Tag Archives: Medical System

CUBA SAYS IT’S ‘BETTING IT SAFE’ WITH ITS OWN COVID VACCINE

“We are seeing a safety profile with the vaccine [Soberana 2] that is very good,” Dr. Vicente Verez, director of the Finlay Institute of Vaccines, told NBC News.

NBC News, April 10, 2021, 3:35 PM EDT

By Orlando Matos and Carmen Sesin

Original Article: Cuba’s Covid Vaccine

HAVANA — Cuba is “betting it safe” with the later development of their own Covid-19 vaccines and encouraged by what they’re seeing in late stage and experimental studies, a top Cuban vaccine scientist said.

If the trials are successful, the relatively small, communist island of 11 million — that has been sanctioned by the United States for decades — would be one of just very few countries with vaccines to fight the coronavirus pandemic, drawing worldwide attention to its potential feat.

The other countries that have developed vaccines, including the United States, the United Kingdom, China, Russia and India, have significantly larger economies and population sizes.

Two of Cuba’s five vaccine candidates are in Phase 3 trials: Soberana 2, which translates to ‘sovereignty,’ and Abdala, named after a book by the Cuban independence hero José Martí.

Around 44,000 people are getting the Soberana 2 vaccine as part of the Phase 3 double-blind study. An additional 150,000 health care workers are being inoculated with Soberana 2 as part of an “interventional study.”

Unlike the mRNA vaccines from Pfizer-BioNTech and Moderna, the Soberana 2 uses synthesized coronavirus proteins to trigger the body’s immune system.

“We are seeing that the vaccine is very safe, the potential risk for applying it to more people is decreasing, and the potential benefits are increasing. There is evidence of certain efficacy and that is why we decided to expand the interventional studies,” Dr. Vicente Verez, director of the Finlay Institute of Vaccines, told NBC News. The institute is named after the Cuban epidemiologist Dr. Carlos Finlay who discovered yellow fever is transmitted through mosquitoes.

The institute was established in 1991 by the late Cuban leader Fidel Castro who invested heavily in the country’s health care system and pharmaceutical sector. Its cancer research center developed a vaccine being tested in the United States and other countries.  

In Cuba, “we began a bit later than the rest of the vaccines [in the world] because we had to wait and know a little more about the virus and the mechanism though which it infects cells,” Verez said. “We are seeing a safety profile with the vaccine [Soberana 2] that is very good.”

With its economy ravaged by the pandemic, decades of sanctions and a decline in aid from its ally Venezuela, the island has been grappling with shortages in food and medicine. Its economy shrank 11 percent in 2020. But it has managed to keep the number of Covid-19 infections and deaths down with strict measures and lockdowns, compared to many developed countries around the world. In recent weeks, the country has averaged around 1,000 cases per day, but it had very low infection rates last year.

The final results of the Phase 3 trials are not expected for months. The government’s plan is to have nearly all the inhabitants of the capital, Havana, vaccinated by May through the interventional study, and the entire country’s population inoculated before the year ends.

Verez said that while the vaccination won’t be mandatory, he thinks “the immense majority of the population wants the vaccine.”

For Cuba, the vaccine is as much about public health as it is a show of force; that a small communist country sanctioned by the U.S. can compete on the world stage with its own vaccine candidates.  Cuba could have acquired vaccines from its allies, China and Russia, but developing its own gives it the opportunity to sell vaccines to underdeveloped countries that have seen few doses, giving it a source of badly-needed hard currency. As U.S. and British vaccines advanced in clinical trials last year, wealthy countries in North America and Europe preordered large quantities, leaving poor and developing countries with a large gap in access.

Verez said some countries have approached Cuban officials with the intent to purchase more than 100 million annual doses of some of its vaccines. He said Cuba’s vaccine production system is being reorganized to produce 100 million doses.  Iran, which banned U.S. and British vaccines, will host a Phase 3 trial of Soberana 2 as part of an agreement that includes producing millions of doses there. Venezuela will produce Abdala vaccines, its government announced Thursday. Mexico and Argentina have also expressed interest in Cuba’s vaccines.

“They are very safe,” Dr. Eduardo Martínez Díaz, president of the state-run BioCubaFarma, said in emailed responses to questions. “After applying thousands of doses, only slight and moderate side effects were seen in a small percentage of volunteers.”

Díaz added that both vaccines are creating a high amount of immunity. If exported, the prices would be affordable, he said.

Verez said the vaccines will be adapted to the new variants, and extra doses could be required to boost immunity.

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EL COVID EN CUBA , EN LINEA ASCENDENTE E IMPLANTANDO RÉCORDS (GRÁFICOS)

Por Humberto Herrera Carles

Articulo Original: Cuba y la Economía,  EL COVID EN CUBA,  Enero 10 de 2021

Decía Jose Martí, nuestro héroe nacional, que “En prever está todo el arte de salvar “, y además dijo que “Gobernar es  prever”.

Al parecer  los modelos matemáticos de pronósticos publicados por nuestras autoridades,  hasta el presente, han fallado, no se han cumplido y se han ignorado otras recomendaciones a las cuales he tenido acceso producto de las preocupaciones que todos tenemos con esta pandemia, por ejemplo de un INDICE de Alarma Epidemiológica (IAE) que predice mejor el comportamiento que nos presentan, así como el ” Método estadístico matemático para identificar el estado de la COVID-19 con relación al pico epidémico publicado en este sitio ( tomado de la Revista Información Científica)  de la autoría del Profesor Javier Pérez Capdevila.

Ahora bien, no me detendré en las comparaciones, pero evidentemente cuando se introdujo en los modelos oficiales, la variable  exógena que representaban la necesaria apertura de nuestras fronteras y la incidencia de los visitantes externos, al parecer una vez más no fueron correctos los pronósticos.  Se trataba de prever  (ex ante), y las medidas previstas hacerlas cumplir. Sin embargo, con solo observar que desde el 16 de diciembre del 2020, excepto un día, pasaban del centenar  el número de confirmados diarios, y ver que la última semana de diciembre 2020 ya era de 165 confirmados diarios como promedio, era suficiente para adoptar las medidas correctoras días atrás.  Así en los últimos 7 días de este 2021, en cinco días los casos diarios han sido por encima de 300, y los últimos 4 días es de 314, 344, 365 y 388 confirmados, además de los récords lamentables, la cota máxima no sabemos hasta donde llegará. Deberían pedir  colaboración nuestras autoridades a los que tienen otros pronósticos y metodos, para tomar las decisiones correctas en tiempo real.  Las ciencias matemáticas en estos momentos  juegan un papel fundamental, esencial.

Ayer se comunicaron varios retrocesos a diferentes fases en las provincias más comprometidas con el rebrote, la Habana paso a fase I de recuperación , cuando se encontraba en la III. 

El presente escrito solo pretende llamar la atención,  con los gráficos elaborados , de la gravedad en que nos encontramos, porque al final esto es tarea de todos. He vistopor ejemplo,  en otros países en colas a los super  que guarda distancia de 1.5 m para entrar entre las personas, e incluso es uno solo por familia y no pueden entrar los menores. En nuestro país, son “molotes” fuera de las tiendas.¿?

Los gráficos a continuación y tablas son elaboración propia con datos del MINSAP. 


Como se observa en el gráfico # 1 desde el día uno de la pandemia, muestra que este tercer rebrote hasta ayer, es casi 5 veces mayor que el momento peor del primero, y que la línea de tendencia polinómica de grado 4 (roja)  de excel va en  ascenso. Aquí es donde se requieren los “otros” pronósticos. 

Los Activos acumulados diarios ( los que tienen la enfermedad y no se han recuperado) en el gráfico # 2 y su línea de tendencia, se han incrementado desde la anterior cota máxima de 847 activos el 25 de abril del 2020 en el primer brote , en 2.99 veces, significando , al no incrementarse el número de fallecidos, que el tiempo de hospitalización- recuperación es menor ( días) ¿ nuevo protocolo médico  ?. Sin embargo, no se publican los casos activos por provincias como una información oficial del MINSAP.  El día cero de casos activos, parece cada vez más lejos, primero hay que aspirar a casos cero de confirmados durante días, y desde que empezó la Covid en nuestro país solo hemos tenido un día con caso cero, el 19 de julio del 2020, esa es la meta a lograr, otra vez.

Observar que la tasa de incidencia con importados (azul) y sin (azul) del gráfico # 3 del MINSAP , desde que empezó la pandemia eran similares, sin embargo hay una diferencia  que inició  diciembre -enero , y esto demuestra dos cosas 1- la tasa de incidencia con los casos importados es mucho mayor que la  autóctona,y 2- que sin los importados (roja) no obstante, hay igualmente un incremento de la tasa de incidencia, es decir el incremento se dio aunque no se hubieran abierto las fronteras. 

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CUBAN MEDICAL TEAMS FOR 2021 NOBEL PEACE PRIZE

Media Statement

Monday, November 16, 2020 – 17:00

The Council of Canadians’ statement on nominating Cuban international health teams for the 2021 Nobel Peace Prize. 

At the June 2020 Annual Meeting, Council of Canadians’ members voted to endorse and promote a Canadian nominating process for the 2021 Nobel Peace Prize to go the Henry Reeve medical teams from Cuba for their international work in the context of COVID-19.

In 2005, Cuba’s leaders looked ahead and saw a world increasingly beset by pandemics and natural disasters. This led them to initiate a program to train professional medical personnel to be able to respond quickly to emergency requests from other nations. This initiative resulted in the mobilization of thousands of Cuban medical personnel with the skills and training to deal with a variety of global calamities, known as the Henry Reeve brigades.

When COVID-19 hit in 2020, Cuba responded to emergency requests for trained medical personnel by sending 53 health teams to 39 countries on four continents. The health teams were able to assist countries with fragile health systems that were ill-equipped to deal with COVID-19.

Cuba’s response to COVID-19 eclipses all other front-line efforts from industrialized nations in the fight against COVID-19. This response is more remarkable given that the island nation has been under a decades-long embargo by the United States of America. The U.S. State Department has made it known since the beginning of the pandemic that they might retaliate against any country receiving Cuban medical personnel. Only one country has capitulated to these threats from the U.S., and that country is Canada.

We are fortunate to have Dr. John Kirk as the nominator. As an expert on Cuba’s humanitarian efforts and its medical internationalism and a professor at Dalhousie University’s Department of Spanish and Latin American Studies, Dr. Kirk easily meets all of the strict requirements outlined by Oslo for those individuals heading up a nomination process for the Nobel Peace Prize. Read Dr. Kirk’s nomination.

The Council of Canadians fully supports this nomination effort, and are honoured to be working in solidarity with the endorsers listed below.

Individual Canadian endorsers for the 2021 Nobel Peace Prize Nomination for the international work of Cuban medical personnel

  • The Hon. Lloyd Axworthy – Canadian politician, elder statesman and academic served as Canadian Minister of Foreign Affairs under P.M. Chretien, invested as a Companion of the Order of Canada and honoured at a sacred pipe ceremony as Waappski Pinaysee Inini (Free Range Frog Man), Chair of the World Refugee Council, among other prestigious international and academic positions;
  • Dr. Anna Banerji – Pediatrics and infectious disease specialist and Associate Professor at University of Toronto Faculty of Medicine, Faculty lead for Indigenous and Refugee Health, invested in the Order of Ontario, 2014 Women’s Courage Award International, among other citations;
  • Jane Bunnett – Flautist, saxophonist and bandleader and jazz legend is a five-time Juno Award winner, invested in The Order of Canada and has more than a dozen albums featuring Cuban music, jazz, and classical as well as dance and pop music;
  • John Cartwright – Chairperson of the Council of Canadians Board of Directors and a long-time labour leader and social justice advocate. He is also the President of the Toronto and York Region Labour Council, and over the years helped develop the Campaign for Public Education, Public Transit for the Public Good, the Toronto Waterwatch and Toronto Hydro campaigns as well as crafting the “Green Jobs Strategy” for the Canadian Labour Congress.
  • George Elliot Clarke – Canadian poet, playwright and literary critic, known for chronicling the experience and history of the Black Canadian communities of Nova Scotia and New Brunswick (“Africadia”), has served as Poet Laureate of Toronto and Canadian Parliamentary Poet Laureate, appointed to the Order of Nova Scotia and as an Officer of the Order of Canada, and has received many other distinctions;
  • Bruce Cockburn – Canadian roots-rock legend, 13-time Juno Award winner, Officer of the Order of Canada, recipient of the Governor General’s Performing Arts Award for Lifetime Artistic Achievement, recipient of the environmental Earth Day Award, and many others honours;
  • Elizabeth Hay – Prize winning author of numerous novels, short stories, non fiction and essays. Among many honours, she was the co-winner of the Edna Staebler Award for Creative Non-Fiction, received the Ottawa Book Award, won the Giller Prize in 2007, was accorded the 2012 Diamond Jubilee Medal, and most recently won the Hilary Weston Writers’ Trust Prize for Nonfiction. Elizabeth worked for ten years as a CBC radio broadcaster in Yellowknife, and also did radio documentaries for CBC’s Sunday Morning.
  • The Rt. Hon. Michaelle Jean – Canadian stateswoman, journalist and a refugee from Haiti, was the 27th Governor General of Canada and the third Secretary-General of the Organisation Internationale de la Francophonie, named member of the Queen’s Privy Council for Canada, and has received many Appointments, Medals, and Awards as well as multiple Honorary degrees;
  • Dr. Noni E. MacDonald – Paediatrics infectious disease specialist and Professor in the Department of Pediatrics at Dalhousie University, invested in the Order of Nova Scotia and in the Order of Canada, and recipient of the Lifetime Achievement Award by the Canadian Society for International Health, among other honours;
  • MP Elizabeth May – Canadian politician who served as leader of the Green Party of Canada from 2006 to 2019. An environmentalist, author, activist and lawyer, May founded and served as Executive Director of the Sierra Club of Canada from 1989 to 2006. Elizabeth has been an officer of the Order of Canada since 2005, and has been named by the United Nations as one of the leading women environmentalists worldwide, among other citations.
  • Senator Pierrette Ringuette – The first francophone woman to be elected to the Legislative Assembly of New Brunswick. In the 1993 federal election she won a seat in the House of Commons of Canada as a Liberal Member of Parliament. In 2002 she was appointed to the Senate on the recommendation of Prime Minister Jean Chretien. In 2007 she received the grade of Officer of the Ordre de la Pleiade in recognition of her contribution to the development of francophone and Acadian culture.  In 2016 she chose to sit as part of the Independent Senators Group. Senator Ringuette continues to be a member of several standing committees and is currently a Counselor of The Inter-Parliamentary Forum of the Americas, Co-Chair of the Canada-Cuba Inter-Parliamentary Group.
  • Svend Robinson – Canadian politician and Member of Parliament for the New Democratic Party, a strong environmentalist and outspoken advocate for the rights of indigenous peoples both in Canada and internationally, he was adopted into the Haida Nation (“White Swan”), J.S. Woodsworth Resident Scholar at Simon Fraser University, and among several awards…the Elena Iberoamerican Award on Ethics and the Hero Award, Sexual Orientation and Gender Identity;
  • David T. Suzuki – Canadian academic, science broadcaster and environmental activist is a Companion of the Order of Canada and invested in the Order of British Columbia, recipient of the Right Livelihood Award and has been awarded honorary degrees from over two dozen universities around the world, and is the host the CBC’s long running series The Nature of Things;

Organizational Canadian endorsers for the 2021 Nobel Peace Prize Nomination for the international work of Cuban medical personnel

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CUBA’S COVID-19 DASHBOARD

 Cuban Government Covid 19 Web Site and Dashboard

 https://covid19cubadata.github.io/#cuba

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CUBA AND COVID-19: WHY IS THEIR MODEL SO SUCCESSFUL?

Original Article: Cuba and Covid-19

McLeod Group guest blog by John M. Kirk, October 29, 2020 

Original Article: Cuba and Covid-19

As the cold winter looms, along with the dreaded “second wave” of COVID-19, Canadians are faced with some alarming facts. While pleased that our infection and death rates are only half those found in the United States, we are doing poorly compared with one country barely mentioned in our media: Cuba. Their death rate (adjusted to population differences) is roughly 1/25 what ours is, while Canadians are ten times more likely to become infected by the virus than Cubans.

How did they manage to do this? Is there anything that we can learn from them?

The world is in a parlous state. There is the possibility that 500,000 Americans might die by February. The intensive care wards are rapidly filling up in Europe. In Canada, we are now hitting almost 1,000 new cases daily in the two most populous provinces of the country, Ontario and Quebec.

Yet, Cuba has managed to control the situation there, with fewer than 7,000 people infected and 128 dead. It has also faced, and curbed, a second wave of infections. Cubans are also over 40 times less likely to contract the virus than people in the United States. Countries of a similar size to Cuba offer interesting data in terms of fatalities. As of October 25, Cuba has experienced 128 deaths, compared with 10,737 in Belgium, 2,081 in Switzerland, 2,297 in Portugal, 5,933 in Sweden, and 1,390 in Hungary.

While there are some aspects of the Cuban model that are not transferable to Canada – largely because of radically different political systems – there are things that we can learn from them.

Cuba is fortunate that it is a small country, with 11.2 million people in an island about twice the surface area of Nova Scotia. It also has an excellent healthcare system, with three times the number of physicians per capita as Canada – the highest rate in the world. Its system emphasizes preventive medicine, as opposed to the curative approach used here. The Cubans moved with enormous speed to limit COVID-19, in part because of a finely tuned system to respond to natural disasters.

When COVID arrived in the island in March, brought by Italian tourists, the government decided to forego the funds derived from the tourism industry, and closed the island to tourists. Healthcare for all was deemed far more important than economic growth.

Continue Reading: Cuba and Covid-19

John M. Kirk is Professor of Latin American Studies at Dalhousie University, and the author/co-editor of 17 books on Cuba, including two on its healthcare system.

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THE WORLD REDISCOVERS CUBAN MEDICAL INTERNATIONALISM

The world rediscovers Cuban medical internationalism

Helen Yaffe,April 8th, 2020, 

 

As coronavirus has spread around the world, the global public has been surprised to see Cuban medicines being used in China and Cuban doctors disembarking in northern Italy. But Cuba’s solidarity-based medical internationalism has been going strong since the 1960s, writes Helen Yaffe (University of Glasgow).

Just weeks ago, in late February 2020, US Democratic Senator Bernie Sanders was vilified by the US establishment for acknowledging education and healthcare achievements in revolutionary Cuba. Now, as the SARS-CoV-2 pandemic sweeps the globe, the island’s medical prowess is back in the spotlight, first because the Chinese National Health Commission listed the Cuban anti-viral drug Interferon alfa-2b amongst the treatments it is using for Covid-19 patients.

Effective and and safe in the therapy of viral diseases including hepatitis B and C, shingles, HIV-Aids, and dengue, the Cuban anti-viral drug has shown some promise in China and the island has now received requests for the product from 45 countries.

Then, on 21 March a 53-strong Cuban medical brigade arrived in Lombardy, Italy, at that time the epicentre of the pandemic, to assist local healthcare authorities. While images spilled out over social media, little was said in mainstream outlets. The medics were members of Cuba’s Henry Reeve Contingent, which received a World Health Organisation (WHO) Public Health Prize in 2017 in recognition of its provision of free emergency medical aid. In addition to Italy, Cuba sent medical specialists to treat Covid-19 cases in 14 of the 59 countries in which their healthcare workers were already operating.

Continue Reading: THE WORLD REDISCOVERS CUBAN MEDICAL INTERNATIONALISM

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CUBA’S REPUTATION AS MEDICAL POWERHOUSE TESTED

Marc Frank, Financial Times, April 5 2020

Cuba has long been proud of sending thousands of its doctors to work around the world as icons of socialist solidarity — and important sources of dollars.

But the coronavirus pandemic has given a communist government with a reputation as a medical power one of its toughest domestic challenges since Fidel Castro seized power six decades ago.

All but bankrupted by US economic sanctions, the Caribbean island nation is grappling with the threat posed to the oldest population in the Americas, where more than 20 per cent are aged over 60.

A severe outbreak of Covid-19 could also potentially threaten the domestic authority of a government whose comprehensive free healthcare system has been a pillar of the revolution’s success.

But the global outbreak has also created diplomatic opportunities, say analysts. The government has stepped up its overseas medical programme, sending doctors and nurses to help fight the virus in the Chinese city of Wuhan, where the pandemic began, as well as Italy, Andorra and elsewhere.

The strategy had long been a soft power play for the island, said Nicholas Watson, Latin America director at the consultancy Teneo, in a note. “[President Miguel] Díaz-Canel is not just looking to restore revenues that the program used to provide but to drive a wedge between the US and Europe over the medical assistance program.”

Cuba has so far reported close to 250 cases of Covid-19, mostly related to foreign visitors, and six deaths — an Italian and a Russian tourist and four Cubans. On March 20 it shut its borders, banned tourism and began implementing measures to curb the virus. This year’s May Day parade has been cancelled for only the third time since the 1959 revolution. Schools, bars and public transport between provinces have been shut down. Restaurants and stores remain open but with new rules on social distancing and hygiene, and all outside gatherings for festive purposes are banned.

Mr Díaz-Canel has appeared daily in the state-run media since the restrictions were rolled out, co-ordinating measures and urging citizens to take the threat seriously. “We have in our favour a public health system for all, a dedicated scientific community and an effective civil defence system, a party and a government that put Cubans at the centre of their attention,” he said in a nationwide address last month as he announced preliminary measures to contain the pandemic. “Serenity, discipline and collaboration, values ​​that every Cuban has incorporated, can prevent the spread of the virus,” he added.

Paul Hare, a former UK ambassador to Cuba who lectures at Boston University’s Pardee School of Global Studies, said the country’s tight social control over its population would also aid the effort. But, he added, “the strains on the Cuban health service will show in equipment and resources”.

While Cuba still boasts the best health statistics in the region, including number of doctors and nurses per capita, many health facilities are in disrepair and there are scattered pharmaceutical shortages.

Cuba initially did little Covid-19 testing but is now conducting more than 500 a day — a fivefold increase since last month — after a donation of kit from China. The government has not said how many ventilators are available. Community-based doctors and nurses, as well as medical students, have been going door to door asking about recent travel, contacts with visitors from abroad and possible symptoms.

Suspected cases are swiftly quarantined in state facilities. Confirmed cases have been hospitalised and their primary contacts quarantined.

The measures appear to have drawn near unanimous support.

“I approve of the measures, though the government should have taken them earlier, especially closing the border like other countries did,” said Anaida González, a retired nurse from central Camagüey province.

The government is, meanwhile, continuing to promote its narrative of global solidarity. As well as sending personnel to virus-stricken nations, state media have broadcast extensive footage of passengers being rescued from the Braemar, a cruise ship that docked in Havana after being refused entry by other Caribbean nations, and images of a Cuban-run hospital in Qatar and nurses marching into hospitals in seven other Caribbean island nations.

Cuba earned $6.3bn from medical services exports in 2018, its biggest source of foreign exchange and twice as much as tourism, its second biggest export earner. It needs the money more than ever given the tourism shutdown.

“Tourism generates $3bn annually in desperately needed hard currency and keeps most of the nascent private sector in business,” said William LeoGrande, a professor and Cuba expert at American University in Washington.

“A prolonged closure will reverberate across the entire economy, producing a recession not quite on the order of the 1990s Special Period [following the collapse of Cuban ally the Soviet Union], but a close second,” he warned.

“The photos of the Cuban medical brigade arriving in Italy are an icon of the revolution’s epic of international solidarity,” said Bert Hoffman, a Latin America expert at the German Institute of Global and Area Studies.

“But this narrative will only function as long as Cuba can control the coronavirus situation on the island itself.”

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Public and Private, Market and Plan: Some Lessons from Cuba and the United States.

Attached is the PDF of a P.Pt. presentation delivered at Kennesaw State University on October 24, 2019 entitled Public and Private, Market and Plan:Some Lessons from Cuba and the United State: 

    Public and Private, Market and Plan, Kennesaw, Oct. 24, 2019

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CHALLENGES AND REALITIES OF CUBA’S HEALTH CARE SYSTEM

Fernando Ravsberg, enero 25, 2018

Artículos de Fernando Ravsberg, English Version, Política, Salud, Sociales

Last November, “Maria de la Caridad” was admitted into one of the best hospitals in the country, waiting for her knee replacement prosthesis, when she slipped in a puddle of water out in the hospital’s corridor and broke both her arms. Now, she’s back at home in a worse state than before.

It’s hard to explain to someone who isn’t Cuban, how a hospital with such high professional standards and so much modern equipment can be lacking in personnel to collect dirty dishes or keep the floor which orthopedic patients walk along, dry.

It’s just as hard as understanding the fact that pharmaceutical employees are dedicating themselves to counterfeit medicines for children so they can be sold secretly via the illicit pharmacy network, as Cuban press reported a few days ago.

How can there be medicine shortages and a black market in a country with scientists capable of inventing innovative vaccines to treat different types of cancer or medicines that prevent diabetes patients from having to be amputated?

There is so much chaos that you can buy any medicine without needing a medical prescription at many pharmacies, as long as you are willing to pay extra on the side. However, all lines are crossed when medicines for children are tampered with.

During the crisis of the ‘90s, I saw a black market seller offering powdered milk to a mother with two small children. She said that it was top quality because it was stolen from the school for children with disabilities. The mother was appalled and refused to buy it.

There are many Cubans like her who clearly know where their boundaries lie, but even they cross these lines when a son is having an asthma attack or their grandfather needs to monitor their heartrate. So they go looking for the medicines they need wherever they may be and they pay whatever is being asked for them.

The black market in Cuba’s public health sector is a death trap. Let’s remember how thirty patients died of cold and hunger at Havana’s psychiatric hospital, when the people who were responsible for protecting them, stole their food and blankets.

We could spend hours talking about how morally bankrupt those who make a business out people’s health are but we can’t explain how these people, who were once young and had the vocation to protect and help others, a pharmacist, a nurse or a doctor, can stoop so low.

Among the causes for this situation, the chronic shortages of medicines and low wages particularly stand out. The combination of both these factors leads to the black market, which we have all been responsible for, some as sellers and others as buyers.

 A few years ago, the government promised that wages would improve in correlation with an increase in productivity. Today, the health sector brings in 70% of the country’s revenue in hard currency but wages continue to be way below what the basic foods costs.

Public health sector workers aren’t even given any perks that wouldn’t cost the State’s coffers a single cent, such as being able to purchase a property for its cost price and in hard currency or being able to freely import a car, after having completed their mission abroad.

And the reality is that if wages of medical personnel don’t increase, the wages of cleaning staff can’t get any better either. Patients will continue to receive “stem-cell” therapy for free while they continue to slip and fall in puddles of water that nobody is cleaning up.’

Many cleaning and technical employees leave the health system looking for a more dignified income in the private sector, that is to say an income that allows them to get to the end of the month without having to steal. Official press “kick the bucket” blaming self-employment for this exodus.

The real problem lies in stagnant reforms, in using the health sector and pharmaceutical industry’s incredible earnings to finance the State’s shortfall companies instead of using them to feed the “hen that lays the golden eggs.”

There are morally bankrupt criminals in the black market but many other people (maybe most of them) only take part so as to meet their family’s basic needs or are forced to because of pressing needs, like the medicines only available from illicit sources.

Ideology awareness classes aren’t enough to stop this loss of values. The answer could once again lie in Jose Marti’s insightful way of seeing things when he explained that “given human nature, one needs to be prosperous to be good.”

In 2017, Cuba reached its record child mortality rate of only 4 per 1000 newborns. Public health needs the financial resources it brings in so as to keep up these levels of efficiency.

Translation: Havana Times

About Fernando Ravsberg: Nacido en Uruguay, corresponsal de Público en Cuba y profesor del post grado de “Información internacional y países del Sur” de la Universidad Complutense de Madrid. Fue periodista de BBC Mundo, Telemundo de EEUU, Radio Nacional de Suecia y TV Azteca de México. Autor de 3 libros, El Rompecabezas Cubano, Reportajes de Guerra y Retratos.

 

 

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HOW DOES CUBA MANAGE TO ACHIEVE FIRST-WORLD HEALTH STATISTICS?

The island’s medical system is envied throughout the region and is a major foreign revenue earner

ÁLVARO FUENTE; EL PAÍS, Havana 10 FEB 2017

Original Article: Cuba’s Medical System

Cuba’s healthcare system is a source of pride for its communist government. The country has well-trained, capable doctors, the sector has become an important export earner and gives Cuba valuable soft power – yet the real picture is less rosy. A lot of health infrastructure is deteriorating and there is a de facto two-tier system that favors those with money.

Cuba’s child mortality rate is on par with some of the world’s richest countries. With six deaths for every 1,000 births, according to World Bank data from 2015, Cuba is level with New Zealand. In 2015, the global average was 42.5 deaths for every 1,000 births. Despite more than half a century of a US economic embargo, Cuba’s average life expectancy matches that in the US: 79.1 years, just a few months shorter than Americans who, on average, live to 79.3 years, according to 2015 data from the World Health Organization (WHO).

Much of Cuba’s success in these areas is due to its primary healthcare system, which is one of the most proactive in the world. Cuba’s population of 11.27 million has 452 out-patient clinics and the government gives priority to disease prevention, universal coverage and access to treatment.

Cuba has also produced innovations in medical research. In 1985 the country pioneered the first and only vaccine against meningitis B. The country’s scientists developed new treatments for hepatitis B, diabetic foot, vitiligo and psoriasis. They also developed a lung cancer vaccine that is currently being tested in the United States. Cuba was also the first country on earth to eliminate the transmission of HIV and syphilis from mother to child, a feat recognized by the WHO in 2015.

In 2015, Cuba spent 10.57% of its GDP on health, slightly higher than the global average. According to the World Bank in 2014, the European average spending GDP spending was 10%, compared to 17.1% in the United States.

TWO-TIER SYSTEM

A lesser-known characteristic of Cuba’s healthcare system is the existence of special clinics, reserved for tourists, politicians and VIPs. The state reserves the best hospitals and doctors for the national elite and foreigners, while ordinary Cubans sometimes must turn to the black market or ask expatriate friends or family to send medicine.

“Cuba’s health service is divided in two: one for Cubans and the other for foreigners, who receive better quality care, while the national population has to be satisfied with dilapidated facilities and a lack of medicines and specialists, who are sent abroad to make money for Cuba,” says Dr. Julio César Alfonzo, a Cuban exile in Miami and director of the NGO Solidaridad Sin Fronteras.

In 2015, Cuba spent 10.57% of its GDP on health, slightly higher than the global average

In 1959, the country had only 6,000 doctors, half of whom emigrated after the Cuban revolution. By 2014, Cuba had 67.2 doctors for every 10,000 inhabitants, with only Qatar and Monaco ahead of it.

However, despite these impressive statistics, the quality of primary healthcare, which has been fundamental to Cuba’s success, has been declining in recent years. Between 2009 and 2014 there was a 62% fall in the number of family doctors, from 34,261 to 12,842, according to Cuba’s National Statistics Office (ONEI).

AN ARMY OF WHITE COATS

In the words of Fidel Castro, Cuba’s “army of white coats” was formed in 1960, when a medical brigade was sent to Chile after an earthquake left thousands dead. Since then, Cuba has sent more than 300,000 healthcare workers to 158 countries in Latin America, Africa and Asia, according to Cuba’s state news agency. Today, around 50,000 Cuban medical workers are present in 67 countries.

“Cuban doctors are rooted in solidarity and in the Hippocratic Oath. Our job would be unthinkable without foreign missions,” says Salvador Silva, a doctor specializing in infectious diseases who has worked in Haiti and Liberia.   “Yes, our salary is low and maybe that pushes us to go abroad, but it also makes us proud when we see our work recognized throughout the world, on top of just helping in our own country,” he adds.

Doctors are arguably Cuba’s most profitable resource and the country’s medical missions have proved to be a lucrative diplomatic tool. The healthcare industry is also one of the country’s main sources of income. In 2014, Cuban authorities estimated overseas healthcare services would bring in $8.2 billion, putting it ahead of tourism.

Cuba has a different deal with each country it works with. For example, in exchange for sending 3,500 health care workers to work in and provide training in Venezuela, a close Cuban ally, Venezuela sends oil.

With such a high demand for personnel, some suspect that the Cuban government has been reducing educational requirements to hasten students’ entry into the work force.  “They are giving doctors licenses in record time to meet the need to export them, and this has been detrimental to the quality of training and medicine, which used to be the best. This has been happening since they started the program in Venezuela, between 2003 and 2004,” says Dr Alfonzo.

Doctors are also eager to be sent abroad, not only to help the less fortunate, but also for money. Salaries are higher – depending on the location, with doctors abroad reportedly making up to $1,000 per month (minus taxes), whereas those in Cuba make around $50. On the island, it isn’t rare to find taxi drivers, shopkeepers or construction workers with medical degrees.

Juan drives a 1950s Chevrolet he bought with his brother and he uses it as a taxi from 6pm to midnight. He’s also a doctor in the clinic Hermanos Ameijeiras. “The wage is a pittance. We find ourselves obligated to make a living doing other things. I have coworkers who sell prescriptions to pharmacies, who work in unlicensed clinics or help their families in shops. It’s frustrating,” he says. “It’s like they’re pushing us to enlist in international missions, the business of Cuba.”

The country’s medical missions abroad have been an important escape route for Cubans looking to defect. Before migratory reforms were passed in January 2013 allowing Cubans with passports and visas to travel abroad, the preferred way to abandon Cuba was via Venezuela. In 2013 and 2014, more than 3,000 doctors deserted the island to go to the United States through a special visa program called Cuban Medical Professional Parole, a program started by George W. Bush to help healthcare workers who had escaped while working abroad.

Lucia Newman, a former CNN correspondent in Habana, said Cuban doctors complain that travel restrictions prevent them from attending conferences or keeping abreast of the latest medical advances. The US trade embargo on Cuba includes some textbooks, but the major problem is that Cuban doctors cannot buy medical equipment from the United States or from any US subsidiaries.

For Odalys, a young patient waiting at the Hospital Salvador Allende, “the situation is becoming unsustainable in this country and it’s not because of a lack of specialists, it’s because we have to bring everything ourselves. I just bought a light bulb for the hospital room. I’ve called home so that they can bring me bedding, towels and even toilet paper. There aren’t even stretchers, I saw a family carrying their sick son into a room. Free and universal health care, yes, but it’s a bit of a mess and very informal,” she says.

English version: Alyssa McMurtry.

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