Socialist Cuba’s long-standing principles of free universal healthcare – enshrined in its Constitution – take expression in its emphasis on primary care. The pinnacle of this approach is Cuba’s Family Doctor and Nurse programme. Teams of doctors and nurses are based in every community. Families receive visits at least yearly, or every three months for those with chronic illnesses. This allows the socialist state to assess the health of the entire population, not just the sick.
On our visit to the intensive care unit at Central Havana Paediatric Hospital, Dr Luis Solar Salaverri, the hospital’s Director of Paediatric Teaching Department, set out the principle behind this approach: ‘We are convinced that if you win the fight here at the ICU, you are late to the problem. The Cuban healthcare system is convinced the focus should be primary care. If a patient is at the hospital, that is already a failure.’
This approach allows Cuba, as a historically underdeveloped country, to have comparable or better healthcare outcomes than the richest nations in the world. Cuba has around nine doctors per 1,000 inhabitants compared with 3.2 in Britain. Cuba’s life expectancy is 78.33 years. In Britain, men living in the most deprived areas can expect to live 74.1 years – over nine years less than men living in the wealthiest parts of Britain.
These achievements are maintained by the socialist state despite the severe consequences of the US blockade. The ICU must use 15-year-old ventilators because the blockade prevents new ones being imported. Despite these difficulties, socialist Cuba continues its world leading example in medical internationalism and solidarity. Most of the medical staff we spoke to had served on international missions providing medical services in underdeveloped countries including Mozambique and Zambia. The hospital trains students from Cuba’s ELAM medical school, where thousands of medical students from poorer countries study for free. Hundreds of Palestinian medical students have trained at ELAM, including six at the paediatric hospital.
George O’Connell
First published in FIGHT RACISM! FIGHT IMPERIALISM! 298 February/March 2024
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