Health Care

The Secrets of Cuban Medicine

In the Havana airport, pale people in wheelchairs and groups of children with a feverish glint in their eyes are barely noticeable among noisy crowds of tourists.There are not too many of them, but there are some on almost every foreign plane landing at the airport of the Cuban capital. These are the people who have come to Cuba seeking medical treatment. It is hard to believe, but even now, as Cubans—living in poverty and cursing the delights of the socialist economy—stand jammed in lines at stores to exchange food stamps for groceries, numerous Cuban clinics and sanitariums are successfully treating thousands of cancer patients every year. In a period of 10 years, 18,000 modest citizens of Russia and Ukraine have undergone treatment in Cuba without having to pay a single kopeck. How did a small tropical republic manage to create the best health-care system in Latin America?

“You are asking where the billions of dollars we receive from foreign tourists go? You think the money is spent on new uniforms and false beards for Fidel?” laughs a government official in Havana. “Take a tour of our hospitals, clinics, and rehabilitation facilities—you will find the answer to your question there. Exactly half of all the currency earned in our country goes toward the health-care system, and it is our policy to spare no expense for that purpose. Maybe there is no gasoline in Cuba to fill the car up before heading off to work in the morning, and they don’t have meat for lunch everywhere, but at least the people are healthy.”

The successes of Cuba in the area of health care are, in fact, amazing, especially if you take into account that the country was on the verge of economic collapse after the Soviet Union ended its generous financial aid program. Physicians from leading clinics in the United States come here in secret (officially it is forbidden for U.S. citizens to visit Cuba) to acquaint themselves with Cuban experience and practices, say officials at the Russian Embassy in Havana. They illegally buy medications, such as the famous Cuban vaccine for meningitis, which is produced nowhere else in the world. Then there are the Cuban physicians who have developed a drug to treat hepatitis B. Regarding treatment for cancerous tumors, the Cubans are well ahead of many of the world’s developed countries.

Che Guevara, the renowned revolutionary, who once owned a popular, inexpensive clinic in Argentina, is taken to be the founding father of the Cuban health-care system. It was he, a physician by profession, who launched the reforms that even-tually transformed the country into the leader in health care throughout Latin America. The formula was utterly simple—no matter what happened in the country, cutting expenditures for the health of the people was categorically forbidden. Even right after 1991 (the year aid from the U.S.S.R. was ended), when plants stopped operating, public buses didn’t run, and shops were empty—no one in the government even suggested reducing health-care expenditures.

The results you can see are stunning. Now there are 350,000 people working in the health-care field (physicians, nurses, and hospital support personnel). And this workforce serves a population of [more than] 11 million people! The infant mortality rate is 7 per 1,000 births [the Russian figure is estimated at 19.51 per 1,000 births—WPR], and now people on the Caribbean island live an average of 80 years.

“I still remember when I was an intern at a large hospital in Moscow,” says Luis, deputy chief medical officer at a Santiago hospital, in excellent Russian. “There was some state-of-the-art imported equipment sitting under snow outdoors for two winters in a row. There was just no one to set it up. Such things simply don’t happen here—the currency has been spent on equipment, patients are waiting for it—so the equipment is assembled without delay.” Complex microsurgery of the eye and successful treatment of breast cancer are widespread in Cuba. There are also projects to develop highly complex vaccines at the Center for Genetic Engineering and Biotechnology. Cuban physicians have even learned to transplant brain cells in an attempt to treat Parkinson’s disease. Strange as it may seem, not all Cubans are happy with this situation. Many harshly criticize Castro, claiming that younger people have to work harder to provide for an aging population.

What is unique about Cuban health care—I have been unable to figure out. But maybe the time has come for us to try to learn some things from Cuba.