Please, take care with the Cuban political approach to global health!

Dear The Lancet Editor,

I agree with Yudkin and col. in “Global health-worker crisis: the UK could learn from Cuba” (April 26, p. 1397-1399),[1]  but to understand well Cuba’s health progress the UK NHS will need to study at least since 1728, when a Havana University medical faculty was opened. It must be noticed that in the 1950s Cuba shown excess of well-qualified physicians (by US standards), and of the best infant mortality, life expectancy, natality, and other indexes in the world.[2]

Cuba in about 50 years of socialism has become world champion exporting healthcare-workers to developing countries and teaching students in the island, but together with Soviet Russia, has exported and taught hundred of thousands military agents and troops for geopolitical misinformation, conspiracy, guerrillas, cold/warm wars, fanatic hate and terrorism against the US and West Europe, facing the longest and deepest living and working crisis since 1492.

It is tragic that Cuban health-collaborators are forced by captivity and misery, to work as strike breakers in the worst places abroad and subvert ideologically the patients against their countries’ health and democratic institutions, free-market economies, and developed countries’ solidarity,[3-5] while they avoid to work in their own poorest Cuban remote villages and slums due to lack of stimulus.

I do not blame the UK NHS for been more concerned with running its health service than with promoting global health. Today, Cuba’s health education and healthcare are collapsed and of the worst quality, except for the political bureaucracy, for foreigners paying in hard currency, and for propaganda.

 

Cuba preserves without private sector and mutualism some trends of public minimum-quality healthcare, education, and animal-quality food security, but should not be considered a healthy country with a socioeconomic and civil-political setback worse than Myanmar: impoverishment of 99% of its population living and working levels with equity at the bottom, repression of dozens individual liberties and rights, indoctrination/robotization, massive political kangaroo-trials, executions/imprisonments, native discrimination, captivity/corruption, massive exodus by the sea with tenth of thousands people drowned or eaten by sharks, and urban infrastructure-destruction. All these flaws deteriorate the well-being mental and social components of the WHO health-concept definition, according to the UN world accepted norms on individual liberties and rights, and on levels of human living.[3-5]

 

I see in the UN, WHO, and some countries a very limited approach to face the global health problems. These problems will not be solved linearly with only “healthcare for all” through “four-million health-workers more”, without approaching all the UN agencies, World Bank, IMF, governments and charities, the integral improvement of the “free living and working care policies/systems for 6.5 billion people” by about two-billion workers (in every field) of the world economy.

 

Thank you.

 

IMF: International Monetary Fund

NHS: National Health System

UN: United Nations

UK: United Kingdom of Britain

US: United States of America

WHO: World Health Organization

 

References:

 

1. Yudkin JS, Owens G, Martineau F, Rowson M, Finer S. Global health-worker crisis: the UK could learn from Cuba. Lancet 2008; 371:1397-1399. http://www.thelancet.com/journals/lancet/article/PIIS014067360860608X/fulltext

 

2. McGuire JW, Frankel LM. Dimensions and determinants of mortality decline in pre-revolutionary Cuba. Harvard Center for Population and Development Studies, Working Paper Series. vol. 14 no. 6. Cambridge, MA, 2004. Available: http://www.globalhealth.harvard.edu/hcpds/wpweb/McGuire_wp1406.pdf  Accessed April 30, 2008.

 

3. Anonymous Cuban professional. Poverty, emigration, government, development, and equity. Ann Fam Med 2007 (Dec 3). http://www.annfammed.org/cgi/eletters/5/6/486#7388

 

4. Anonymous Cuban professional. Achieving health equity with more liberty, wealth, and ethics. BMJ 2007 (Oct 5). http://www.bmj.com/cgi/eletters/335/7621/628-b#177601

 

5. Anonymous Cuban professional. Does neo-liberalism is worse than Soviet socialism and terrorism globalization? Lancet 2008 (Apr 16). http://www.thelancet.com/journals/lancet/article/PIIS0140673608605085/comments?action=view&totalcomments=1