From: jbarth@ep.ieee.org (Jeremy Barth)
Newsgroups: soc.culture.latin-america
Subject: Re: Human Rights in Cuba
Date: 23 Dec 92 18:57:19 GMT
Reply-To: jbarth@ep.ieee.org
Organization: IEEE, New York, NY

Ray, 

Thanks for the civilized tone of your comments ... you may
disagree with my views, but I appreciate your civility.

> Jeremy, I just wonder if you know how all those statistics were obtained
> and who compiled them? All I know is that everytime a UN delegation such as
> the Humans Rights tries to go to Cuba to inspect the situation, Castro's
> government denies them the right to do so.
>
> Is the United Nations taking Castro's government stats at face value?
> I remember that not too long ago the Soviet Union's stats looked impressive
> too!

The statistics are principally from the Cuban Ministry of Health.  Your
question about the validity of the stats is reasonable -- as the saying
goes,

	"There are lies, damn lies, and statistics."

The only answer I can give is that serious scholars in the medical, public
health, and nursing fields from throughout the world, especially other
Third World countries seeking to modernize their own health care systems,
have been closely studying the Cuban health system for many years.  There
are countless articles in the specialty journals and many monographs have
been written on the subject.  

The Cuban health model has not been accepted unquestioningly -- its "Community 
Doctor" initiative, for example, has been criticized for spending scarce health 
funds on physicians instead of training community health workers.  And the
practice of quarantining AIDS patients has raised serious human rights
questions.

But on the whole, the public health initiatives that Cuba has undertaken,
especially in the field of pre-natal care, infant and child health, and
immunization, are undoubted successes.  No serious scholar in the field
of international public health questions these successes; that doesn't
mean that there aren't substantive debates within the field about 
other facets of the Cuban health system.

I too deplore Cuba's reluctance to admit human rights delegations into
the country (though medical delegations are routine).  But, though I'm
sure you'll disagree with me, I don't believe this is a one-way street.  
The US government, for example, denied the Cuban Minister of Public Health 
an entry visa just last month; he was to have spoken at the American 
Public Health Association annual conference in Washington, D.C.  After 30 
years of acrimony on both sides, who can say which side should "blink" first?  
The US says Cuba should its citizens travel freely but denies US citizens 
the right to travel to Cuba.  Cuba is guilty of the same offense.  It's 
almost like the Israelis and the Palestinians -- neither side can break out 
of the dance of death, though it's in both parties' interest to do so.


> Maybe all my relatives and friends now in Cuba are nothing but cry babies
> since all I hear from them is that there are not even tetanus shots, aspirin,
> etc., but then people on this net say things like Castro is selling vaccines
> of different kinds to countries like Brazil, and medical care in Cuba is the
> best, etc.

The shortages aren't surprising since Cuba is in the middle of a severe economic 
depression.  Up until the recent past, Cuba was close to self-sufficiency in
supplying its pharmaceutical needs -- in the late 1980's it was producing
about 80% of its drugs locally and exporting about $100 million/year of
drugs to the rest of Latin America.  Most Third World countries have little
if any indigenous pharmaceutical industry and import close to 100% of their
needs.  Cuba is still nowhere near falling back to that stage of dependency,
but it's true that there are ever-increasing shortages in just about
everything.  (The US economic blockade has been quite "successful," especially
with the collapse of the Eastern block).

I wouldn't say that Cuba's *medical* care is the important facet of the Cuban
health system:  tertiary care is not what principally lives, its basic,
primary health care.  Immunizations, pre-natal care, education of women,
increased birth spacing, clean water, etc. are what really count.  Cuba
emphasized this course of action years ago, but it can be criticized 
nowadays for de-emphasizing public health and putting more into doctor-centered
care.


> Recently the Madrid, Spain newspaper ABC reported that Castro purchased
> 2 submarines, 30 jet fighters, several battleships and other military
> equipment from Rusia with a total tag (to be paid over a 4 year period) of
> 2 billion dollars. In the meantime reports from Cuba say that people are
> even eating dogs and cats and the animals in the zoo are also being stolen
> for food. Cats go for as much as 200 cuban pesos!

In the "guns vs. butter" debate I've always sided with butter.  Cuba is
not the *only* country where this is an issue -- in fact, I can't think
of any country where it's not an issue, especially in the Third World.
India, the world's largest democracy, has millions of beggars living
on the streets while it builds nuclear bombs.  Brazil had a clandestine
nuclear program sucking up scarce financial resources when shantytown
dwellers couldn't get clean water.  Some will view this as "obsfucation,"
but I don't feel that Cuba is near being the worse offender in the "guns 
vs. butter" conundrum, which doesn't "justify" any of its actions, it
just puts them into context.


> Also, the Panamanian magazine "Momento" reported that Castro owns a cattle ranch
> named "Lone Star" in that country which supplies beef to the Cuban
> "nomenclature" or party bosses. The beef is transported on the Cuban airline
> (Cubana). The ranch is administered by army lt. cor. Orlando Perez and
> commander Berto Perez Orama, both officers of the Cuban army.

As I stated, I believe Castro should have left politics years ago.  Any
ruling class that consists of the self-same group of people year after
year grows incestuous, loses touch with its roots and early ideals.  

But I differentiate between individuals and the social and political
system of which they are a part.  Where I differ with people who want
to overthrow the entire political system is that they choose to 
ignore major successes, such as health, which were *produced* by that
system.  The point of my statistical comparison between Cuba and the
rest of Latin America is that an obvious question is this:

	Suppose there had been no revolution in 1959.  Would
	Cuba's health stats be as good as they are today?  

If you were a social scientist, your control might be, say,
Brazil.  Now, in 1992, you do your comparison and what do you find?
You find that Brazil is far behind Cuba in basic health indicators.
So Cuba, whatever its faults (and there are many), has done
*something* right over the past 30 years that other countries
have not.  The system is neither all "good" nor all "bad."

I suppose to some this will seem an extreme position.


Jeremy