Sergio del Valle Jimenez
Authors: Jeanne Lenzer
Journal: BMJ (2008)

Cuban physician Sergio del Valle Jimenez, who joined Fidel Castro’s revolutionary forces as a doctor and soldier, said that guerrilla doctors must be doubly human to save not only the lives of the wounded but also the causes for which they fight.

Del Valle served in various capacities during events in Cuba that would have ripple effects around the world. After the overthrow of Cuban dictator Fulgencio Batista on 1 January 1959, he rose to position of commander. He was a trusted adviser to Castro during the unsuccessful US invasion at Playa Giron (Bay of Pigs) in 1961. He became the army chief of staff during the Cuban missile crisis in October 1962. He also helped carry out land reform asan agriculture director before he became the head of the nation’s internal security apparatus—a position he left to become the minister of health.

As the minister of health from March 1979 to January 1986, del Valle oversaw some highly controversial healthcare decisions that have been both praised and condemned. One policy that has been largely praised was the 1983 decision to destroy millions of dollars worth of foreign blood products purchased by Cuba to protect the public from potential infection with HIV infected blood. That decision came two years before the United States and Britain decided to screen their blood supplies. The early move to protect the Cuban blood supply is credited with helping to keep the incidence and prevalence of HIV/AIDS in Cuba among the lowest in the world. The prevalence of HIV in Cuba was reported to be 0.03% of the population in 2002—10 times lower than the 0.3% incidence in the US, according to UNAIDS.

Another health policy launched under del Valle would prove to be far more controversial. In 1985 Cuba began a policy of confining patients with HIV/AIDS to a sanatorium. Some critics called the policy draconian and referred to the sanatoriums as concentration camps. But others say they helped to save lives and provided some of the most progressive and humane care for patients with HIV/AIDS in the world. Patients were guaranteed jobs and given free food and medical care, as well as free, air conditioned housing—this during a time of serious economic hardships for Cubans. Patients could leave the grounds on visits, and gay couples could live openly together. Even though the mandatory quarantine was lifted in 1994, half of all Cuban patients with HIV/AIDS still chose to live in a sanatorium in 2003, according to a report published in JAMA.

In 1982, under del Valle, the 750 bed Hospital Hermanos Almejeiras was opened. The building was originally designed under Batista to be a bank. However, work was not completed until well after the Cuban revolution. The health ministry turned the hospital into one of the top transplantation centres in the region, and it is one of five facilities accredited to do bypass surgery. Several floors of the hospital are reserved for international health tourists who are willing to pay for the services of Cuban physicians. It was at Hospital Almejeiras that three New York rescue workers injured in the World Trade Center attacks of September 11 were treated—and filmed for Michael Moore’s film SiCKO.

Saul Landau, professor emeritus at California State University, Pomona, says that under del Valle, foreigners who couldn’t afford to go to Houston or Miami from Latin America could come to Hospital Almejeiras if they needed organ transplantation. Cuban medical care, says Landau, “really matured” under del Valle and served as a model for third world countries. Landau, who has travelled to Cuba frequently over the past 40 years while producing and directing documentaries about Cuba and Castro, says del Valle was “one of the leaders in the move to get the health system going—but he played whatever role he was assigned in the Castro cabinet, ranging from minister of the interior to carrying out agrarian reform.”

As minister of the interior from 1968 to 1979—a position that included control of the secret police, according to Landau—del Valle reigned over the infamous Padilla affair. Herberto Padilla, a Cuban poet, won a national poetry prize for his collection of poems Fuera del Juego (Out of the Game), in which he made critical allusions to the Cuban revolution. In 1971 the political police arrested and held him for more than a month. His detainment touched off international outrage. Landau says he doubts that del Valle controlled the events surrounding the Padilla affair but that “he nevertheless, gave the green light to arrest him.”

Del Valle was the firstborn child of “proletarian” parents, Jorge del Valle and Felicia Jimenez. He said that he came to believe at a very early age that “something was wrong with the world.” By the time he studied medicine at the University of Havana during the late 1940s, del Valle was committed to revolutionary struggle. After joining Castro’s rebel forces, he manned a first aid post at an encampment led by another revolutionary, Argentinean physician Ernesto Che Guevera.

Although he was a trusted aide to Castro during the Bay of Pigs invasion, Castro admits that not heeding del Valle’s tactical advice then was something he regretted, saying that Cuban troops might not have suffered as many casualties had he listened to del Valle.

According to Granma, del Valle founded the Communist Party of Cuba and was elected to its political bureau. He received the title hero of the revolution in April 2001.

After del Valle’s death, Castro paid tribute, saying that he and del Valle had “lived exceptional moments” and that the lessons and examples set by del Valle “shall live on.”