© 2000 by Oxford University Press
Journal of the National Cancer Institute, Vol. 92, No. 12, 963,
June 21, 2000
© 2000 Oxford University Press
NEWS |
Does the U.S. Embargo Affect Cuban Health Care?
The average life expectancy in Cuba is almost 76, about the same as in the United States. And at 9 deaths per 1,000 newborns—down from 70 at the outset of the Castro regime 41 years ago—the country’s infant mortality rate is impressively low.
Moreover, Cuba now boasts more than 30,000 physicians, the highest doctor-patient ratio in the world. But though Cuban biotechnology has met the challenge of the loss of Soviet subsidies and the squeeze of the U.S. trade embargo with reasonable success, public health in Cuba and the country’s health care have fared less well.
Visitors to Cuba, for example, are told to buy bottled water—something few Cubans can afford—because the local water is unfit to drink. The embargo is to blame in two ways. One is that replacement parts for the aging U.S.-made water treatment system are unavailable.
The other is that water purification chemicals are exorbitantly expensive and often unobtainable. According to the American Association for World Health, the U.S. committee for the World Health Organization, illness due to waterborne causes in Cuba has soared as a result and some hospital-acquired infections have been traced to tainted water, too.
Or consider the experience of Peter Greenberg, M.D., of Stanford University Medical School. A hematologist, Greenberg has twice been to Cuba—in 1998 and again in 1999—to lecture about his specialty and to spend time with counterparts at hospitals in Havana and Santa Clara.
"These hospitals were all well staffed with very qualified physicians, highly committed and knowledgeable in their fields," he said. He was pleased to find, too, that Cuban health care, tertiary care included, is free and available for everyone. But he also found that, because of the embargo, "the management of patients can be difficult" due to a lack of such items as bone-marrow aspiration needles and high-dose formulations of cytosine-arabinoside and shortages of antibiotics, equipment, current textbooks, and basic medical supplies.
Variations on the above themes are not hard to find. Under a program called MEDICC (http://www.medicc.org), students working toward health sciences degrees in the United States and Canada spend 4 to 8 weeks in Cuba taking courses in their fields and doing clinical rotations mentored by local physicians.
They often return from the experience to report that universal precautions are not observed in Cuba; for example, the precious few rubber gloves available are reserved for surgical procedures, and, just as cars in Cuba are likely to be vintage models, things like anesthesia and x-ray machines are, too.
The American government has a "Who, me?" response to such observations. Washington’s chief of mission at the U.S. Interests Section at the Swiss Embassy in Havana, Vicki Huddleston, denies that the embargo is to blame for Cuba’s health woes. A "Dear Visitor" paper that she hands out to fellow Americans says, "Medicines are in short supply not because of the U.S. embargo as the Cuban government often alleges, but simply because the Cuban government has . . . not allocated the money to buy medicines."
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