The email publication Cubanalysis is an example of the new sophisticated methods being employed by the counterrevolution to counteract and undermine growing support for the Cuban Revolution and the end of the economic blockade. Plans elaborated by US policy makers to mask the counterrevolution in a more progressive and benign face are beginning to emerge in the form of dissatisfied Cuban workers, the appointment of a Cuban labor leader to head Radio Marti and the dissemination of seemingly objective information to cast an unfavorable light on the Cuban Revolution.
The strategy is a departure from previous crude methods, although not a complete abandonment of the Spartan tactics that have long characterized the exiled counterrevolution. One of the objectives is to counteract the growing pressures on congress by more powerful and enlightened entities attempting to fracture the economic blockade of Cuba.
Every good fictional literature contains a theme, a plot and a setting.
This critique will identify these elements throughout Cubanalysis issue #13
titled "LEARNED, HEALTHY… AND SKINNY". It will expose its biased theme and
invalid interpretations. It will describe the valid and reliable methods of
analysis that accurately reflect the reality of what is being measured.
It
will present figures that will disprove the conclusions contained
therein.
Cubanalysis presents its propaganda in the setting of a formal document containing simple statistics, authoritative sources, conclusions and clever comments. The style attempts to project scientific impartiality in order to seduce the less informed reader, perhaps even a US congressman.
The statistical exercise on Cuban education and health care by Cubanalysis is based on faulty comparison, limited criteria, incorrect conclusions and biased speculation.
Cubanalysis does a delicate political balancing act in its
interpretations of the figures. On one hand, it offers recognition to the
Cuban revolutionary government for its high ranking on education and health.
On the other, it also fraudulently claims that the high ranking in health
and
education is not a distinctive accomplishment of the
revolution.
Next, Cubanalysis introduces its theme: "it is not necessary to adopt a Cuban or socialist model in order to deliver adequate health care". Typical of bourgeois intellectuals, distribution is not an indicator of adequacy.
What really matters to them are averages: marketing figures of where
and
what may be sold at the highest possible profit.
Why does Cubanalysis deny the demonstrated superior quality of health
care and education under socialism? The theory of the "privileged condition"
of Cuba under pre-revolutionary governments is the corner stone of the
ideological and political attacks by the enemies of the Revolution. Advanced
by bourgeois scholars such as Mann and Draper, it constitutes
a
philosophical juncture where the enemies of the revolution, on the right
and the anti-Marxist left, join forces to discredit Cuba. As will be shown
here, reputable studies do not sustain any of these assertions.
The health of a people depends on their income, diet and housing conditions. How well health care can perform depends on the availability of hospitals, physicians and medicine and how all these factors are distributed among the population.
According to researcher Ricardo Leyva: "Arguments have been put forth trying to prove that the health system of Cuba (before the revolution) was efficient and progressive and needed little reform. Such assessments based on national averages, however, present a false impression. Any useful analysis of Cuban health hinges, not on the question of figures for the whole nation, but on how health facilities and personnel were distributed."
This happen to be very true of the comparison with Costa Rica, where health care, education, etc. are more highly concentrated in the urban areas than in revolutionary Cuba.
On sanitation Cubanalysis concludes:
"Again, Cuba fares relatively well in the continent, but Costa Rica does as well or better. A clear indication of these figures is that is not necessary for a developing country to adopt a Cuban or socialist economic model in order to deliver adequate health care to its population."
First, Cubanalysis confuses the performance of a health care system with the sanitary environment of a people. The sanitary environment, i.e. income, diet and housing, only determines the preponderance of disease. But the availability of physicians, hospitals and medicine determines the performance of health care.
Sanitation is a preventive measure against disease. The health care of Cuba is unique in that it practices prevention by means of holistic family medicine. In fact, public health officials from Costa Rica have praised Cuba's system and have asked Cuba to help them implemented in their country.
Second, it is possible for any rich capitalist nation to deliver fairly adequate social services. The US governments, for example, have yielded to demands for public education, social security, medical care for the poor, etc. when threatened with revolt or during periods of prosperity fostered by fictitious capital. However, those achievements are the first to be ripped away by the ruling class when it must drive for higher rates of profit. As demonstrated by Cuba, only an economic model that is truly socialist is capable of preserving those gains, even during economic hardship.
The concentration of health care in the cities, before the revolution, is the result of a health care system based on commitment to profits rather than serving the needs of the population.
A comparison of the figures before and after the revolution show that in
spite of much progress in housing, income and diet, the revolutionary
government has achieved a modest improvement through better distribution among
the rural population. The total figures for diet, however, have
actually
decreased.
During the most recent period of the colonial epoch, medical attention was practically non-existent for workers in Cuba. According to a 1957 survey, only 8% of the population received free health services.
In 1959 Cuba only had 10 hospitals with only a small increment from the preceding years. The countryside, however, had only 1 hospital and 109 beds for the entire rural population. Before the revolution, 80% of all hospital beds were in Havana.
In 1958 Cuba had 3.9 beds/1000 persons; that figure steadily climbed to 5.9 in 1968.
From 1959 to 1964, the revolutionary government build a total of 66 hospitals; 38 in the countryside (leyva 477). From 1959 to 1968 the number of beds in Cuba almost tripled.
In 1997 Cuba had 80,528 total number of hospital beds, for an index of 7.3 per 1,000 inhabitants. There were 89 intensive care units: 53 for adults and 36 for children.
A study in 1959 revealed that 72% of all Cubans had parasites; the figure for the rural areas was 87%. Shortly after the study was published the figures declined dramatically.
As early as 1970 the revolutionary government eradicated malaria and poliomyelitis in Cuba and over 90% of children were immunized.
In 1957 the doctor population ratio in Cuba was 1 physician for 998 persons. These services, however, were relatively inaccessible to the rural population. Medical skills and facilities were concentrated in the cities while the country folk were disproportionately consumed by disease.
In 1958, Havana with less than 1/3 of the population had 2/3 of all physicians. This means that 60% of all physicians worked in Havana for a ratio of less than 1 doctor for 420 persons. Pinar del Rio province had 1/1000 and Oriente province had 1/2500.
According to Cuba's Minister of Public Health: "Before the revolution, 6,000 doctors were poorly distributed (about 3,000 abandoned the country encouraged by the United States). But later, we had 63,000 doctors (one for each 174 inhabitants) and more than 30,000 units of health, located in all corners of the country".
Now Cuba has 338,983 persons working in the public health sector. Total number of doctors is 63,384 placing Cuba first among all the countries of the world, developed or not.
Health care expenditures deserve mention here because the counterrevolution propagates the myth that Cuba does not spend enough in this area. In 1968 Cuba spent in health care 10 times what was spent in 1958. In 1959 Cuba spent $3/person on health care; That figure increased to $23/person in 1968.
Cubanalysis states the following on infant mortality in Cuba, one of three indicators of health care performance :
"So although there has been great improvement since then, it would be erroneous to claim that Cuba has passed from being a relatively poor performer to a great one. A more correct appraisal is that the country has maintained its high performance during recent decades".
This is also nonsense. In order to arrive at a correct evaluation of the
accomplishments of Cuban Public Health, it is necessary to place it in two
different times. A sudden leap of the figures is a sure indication that a
radical change has occurred. From 32/1000 live births in 1957 to 9/1000
in
1995 and from 13th in rank to 1st is a dramatic improvement.
Early in the revolutionary epoch infant mortality was dramatically reduced from a previous average of 60 deaths/1000 live births. Thereafter, infant mortality continued to decline, reaching a low of 7.2/1000 live births in1997, a figure which is comparable only to highly developed nations.
According to UNICEF (based in Costa Rica) Cuba leads all other Latin
American countries in the care of children. UNICEF's Francisco Rojas has said
in 1998 that "Cuba offers more protection for its children than any other
country in the region". He also told journalists that Cuba should be used as
an example for other Latin American nations, pointing to the low
infant
mortality rate.
Cubanalysis questions Cuba's low infant mortality rate saying: "perhaps" it is the result of legalized abortion on the island.
This biased speculation can be summarily dismissed by considering that the high incidence of under-reporting in the rural areas of Latin-America, or anywhere where abortions are illegal, such as Costa Rica, is more likely to have a greater effect on improving infant mortality rates.
The Population Fund of the United Nations states that more than 20 million women in the world undergo abortions in bad conditions; 70 thousand die as a result thereof and millions more suffer hemorrhages and other health problems that could cause permanent injuries.
According to Dotres, Minister of Cuban Public health: "That situation existed in Cuba before 1959. What our health organization does is to institutionally channel that reality and works to educate the population with promotion and prevention programs...In the previous years the figures began to diminish. Today, there is a recorded rate of abortion of 0.5-0.6 for each birth".
So far the only known recognized variant of infant mortality is an unmistakable correlation between education and mortality rates, especially child mortality. According to UNICEF a 10% increase in girls' primary enrolment can be expected to decrease infant mortality by 4.1 deaths per 1,000 and a similar rise in girls' secondary enrolment could slash mortality among infants by another 5.6 deaths per 1,000.
Before the revolution, life expectancy was 59.5 years; now the figure goes beyond the age of 75.
In its 1997 Report of Human Development, the United Nations Development
Program established a new definition of poverty that uses the availability of
basic health services, life expectancy, illiteracy and low birth-weight
children as a more accurate measure of poverty than comparisons of low income
alone. Although we have not located low birth weight data on Cuba,
the
remaining combined indicators are testimony to the outstanding performance of
the Cuban health care system worldwide.
According to this more accurate study of 78 underdeveloped countries, Cuba ranks second among the top 5 nations that have reduced their poverty rates below 10 percent:
| Country | Poverty Rate (%) |
|---|---|
| Trinidad and Tabago | 4.1 |
| Cuba | 5.1 |
| Chile | 5.4 |
| Singapore | 6.6 |
| Costa Rica | 6.6 |
These figures, however, do not reflect the blockade nor all attempts to crush the revolutionary process that has earned Cuba its high ranking on living standards.
To be continued
PART II:
EDUCATION, CONCLUSIONS & SOURCES