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Why Is Cuba's Health Care System the Best Model for Poor Countries?

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Reprinted from the Black Agenda Report


by Don Fitz

Cuba has become a world-class medical powerhouse with very limited resources, while "the US squanders perhaps 10 to 20 times what is needed for a good, affordable medical system." As a result, the Cuban infant mortality rate is "below that of the US and less than half that of US Blacks," and Americans can hardly claim to have a health care system.


Why Is Cuba ' s Health Care System the Best Model for Poor Countries?

by Don Fitz

" Cuban-trained doctors know their patients by knowing their patients ' communities."

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, making the poor sicker by refusing them treatment, creation of illnesses, exposure to contagion through over-hospitalization, and disease-focused instead of prevention-focused research. [1]

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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. [2]

The most revolutionary idea of the Cuban system is doctors living in the neighborhoods they serve. A doctor-nurse team is part of the community and know their patients well because they live at (or near) the consultorio (doctors ' office) where they work. Consultorios are backed up
by policlÃnicos which provide services during off-hours and offer a wide variety of specialists. PoliclÃnicos coordinate community health delivery and link nationally designed health initiatives with their local implementation.

Cubans call their system medicina general integral (MGI, comprehensive general medicine). Its programs focus on preventing people from getting diseases rather than curing them after they are sick

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. [3] 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). [4]

" Programs focus on preventing people from getting diseases rather than curing them after they are sick."

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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 consultorio staff know everyone in their neighborhood and who to call for help getting disabled residents out of harms way. At the same time New York City (roughly the same population as Cuba) had 43,000 cases of AIDS, Cuba had 200 AIDS patients. [5] More recent emergencies such as outbreaks of dengue fever are quickly followed by national mobilizations. [6]

Perhaps the most amazing aspect of Cuban medicine it that, despite its being a poor country itself, Cuba has sent over 124,000 health care professionals to provide care to 154 countries. [7] 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, Escuela Latinoamericana de Medicina). [8]

In a recent Monthly Review article, I gave in-depth descriptions of ELAM students participating in Cuban medical efforts in Haiti, Ghana and Peru. [9] 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.

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http://blackagendareport.com/blog/5854

Don Fitz ( fitzdon@aol.com ) is editor of Synthesis/Regeneration: A Magazine of Green Social Thought. He is Co-Coordinator of the Green Party of St. Louis and produces Green Time in (more...)
 

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Why Is Cuba's Health Care System the Best Model for Poor Countries?