Revolutionary Doctors reviewed by the Canadian Centre for Policy Alternatives

FAST FACTS: Revolutionary Health Care

January 5, 2012

Each of us read Steve Brouwer’s Revolutionary Doctors (MR Press, 2011) the same week the media reported average gross fee-for-service earnings of Manitoba doctors at $298,119. The media also reported, again, that many Canadians do not have access to a family doctor; that some specialists are in short supply; and that health conditions in many Aboriginal communities are appalling.

While we are fervent supporters of Canada’s Medicare system, we think there is much to be learned about health care from Brouwer’s book.

First, Cuba produces large numbers of high quality health care providers, including doctors—more doctors per capita than any country in the world. This is a tribute to the quality and cost—free tuition—of their entire education system. The benefits to the Cuban people are reflected in two key health indicators: average life expectancy in Cuba at 77.7 years, while behind Canada at 81.4 years, is on a par with the U.S. and higher than most countries in the Americas; the infant mortality rate (number of deaths of children under one year per 1000 live births) at 4.90 is the same as Canada at 4.92, and less than the U.S. at 6.06.

Moreover, at Cuba’s Latin American School of Medicine, established in 1998 as part of the Cuban vision of a “caring socialism” rooted in international solidarity, large numbers of international students are studying to be doctors. This includes 23 Americans who enrolled because they are unwilling to take on the $150,000–200,000 in debt to pay for a U.S. medical degree, and are attracted by the obligation, in return for free tuition, to return home to practice medicine in poor communities.

Second, large numbers of Cuban medical personnel are sent around the world in response to natural disasters. Cuba’s medical team was particularly important in responding to Haiti’s January, 2010 earthquake, for example, although it earned them virtually no media coverage. The highly publicized U.S. hospital ship that anchored off Haiti, the USNS Comfort, performed 843 medical operations; Cuba’s medical brigades performed 6499. Meanwhile 547 Haitians graduated from Cuba’s Latin American School of Medicine between 2005 and 2009, and more will continue to graduate year after year.

Third, and the main focus of this book, Cuba sends physicians and other health care professionals to Venezuela in return for much-needed oil. Cuban medical practitioners work and live in Venezuela’s barrios. From 2004 to 2010 one Cuban program “continually deployed between 10,000 and 14,000 Cuban doctors and 15,000 to 20,000 other Cuban medical personnel—dentists, nurses, physical therapists, optometrists, and technicians,” to work among the poor. In the barrios the Cuban health care workers practice primary health care, and promote a holistic and preventative approach—Medicina Integral Comunitaria (MIC), or Comprehensive Community Medicine (a concept, Brouwer notes, that appealed to health experts and some medical schools in Canada and the U.S. when first proposed 1978, but that was abandoned in the pursuit of profits in ‘health care markets’).

Cuban doctors work directly with Venezuelan medical students in the morning; the students take medical classes in the afternoons. The medical training, which is state of the art, is extremely demanding. Yet large numbers of Venezuelans—30,000 as of 2011, including many of the poor who have longed to be doctors but have never had the chance because of the huge cost of medical education—are now studying to be doctors. Most want to practice as the Cubans do: meeting the needs of low-income people in the low-income communities long neglected by the Venezuelan medical establishment; promoting a holistic and preventative form of medicine; and working in the context of the values that are a central part of Cuban medical practice….

Read the entire review on the Canadian Centre for Policy Alternatives website