Healthcare of Cuba
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The Cuban government operates a national health system and assumes full fiscal and administrative responsibility for the health care of its citizens. According to World Health Organization statistics, Cuba is in the top quintile in worldwide comparisons of major health indicators such as doctors per capita, life expectancy and infant mortality. However, like the rest of the Cuban economy, Cuban medical care has suffered from severe material shortages following the end of Soviet subsidies and the ongoing U.S. embargo [link]. Support from the Venezuelan government of Hugo Chávez has alleviated some of those problems. The present Minister for Public Health is José Ramón Balaguer.
History
Cuban traditional medicine has existed since before the Spanish conquest, these high status practitioners were called Bohiques. After colonization Cuban medicine followed the Spanish tradition which was inherited from the Moors, who reputedly had access to ancient Greek and Roman traditions. Chinese medicine has also been practiced in Cuba, the most famous was the 19th century doctor Cham Bom Biam or “El Medico Chino” [link]. The doctor's fame on the island gave rise to the expression “no le salve ni el medico chino” which was applied to those who had a terminal illness. Modern Western Medicine has been practiced in Cuba by formally trained doctors since at least the beginning of the 19th Century [link]. Cuba has had many world class doctors, including Carlos Finlay, who determined how Yellow fever was spread under the direction of Walter Reed, James Carroll, and Aristides Agramonte. During the period of U.S presence (1898-1902) yellow fever was essentially eliminated due to the efforts of Clara Louise Maas and surgeon Jesse W. Lazear. The University Hospital of the University of Havana, The Calixto Garcia Hospital, was expanded following Cuban independence in 1902 to become Cuba's largest hospital. In total, 72 hospitals on the island were in operation before the 1959 revolution.[link]Present
| Life expectancy at birth m/f:
| 75.0/79.0 (years) |
| Healthy life expectancy at birth m/f: | 67.1/69.5 (years) |
| Child mortality m/f: | 8/6 (per 1000) |
| Adult mortality m/f: | 137/87 (per 1000) |
| Total health expenditure per capita: | 6 |
| Total health expenditure as % of GDP: | 7.5
|
According to Cuban government statistics, Cuba has over 71,000 doctors [link] and one of the highest doctor to patient ratios in the world [link]. All fiscal and administrative aspects of health care in Cuba are run by the state; no private hospitals or clinics are permitted, and medical workers are required to work for the state. Historically, Cuba has long ranked high in numbers of medical personnel; in 1957, before the revolution, it ranked third in Latin America and ahead of many European nations.
Life expectancy and infant mortality rates in Cuba have been comparable to Western industrialized countries since the 1950s. Among adults less than 49 years old, accidents are the leading cause of death, though occupational accidents have declined significantly in the last decade. Among older adults heart disease and cancer predominate as causes of mortality. The suicide rate of 18.2 per 100,000 is higher and the homicide rate of 7.0 per 100,000 is lower than that of other Latin Caribbean nations. General mortality has been "characterized by a marked predominance of causes associated with chronic noncommunicable diseases," according to the Pan American Health Organization.[link]
Cuba and international healthcare
Cuba has entered into agreements with United Nations agencies specializing in health: PAHO/WHO, UNICEF, the United Nations Food and Agriculture Organization (FAO), the United Nations Population Fund (UNFPA), and the United Nations Development Fund (UNDP). Since 1989, this collaboration has played a very important role in that Cuba, in addition to obtaining the benefits of being a member country, has strengthened its relations with institutions of excellence and has been able to disseminate some of its own advances and technologies [link].Because the education of physicians came to exceed the country's internal requirements, Cuba has been able to export primary care practitioners and specialists for periods of service in other Third World nations. Cuban doctors have therefore played a role in many regions of the world. Cuba's missions in 68 countries are manned by 25,000 Cuban doctors, and medical teams have assisted victims of both the South Asian Tsunami and the Pakistan earthquake. [link] Cuba currently exports considerable health services and personnel to Venezuela in exchange for subsidized oil.[link]. Since the Chernobyl nuclear plant exploded in 1986, more than 20,000 children from Ukraine, Belarus and Russia have traveled to Cuba for treatment of radiation sickness and psychologically based problems associated with the radiation disaster. [link]
Operación Milagro
- See also:Healthcare of Venezuela
Health tourism and pharmaceutics
As well as its national health coverage, Cuba attracts paying health tourists, generating revenues of around $40m a year for the Cuban economy. In 2002 more than 5000 foreign patients travelled to Cuba for a wide range of treatments including eye-surgery, neurological disorders such as multiple sclerosis and Parkinsons disease, and orthopaedics. Most patients are from Latin America although medical treatment for retinitis pigmentosa, often known as night blindness, has attracted many patients from Europe and North America. Cuba also successfully exports many medical products, such as vaccines.[link]HIV / AIDS in Cuba
According to the UNAIDS report of 2003 there were an estimated 3,300 Cubans living with HIV/AIDS (approx 0.05% of the population). In the mid-1980s, when little was known about the virus, Cuba compulsorily tested thousands of its citizens for HIV. Those who tested positive were taken to Los Cocos and were not allowed to leave. The policy drew criticism from the United Nations and was discontinued in the 1990’s. Since 1996 Cuba began the production of generic anti-retroviral drugs reducing the costs to well below that of developing countries. This has been made possible through the substantial government subsidies to treatment [link]. In 2003 Cuba had the lowest HIV prevalence in the Americas and one of the lowest in the world. Comparatively, infection rates in the Caribbean as a whole are second only to sub-Saharan Africa, the UNAIDS study estimated 88,000 HIV/AIDS sufferers in Dominican Republic and 150,000 in Haiti [link]. Education in Cuba concerning issues of HIV infection and AIDS is implemented by the Cuban National Center for Sex Education.Criticism of Cuban Healthcare
Some groups in the United States have been critical of the Cuban healthcare system. The American magazine NewsMax describes the exportation of Cuban doctors to Third World countries as a "propaganda" exercise, stating that "it is easy because Cuba has an overabundance of physicians and professionals of all types, a perpetual oversight of the communist central planners".[link].Some complaints have arisen that foreign "health tourists" receive a higher quality of care than Cuban citizens. The Cuban American National Foundation claims that the Cuban authorities mask the truth behind the Cuban health care system. They argue that real Cuban healthcare is "substandard" and that what is shown to non-Cubans is a healthcare system unavailable to the average Cuban.[link]
The US State Department, citing many independent sources, states that Cuba's infant mortality rate in 1957 was the lowest in Latin America and the 13th lowest in the world, according to UN data. Cuba ranked ahead of France, Belgium, West Germany, Israel, Japan, Austria, Italy, and Spain, all of which would eventually pass Cuba in this indicator during the following decades. Cuba’s comparative world ranking has fallen from 13th to last out of the 25 countries examined. Also missing from the conventional analysis of Cuba's infant mortality rates is its very high abortion rate, which, because of selective termination of "high-risk" pregnancies, yields lower numbers for infant mortality. Cuba's abortion rate was the 3rd highest out of the 60 countries studied. In terms of physicians and dentists per capita, Cuba in 1957 ranked third in Latin America, behind only Uruguay and Argentina -- both of which were more advanced than the United States in this measure. Cuba's physicians and dentists in 1957 was the same as the Netherlands, and ahead of the United Kingdom and Finland. The report states "Unfortunately, the UN statistical yearbook no longer publishes these statistics, so more recent comparisons are not possible, but it is completely erroneous to characterize pre-Revolutionary Cuba as backward in terms of healthcare."[link]
According to the same United States State department report, Pre-Castro Cuba ranked third in Latin America in per capita food consumption but ranked last out of the 11 countries analyzed in terms of percent of increase since 1957. Overall, Cuban per capita food consumption from 1954-1997 has decreased by 11.47 percent. Per capita consumption of cereals, tubers, and meat are today all below 1950's levels.[link]"
See also
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