CUBA'S HEALTH CARE REVOLUTION, LATIN AMERICA'S HIDDEN HOLOCAUSTSomething for Fidel to Be Proud OfJames S. Henry

While US media conglomerates like Time and Fox have been obsessing for months about whether or not 80-year old Fidel Castro is finally about to meet El Fabricante,  Cuba has been busy setting health records -- helping its 11.4 million citizens achieve lower mortality and longer lives than almost anywhere else in the developing world.

Now that a leading Madrid surgeon has made it clear -- contrary to USG agitprop -- that Fidel is not suffering from terminal cancer, and, indeed, is recovering well from last summer's stomach operation,   perhaps this other Cuban health story will finally receive the attention that it deserves. 

Just this month Cuba announced that its infant mortality rate has reached the First World average of just 5.3 per thousand -- on a par with the latest rates for the UK, Canada and New Zealand, even lower than the 6.7 US average,  and less than half the 14.1 average rate for all African-Americans in the US.

LATIN AMERICA'S HIDDEN HOLOCAUST

Even more to the point, Cuba's infant mortality rate is also the lowest in Latin America and the Caribbean, and indeed, the lowest for any developing country in the world.

The corollary is another important story. This is the fact that while Fidel's tiny, isolated, centrally-planned, highly-inefficient, antediluvian island economy has managed to set record after record on public health, education, poverty reduction, and gender equality since the 1970s,  the "non-revolutionary" rest of Latin America has lagged far behind. Over time, the cumulative impact has been huge.

For example, as we'll see below, if other Latin American and Caribbean countries had simply kept pace with Cuba's percentage improvements in infant mortality from the 1960s to 2005, an additional 6.4 million infants -- an average of 184,000 per year for the region as a whole -- would have survived the first year of childbirth.

In effect, all these "missing children" amount to nothing less than a continuing hidden holocaust -- attributable at least in part to the pro-elite development paths that most of these countries have pursued.

Many of those critics on the Right who like to rail against the deficiencies of Castro's regime -- its admitted lack of US-style national elections and market freedoms, its shortage of big fancy cars and other consumer goods -- also profess to be profoundly concerned about human rights,  the welfare of Elian Gonzalez, "the rights of the unborn," and so forth.

Perhaps they will now bring themselves to admit that at least in one respect, Fidel's Revolution is actually a role model -- and that naked capitalist development also has very high costs. 

This goes a long way to explain why, far from being the pariah that USG has tried to make him, Fidel is today treated with greater respect and admiration throughout Latin America than ever before -- certainly in comparison with former US-backed right-wing thugs like Pinochet, Rios Montt, Banzer, Fujimori, and the Argentine and Brazilian juntas.

Consistent with this, on October 28, 2006, the UN General Assembly voted for the 13th year in a row to condemn the US embargo on Cuba. Every Latin American and Caribbean country voted to support the resolution, joining 179 countries that did so. Only four countries voted against it -- the US, Israel, the Marshall Islands, and Palau.

In any case, whatever the quality of life in Cuba for adults today, the fact is that if you are an unborn infant of average means who somehow gets to decide where in the entire developing world to be born, there's no contest.

(For all the gory statistical details, read on below):

 

THE CASE FOR CUBA

Cuba's progress on health metrics is indeed impressive, especially when compared with countries like Guatemala, Haiti, Panama, El Salvador, Peru, Argentina, Nicaragua, Honduras, Paraguay, Mexico ("leftist" in name only), Brazil, Bolivia, and Chile, which spent decades under US-backed right-wing authoritarian regimes that were too busy lining their own pockets, serving foreign masters and elite interests to give much of a hoot about ordinary people.

During his entire 17-year reign, for example, Chile's General Augusto Pinochet did not build a single new hospital.

Meanwhile,  thanks in no small measure to the Cuban regime’s emphasis on social goods like basic nutrition, free health care, and education, Cuba’s infant mortality rate – along with many other social indicators – improved dramatically, both in absolute terms and relative to other developing countries.

As a result, Cuba's infant mortality rate today trumps Chile's 7.6, Costa Rico's 11.3, Venezuela's  16, Argentina's 16.2, Colombia's 17.5, Panama's 18.8, Paraguay's 20.6, Mexico's 22.6, Ecuador's 23, El Salvador's 24.2, Peru's 24.2, the Dominican Republic's 27.6, Brazil's 31.8, and Guatemala's 33.4, let alone Guyana's shameful 48, Bolivia's 54, and Haiti's 74.

Beyond Latin America, Cuba also easily trumps Russia's 16.8, Romania's 17.3, Vietnam's 17.4, China's 26, Turkey's 28.3, Indonesia's 30,  Iran's 32,  South Africa's 54, India's 61.6, Kenya's 78.5, Pakistan's 80, and Iraq's 108.

More generally,  Cuba also leads its region on many other health and social indicators, including life expectancy,  expected years of disease-free life, the highest vaccination rates, the lowest incidence of HIV,  the highest literacy rate, the highest rate of female participation in the national legislature, the highest proportion of students enrolled in primary and secondary education, and the number of doctors, nurses, and hospital beds per capita.  

• The incidence of tuberculosis in Bolivia is 210 per 100,000.  in Haiti, Cuba's Caribbean neighbor, it is 306. In Cuba, it is 10.

• The prevalence of HIV among US adults (ages 15-49) is now .6 percent. In Guatemala it is 1.1 percent; in the Dominican Republic, 1.7 percent; in Honduras, 1.8 percent; in Trinidad, 3.2 percent; in Haiti, 5.8 percent. In Cuba it is .1 percent.

• In Guatemala, according to the WHO, just 41 percent of all childbirths are attended by skilled health workers. In Honduras, the figure is 56 percent; in Bolivia, 60 percent; in Nicaragua, 67 percent; in El Salvador, 69 percent; in Brazil, 88 percent;  in Haiti, 24 percent. In Cuba, the figure is 99 percent.

• In Guatemala, 49.2 percent of all children under the age of 5 suffer from stunted growth. In Honduras the proportion is 29 percent; in Bolivia, 26 percent; in Peru, 25 percent; in Nicaragua, 20 percent; in Panama, 18 percent; in Argentina, 12 percent; in Brazil, 11 percent. In Cuba, the figure is 4.6 percent.

• In Cuba, life expectancy for males at birth is 75 years, the same as in the US and Costa Rica, but lower than Canada's 78 years. In Chile it is 74; in Mexico, 72; in Argentina, 71; in El Salvador, 68; in Brazil, 67; in Guatemala and Honduras, 65; in Bolivia, 63; in Haiti, 53.In terms of healthy male life expectancy, Cuba leads the Latin American pack, tied with the US at 69 years.
  

• In Cuba, life expectancy for females at birth is 80 years, the same as in the US and Costa Rica, but lower than Chile's 81 and Canada's 83. In Mexico it is 77; in Argentina, 78; in El Salvador and Brazil, 74; in Guatemala, 71; in Honduras, 70; in Bolivia, 66; in Haiti, 56. In terms of healthy female life expectancy, Cuba is tied with Chile at 70 years.

• Cuba has trained 88,000 nurses and more than 67,000 doctors -- as many as there are in all of Canada, whose population is three times Cuba's. By comparison, Chile has just 17,000 doctors to serve its 16.5 million people, while Guatemala has just 10,0000 to serve 12.3 million. Cuba now has more doctors per capita than any country in the Western Hemisphere, including the US. 

Overall, Cuba is one of just a handful of developing countries that have attained nearly all of the "Millenium Development Goals" for poverty reduction, health care, gender equality, and environmental sustainability that were set by the UN in 2000. These goals were supposed to be realized by the year 2015. Even in Latin America, many countries will find it difficult to achieve them even by then.

DISINFORMATION

Under the Bush Administration, which owes so very much to theultra-derechistas in Florida’s overly-influential Cuban exile community, the US State Department has gone to outlandish lengths to deny Fidel Castro any credit whatsoever even for improvements in these widely-accepted metrics.

For example, a 2006 US State Department website argues that as of 1957, before Castro took power, Cuba was already far ahead of most other Latin American countries on infant mortality.

That was indeed part of the story. As of 1960, for example, infant mortality in Cuba was already just 35.4 per 1000, 2.7 times lower than Mexico’s average rate, 3.3 times lower than Brazil’s, 3.8 times lower than Guatemala’s, and 4.3 times lower than Bolivia’s. 

However, a closer look shows that during the following four decades after Fidel took power, despite the relentless US embargo on trade/investment that considerably increased the cost of pharmaceuticals, medical equipment, and other medical supplies –-  Cuba’s relative gains on infant mortality actually accelerated, boosting the comparative country ratios even higher –  from 3.8 times lower in 1960 to 5.4 in 2004 for Guatemala, from 4.3 to 8.6 for Bolivia, from 2.7 to 3.6 for Mexico, and from 3.3 to 5.1 for Brazil.

EXPORTING DOCTORS

One side-effect was that this helped to make medical doctors a leading Cuban export -- and a very helpful instrument for Cuban foreign policy, especially in Latin America.

Not for nothing is Cuba's image strong in countries like Bolivia, Venezuela, Nicaragua, Brazil, and Angola, where thousands of Cuban doctors have been providing thousands of people with free medical services for years.

Regrettably, the US has no equivalent foreign medical assistance program. The vast majority of our 730,000 doctors and more than 2.7 million nurses are all just far too busy making money, filling out forms,  and dealing with armies of insurance bureaucrats, managed care companies, and malpractice attorneys, to lend a hand to the world's poor.   
 
YEARNING TO BE "FREE?"

None of this is meant to deny the fact that, if asked,  many Cubans would undoubtedly prefer more economic freedom and a higher private standard of living.

Given this pent-up demand, a substantial degree of economic liberalization is probably in the cards whether Fidel lives a month or 10 years.

However, before they embrace the neoliberal paradigm wholeheartedly, Cubans would do well to examine the post-liberalization traumas and disappointed expecations of many Russians, Poles, Serbs, and Czechs, the pervasive poverty, corruption, and inequality in the Philippines, Honduras, Guatemala, El Salvador, Panama, Nicaragua, Haiti, Jamaica, and the Dominican Republic, and the plight of many right-less small business owners, workers and peasants in "the New China" and "the New Vietnam."

It is all too easy for privileged Americans who have inherited a huge, prosperous market economy, political rights, civil liberties, and world power at birth to criticize Fidel's miniature socialist dictatorship. 

Of course Cuba bet on the wrong Empire.  The interesting question is whether Fidel ever really had any choice.

In other words, way back in the 1960s and 1970s, at the peak of the Cold War, did Cuba ever really have an option for a more democratic, non-revolutionary alternative to restoring an even more repressive version of Batista's right-wing dictatorship -- sort of a mix of Rios Montt's bloody Guatemala and Pinochet's Chile, with cruise ships, rumbas, and mobsters.

Would the USG have tolerated a Fidel who preferred "democratic socialism" to armed revolution? Wouldn't he have quickly gone the way of all earlier Cuban non-violent progressive reformers, let alone Colombia's Jorge Gaitan, Guatemala's Arbenz, Guyana's Cheddi Jagan, Chile's Allende, and Jamaica's Michael Manley? 

Sooner or later, all of these pacifists discovered that when it came to progressives, the USG lumped all "demsocs" together with revolutionaries, and declared open season on all of them.

On the other hand, would the absence of Cuba's "revolutionary threat" have made the USG more tolerant of the demsocs? I doubt it -- after all, long before Castro and Che seized Havana in 1959, the USG had been busy overthrowing demsocs like Mossadegh (Iran) and Arbenz.

What is clear is that the US quickly wrote Castro off, tried many times to remove him by force, and then maintained a stiff embargo for 46 years. 

None of that was ever likely to encourage political -- or economic -- liberalization. Indeed, Fidel owes much of his long career to a weird alliance d'interets between hard-liners on the Left and the Right, who shared a stake in each others' continued existence.

RIGHTS OF THE NEW BORN?

The high costs of Cuba's state-socialist development path are well-known. They include political repression, the loss of market freedom, and decades of economic isolation from the US, Cuba's traditional key trading partner. 

However, the reactionary capitalist development path "chosen by" or imposed upon Cuba's neighbors in Latin America and the Caribbean has also had very high costs.

Of course these costs included the high direct costs of the repressive, corruption-ridden,  debt-heavy development paths that were implemented by most right-wing dictatorships. They also included other costs that were less visible, but, over time, even more pervasive and detrimental.

For example, as shown in the adjacent slides,  Latin America's "non-revolutionary”  countries have all sustained infant mortality rates that  are several times as high as Cuba's since at least the late 1950s. 

While Cuba  did have much lower infant mortality rates even before Castro took power in 1959, since the early 1970s his regime -- which focused so heavily on delivering mass health care -- has been able to achieve much faster improvement than the rest of the region.

Over time, this difference has really added up.  If the rest of Latin America and the Caribbean had just been able to match Cuba’s rate of improvement on infant mortality since 1970,  at least 6.4 million more Latin American babies would have survived their first year -- on average, about 180,000 more infants per year.

Furthermore, if these countries had managed not only to match Cuba's rate of improvement in infant mortality, but also to match Cuba's actual average levels per year of infant mortality, the difference would have been more than 16 million infant lives.

On the other hand, if the ultrasderechistas in Miami and the USG had had their way, and had tossed Castro out -- sacrificing Cuba's faster improvements in infant mortality from 1970 to 2005  -- then at least 41,400 more Cuban infants would also have never survived their first year, a 41 percent increase in Cuba's infant deaths during this period.

As for the brutalitarian balance sheet, which is of course all that matters to economists, while Stalin and Mao undoubtedly were responsible for the deaths of millions, and, on the other hand, the victims of Argentine's junta (30,000), Fujimori (30,000+), Pinochet (3-4,000), and Guatemala's military (200,000) are huge, no one has ever accused Fidel of executing more than a few hundred of his political opponents over the years.

So avoiding these 41,000 extra Cuban infant deaths looks like a pretty good deal-- even apart from the sheer satisfaction of keeping cabrones like Luis Posada Carriles out of power. 

All told, then, all these missing infant souls in Latin America were a pretty hefty price to pay for the non-socialist path to development in any currency, n'est pas?

Newborn workers of the world, unite!  You have nothing to lose but your diapers and your lives!  Largo vive Fidel y la revolucion Cubano de la salud!

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©SubmergingMarkets, 2007

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