Military might and patriotic display are now in charge, ever since Sept. 11. Yet reminders surface of U.S. misbehavior over many years in the name of anti-communism and defending U.S. interests. Here the plight of Cuba’s children is recalled.
The place to begin is the U. S. blockade of Cuba, now 40 years old. I first began to think about that policy in 1994 during a trip to Cuba. I discovered that the Cuban people were healthy despite crushing shortages. Cuba’s life expectancy and infant mortality rates rivaled those of the United States.
After the revolution, the government transformed a constitutional right to health care into reality.
One medical school in 1961 had become 24 by 1994; 3,000 doctors in l961 became 55,000 in 1994 and today there are 65,000.
With the world’s highest ratio of doctors per capita, all Cuban citizens have had free care available for common health problems or complicated illnesses. Cuba’s research institutions and specialty hospitals became referral centers for all of Latin America.
I chose to be a pediatrician because pediatrics is concerned with the health of all children in the community. Thirty years of practice have taught me that U.S. society accepts as normal striking inequalities in health status among groups of children.
I learned from Cuba’s example that an alternative was possible. During that 1994 trip, I made hospital rounds in Havana with Dr. Alberto Ruiz, a pediatric surgeon. We visited two girls who suffered from corrosive esophagitis, the result of their having accidentally swallowed homemade soap made from lye. Cubans have very little soap, he noted, and people have to make their own.
Dr. Ruiz had had to replace parts of the esophagus – with sections of their colon – of over 100 such children.
The U.S. government turned out to have been involved. State Department representatives had informed the Spanish soap manufacturer providing most of Cuba’s soap that it would lose its U.S. markets if exports continued to Cuba.
Pressure was also put upon a Mexican soap-maker, and U.S officials allegedly arranged for the sale of a soap factory in Dominica to Proctor & Gamble, thereby putting that soap, too, under embargo rules.
Foreign companies with connections to U.S. corporations come under embargo restrictions, if their products contain U.S. components or if they have financial ties to U.S. corporations. Cuba had come to depend upon those foreign subsidiaries for food and medical supplies after the fall of the Soviet block.
In the era of globalization, almost 70 percent of the world’s new drugs are now being manufactured or marketed by U.S. companies or their foreign subsidiaries.
The 1992 law placing foreign subsidiaries under embargo restrictions did allow foreign exporters to apply for a license to export humanitarian materials to Cuba, but administrative roadblocks are so onerous that foreign subsidiaries rarely seek licensure. Subsequently I learned from Cuban pediatricians about specific shortages and their effects on doctors and on children. The shortages include:
• Asparaginase, an anti-leukemic drug made only in the United States. In Cuba, children with leukemia consequently have a 75 percent chance of being alive in five years, rather than the 95 percent likelihood granted to U.S. children.
• X-ray film supplied by Canadian companies and spare parts for X-ray machines made by Siemans of Germany. These companies have U.S. connections, and shortages often make X-rays examinations impossible.
• Replacement parts for pumps and valves for the Cuban water system. Their U.S. origin makes repairs difficult, and now intestinal infections have increased.
• Anti-vomiting medicines. Doctors are sometimes unable to relieve the vomiting caused by chemotherapy.
• Anti-cancer drugs. Pediatric specialists often have to make cruel decisions about withholding or shortening courses of treatment.
• Pre- and post-operative medicines. Urgent heart operations have had to be postponed until supplies arrive from Europe.
• Baby scales, hospital bedsheets and surgical gloves.
• English-language medical literature. McGraw-Hill purchased a Spanish company that provided all Latin America with such material.
Embargo-related extra costs take money away from replenishing the stocks of everyday items. U.S. drugs obtained through third countries are expensive, as is reliance upon air freight.
Ships are reluctant to visit Cuba because, if they do they may not sail to the United States for the next six months. I suggest that the mean spirit behind our own health-care system extends to Cuba and that U.S. policy makes Cuban children suffer. An exemplary health-care system is being trashed.
In the name of simple decency, the American people need to lend a hand to health workers in Cuba and honor them for their accomplishments.
Second, we need to oppose Washington’s war against Cuban health care. Third, we need to finish off the whole policy of blockade.
Finally, we need to make a reality of universal health care in our own country. Where is the good in harassing doctors and patients in Cuba? The U.S. embargo is a crime against humanity.
W.T. Whitney is a pediatrician in Maine and active in U.S.-Cuba solidarity movement.