Health under siege

Letter from cuba.

Dock visited Cuba last year and found an extensive health care
system and programme of medical innovation under strain as a result
of the economic blockade imposed by the US.

Health care under the Cuban constitution is a
basic human right of every citizen. Provision is universal,
comprehensive and essentially free. In 1993, when 40 per cent of US
citizens had no health care, the Cuban population was 100 per cent

has a universal programme of vaccinations. Moreover, the infant
mortality rate is seven per 1,000. In US cities such as New York
and Washington DC, the infant mortality rate can approach 40-50 per

health care focuses primarily on prevention. There is one doctor
for every 175 people who live in Cuba – the highest of any nation.
Doctors are located in schools, day care centres, workplaces and
bus stations.

has neighbourhood clinics – one for every 3,000 people. Their
existence means that attendance at the country’s 238 hospitals is
falling. I visited a rural clinic in a community of about 590
people. The clinic provides dental care, ambulance services,
monitoring for high blood pressure and diabetes control.

common ailments are bronchitis and asthma. Teenagers have access to
family planning advice and sex education at the clinics. There is
also a senior citizens’ club for cultural and physical

upkeep of this system is very expensive for the Cuban government,
especially given the US economic blockade and the collapse of the
Soviet bloc, which causes shortages of medicines, equipment and
medical supplies.

can now only acquire 20-30 per cent of its essential medical
supplies from foreign markets. Cuban children with leukaemia, for
example, are denied new life-prolonging drugs. Defibrillators,
often the key to surviving Cuba’s number one killer – heart disease
– are in short supply.

is at the cutting edge of medical advances. It has developed unique
treatments for diseases that US doctors do not know how to cure.
Research into the development of a cancer vaccine is now
well-advanced in Cuba. US pharmaceutical companies have shown
interest in Cuban formulas but, because of the blockade, they are
unable to exchange information.

Humanitarianism demands the
embargo be lifted. The US denies entry to any ship that has docked
in Cuba during the previous 180 days. US ports are closed to
third-country vessels carrying goods in which Cuba or Cuban
nationals have an interest.

The US
bans exports to Cuba by third-country companies of goods containing
20 per cent or more components of US origin. Licences are required
for humanitarian aid and under no circumstance is the sale of food

citizens have been told by the media and government sources that
life in Cuba is barbaric. My visit confirmed to me that this was
not the case and that people there have more things in common with
US families than many in the US might think.

Nancy Dock is a social worker
based in Michigan, US.


– Cuba is the largest country in Caribbean.
But with a total area of 110,860 square km, it is less than half
the size of the UK. It has a population of just over 11 million –
less than a fifth of the UK. Tourism plays a major role in foreign
currency earnings.

– Ethnic groups: mulatto 51 per cent, white 37
per cent, black 11 per cent, Chinese 1 per cent.

– Religions: nominally Roman Catholic, who
made up 85 per cent of the population before Fidel Castro came to
power. Protestants, Jehovah’s Witnesses, Jews, and Santeria are
also represented.

– The US embargo began on 19 October 1960.
Guantanamo naval base is Cuba’s only “border” country. It is leased
by the US and thus remains part of Cuba, and only mutual agreement
or US abandonment of the area can terminate the lease.


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