Talk:Healthcare in Cuba/Archive 1

message: Should AIDS statistics be mentioned ? -- Beardo 18:24, 16 May 2006 (UTC)
thread_title: AIDS statistics

message: A number of sentances have been removed recently on the basis that they are unreferenced. If that is the only reason to remove, they should have been tagged "citation needed" at first.  
"They offer medical services to 85,154,748 people; 34,700,000 in Latin America and the Caribbean and 50,400,000 in Africa and Asia."
"During the UN's general assembly in 2000, Fidel Castro offered the United Nations 6,000 doctors for service in the third world."
"Cuban doctors played a vital role in the health-care system of Sri Lanka in the 1980s, particularly in the war-torn North-east province, when a crisis in that country's education system limited the number of doctors coming out of universities."
The second seems to be based on the offer included here - "Cuba is willing to supply up to 3,000 additional Cuban doctors and medical personnel for such endeavor in Sub-Saharan Africa - who would also contribute to training African health staff on the field. But it is essential for industrialized countries to do their share and supply the necessary medications and inputs for the programme. Africa is waiting for us. Cuba stands ready. Developed countries now have the floor." - http://www0.un.org/ga/webcast/statements/cubaE.htm
*-*-*-*-*
We ought to be able to find better references that Cubanet. (see Peru/Nicaragua).
-- 19:59, 20 May 2006 (UTC)
replies: text: Going to try and sort this out over the next few days, Beardo. It's a real job unravelling all the propoganda from all sides and attempting to find balance. I agree about the aids information, and have found some details on that.--Zleitzen 22:31, 20 May 2006 (UTC)
thread_title:  Referencing 

message: I suggest we have separate sections for:
- healthcare in Cuba
- Operacion Milagro eye operations
- other overseas missions - Venezuela etc.
-- Beardo 20:29, 20 May 2006 (UTC)
thread_title:  Sections 

message: Some groups in the United States have been critical of the Cuban healthcare system.
The American magazine NewsMax describes the exportation of Cuban doctors to Third World countries as a "propaganda" exercise, stating that "it is easy because Cuba has an overabundance of physicians and professionals of all types, a perpetual oversight of the communist central planners"..
This is not a criticism of healthcare, but of Cuban foreign policy. I have to say its pretty interesting how the Health care in the United States article isn't taken up by half a page stating essentially "it is notable that people die of easily curable diseases in the United States, a perpetual oversight of the free market ideologues that run the country". Not that I necessarily agree with the statement, but makes for an interesting comparison. - FrancisTyers · 16:19, 19 July 2006 (UTC)
thread_title: Removal

message: *Mission Barrio Adentro:  The Venezuelan Medical Federation, the largest association of medical doctors in Venezuela, has lobbied vigorously against Mission Barrio Adentro, and is in a legal dispute with the Chávez administration over the legitimacy of the Cuban doctors' licensure and practice. Critic and ex-minister of health Rafael Orihuela claims that the number of cases of infant mortality, mothers dying during birth, yellow fever and malaria have risen, even though the program receives a third of the budget of the Ministry, providing statistical proof that the Cuban doctors seem unqualified to practice medicine. http://buscador.eluniversal.com/2005/06/29/ccs_art_29401A.shtml
*Dudley, Steven.  CUBA-VENEZUELA HEALTH PROGRAM.  Cuban doctors defect, speak out:  Two Cuban doctors who defected gave an inside account of the Cuban- Venezuelan health program.  Miami Herald (15 August 2006).
Sandy 16:33, 16 September 2006 (UTC)
replies: text: Very interesting.Ultramarine 17:31, 16 September 2006 (UTC)
replies: text: Generally, I find it easy to verify State Dept information, and that they are usually accurate in these cases. You just have to invest the time in your library :-)  I do understand the concern over having such a large section of criticism dominated by one source.  I used to travel to Venezuela for all of my specialty health care, no matter where I was living, as I preferred my specialists there to what I had in the USA, Europe, or other South American countries where I lived: my Venezuelan doctors were utterly topnotch specialists, the best I had in the world in some areas of specialty, my family and I have much to thank them for, and my employees in Venezuela years ago had far better health care in Venezuela than they could get in the USA today. This is no longer true:  the situation with the Cuban doctors is an abomination.  Because I have so many personal doctor friends who volunteered, trained, and spent a great deal of time in the Barrios, and because I knew my employees' health care situation and could contrast it to other countries where I had lived, I'm not buying the Chavez/Castro propoganda for a second.   You can write the necessary information here by spending more time in a library, and diversifying your sources:  the information is out there.  I have also found Zleitzen to be reasonable when presented with the multitude of information that backs a particular point, and Francis has always been a fair editor.  Good luck! There are far too few editors on Wiki presenting necessary balance to these topics.  Sandy 17:55, 16 September 2006 (UTC)
replies: text: PS, I have to smile at the rejection of State Dept info in the same discussion endorsing UN data. No corruption or leadership issues at the UN, now, are there?  Now there's a "reliable" (cough, cough) source :-))  Sandy 17:58, 16 September 2006 (UTC)

text: I find all the material on the Venz-Cuba health connection relevant and interesting and certainly worth expansion as we have discussed before on other pages Sandy. This would also play a part in the Cuba-Venz relations article I meant to get round to starting. The newsmax piece "it is easy because Cuba has an overabundance of physicians and professionals of all types, a perpetual oversight of the communist central planners" is just not very interesting I'm afraid (and I wrote it). Likewise the US state department material, as I've tried to explain many times above, is just tedious and unworthy. It is not criticism, just a play on figures which is explained anyway earlier in the article. And certainly not worth over 20 lines quoted in whole on this page. It totally overshadows the most important critic of Cuban healthcare, which is former minister and Castro doyen Hilda Molina. I certainly support a section detailing the problems at the Mission Barrios, notably the level of training of Cuban doctors abroad which is never clear. In essence, are they who they say they are? I suggest that this should replace the present chunk of clumsy US state department fuzzy maths.--Zleitzen 09:31, 17 September 2006 (UTC)
replies: text: You still not given any explanation for why a significant view should be excluded, other than that you as a person finds it "tedious and unworthy". The cited statistics are not any more a "play on figures" than it it to state that Cuba compares favorably to other nations when comparing statistics regarding life expectancy and so on. It is a double standard to only quote favorable international statistics and not unfavorable.Ultramarine 10:08, 17 September 2006 (UTC)
replies: text: I don't read Zleitzen as saying to exclude the view, rather to write it from crisper, more diverse sources.  Sandy 14:12, 17 September 2006 (UTC)
thread_title: Some other sources

message: However, the average life expectancy in Cuba has increased less than the average increase in Latin America. Ín Cuba is has increased 14.9 years, in South America as whole it has increased 16.4 years, and in the Caribbean and Central America it has increased 18.1 years. In Latin America infant mortality per 1,000 live births decreased by 76 between 1960 and 2004. In Cuba, it only decreased by 33.[http://earthtrends.wri.org/searchable_db/results.php?years=1960-1960,2004-2004&variable_ID=383&theme=4&cID=37,46&ccID=6,7
# You make some of that Original Research "However, the average life expectancy in Cuba has increased less than the average increase in Latin America." — This is your conclusion from your analysis of the data.
# You state that in Cuba, infant mortality per 1,000 decreased by "only" 33, more Original Research by comparing this with the rest of Latin America. Also bad, POV research because you don't give the numbers which they started with. 
- Francis Tyers · 11:25, 9 October 2006 (UTC)
replies: text: This is not more original research than stating the Cuba has very good numbers regarding life expectancy and so on compared to other nations. Also, this is not a "conclusion", it is a statistical fact. Regarding the actual numbers, they can be found easily in the source.Ultramarine 11:28, 9 October 2006 (UTC)
replies: text: Wrong again, we're reporting the WHO analysis, we aren't reporting our analysis of WHO statistics. - Francis Tyers · 11:30, 9 October 2006 (UTC)
replies: text: No, you are looking at WHO statistics and drawing a "conclusion" by comparing numbers between nations.Ultramarine 11:32, 9 October 2006 (UTC)

text: This page  has loads of graphs, Cuban life expectancy is 14th of 142 countries. Christopher Murray, M.D., Ph.D., Director of WHO's Global Programme on Evidence for Health Policy, states that Cuba has the highest healthy life expectancy in Latin America, near U.S. levels.--Zleitzen 12:49, 9 October 2006 (UTC)
thread_title: Original research (from above)

message: Necessity of ending the economic, commercial and financial
embargo imposed by the United States of America against Cuba
This question was included as a supplementary item in the agenda of the forty-sixth
session of the General Assembly, in 1991, at the request of Cuba (A/46/193).
The General Assembly considered the question at its forty-sixth to fifty-eighth
sessions (decision 46/407 and resolutions 47/19, 48/16, 49/9, 50/10, 51/17, 52/10,
53/4, 54/21, 55/20, 56/9, 57/11, 58/7 and 59/11).
At its sixtieth session, the General Assembly reiterated its call upon all States to
refrain from promulgating and applying laws and measures of the kind referred to in
the preamble to the resolution in conformity with their obligations under the Charter
and international law, which, inter alia, reaffirmed the freedom of trade and
navigation; once again urged States that had and continued to apply such laws and
measures to take the necessary steps to repeal or invalidate them as soon as possible
in accordance with their legal regime; and requested the Secretary-General, in
consultation with the appropriate organs and agencies of the United Nations system,
to prepare a report on the implementation of the resolution in the light of the
purposes and principles of the Charter and international law and to submit it to the
Assembly at its sixty-first session (resolution 60/12).
Document: Report of the Secretary-General (resolution 60/12).
References for the sixtieth session (agenda item 18)
Report of the Secretary-General A/60/213
Draft resolution A/60/L.9
Plenary meeting A/60/PV.45
Resolution 60/12
It is difficult to find another copy of the report online. However I'm sure if you go to your local library they will be able to procure you one. Some of the information is repeated in other UN documents.  - Francis Tyers · 11:10, 9 October 2006 (UTC)
thread_title: UN Report

message: It would be nice to have some photographs of hospitals/healthcare providers/etc. on the page. AFAIK stuff published by the Cuban govt. before 1997 is public domain, so it might not be so hard to find. - Francis Tyers · 11:33, 9 October 2006 (UTC)
replies: text: If anyone reads spanish... http://www.bvs.sld.cu/revistas/his/vol_2_98/his06298.htm - Francis Tyers · 11:36, 9 October 2006 (UTC)
thread_title: Photographs

message: I would like a clear explanation for why the article should not mention that these statistcs are based on official government sources. This is obviously relevant for totalitarian state like Cuba that can control them for propagand purposes.Ultramarine 07:16, 10 October 2006 (UTC)
replies: text: What does your source about the correlation of figures say.--Zleitzen 07:51, 10 October 2006 (UTC)
replies: text: Huh? There is no correletion used.Ultramarine 07:56, 10 October 2006 (UTC)
replies: text: What does your source say pal?--Zleitzen 08:06, 10 October 2006 (UTC)
replies: text: It says nothing about any correlation.Ultramarine 08:07, 10 October 2006 (UTC)
replies: text: So you are now making no attempt to answer questions - yet are demanding answers from others. --Zleitzen 08:12, 10 October 2006 (UTC)
replies: text: Huh again? No correlation in mentioned in the sources I have given before. What is your point? Ultramarine 08:23, 10 October 2006 (UTC)

text: Cuba has many times been described so. Please answer the question above.Ultramarine 08:15, 10 October 2006 (UTC)
replies: text: By partisan commentators. Academic sources (without an axe to grind) are more likely to describe it as "Authoritarian". As I have been repeating, the article on the WHO describes how they compile their statistics. It is better to have the information in one relevant place, rather than one hundred and ninety five irrelevant places. - Francis Tyers · 08:37, 10 October 2006 (UTC)
replies: text: Authoritarian is fine. Again, it is obviously relevant for authoriarian state like Cuba without freedom of speech or information that can easily control statistics for propagand purposes. This should be mentioned.Ultramarine 08:41, 10 October 2006 (UTC)
replies: text: Again, not relevant. The US alters its statistics for propaganda purposes. All states do it (except maybe Iceland). - Francis Tyers · 08:56, 10 October 2006 (UTC)
replies: text: Maybe, but it is much more difficult in the US due to independent newspapers, freedom of speech, and right to information legislation.Ultramarine 09:05, 10 October 2006 (UTC)
replies: text: Surely that depends? - Francis Tyers · 09:27, 10 October 2006 (UTC)
replies: text: Depends on what? Ultramarine 09:14, 12 October 2006 (UTC)
replies: text: Depends on what you're talking about ! - Francis Tyers · 09:16, 12 October 2006 (UTC)
replies: text: Again, it is obviously relevant for authoriarian state like Cuba without freedom of speech or information that can easily control statistics for propagand purposes. This should be mentioned. If objecting, explain why.Ultramarine 11:07, 14 October 2006 (UTC)
thread_title:  WHO statistics 

message: Apologies for starting a new section, but the other one was too long and difficult to find my place in. have removed the 2nd and third paras from the criticisms section as the first (concerning the state dept comment on 1950s cuban healthcare being good, essentially repeats the third para in the history section and is thus redundant. If anyone feels that any points made in this para are not dealt with in the history section-they should be added there. The third para from this section which I've removed concerned food consumption, which is entirely irrelevant to healthcare provision.Felix-felix 16:16, 13 October 2006 (UTC)
replies: text: The removed material is certainly not repeated elsewhere. However, we could move it to the history section.Ultramarine 11:09, 14 October 2006 (UTC)
replies: text: I'm afraid it is. I have reverted your changes, by which I mean, I have removed these two paras;
The US State Department, citing many independent sources, states that Cuba's infant mortality rate in 1957 was the lowest in Latin America and the 13th lowest in the world, according to UN data. Cuba ranked ahead of France, Belgium, West Germany, Israel, Japan, Austria, Italy, and Spain, all of which would eventually pass Cuba in this indicator during the following decades. Cuba’s comparative world ranking has fallen from 13th to last out of the 25 countries examined.  Also missing from the conventional analysis of Cuba's infant mortality rates is its very high abortion rate, which, because of selective termination of "high-risk" pregnancies, yields lower numbers for infant mortality. Cuba's abortion rate was the 3rd highest out of the 60 countries studied. In terms of physicians and dentists per capita, Cuba in 1957 ranked third in Latin America, behind only Uruguay and Argentina -- both of which were more advanced than the United States in this measure. Cuba's physicians and dentists in 1957 was the same as the Netherlands, and ahead of the United Kingdom and Finland. The report states "Unfortunately, the UN statistical yearbook no longer publishes these statistics, so more recent comparisons are not possible, but it is completely erroneous to characterize pre-Revolutionary Cuba as backward in terms of healthcare."
According to the same United States State department report, Pre-Castro Cuba ranked third in Latin America in per capita food consumption but ranked last out of the 11 countries analyzed in terms of percent of increase since 1957. Overall, Cuban per capita food consumption from 1954-1997 has decreased by 11.47 percent. Per capita consumption of cereals, tubers, and meat are today all below 1950's levels."
As the first repeats the third para in the history section;
By the 1950s, the island had some of the most positive health indices in the Americas, not far behind the United States and Canada. Cuba was one of the leaders in terms of life expectancy, and the number of doctors per thousand of the population ranked above Britain, France and Holland. In Latin America it ranked in third place after Uruguay and Argentina.[4] There remained marked inequalities however. Most of Cuba's doctors were based in the relatively prosperous cities and regional towns, and conditions in rural areas, notably Oriente, were significantly worse. [4] Only 8% of the rural population had access to healthcare. [5]
And the second has nothing to do with healthcare provision.
if you disagree, we should sek concensus.Felix-felix 12:38, 14 October 2006 (UTC)

text: As can be seen above, your paragraph excludes most of the content of the sourced text. Also, this is a criticism of the claims of remarkable achievements compared to the rest of Latin America. As such, it should be in the criticism sections. Regarding nutrition, that is obviously part of health status.Ultramarine 14:29, 14 October 2006 (UTC)
replies: text: There is little difference between the facts of the two paragraphs, rendering your paragraph irrelevant. But a big difference between the background, the inference of the piece and source. One is acceptable and neutral from a reliable source. The other comes from an unreliable US state department report aimed to discredit the recent Cuban government. Surely neutrality is the key here, and a non-negotiable tenet of wikipedia.--Zleitzen 16:38, 14 October 2006 (UTC)
replies: text: The report is online and cites United Nations statistics. Again, much of the content is excluded. Also, this is a criticism of the claims of remarkable achievements compared to the rest of Latin America. As such, it should be in the criticism sections. Regarding nutrition, that is obviously part of health status.Ultramarine 16:42, 14 October 2006 (UTC)
replies: text: Nutrition has to do with nutrition, not health care provision, which is what this article is about, or why not include violent crime statistics, or education or socioeconomic status and mobility which can all be vaguely "part of health status". We should be atempting to create a good encyclopedia article, not grinding a personal political axe.Felix-felix 11:19, 15 October 2006 (UTC)

text: Is it a criticism? I don't know what it is criticising. But then I have no respect for or dislike of the Cuban government, and follow no particular political system or ideology - I'm only interested in history, politics and the presentation of detail related to Cuba/Caribbean/Latin America. So that is perhaps where we differ. Listen, Cuba is obsessed with healthcare. Everyone in Cuba is a hypercondriac including Castro himself. That is what they do whether it's under a socialist model or a captialist model and have been doing for over a hundred years. That is what people want to read about. Not the US's bizarre view that "it is completely erroneous to characterize pre-Revolutionary Cuba as backward in terms of healthcare". Who is characterizing it as such? No one. It doesn't make any sense and is totally out of place. The worst crime in my view in all your additions is that it actually obscures the criticisms from serious and notable Cuban physicians. There's woman called Hilda Molina that has worked her back off making great sacrifices to speak about some of the problems in Cuban healthcare. And you relegated her comments below the work of an American graduate kid, the US government and obscured it with comments by the CANF - a famously dubious organisation. --Zleitzen 16:38, 14 October 2006 (UTC)
replies: text: Again, 10% of the population of Cuba has fled to the US, so the US view is certainly relevant. I repeat, since you refuse to answer: The US report is online and cites United Nations statistics. Again, much of the content is excluded in the current text. Also, this is a criticism of the claims of remarkable achievements compared to the rest of Latin America. As such, it should be in the criticism sections. Regarding nutrition, that is obviously part of health status.Ultramarine 17:04, 14 October 2006 (UTC)
replies: text: What is the substantive message missing from the text as it stands that is in the US 'report'? If you can name anything substantive, and the concensus is that it should be included, then let's include it. Otherwise, what's the issue?Felix-felix 11:19, 15 October 2006 (UTC)
replies: text: If there is no difference, then there should be no problem with keeping the sourced text using UN sources.Ultramarine 11:59, 15 October 2006 (UTC)
replies: text: So there's no difference?Felix-felix 12:03, 15 October 2006 (UTC)
replies: text: As you keep repeating the nutrition line, I'll repeat, to make sure you don't miss the point-Nutrition has to do with nutrition, not health care provision, which is what this article is about, or why not include violent crime statistics, or education or socioeconomic status and mobility which can all be vaguely "part of health status".Felix-felix 12:02, 15 October 2006 (UTC)
replies: text: Nutrition directly causes many specific medical conditions, lacking education do not. I repeat, since you refuse to answer: The US report is online and cites United Nations statistics. Again, much of the content is excluded in the current text. Also, this is a criticism of the claims of remarkable achievements compared to the rest of Latin America. As such, it should be in the criticism sections.Ultramarine 12:24, 15 October 2006 (UTC)
replies: text: No, I'm afraid you're mistaken, both education and socioeconomic status have a direct effect on health as do many other things, but this does not mean they are relevant to an encyclopedia article on Cuban healthcare provision.The criticism section, as i have said earlier is blunt and crass and individual criticisms should be in relevant sections. Once again you have failed to state how the removed text is substantively differnt to the third para of the history section-both essentially say that cuban healthcare was pretty good before the revolution.Felix-felix 12:57, 15 October 2006 (UTC)
replies: text: Lacking education has only a very indirect effect on health, but lacking vitamin A in childhood will cause blindness, lacking vitamin D ricketts, and so on.Ultramarine 13:02, 15 October 2006 (UTC)
replies: text: Being assaulted in a mugging may also cause both blindness and broken bones, however cuban crime has no place in this article about cuban healthcare provision either.Felix-felix 13:40, 15 October 2006 (UTC)
replies: text: Muggings do not cause widepsread health problems, nutritional deficiencies do.Ultramarine 13:46, 15 October 2006 (UTC)

text: Your text states "By the 1950s, the island had some of the most positive health indices in the Americas, not far behind the United States and Canada. Cuba was one of the leaders in terms of life expectancy, and the number of doctors per thousand of the population ranked above Britain, France and Holland. In Latin America it ranked in third place after Uruguay and Argentina". Compares this to deleted text above. No mention of nutrition, infant mortality, abortion, and most importantly, no mention of greater improvement in other Latin American nations.Ultramarine 12:38, 15 October 2006 (UTC)
replies: text: See aboveFelix-felix 12:57, 15 October 2006 (UTC)
replies: text: You have not made any attempt to answer why infant mortality and abortion were excluded or, most importantly, greater improvement in other Latin American nations. Ultramarine 13:02, 15 October 2006 (UTC)
replies: text: See aboveFelix-felix 13:40, 15 October 2006 (UTC)
replies: text: I have looked, and there is nothing explaining excluding infant mortality and abortion, most importantly, greater improvement in other Latin American nations..Ultramarine 13:44, 15 October 2006 (UTC)
thread_title: Criticism of cuban healthcare 2

message: Not all is free in the basic system. Patients must pay for drugs prescribed on an outpatient basis, hearing, dental, and orthopedic processes, wheelchairs, crutches, and similar devices, as well as eyeglasses.
Right. Lets see. This is based on a 1999 PAHO study, so should be fairly reputable. But is the guy giving the full picture? 
Oral Health. In 1996 there were more than 17 million visits to the dentist in Cuba, which makes the rate 1.6 visits per person. Of these visits, more than 85% were for general dentistry services provided in the framework of primary health care. During the year, 3,361,122 persons were examined; 51.7% of them were under the age of 15 years. Of all those examined, 28.4% were found to have good oral health. Of those under 15 years of age, 31.8% had good oral health. The preventive program continues to be carried out at the national level, and during the year 24,103,414 fluoride rinse treatments were administered to children aged 5–14 years and 1,324,971 topical fluoride treatments were given to children under the age of 4 years. Oral cancer was detected in 1,922 of the patients examined.  
::Nothing there contradicts the criticism.Ultramarine 16:20, 16 October 2006 (UTC)
replies: text: I agree with the above going in the "present" section of the article. --Zleitzen 09:58, 17 October 2006 (UTC)
replies: text: Done. - Francis Tyers · 10:15, 17 October 2006 (UTC)
replies: text: Just to add that I'm unawre of any healthcare system in the world where everything is provided free of charge, charges are levied off patients for prescriptions etc in the UK NHS and other state run healthcare systems.Felix-felix 13:13, 17 October 2006 (UTC)
replies: text: This is true. Except for under-25s in Wales maybe :) - Francis Tyers · 13:35, 17 October 2006 (UTC)
replies: text: The above source gives no supporting sources for this claim. Using you own standard, I require at least 2 or 3 sources for this claim.Ultramarine 16:39, 19 October 2006 (UTC)
thread_title: More stuff that Ultramarine wants included

message: The Medical Journal  was part of the introduction, which has already been hacked to bits by Ultramarine to half it's size. Where should it go?--Zleitzen 16:14, 16 October 2006 (UTC)
thread_title: Medical Journal info