JOIN USCuba, a shining star in healthcare
Cuba is a small country, almost half the size of Karnataka. But Cuba has been in big news in spite of it being so small. For several decades, it had huge problems with its neighbour USA.
This tension with the ‘global big brother’ resulted in several problems leading to several trade restrictions. In April 2015, US President Barack Obama visited Cuba. This again created big news. It is amazing how a small country can make such global news.
There is another extremely interesting feature about Cuba that has not attracted much media attention and is indeed most fascinating. That is about Cuban healthcare. Just look at these very impressive health indicators: the Infant Mortality Rate is 4.2 per thousand births which is even lower than that of the USA and is one among the lowest in the world.
Just compare it with Karnataka which is 38, while the Indian national average is 40. Life expectancy in Cuba is 77.5 years, one of the highest for any country, whereas for India, it is 68. There is one doctor for every 170 Cuban citizens and India has one doctor for 1,700.
These remarkable achievements can be shot down by the critics on the basis that Cuba is a small country with little population (Cuba population is 11 million). What is to be noted is that Cuba’s health care services extend to several needy countries all over the world. Since 1960, Cuban medical personnel have served in 158 countries, conducted 1.2 billion consultations, attended 2.2 million births and performed more than eight million surgeries. In September 2014, Cuba had 50,731 medical personnel, including 25,412 doctors, serving in 66 countries.
Cuban medical staff were offering healthcare to over 70 million people in the world, more than the whole of G8 (the global club of the rich nations), the World Health Organisation and Médicins Sans Frontières (Doctors Without Borders) put together. One and a half million people owe their lives to Cuba’s medical programmes. This level of humanitarian solidarity is unprecedented, with Cuba doing more to assist the world’s poorer nations than any other country in the world. This is what a sovereign country all over the world can and should do.
Since 2004, Cuba’s Operation Milagro (Operation Miracle programme) has restored sight of three million people from 34 countries through free eye surgery. UN Secretary-General Ban Ki-moon wrote that it “has given us a new vision of the world – one of generosity and solidarity: we are all one, human beings who are all brothers and sisters. Healthcare has to cease being a privilege for a few, and should become the right of the majority.”
In Venezuela, Cubans carried out 80% of the 647 million medical consultations between 2003 and 2014. Infant Mortality Rate (IMR) fell from 25 per 1,000 live births in 1990 to 13 in 2010. In 2013-14, Cuba sent 11,400 doctors to work in Brazil to support the government’s Mais Médicos (more doctors programme) effort to provide healthcare to 50 million people living in poor, rural areas in Brazil’s north.
Pak earthquake
In 2005, earthquake in Pakistan killed 80,000 people and Cuba at once sent 2,500 members of the medical team with 32 field hospitals, providing 1,000 medical scholarships to local students. The Cubans stayed for seven months, treating 17,43,000 patients, 73% of those medically assisted in all of Pakistan after the earthquake. As against this, the USA and European Union sent just one base camp each and stayed for a month.
Cuba has provided free medical education for thousands of Cubans as it has now 70,000 doctors. It has been providing free medical education since 1959 to 52,000 students to be trained as doctors from 130 countries every year.
Its Latin American Medical School, with an enrolment of more than 8,000 students from Third World countries, is the world’s largest medical school. Ban Ki-moon called it “the most advanced medical school in the world.” The curriculum blends evidence-based medical education, an understanding of health as a “right for all,” and compassionate care. Medical care is guided by need and not patient’s ability to pay.
Students selected for medical training are mandatorily from the poor community only and are not charged tuition fees. They get monthly pocket money and free housing, food and toiletries. “Rather than using a business model of a university as a profit machine, the medical school only requires that the students sign a contract agreeing to practice in an underserved community upon graduation.”
Director-General of World Health Organisation Dr Margaret Chan sums it succinctly: “Cuba has shown that it is possible to have health and well-being for all. These medical cooperation programmes are not paternalistic ‘aid’. The fundamental nature of Cuban medical internationalism is to provide a sustainable system – one that is not dependent on foreign participation, but instead (one that) trains local talent to take over from the Cubans.”
(The writer is President, Drug Action Forum – Karnataka)