From: <b class="gmail_sendername">gaurab roy</b> <span dir="ltr"><<a href="mailto:gaurab18@gmail.com">gaurab18@gmail.com</a>></span><br><div class="gmail_quote"><font size="5"><font color="#0000a0"><b><span><font face="Times New Roman">Why Is Cuba's Health Care System the Best Model for Poor
Countries?</font></span><br></b></font></font>
<div class="gmail_quote"><div class="gmail_quote"><div><div><div class="gmail_quote"><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex"><div><div><div class="gmail_quote">
<blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex"><div class="gmail_quote"><div><div><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex">
<div><div><div class="gmail_quote"><div><div><div class="gmail_quote"><blockquote style="margin:0px 0px 0px 0.8ex;padding-left:1ex;border-left-color:rgb(204,204,204);border-left-width:1px;border-left-style:solid" class="gmail_quote">
<div class="gmail_quote"><div><div><div class="gmail_quote"><div class="gmail_quote"><div dir="ltr"><div dir="ltr"><div style="font-family:"Calibri";font-size:12pt"><p><font face="Arial Unicode MS"><b>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.</b></font><a title="" href="http://mrzine.monthlyreview.org/2012/fitz071212p.html#_edn1" name="13bb8c8d0df061d6_13ba91550fe391bc_13ba75e256ae2af1_13ba74f9e5f5a6ad_13b8eba77c60cee4_13b8d28e655eefdc_13b8d1abb2d51824_13b8a3b01c7da828_13b8a323247a41ad_13b89f13e5584b9b_13b88e1fba9e66c7__ednref1" target="_blank"><sup><font face="Arial Unicode MS"><b>1</b></font></sup></a></p>
<p><font face="Arial Unicode MS"><b>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.</b></font><a title="" href="http://mrzine.monthlyreview.org/2012/fitz071212p.html#_edn2" name="13bb8c8d0df061d6_13ba91550fe391bc_13ba75e256ae2af1_13ba74f9e5f5a6ad_13b8eba77c60cee4_13b8d28e655eefdc_13b8d1abb2d51824_13b8a3b01c7da828_13b8a323247a41ad_13b89f13e5584b9b_13b88e1fba9e66c7__ednref2" target="_blank"><sup><font face="Arial Unicode MS"><b>2</b></font></sup></a></p>
<p><font face="Arial Unicode MS"><b>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 <i>consultorio</i> (doctor's office) where they
work. <i>Consultorios</i> are backed up by <i>policlínicos</i> which
provide services during off-hours and offer a wide variety of specialists.
<i>Policlínicos</i> coordinate community health delivery and link
nationally-designed health initiatives with their local
implementation.</b></font></p>
<p><font face="Arial Unicode MS"><b>Cubans call their system <i>medicina
general integral</i> (MGI, comprehensive general medicine). Its programs
focus on preventing people from getting diseases and treating them as rapidly as
possible.</b></font></p>
<p><font face="Arial Unicode MS"><b>This has made Cuba extremely effective
in control of everyday health issues. Having doctors' offices in every
neighborhood has brought the Cuban infant mortality rate below that of the US
and less than half that of US Blacks.</b></font><a title="" href="http://mrzine.monthlyreview.org/2012/fitz071212p.html#_edn3" name="13bb8c8d0df061d6_13ba91550fe391bc_13ba75e256ae2af1_13ba74f9e5f5a6ad_13b8eba77c60cee4_13b8d28e655eefdc_13b8d1abb2d51824_13b8a3b01c7da828_13b8a323247a41ad_13b89f13e5584b9b_13b88e1fba9e66c7__ednref3" target="_blank"><sup><font face="Arial Unicode MS"><b>3</b></font></sup></a><font face="Arial Unicode MS"><b> Cuba has a record unmatched in dealing
with chronic and infectious diseases with amazingly limited resources.
These include (with date eradicated): polio (1962), malaria (1967), neonatal
tetanus (1972), diphtheria (1979), congenital rubella syndrome (1989),
post-mumps meningitis (1989), measles (1993), rubella (1995), and TB meningitis
(1997).</b></font><a title="" href="http://mrzine.monthlyreview.org/2012/fitz071212p.html#_edn4" name="13bb8c8d0df061d6_13ba91550fe391bc_13ba75e256ae2af1_13ba74f9e5f5a6ad_13b8eba77c60cee4_13b8d28e655eefdc_13b8d1abb2d51824_13b8a3b01c7da828_13b8a323247a41ad_13b89f13e5584b9b_13b88e1fba9e66c7__ednref4" target="_blank"><sup><font face="Arial Unicode MS"><b>4</b></font></sup></a></p>
<p><font face="Arial Unicode MS"><b>The MGI integration of neighborhood
doctors' offices with area clinics and a national hospital system also means the
country responds well to emergencies. It has the ability to evacuate
entire cities during a hurricane largely because <i>consultorio</i> staff know
everyone in their neighborhood and know who to call for help getting disabled
residents out of harm's way. At the time when New York City (roughly the
same population as Cuba) had 43,000 cases of AIDS, Cuba had 200 AIDS
patients.</b></font><a title="" href="http://mrzine.monthlyreview.org/2012/fitz071212p.html#_edn5" name="13bb8c8d0df061d6_13ba91550fe391bc_13ba75e256ae2af1_13ba74f9e5f5a6ad_13b8eba77c60cee4_13b8d28e655eefdc_13b8d1abb2d51824_13b8a3b01c7da828_13b8a323247a41ad_13b89f13e5584b9b_13b88e1fba9e66c7__ednref5" target="_blank"><sup><font face="Arial Unicode MS"><b>5</b></font></sup></a><font face="Arial Unicode MS"><b> More recent emergencies such as outbreaks
of dengue fever are quickly followed by national
mobilizations.</b></font><a title="" href="http://mrzine.monthlyreview.org/2012/fitz071212p.html#_edn6" name="13bb8c8d0df061d6_13ba91550fe391bc_13ba75e256ae2af1_13ba74f9e5f5a6ad_13b8eba77c60cee4_13b8d28e655eefdc_13b8d1abb2d51824_13b8a3b01c7da828_13b8a323247a41ad_13b89f13e5584b9b_13b88e1fba9e66c7__ednref6" target="_blank"><sup><font face="Arial Unicode MS"><b>6</b></font></sup></a></p>
<p><font face="Arial Unicode MS"><b>Perhaps the most amazing aspect of
Cuban medicine is that, despite its being a poor country itself, Cuba has sent
over 124,000 health care professionals to provide care to 154
countries.</b></font><a title="" href="http://mrzine.monthlyreview.org/2012/fitz071212p.html#_edn7" name="13bb8c8d0df061d6_13ba91550fe391bc_13ba75e256ae2af1_13ba74f9e5f5a6ad_13b8eba77c60cee4_13b8d28e655eefdc_13b8d1abb2d51824_13b8a3b01c7da828_13b8a323247a41ad_13b89f13e5584b9b_13b88e1fba9e66c7__ednref7" target="_blank"><sup><font face="Arial Unicode MS"><b>7</b></font></sup></a><font face="Arial Unicode MS"><b> In addition to providing preventive
medicine Cuba sends response teams following emergencies (such as earthquakes
and hurricanes) and has over 20,000 students from other countries studying to be
doctors at its Latin American School of Medicine in Havana (ELAM, <i>Escuela
Latinoamericana de Medicina</i>).</b></font><a title="" href="http://mrzine.monthlyreview.org/2012/fitz071212p.html#_edn8" name="13bb8c8d0df061d6_13ba91550fe391bc_13ba75e256ae2af1_13ba74f9e5f5a6ad_13b8eba77c60cee4_13b8d28e655eefdc_13b8d1abb2d51824_13b8a3b01c7da828_13b8a323247a41ad_13b89f13e5584b9b_13b88e1fba9e66c7__ednref8" target="_blank"><sup><font face="Arial Unicode MS"><b>8</b></font></sup></a></p>
<p><font face="Arial Unicode MS"><b>In a recent <i>Monthly Review</i>
article, I gave in-depth descriptions of ELAM students participating in Cuban
medical efforts in Haiti, Ghana, and Peru.</b></font><a title="" href="http://mrzine.monthlyreview.org/2012/fitz071212p.html#_edn9" name="13bb8c8d0df061d6_13ba91550fe391bc_13ba75e256ae2af1_13ba74f9e5f5a6ad_13b8eba77c60cee4_13b8d28e655eefdc_13b8d1abb2d51824_13b8a3b01c7da828_13b8a323247a41ad_13b89f13e5584b9b_13b88e1fba9e66c7__ednref9" target="_blank"><sup><font face="Arial Unicode MS"><b>9</b></font></sup></a><font face="Arial Unicode MS"><b> What follows are 10 generalizations from
Cuba's extensive experience in developing medical science and sharing its
approach with poor countries throughout the world. The concepts form the
basis of the New Global Medicine and summarize what many authors have observed
in dozens of articles and books.</b></font></p><table align="right" border="1" cellpadding="5" cellspacing="5" width="284"><tbody><tr><td align="center"></td></tr></tbody></table><p><font face="Arial Unicode MS"><b>First, it is not necessary to focus on
expensive technology as the initial approach to medical care. Cuban
doctors use machines that are available, but they have an amazing ability to
treat disaster victims with field surgery. They are very aware that most
lives are saved through preventive medicine such as nutrition and hygiene and
that traditional cultures have their own healing wisdom. This is in direct
contrast to Western medicine, especially as is dominant in the US, which uses
costly diagnostic and treatment techniques as the first approach and is
contemptuous of natural and alternative approaches.</b></font></p>
<p><font face="Arial Unicode MS"><b>Second, doctors must be part of the
communities where they are working. This could mean living in the same
neighborhood as a Peruvian <i>consultorio</i>. It could mean living in a
Venezuelan community that is much more violent than a Cuban one. Or it
could mean living in emergency tents adjacent to where victims are housed as
Cuban medical brigades did after the 2010 earthquake in Haiti. Or staying
in a village guesthouse in Ghana. Cuban-trained doctors know their
patients by knowing their patients' communities. In this they differ
sharply from US doctors, who receive zero training on how to assess homes of
their patients.</b></font></p>
<p><font face="Arial Unicode MS"><b>Third, the MGI model outlines
relationships between people that go beyond a set of facts. Instead of
memorizing mountains of information unlikely to be used in community health,
which US students must do to pass medical board exams, Cuban students learn what
is necessary to relate to people in <i>consultorios, polyclínicos</i>, field
hospitals, and remote villages. Far from being nuisance courses, studies
in how people are bio-psycho-social beings are critical for the everyday
practice of Cuban medicine.</b></font></p>
<p><font face="Arial Unicode MS"><b>Fourth, the MGI model is not static but
is evolving and unique for each community. Western medicine searches for
the correct pill for a given disease. In its rigid approach, a major
reason for research is to discover a new pill after "side effects" of the first
pill surface. Since traditional medicine is based on the culture where it
has existed for centuries, the MGI model avoids the futility of seeking to
impose a Western mindset on other societies.</b></font></p>
<p><font face="Arial Unicode MS"><b>Fifth, it is necessary to adapt medical
aid to the political climate of the host country. This means using
whatever resources the host government is able and willing to offer and living
with restrictions. Those hosting a Cuban medical brigade may be friendly
as in Venezuela and Ghana, be hostile as is the Brazilian Medical Association,
become increasingly hostile as occurred after the 2009 coup in Honduras, or
change from hostile to friendly as occurred in Peru with the 2011 election of
Ollanta Humala. This is quite different from US medical aid which, like
its food aid, is part of an overall effort to dominate the receiving country and
push it into adopting a Western model.</b></font></p>
<p><font face="Arial Unicode MS"><b>Sixth, the MGI model creates the basis
for dramatic health effects. Preventive community health training, a
desire to understand traditional healers, the ability to respond quickly to
emergencies, and an appreciation of political limitations give Cuban medical
teams astounding success. During the first 18 months of Cuba's work in
Honduras following Hurricane Mitch, infant mortality dropped from 80.3 to 30.9
per 1,000 live births. When Cuban health professionals intervened in
Gambia, malaria decreased from 600,000 cases in 2002 to 200,000 two years
later. And Cuban-Venezuelan collaboration resulted in 1.5 million vision
corrections by 2009. Kirk and Erisman conclude that "almost 2 million
people throughout the world . . . owe their very lives to the availability of
Cuban medical services."</b></font><a title="" href="http://mrzine.monthlyreview.org/2012/fitz071212p.html#_edn10" name="13bb8c8d0df061d6_13ba91550fe391bc_13ba75e256ae2af1_13ba74f9e5f5a6ad_13b8eba77c60cee4_13b8d28e655eefdc_13b8d1abb2d51824_13b8a3b01c7da828_13b8a323247a41ad_13b89f13e5584b9b_13b88e1fba9e66c7__ednref10" target="_blank"><sup><font face="Arial Unicode MS"><b>10</b></font></sup></a></p>
<p><font face="Arial Unicode MS"><b>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.</b></font></p>
<p><font face="Arial Unicode MS"><b>Eighth, dedication to the New Global
Medicine is now being transferred to the next generation. When students at
Cuban schools learn to be doctors, dentists, or nurses their instructors tell
them of their own participation in health brigades in Angola, Peru, Haiti,
Honduras, and dozens of other countries. Venezuela has already developed
its own approach of MIC (<i>medicina integral comunitaria</i>, comprehensive
community medicine) which builds upon, but is distinct from, Cuban
MGI.</b></font><a title="" href="http://mrzine.monthlyreview.org/2012/fitz071212p.html#_edn11" name="13bb8c8d0df061d6_13ba91550fe391bc_13ba75e256ae2af1_13ba74f9e5f5a6ad_13b8eba77c60cee4_13b8d28e655eefdc_13b8d1abb2d51824_13b8a3b01c7da828_13b8a323247a41ad_13b89f13e5584b9b_13b88e1fba9e66c7__ednref11" target="_blank"><sup><font face="Arial Unicode MS"><b>11</b></font></sup></a><font face="Arial Unicode MS"><b> Many ELAM students who work in Ghana as
the Yaa Asantewaa Brigade are from the US. They learn approaches of
traditional healers so they can compliment Ghanaian techniques with Cuban
medical knowledge.</b></font></p>
<p><font face="Arial Unicode MS"><b>Ninth, the Cuban model is remaking
medicine across the globe. Though best-known for its successes in Latin
America, Africa, and the Caribbean, Cuba has also provided assistance in Asia
and the Pacific Islands. Cuba provided relief to the Ukraine after the
1986 Chernobyl meltdown, Sri Lanka following the 2004 tsunami, and Pakistan
after its 2005 earthquake. Many of the countries hosting Cuban medical
brigades are eager for them to help redesign their own health care
systems. Rather than attempting to make expensive Western techniques
available to everyone, the Cuban MGI model helps re-conceptualize how healing
systems can meet the needs of a country's poor.</b></font></p>
<p><font face="Arial Unicode MS"><b>Tenth, the New Global Medicine is a
microcosm of how a few thousand revolutionaries can change the world. They
do not need vast riches, expensive technology, or a massive increase in personal
possessions to improve the quality of people's lives. If dedicated to
helping people while learning from those they help, they can prefigure a new
world by carefully utilizing the resources in front of them. Such
revolutionary activity helps show a world facing acute climate change that it
can resolve many basic human needs without pouring more CO2 into the
atmosphere.</b></font></p>
<p><font face="Arial Unicode MS"><b>Discussions of global health in the
West typically bemoan the indisputable fact that poor countries still suffer
from chronic and infectious diseases that rich countries have controlled for
decades. International health organizations wring their hands over the
high infant mortality rates and lack of resources to cope with natural disasters
in much of the world.</b></font><a title="" href="http://mrzine.monthlyreview.org/2012/fitz071212p.html#_edn12" name="13bb8c8d0df061d6_13ba91550fe391bc_13ba75e256ae2af1_13ba74f9e5f5a6ad_13b8eba77c60cee4_13b8d28e655eefdc_13b8d1abb2d51824_13b8a3b01c7da828_13b8a323247a41ad_13b89f13e5584b9b_13b88e1fba9e66c7__ednref12" target="_blank"><sup><font face="Arial Unicode MS"><b>12</b></font></sup></a></p>
<p><font face="Arial Unicode MS"><b>But they ignore the one health system
that actually functions in a poor country, providing health care to all of its
citizens as well as millions of others around the world. The conspiracy of
silence surrounding the resounding success of Cuba's health system proves the
unconcern by those who piously claim to be the most
concerned.</b></font></p>
<p><font face="Arial Unicode MS"><b>How should progressives respond to this
feigned ignorance of a meaningful solution to global health problems? A
rational response must begin with spreading the word of Cuba's New Global
Medicine through every source of alternative media available. The message
needs to be: Good health care is not more expensive -- revolutionary medicine is
far more cost-effective than corporate-controlled medicine.</b></font></p>
<p><b><font face="Arial Unicode MS">URL for Video interview <a title="http://www.youtube.com/watch?feature=player_embedded&v=uJrOOHnOLRk#t=0s" href="http://www.youtube.com/watch?feature=player_embedded&v=uJrOOHnOLRk#t=0s" target="_blank">http://www.youtube.com/watch?feature=player_embedded&v=uJrOOHnOLRk#t=0s</a></font></b></p>
<p><font color="#333333"><font face="Arial Unicode MS"><b><span>by Don Fitz</span> </b></font></font></p><br></div></div></div></div></div></div></div></div></blockquote></div></div></div></div></div></div></blockquote></div>
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