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Revolutionary Doctors reviewed on A World to Win

Healthcare as it should be

What is being done in Cuba and Venezuela puts to shame the dysfunctional healthcare system of the US and exposes the Coalition government in Britain as it steers the NHS towards the profit-driven American model. Peter Arkell reports.

Of the many statistics in Steve Brouwer’s book, Revolutionary Doctors: How Venezuela and Cuba are changing the World’s Conception of Health Care, one in particular stands out. There are more students, about 73,000, in medical school in Cuba and Venezuela, with a combined population of 39 million people, than there are in the whole of the US with a population of 300 million.

And they are all educated and trained for free. Many of them will go to Bolivia, Haiti and other countries in order to “to serve the poor, heal the afflicted and make a better world”.

This is the complete opposite of what happens in the United States where the average debt of graduates who take out loans to attend medical college approaches $200,000. The new doctors there, not surprisingly, are attracted to careers in high-paid disciplines like plastic surgery in order to pay off the loans, rather than the less well-paid jobs in family medicine and community practice. The health issues of the community, of primary care treatment, of preventative medicine, of an integrated health system in the interest of the mass of the people, take on a secondary role, as the doctors and other health workers plan out their careers in a market economy.

The book recounts the inspiring story of the birth and growth of a new kind of health provision in Cuba after 1960 when half of the country’s 6,000 doctors left for the US rather than co-operate with the revolution. Che Guevara, who was himself a doctor, took an active role in the early development of the ideas behind the new provision of universal health care. He is revered in Cuba, of course, but also in Venezuela and Bolivia.

Unbelievably, the Bolivian army sergeant, Mario Teran, who was ordered by his superiors (working to the CIA agenda) to murder Che after his capture in 1967, was one of 300,000 Bolivians who had their eyesight restored for free between 2006 and 2008 by Cuban doctors. A programme called Miracle Mission was financed by Venezuela to provide free eye surgery to more than 1.5m people in the whole of Latin America.

In 1962 a second medical university was opened in Santiago de Cuba at the opposite end of the island to Havana. By 2008 there were 25 medical schools in the country. The new doctors and other medical workers were deployed in an entirely different manner. The emphasis was on providing primary care for the whole population. The remote and under-served areas were assigned doctors. Medical teams were sent out to every part of Cuba, while local residents were encouraged to help in promoting preventive care and participate in public health campaigns. The doctors and nurses were generally expected to live in the area they practised in. “By gathering vital statistics on everyone, and then emphasising preventive care and health education, the doctors and nurses made Cuban citizens more conscious of maintaining good health, which led to a marked reduction in hospitalisation rates,” Brouwer writes.

In 1998 the Latin American School of Medicine (ELAM) was set up near Havana to promote internationalism and solidarity on the part of health professionals. By 2000, there was one doctor for every 167 people, allowing Cuba to accelerate its international programme and ELAM to step up the project for training doctors from all over the world (including even a few from the US).

Between 1961 and 2008, Cuba sent 185,000 medical specialists to work in 103 nations. Most of the placements were for years. By 2005 this new model healthcare army had developed to the point where the medical experts felt able to make a big leap. Fidel Castro announced that Cuba and Venezuela would join forces to educate 100,000 more doctors over the following ten years: 30,000 from Venezuela, 60,000 from other countries in Latin America and the Caribbean, and another 10,000 from nations in Africa and Asia. The Cuban doctors serving overseas took on a double role: as practising doctors and as educators for medical students from the host country….

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