream being underwritten by the Cuban government.

"I wanted the best so I came to Cuba. And it was free," Falls said, in explaining why she chose to attend the medical school. "Because I am a parent and have to pay rent and keep the lights on, living free with a bunk mate is heaven to me. I could be at home struggling."

Falls is one of 92 American students – more than half of them black – who are enrolled in the scholarship program. Started by Cuban President Fidel Castro in 2000, the program offers low-income students a free medical school education in Cuba. In exchange, the students must agree to go back to the United States to provide much needed health care in underserved communities.

The students receive tuition, books, room and board for six years. They are also provided Spanish language immersion courses, if necessary. All of the instruction at the school is conducted in Spanish.

Rev. Lucius Walker, executive director of the Interreligious Foundation for Community Organization, the New York-based group that facilitates the program stateside, said students are given the rare opportunity to learn from world-renowned doctors for free. Walker said the program is working to address a critical need in the black community, which is seeing an increasing number of health care providers leave. Currently, only about six percent of U.S. doctors are black.

More:
http://www.ifajs.org/cuba/ataiyero_dream.html

[center]~ ~ ~[/center]
A very quick search produced this article:

Eight Americans graduate from free Cuban medical school

Posted 7/25/2007 3:42 AM


[font size=1]
From left to right: Melissa Barber, Carmen Landau, Evelyn Erickson, Toussaint Reynolds, Jose
De Leon, Kenya Bingham, Wing Wu and Teresa Thomas. The eight Americans were among more
than 2,100 graduates who received diplomas Tuesday at Havana's Karl Marx theater. [/font]

HAVANA (AP) — Eight Americans who graduated from a Cuban medical school say they will put the education paid for by Fidel Castro's communist government to use in hospitals back home.

Four New Yorkers, three Californians and a Minnesotan, all from minority backgrounds, have studied in Havana since April 2001, forming the first class of American graduates from the Latin American School of Medicine.

One other American previously graduated from the school after transferring from a U.S. university, but the six women and two men graduating Tuesday were the first Americans to complete the entire six-year program since Castro offered the free medical training to U.S. students. The offer followed a meeting a delegation from the U.S. Congressional Black Caucus.

The students said that much of what they learned in Cuba matched the curriculum at American medical schools, but that instructors here placed a special emphasis on preventative care.

"I will be heading back to the United States with a great advantage over the American students who have stayed there," said Wing Wu, from Minneapolis, Minnesota.

"I've learned that medicine is not a business, it's social, it's humane," said Toussaint Reynolds, a graduate from Massapequa, New York. "I will be a better doctor in the United States for it."

More:
http://usatoday30.usatoday.com/news/health/2007-07-25-cuba_N.htm

EX500rider

(10,849 posts)
6. Problems within Cuba's health system, including:
Wed Oct 29, 2014, 02:43 PM
Oct 2014
Low pay of doctors.
Poor facilities—buildings in poor state of repair and mostly outdated.
Poor provision of equipment.
Frequent absence of essential drugs.
Concern regarding freedom of choice both for patient and doctor.
Katherine Hirschfeld, an anthropology professor at the University of Oklahoma, did her Ph.D. thesis on the Cuban health system, spending nine months conducting ethnographic work in Cuba in the late 1990s. According to Hirschfeld, "public criticism of the government is a crime in Cuba", which means that "formally eliciting critical narratives about health care would be viewed as a criminal act both for me as a researcher, and for people who spoke openly with me". Nevertheless, she was able to hear from many Cubans, including health professionals, "serious complaints about the intrusion of politics into medical treatment and health care decision-making". She points out that "there is no right to privacy in the physician-patient relationship in Cuba, no patients’ right of informed consent, no right to refuse treatment, and no right to protest or sue for malpractice". In her view medical care in Cuba can be dehumanizing.

Hirschfeld explains also that the Cuban Ministry of Health (MINSAP) sets statistical targets that are viewed as production quotas. The most guarded is infant mortality rate. To illustrate this, Hirschfeld describes a case where a doctor said that if the ultrasound examination revealed "some fetal abnormalities", the woman "would have an abortion", to avoid an increase in the infant mortality rate.

Hirschfeld refer to well-documented research about the Soviet Union and the People's Republic of China, showing that "revolutionary" efforts "can also include such practices as deliberate manipulation of health statistics, aggressive political intrusion into health care decision-making, criminalizing dissent, and other forms of authoritarian policing of the health sector designed to insure health changes reflect the (often utopian) predictions of Marxist theory". But, according to Hirshfeld, "the true extent of these practices was virtually unknown in the West", where "social scientists frequently cited favorable health statistics supplied by [these regimes], without critically looking at the ways these were created and maintained by state power".

Hirschfeld concludes that "Cuba’s health indicators are at least in some cases obtained by imposing significant costs on the Cuban population -- costs that Cuban citizens are powerless to articulate or protest, and foreign researchers unable to empirically investigate"


http://en.wikipedia.org/wiki/Health_care_in_Cuba#Criticism

Judi Lynn

(160,542 posts)
7. Cuba's Health Care System: a Model for the World
Wed Oct 29, 2014, 10:13 PM
Oct 2014

Salim Lamrani

Doctor, Paris Sorbonne Paris IV University, Lecturer, University of La Réunion

Cuba's Health Care System: a Model for the World

Posted: 08/08/2014 9:46 am EDT Updated: 10/08/2014 5:59 am EDT

According to the UN's World Health Organization, Cuba's health care system is an example for all countries of the world.

The Cuban health system is recognized worldwide for its excellence and its efficiency. Despite extremely limited resources and the dramatic impact caused by the economic sanctions imposed by the United States for more than half a century, Cuba has managed to guarantee access to care for all segments of the population and obtain results similar to those of the most developed nations.

During her recent visit to Havana in July of 2014, Margaret Chan, Director-General of the World Health Organization (WHO), impressed by the country's achievements in this field, praised the Cuban health care system: "Cuba is the only country that has a health care system closely linked to research and development. This is the way to go, because human health can only improve through innovation," She also praised "the efforts of the country's leadership for having made health an essential pillar of development" [1].

Cuba's health care system is based on preventive medicine and the results achieved are outstanding. According to Margaret Chan, the world should follow the example of the island in this arena and replace the curative model, inefficient and more expensive, with a prevention-based system. "We sincerely hope that all of the world's inhabitants will have access to quality medical services, as they do in Cuba," she said. [2]

WHO notes that the lack of access to care in the world is by no means a foregone conclusion arising from a lack of resources. It reflects, instead, a lack of political will on the part of leaders to protect their most vulnerable populations. The organization cites the case of the Caribbean island as the perfect counter-example [3]. Moreover, in May 2014, in recognition of the excellence of its health care system, Cuba chaired the 67th World Health Assembly [4].

More:
http://www.huffingtonpost.com/salim-lamrani/cubas-health-care-system-_b_5649968.html

Judi Lynn

(160,542 posts)
8. Continuing with more info. on Cuba's amazing health system:
Thu Oct 30, 2014, 12:08 AM
Oct 2014

07.12.12
Why Is Cuba's Health Care System the Best Model for Poor Countries?
by Don Fitz
Furious though it may be, the current debate over health care in the US is largely irrelevant to charting a path for poor countries of Africa, Latin America, Asia, and the Pacific Islands. That is because the US squanders perhaps 10 to 20 times what is needed for a good, affordable medical system. The waste is far more than 30% overhead by private insurance companies. It includes an enormous amount of over-treatment, creation of illnesses, exposure to contagion through over-hospitalization, disease-focused instead of prevention-focused research, and making the poor sicker by refusing them treatment.1

Poor countries simply cannot afford such a health system. Well over 100 countries are looking to the example of Cuba, which has the same 78-year life expectancy of the US while spending 4% per person annually of what the US does.2

The most revolutionary idea of the Cuban system is doctors living in the neighborhoods they serve. A doctor-nurse team are part of the community and know their patients well because they live at (or near) the consultorio (doctor's office) where they work. Consultorios are backed up by policlínicos which provide services during off-hours and offer a wide variety of specialists. Policlínicos coordinate community health delivery and link nationally-designed health initiatives with their local implementation.

Cubans call their system medicina general integral (MGI, comprehensive general medicine). Its programs focus on preventing people from getting diseases and treating them as rapidly as possible.

~snip~

Seventh, the New Global Medicine can become reality only if medical staff put healing above personal wealth. In Cuba, being a doctor, nurse, or support staff and going on a mission to another country is one of the most fulfilling activities a person can do. The program continues to find an increasing number of volunteers despite the low salaries that Cuban health professionals earn. There is definitely a minority of US doctors who focus their practice in low-income communities which have the greatest need. But there is no US political leadership which makes a concerted effort to get physicians to do anything other than follow the money.

More:
http://mrzine.monthlyreview.org/2012/fitz071212.html

Judi Lynn

(160,542 posts)
9. Why Does Health Care in Cuba Cost 96% Less than in the US?
Thu Oct 30, 2014, 01:20 AM
Oct 2014

Why Does Health Care in Cuba Cost 96% Less than in the US?
Written by Don Fitz
Thursday, 06 January 2011 17:49

When Americans spend $100 on health care, is it possible that only $4 goes to keeping them well and $96 goes somewhere else? Single payer health care advocates compare American health care to that in Western Europe or Canada and come up with figures of 20–30% waste in the US. But there is one country with very low level of economic activity yet with a level of health care equal to the West: Cuba.
Life expectancy of about 78 years of age in Cuba is equivalent to the US. Yet, in 2005, Cuba was spending $193 per person on health care, only 4% of the $4540 being spent in the US. Where could the other 96% of US health care dollars be going?

1. A fragmented system

Explaining why health care is 16% of the US gross domestic product while it is less than half that in the UK, a 2008 article in Dollars and Sense pointed out that…the US has the most bureaucratic health care system in the world, including over 1500 different companies, each offering multiple plans, each with its own marketing program and enrollment procedures, its own paperwork and policies, its CEO salaries, sales commissions, and other non-clinical costs—and, of course, if it is a for-profit company, its profits.

An article widely cited during the debate on single-payer calculated that administration eats up 31% of health care costs. Insurance companies that compete in the market have duplicative claims-processing facilities and must keep track of a variety of approval and co-payment requirements.

Several Canadian physicians who peeked at US hospitals found that for-profit ones paid executive bonuses that were up to 20% higher, were more likely to upcode diagnoses in order to receive more reimbursement, and overwhelmingly had more lawsuits against them for performing unnecessary surgeries and billing for services not provided.

More:
http://upsidedownworld.org/main/cuba-archives-43/2852-why-does-health-care-in-cuba-cost-96-less-than-in-the-us

 

Mika

(17,751 posts)
4. In a private clinic?
Mon Oct 27, 2014, 05:23 PM
Oct 2014

Hmmmm.
Maybe it is a Cuban who emigrated and is working in Nicaragua?
Cuban Ministry of Health brigadistas don't work in private clinics. They work in public clinics and public hospitals.
My experiences with Cuban Drs in Cuba and their international brigade doctors and auxiliaries were all excellent.

- -

I went to a podiatrist in Miami a while back, and the orthotic insert I got wasn't quite right, so, I guess it makes me question the overall quality of the entire US health system. Uh huh.


Judi Lynn

(160,542 posts)
5. Thanks, Mika, for calling our attention to this puzzling comment.
Mon Oct 27, 2014, 05:46 PM
Oct 2014

I totally missed the "private clinic" the first time around. Very mysterious!

Maybe the Cuban doc was moonlighting from his/her regular job by seeking extra work in the private sector!

[center]



Paul Lynde, R.I.P. [/center]

Judi Lynn

(160,542 posts)
10. W. Post article: In the medical response to Ebola, Cuba is punching far above its weight
Thu Oct 30, 2014, 01:26 AM
Oct 2014

In the medical response to Ebola, Cuba is punching far above its weight
By Adam Taylor October 4

While the international community has been accused of dragging its feet on the Ebola crisis, Cuba, a country of just 11 million people that still enjoys a fraught relationship with the United States, has emerged as a crucial provider of medical expertise in the West African nations hit by Ebola.

On Thursday, 165 health professionals from the country arrived in Freetown, Sierra Leone, to join the fight against Ebola – the largest medical team of any single foreign nation, according to the World Health Organization (WHO). And after being trained to deal with Ebola, a further 296 Cuban doctors and nurses will go to Liberia and Guinea, the other two countries worst hit by the crisis.

Cuba is, by any measure, not a wealthy country. It had a Gross Domestic Product (GDP) of slightly more than $68 billion in 2011, according to the World Bank, putting it a few places higher than Belarus. At $6,051, its GDP per capita was less than one-sixth of Britain's. However, its official response to Ebola seems far more robust than many countries far wealthier than it – and serves as further proof that health-care professionals are up there with rum and cigars in terms of Cuban exports.

Cuba's universal health-care system enables such an export. The country nationalized its health care shortly after its revolution, ending private health care and guaranteeing free health care in its constitution. The results have been widely praised. In 2008, evaluating 30 years of Cuba's "primary health care revolution," the Bulletin of the World Health Organization pointed to impressive strides that the country had made in certain health indicators. "These indicators – which are close or equal to those in developed countries – speak for themselves," Gail Reed noted, pointing to a huge reduction in number of deaths for children under five years old and Cuba's high life expectancy of 77 years.

Cuba's health-care success is built upon its medical training. After the Cuban revolution, half of the country's 6,000 doctors fled and the country was forced to rebuild its work force. The training system grew so much that by 2008, it was training 20,000 foreigners a year to be doctors, nurses and dentists, largely free of charge.


More:
http://www.washingtonpost.com/blogs/worldviews/wp/2014/10/04/in-the-medical-response-to-ebola-cuba-is-punching-far-above-its-weight/

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