How Cuba is eradicating child mortality and diseases of the poor

Palpite, Cuba, is just a few miles away from Playa Girón, along the Bay of Pigs, where the US attempted to overthrow the Cuban revolution in 1961. Down a modest street in a small building with a Cuban flag and a large picture of Fidel Castro near the front door, Dr Dayamis Gómez la Rosa sees patients from 8am to 5pm. 

In fact, that is an inaccurate sentence. La Rosa, like most primary care doctors in Cuba, lives above the clinic that she runs. “I became a doctor,” she told us as we sat in the clinic’s waiting room, “because I wanted to make the world a better place.” Her father was a bartender, and her mother was a housecleaner, but “thanks to the revolution,” she says, she is a primary care doctor and her brother is a dentist. Patients come when they need care, even in the middle of the night.

Apart from the waiting room, the clinic only has three other rooms, all of them small and clean. The 1 970 people in Palpite come to see La Rosa, who emphasises that she has in her care several pregnant women and infants. She wants to talk about pregnancy and children because she wants to let me know that over the past three years, not one infant has died in her town or in the municipality. 

“The last time an infant died,” she said, “was in 2008 when a child was born prematurely and had great difficulty breathing.” When we asked her how she remembered that death with such clarity, she said that for her as a doctor any death is terrible, but the death of a child must be avoided at all costs. “I wish I did not have to experience that,” she said.

Eradicate the diseases of the poor

The region of the Zapata Swamp, where the Bay of Pigs is located, had an infant mortality rate of 59 per 1 000 live births before the revolution. The population of the area, mostly engaged in subsistence fishing and in the charcoal trade, lived in great poverty. Castro spent the first Christmas Eve after the revolution of 1959 with the newly formed cooperative of charcoal producers, listening to them talk about their problems and working with them to find a way to exit the condition of hunger, illiteracy and ill-health. 

A large-scale project of transformation had been set in motion a few months before, which drew in hundreds of very poor people into a process to lift themselves up from the wretched conditions that afflicted them. This is the reason why these people rose in large numbers to defend the revolution against the attack by the US and its mercenaries in 1961.

To move from 59 infant deaths out of every 1 000 live births to no infant deaths in the matter of a few decades is an extraordinary feat. It was done, La Rosa says, because the Cuban revolution pays an enormous attention to the health of the population. Pregnant mothers are given regular care from primary care doctors and gynaecologists and their infants are tended by paediatricians — all of it paid from the social wealth of the country. Small towns such as Palpite do not have specialists such as gynaecologists and paediatricians, but within a short ride a few kilometres away, they can access these doctors in Playa Larga.

Walking through the Playa Giron museum earlier that day, museum director Dulce María Limonta del Pozo tells us that many of the captured mercenaries were returned to the US in exchange for food and medicine for children; it is telling that this is what the Cuban revolution demanded. From early into the revolution, literacy campaigns and vaccination campaigns developed to address the facts of poverty. Now, La Rosa reports, each child gets between 12 and 16 vaccinations for such ailments as smallpox and hepatitis.

In Havana’s Centre for Genetic Engineering and Biotechnology, Dr Merardo Pujol Ferrer tells us that the country has almost eradicated hepatitis B using a vaccine developed by their centre. That vaccine — Heberbiovac HB — has been administered to 70-million people around the world. “We believe that this vaccine is safe and effective,” he said. “It could help to eradicate hepatitis around the world, particularly in poorer countries.” 

All the children in her town are vaccinated against hepatitis, La Rosa says. “The health care system ensures that not one person dies from diarrhoea or malnutrition, and not one person dies from diseases of poverty.”

Public health

What ails the people of Palpite, La Rosa says, are now the diseases that one sees in richer countries. It is one of the paradoxes of Cuba, which remains a country of limited means — largely because of the US government’s blockade of this island of 11-million people — and yet has transcended the diseases of poverty. The new illnesses that she says are hypertension and cardiovascular diseases as well as prostate and breast cancer. These problems, she points out, must be dealt with by public education, which is why she has a radio show on Radio Victoria de Girón, the local community station, each Thursday, called Education for Health.

If we invest in sports, says Raúl Fornés Valenciano, the vice president of the Institute of Physical Education and Recreation, then we will have less health problems. Across the country, the institute focuses on getting the entire population active with a variety of sports and physical exercises. Over 70 000 sports health workers collaborate with the schools and the centres for the elderly to provide opportunities for leisure time to be spent in physical activity. This, along with the public education campaign that La Rosa told us about, are key mechanisms to prevent chronic diseases from harming the population.

If you take a boat out of the Bay of Pigs and land in other Caribbean countries, you will find yourself in a situation where healthcare is almost nonexistent. In the Dominican Republic, for example, infant mortality is at 34 per 1,000 live births. These countries — unlike Cuba — have not been able to harness the commitment and ingenuity of people such as doctors La Rosa and Ferrer. In these other countries, children die in conditions where no doctor is present to mourn their loss decades later.

This article was produced by Globetrotter, a project of the Independent Media Institute. The views expressed are those of the author and do not necessarily reflect the official policy or position of the Mail & Guardian.

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Vijay Prashad
Vijay Prashad is an Indian historian, editor and journalist. He is the chief editor of LeftWord Books and the director of Tricontinental: Institute for Social Research. He is a senior non-resident fellow at Chongyang Institute for Financial Studies, Renmin University of China. He has written more than 20 books, including The Darker Nations and The Poorer Nations. His latest book is Washington Bullets, with an introduction by Evo Morales Ayma.
Manolo De Los Santos
Manolo De Los Santos is the co-executive director of the People’s Forum and is a researcher at Tricontinental: Institute for Social Research. He is a co-coordinator of the People’s Summit for Democracy

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