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There appeared to be little evidence of a divide between the prevention/proactive response and the disease management/reactive response within Cuban healthcare
The communist regime did not want to reveal to the world the existence of an epidemic of dengue fever in the spring and summer of 1997 because it was a personal embarrassment to Fidel Castro, who had previously declared that the mosquito responsible for dengue, the Aedes aegypti, had been eradicated long before by the long arm of the Revolution.
The dengue fever epidemic has become endemic in the Island. Castro’s regime has always tried to hide the facts, instead of asking the international community for help to eradicate the epidemic. This excellent article about the Dengue Epidemic is a must read:
“THE DENGUE EPIDEMIC IN CUBA”
http://www.lanuevacuba.com/archivo/humb ... o-1eng.htmQuote:
In Cuba it was one doctor per 175 people, in the UK the figure was one doctor per 600 people.
Mora than 36,000 Cuban health workers, most of them doctors, who work overseas in 71 countries according to official figures, brought in $2.3 billion last year, more than any other industry, including tourism. Most of them are paid $150 to $375 a month, 10% to 15% only of the cash or trade benefits the Cuban government pockets in exchange for their work.
Physicians in Cuba are forced to work for a salary of $22 per month (530 pesos) which does not cover even their bare necessities. Many doctors quit the profession and seek jobs in the only industry that offers any chance for economic opportunity and access to dollars, the Cuban tourism industry.
Because so many health workers are working overseas, and others have quit the profession, there is a shortage in Cuba. The situation has become so bad that on December 2007 the vice minister of public health, Joaquín García Salaberría, took the highly unusual step of admitting on Cuban television that there were shortages of doctors and nurses.
The physicians serving in those countries are essentially under surveillance all the time and any change in their plans not consistent with the orders given from Havana invariably lead to the involvement of police or paramilitary security forces. It is no wonder that many physicians in such missions defect to freedom. About 6,000 health workers, many of them physicians, have left Cuba in the last six years.
There are a total of 65,000 Cuban doctors. According to MINSAP 25,000 Cuban doctor’s work overseas and another 10,000 have left Cuba. The actual numbers of doctors in Cuba reach 30,000, but 10% quit the profession and work in more lucrative jobs. Only 27,000 doctors are working in Cuba in their profession. The actual per capita of doctors is one doctor per 422 people.
Financially, "doctor diplomacy" is an outstanding source of income for Castro's economy since his MINSAP pays doctors and other personnel only a small fraction of the millions of dollars that are received by Cuba.
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[1]Extensive involvement of "patient" and the public in decision making at all levels.[/i]
Many physicians had serious complaints about the intrusion of politics into medical treatment and health care decision-making. There is no right to privacy in the physician-patient relationship, no right of informed consent, no right to refuse treatment, and no right to protest or sue for malpractice. Family doctors are also expected to report on the “political integration” of their patients, and to share this information with state authorities.
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Integration of hospital/community/primary care via polyclinics.
Under the Cuban government's health care monopoly, the state assumes complete control. Average Cubans suffer long waits at government hospitals, while many services and technologies are available only to the Cuban party elite and foreign "health tourists" who pay with hard currency. Moreover, access to such rudimentary medicines as antibiotics and Aspirin can be limited, and patients often must bring their own bed sheets and blankets while in care.
Cubans who needed treatment often used social networks or bartered favors to have doctors see them outside the official clinic settings. If people had to go to the hospital, they tried to prepare in advance, getting surgical thread and bandages on their own, even obtaining drugs from the United States if they could.
The increase in transmissible diseases has given rise to an ever increasing state if problems. Most of the population is affected by parasites, anemia and mal nutrition. Pathologies such as tuberculosis have high rate of occurrences and prevalence that are alarming.
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Team-work that works is much more evident both in the community and the hospital sector and the mental-health and care of the elderly sites visited were very well staffed and supported.
Cuba still houses their criminals and mentally challenged in squalid jails and disgusting state run asylums. Around 25 years ago Castro released his criminals and mentally deficient people out of jail and institutions and sent them in overcrowded boats to enter America as political escapees.
The book "The Politics of Psychiatry in Revolutionary Cuba," by Charles J. Brown and Armando M. Lago, published in the U.S. in 1991, documented Castro,s use of psychiatry against political dissidents in 31 cases of psychiatric abuses at Mazorra Psychiatry Hospital in Havana. In addition to this book, two addendums to the United Nations Human Rights Commission in Geneva (1992 and 1993) presented 40 more documented cases. The South Florida Psychiatric Association found approximately 100 new cases in 1995 among the rafters detained at Guantanamo. And in 1996, the office of Research at Radio Marti found 200 more documented cases, making a total of 371 known cases.
Said Dr. Lago, one of the authors of the book: "In the former Soviet Union, with a population of three hundred million, there were 300 well documented cases of psychiatric abuse against political dissidents (1 per million). However, Cuba's eleven million inhabitants, with 371 cases is a shocking contrast (1 per 30,000)."
Mazorra Psychiatry Hospital is notorious for punishing political dissidents with heavy doses of psychotropic drugs and electroconvulsive therapy (ECT). On August 2002, Heriberto Mederos was found guilty of lying to Miami's INS officers about his past, denying he tortured political prisoners by administering electroshock treatments as a nurse at the Mazorra Psychiatric Hospital in Havana.
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Taking the good parts of the Cuban system and applying it to the US model might not be the worst thing to happen.
The myth of Castro tyranny about the success of the Cuban Health Care System, is debunked by an article titled “Re-examining the Cuban Health Care System” included in the latest edition of the online journal, “Cuban Affairs,” published by the University of Miami’s Institute for Cuban and Cuban-American Studies.
The author, University of Oklahoma Professor Katherine Hirschfeld, spent nine months in the island living with a Cuban family and interviewing family doctors, medical specialists, social workers, nurses and patients as part of her research. Katherine Hirschfeld ,
http://www.cubanaffairsjournal.org, Vol. 2, Issue 3-July 2007.
Dr. Hilda Molina, a former member the Cuban National Assembly, is one of Cuba's most distinguished scientists. She broke with the government on the issue of medical apartheid, the denial of medical care or medicine to Cubans while the same services are provided to dollar-paying foreign patients. Dr. Molina is founder of Havana's International centre for Neurological Restoration. She and her elderly mother were virtual hostages on the island for15 years, until recently that were permitted to travel abroad. Dr. Hilda Molina report “Cuban Medicine Today”, was smuggled out of the island, and published by centre for a Free Cuba, December 28, 2004
http://www.cubacenter.org/media/archives/1998/summer/medicine_today.php3Quote:
Rather, one needs to mark the quality of health care against the nation's per capita GDP. In this respect, Cuba has a phenomenal health care system.
For the quality of health care in Cuba see Katherine Hirschfeld article “Re-examining the Cuban Health Care System”, and Dr. Hilda Molina report “Cuban Medicine Today” referenced above.
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Sandokan, the Cubans do have a higher per capita amount of doctors than any Western nation. Are they as well trained, paid, capable, or do they have the proper facilities?
See response above for "doctor diplomacy."
There are enormous differences between medicine in Cuba and in the United States. Aside from old books used in their training, Cuban medical students and doctors must contend with a lack of modern equipment and, often, of drugs and diagnostic tools taken for granted in developed countries.
Foreign doctors trained in languages other than English face immense challenges getting a license to practice in the United States. Not only must they relearn their profession in English, but many must also work to support themselves and their families. Cuban doctors, in particular, tend to be older by the time they arrive in the United States, sometimes too old to dedicate years to studying for exams and finding and completing a residency program.
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When will the effects of McCartyism ever stop. Just because they have a communist based system ti does not mean that they experiment on their population.
Dr. Hilda Molina, a former member the Cuban National Assembly: “I opposed the efforts of Dr. José Angel Obeso to perform functional surgery in cases of Parkinson's disease, judging them as too risky for patients and insufficiently studied. In other words, I opposed the use of Cuban patients as laboratory animals.” See Dr. Hilda Molina report “Cuban Medicine Today” reference above.
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I would rather be sick and need hospital care in Cuba than in the US.
Good luck. For an accurate picture of what the average Cuban undergoes in healthcare, please visit the harrowing pictures smuggled out of Cuba (at enormous peril) and posted on
http://therealcuba.com/. If a picture is normally worth a thousand worth then these are worth a million. The 20/20 program about healthcare in Cuba video:
http://www.youtube.com/watch?v=o-8TcpOz6A4. Hannity and Colmes' program about health care in Cuba for regular Cubans video:
http://www.youtube.com/watch?v=25_RgM1jHeo&eurl=http://www.babalublog.com/The man who assumed most of the risk during the filming and smuggling was Cuban dissident Dr. Darsi Ferrer, a medical doctor himself. Dr. Ferrer was also willing to talk on camera, narrating the video’s revelations. Dr Ferrer works in these Cuban hospitals, a daily witness to the truth that some prefer to ignore.
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Cuba has a number of unique medical treatments that are beginning to attract world-wide attention, and, in addition are running world class medical ltouriswm centres that finance the regular national system.
For the so call “unique medical treatments” and “health tourism” see reference above of Dr. Hilda Molina report “Cuban Medicine Today”
Cuba is only a medical power in a few hospitals that are adequately equipped and they do not lack anything, and in which only have access the foreigners who pay in dollars, the nomenclature and members of the party. In other words Cuba is an example of the call “medical apartheid.”
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There can be little argument with this, they export doctors and have a higher life expectancy/lower infant mortality than nations of similar means in the area.
For "doctor diplomacy" see response above.
In all nations with high emigration rates longevity rates skew high. This occurs because the birth is recorded but the death gets recorded in the nation migrated to. So it seems like fewer people die. A nation with high longevity but with high emigration has little to boast about with regards to longevity figures. During the last 50 years, 2.6 millions Cubans have emigrated/born abroad. The actual island population is 11.4 millions. The 2.6 millions represent 18.5% of the total population, a high emigration rate.. This explains the high life expectancy.
According to UN figures, Cuba's current infant mortality rate places the country 44th from the top in worldwide ranking. According to those same UN figures, in 1958 (the year prior to the revolution), Cuba ranked 13th from the top, worldwide. This meant that pre-Castro Cuba had the 13t lowest infant-mortality rate in the world.
Cuba's infant mortality rate is kept low by the regime’s tampering with statistics, by a
low birth rate of 12.5 births per 1000 population, and by a staggering abortion rate of 77.7 abortions per 1,000 women. Cuba had the lowest birth rate and doubles the abortion rate in Latin America. Cuba's abortion rate was the 3rd highest out of the 60 countries studied. (
http://www.guttmacher.org/pubs/journals/25s3099.html)
Another health parameter linked to infant mortality, is the maternal mortality rate. Cuba’s maternal mortality rate is 33 deaths per 100,000 live births. This health statistic is high despite the fact that Cuba has the lowest birth rate in Latin America. The doctors are supposed to suggest abortion in risky pregnancies and, in some occasions, must perform the interruption without the consent of the couple. Cuban pediatricians constantly falsify figures for the regime. If an infant dies during his first year, the doctors often report he/she was older. Otherwise, such lapses could cost him severe penalties and his job.