CUBA GIVES PRIORITY TO PREVENTION: Health Care Much Better and Cheaper in Cuba Than in U.S

By Carroll, Rory; Boseley, Sarah | CCPA Monitor, November 2007 | Go to article overview

CUBA GIVES PRIORITY TO PREVENTION: Health Care Much Better and Cheaper in Cuba Than in U.S


Carroll, Rory, Boseley, Sarah, CCPA Monitor


A tropical sun rises over Havana and in the neighbourhood of Vedado, a maze of worn, bleached apartment blocks, a unique health care system limbers up for another day. In Parque Aguirre, a small plaza shaded by palms, two dozen pensioners form a semi-circle and perform a series of stretches and gentle exercises, responding to the commands of a spry septuagenarian.

Two blocks away, in a small shabby office, two doctors receive a steady stream of phone calls and visitors, mostly minor queries, but a few people are directed to the nearby Joaquín Albarrán clinic for blood tests, X-rays, and prescriptions. Serious cases are referred to Calixto García hospital, an antiquated complex, in which Julio Hernandez, 43, lies in a narrow bed hooked to two intravenous drips after intestinal surgery. His skin is waxy and orange because the hospital lacks vitamins, but he will survive that, and the surgery has gone well. "They say I'll be up and out by tomorrow," he says.

This snapshot of Havana shows a health care system that is extensive, accessible and, at times, ropey. What is unique is the blend of Third World conditions with a progressive ethos and First World results.

Michael Moore's documentary, Sicko, holds up Cuba as a model. Whether it is a consultation, dentures, or open heart surgery, citizens are entitled to free treatment. As a result, this impoverished Caribbean island has better health indicators than its much wealthier neighbour 90 miles across the Florida straits.

"There's a reason Cubans live on average longer than we do," Moore told Time magazine. "I'm not trumpeting [Fidel] Castro or his regime. I just want to say to fellow Americans, 'C'mon, we're the United States. If they can do this, we can do it.'"

Other outsiders such as Kofi Annan, the former UN Secretary General, a British House of Commons select committee, and an array of non-governmental organizations have also lauded Cuban health care. Even some senior U.S. officials, between bouts of Castro-bashing, have ceded some plaudits.

"Health and education are the revolution's pillars of legitimacy, so the government has to make them work," says a senior western diplomat in Havana. "If they don't, it loses all its moral authority. My sense is that the health system is quite good."

But how good, exactly? And how does Cuba do it given such limited means? Neither question is easy to answer. The communist government is not transparent, some statistics are questionable, and citizens have reason to muffle complaints lest they be jailed as political dissidents.

According to the World Health Organization, a Cuban man can expect to live to 75 and a woman to 79. The probability of a child dying aged under 5 is five per 1,000 live births. That is better than the U.S. and on a par with the UK.

Yet these world-class results are delivered by a shoestring annual per capita health expenditure of $260-less than a 10th of Britain's $3,065 and a fraction of America's $6,543.

There is no mystery about Cuba's core strategy: prevention. By promoting exercise, hygiene and regular check-ups, the system is geared towards averting illnesses and treating them before they become advanced and costly.

This is on display in the neighbourhood of Vedado. By 8:30 a.m., the pensioners of Parque Aguirre are assembled and following the lead of Carmelina Díaz, 76, and raising arms, swivelling hips, and marching on the spot.

Mrs. Díaz learned these techniques "for those in their third age" at the National Sports Institute. A volunteer, she has led these sessions five days a week for 21 years and keeps note of attendance in a leather-bound copybook. "It's not just physical, it's also social, we arrange outings to the theatre, the beach," she says.

A star participant is Lilia García Fernández, 81, who uses a cane to circle the park three times before the class. She has seven ailments, including diabetes, rheumatism, and arthritis, but remains relatively fit.

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CUBA GIVES PRIORITY TO PREVENTION: Health Care Much Better and Cheaper in Cuba Than in U.S
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