Daniel Raisbeck and John Osterhoudt at Reason on Monday April 18, 2022 premiered a documentary on "The Myth of Cuban Health Care" that is required viewing. Not mentioned in the report is that other Latin American countries ( Costa Rica, and Chile ) rate higher than the U.S. on international indices with regards to their healthcare systems, but are rarely mentioned as models to emulate. Despite Cuba's unreliable and inflated statistics, its health care system still rates lower than the United States, but that is the system that Senator Bernie Sanders, Angela Davis, and Michael Moore celebrate.
Anything that does not fit the narrative is memory holed.
Three of 26 patients who died of exposure in 2010 in Cuba
For example, in January 2010 pictures smuggled out of the Cuban psychiatric hospital Mazorra revealed that patients were dying of exposure to the elements, and had suffered greatly through their time there. Claudia Cadelo, now exiled out of Cuba, wrote in 2010 her reaction to seeing this photos:
When I opened the little folder called “Mazorra” a series of monstrosities hit me in the face and I couldn’t stop looking at the cruel graphic testimony. A friend who is a doctor visited and while he analyzed images I didn’t have the courage to look at, expressions like, “Holy Virgin Mary, Blessed God, What in God’s name is this?” issued from his outraged throat, mixed with obscure pathologies and the names of diseases both treatable and curable. Enormous livers, tubercular lungs, and wormy intestines are the proof, Senora Arlin, of the sacredness of life in Cuba. Meanwhile The Roundtable throws a fit because the death of Orlando Zapata Tamayo has unmasked a crumbling public health system, and they try to cover up the disgrace of seeing soldiers dragging and beating a group of women dressed in white with flowers in their hands. I ask myself, Gentlemen Journalists, when will they explain to Cubans the reasons why twenty-six mentally incapacitated people died in inhumane conditions during their confinement in Mazorra?
Havana was forced to acknowledge what had happened thanks to the still unknown whistleblower and courageous independent journalists who made the images public. The New York Times reported on January 15, 2020 that "26 patients at a mental hospital died during a cold snap this week, the government said Friday. A Health Ministry communiqué blamed “prolonged low temperatures that fell to 38 degrees."
This raises some important questions on the continued praise of the healthcare system in Cuba.
Is it because Chile and Costa Rica do not need to set up propaganda and influence operations to justify their existing political systems, because both are democracies and the regime in Havana is not? The claim that Havana's situation cannot be compared because it has a hostile neighbor in the United States leads to an obvious question: Why not compare Cuba with Taiwan that also has a hostile neighbor in Communist China? The answer is simple because Taiwan has done a better job on public health generally, and especially during the current Pandemic.
What do Costa Rica, Chile, and Taiwan have in common? All three countries are democracies. Do democratic norms favor improved healthcare outcomes?
Katherine Hirschfeld, is a medical anthropologist who spent time in Cuba examining the healthcare system and author of the book Health, Politics, and Revolution in Cuba Since 1898 published in 2009. In 2018 Professor Hirschfeld in the journal Health Policy and Planning made the case for democratic norms generating better results in public health in “Response to ‘Cuban infant mortality and longevity: health care or repression?’” and analyzed the shortcomings found in Havana’s governing style.
”The regime governs from the top down, as a dynastic military dictatorship that does not permit anyone outside the government—no independent associations of health professionals or journalists—to objectively assess policy outcomes. The role of public media in an autocracy is instead to praise the regime and explain away its failures as the work of real or imagined political enemies. Public information about health trends is correspondingly configured to fit these predetermined narratives.”
The Covid-19 pandemic, mentioned in the new documentary, again demonstrated Havana's mastery in setting the narrative of "great successes in healthcare by the Cuban Revolution" in contrast with the stark reality on the ground in Cuba.
The documentary also raises the issue of doctors sent out on medical missions creating a positive buzz about the Cuban healthcare system, while Cuban doctors denounce being trafficked and exploited.
However these international missions have an additional dark side. Mary Anastasia O'Grady in her June 14, 2020 column in The Wall Street Journal warned about "Cuban Medical Brigades to Mexico" and more specifically Havana's "history of using its doctors to propagandize and build intel networks."
Cuban doctors sent to Venezuela were ordered to deny or ration care to advance Nicolas Maduro's election prospects reported The New York Times in the March 17, 2019 article, "It Is Unspeakable’: How Maduro Used Cuban Doctors to Coerce Venezuela Voters," including the denial of needed oxygen to deathly ill patients.
Politicized Cuban medical brigades denied patients treatment if they did not back Havana's allies
Equally troubling is that the World Health Organization's regional office for the Americas, the Pan American Health Organization (PAHO)is facing a lawsuit for conspiring with Havana to circumvent Brazilian laws to profit off the trafficking of Cuban doctors.
The U.S. State Department's 2021 Country report on Cuba documented that "oncologist Carlos Leonardo Vazquez Gonzalez, also known as “agent Fernando,” admitted on state television to working as an informant for State Security for 25 years." Furthermore that "multiple sources came forward and credibly accused him of intentionally denying medical care to dissidents. Friends and relatives of deceased activist Laura Pollan and independent journalists accused Vazquez and other doctors of playing a role in her 2011 death and falsifying the medical certificate of death."
Luis Manuel Otero Alcántara and Maykel Castillo Pérez "El Osorbo"
Cuban prisoners of conscience have died of medical neglect over the years. This is why many are concerned with the plight of hundreds of political prisoners today in Cuba, including artists Luis Manuel Otero Alcántara and Maykel Castillo Pérez "El Osorbo" who are both in poor health. Luis Manuel and Maykel are both prisoners of conscience. On April 21, 2022 at 6pm EST at Father Duffy Square located at 7th Ave &, W 47th Street New York, NY 10036 Artists at Risk Connection and Pen International will host the event “Cuba will be free. I already am": Remembering Reinaldo Arenas and a vigil for detained artists in Cuba".
Reason, April 18, 2022
The Myth of Cuban Health Care
How did something so at odds with reality persist for so long? And why is it finally crumbling?
Daniel Raisbeck and John Osterhoudt | 4.18.2022 10:00 AM
"If there's one thing they do right in Cuba, it's health care," said Michael Moore in a 2007 interview. "Cuba has the best health care system in the entire area," according to Angela Davis, "and in many respects much better than the U.S."
"One thing that is well established in the global health community is the strength of the Cuban national health system," said Clare Wenham, a professor at the London School of Economics.
Claims like these have appeared in hundreds of documentaries, newspaper articles, and magazine features over the years celebrating the supposed marvel of Cuba's health care system. It's a testament to the effectiveness of the Castro regime's propaganda apparatus that this myth, so deeply at odds with reality, has persisted for so long.
"The Cuban health care system is destroyed," Rotceh Rios Molina, a Cuban doctor who escaped the country's medical mission while stationed in Mexico, tells Reason in Spanish. "The doctor's offices are in very bad shape."
"People are dying in the hallways," says José Angel Sánchez, another Cuban doctor who defected from the medical mission in Venezuela, interviewed by Reason in Spanish.
According to Rios, Sánchez, and others with firsthand experience practicing medicine in Cuba, the island nation's health care system is a catastrophe. Clinics lack the most routine supplies, from antibiotics to oxygen and even running water, and their hallways are often occupied by ailing patients because there aren't enough doctors to treat their most basic needs. Cuban hospitals are unsanitary and decrepit. It's exactly what you'd expect in a country impoverished by communism.
The only thing that's changed is that because of social media and the COVID-19 pandemic, the government's propaganda facade has finally started to shatter.
And yet in 2021, some journalists were falling for the claim that the Cuban government had set the model in its response to COVID-19. By July of that year, ordinary Cubans had taken to the streets—and to Twitter and Facebook—in part to call attention to what the pandemic had actually meant for Cuban hospitals and clinics.
In the 15 years since the release of Michael Moore's documentary Sicko, which celebrated Cuban health care, everyday citizens have been armed with smartphones, Twitter, Instagram, and Facebook, empowering them to tell the truth about what it's really like to walk into a Cuban hospital.
So how did the Castro regime's propaganda machine manage to fool so many for so long? According to Maria Werlau, executive director of the Cuba Archive, the answer lies with Cuba's foreign medical missions, which are teams of health care professionals dispatched to provide emergency and routine care to foreign countries.
The first medical mission was sent to Algeria in 1963. After the fall of the Soviet Union, when the government lost its major source of aid, the program was ramped up significantly as a source of revenue for the impoverished nation.
The Cuban government has promoted the missions as a humanitarian endeavor, and a demonstration of the community spirit and selflessness central to the communist project. In his 1960 speech "On Revolutionary Medicine," the Marxist revolutionary Che Guevara said that "Individualism…must disappear in Cuba." He recounted the story of a group of physicians in Havana "who demanded remuneration" before going into the country's rural areas to treat the sick. He dreamed of replacing them with a new class of doctors drawn from the peasantry who would "run, immediately and with unreserved enthusiasm, to help their brothers."
Rios participated in the medical mission in Sierra Leone in 2013, where health care specialists from around the world came to help contain the Ebola epidemic. The members of the mission were told that when they returned to Cuba, they would be received as heroes. Rios says that, while he did receive a stipend that went to cover his living expenses, medical personnel from other countries were generously compensated.
The myth of Cuban physicians as selfless healers started to fracture in 2000 when two doctors from the mission in Zimbabwe slipped a note to an airline official with the handwritten word kidnapped. They had denounced the Castro regime and were being brought back to Cuba against their will, possibly to face jail time. Instead, they wound up in the U.S. and were granted political asylum.
In a 2020 report, Human Rights Watch said the Cuban medical missions "violate [doctors'] fundamental rights," including "the right to privacy, freedom of expression and association, liberty, and movement, among others." It noted that "many doctors feel pressured to participate in the missions and fear retaliation if they do not," and that "governments that accept Cuban assistance that includes the abusive conditions imposed by Cuba risk becoming complicit in human rights violations."
In 2006, the George W. Bush administration created the Cuban Medical Professional Parole Program, granting health care workers stationed abroad permanent resident status. All they had to do was make it to a U.S. embassy. Over 7,000 medical workers took advantage of the program.
In 2014, the New York Times op-ed page published an editorial calling for an end to the program. American immigration policy "should not be used to exacerbate the brain drain of an adversarial nation," it noted. In other words, the rights of doctors to decide where and how to live should be subordinate to what was best for the Cuban government.
After the mission in Sierra Leone, Rios was redeployed to a military base in Mexico. One day, he was sent with a group of doctors to buy some phone cards so they could connect with their relatives back home. He decided to make his escape. Rios found a job at a Mexican pharmacy and started saving money to pay a coyote to bring him into the U.S. He was picked up by border officials, and taken to an immigrant detention center for 42 days. After his release, he could join his family in Miami.
In 2018, a group of Cuban doctors who defected from the medical missions sued the Pan American Health Organization, which is part of the World Health Organization, for aiding in human trafficking and for earning $75 million in fees by acting as a middle man.
The medical missions are primarily a way of selling Cuban health care services abroad. So what's health care like for those living on the island?
Julio Cesar Alfonso is the president of the Miami-based Solidarity Without Borders, which helps Cuban doctors who have escaped. He says that there are two health care systems in Cuba—one that is used by the majority of regular citizens, and another that is reserved for tourists and the Cuban elite.
When defenders of Cuban health care acknowledge its deficiencies at all, they usually point the finger at the U.S. trade embargo, which has been in place since 1962. But the deplorable conditions in Cuban hospitals have more to do with a lack of basic health care supplies, which are readily available from other countries, such as antibiotics and steroids. Cuban hospitals also have a shortage of beds and stretchers, and some were without water for six to 12 hours a day at the height of the pandemic.
So what impact does the embargo really have on Cuban health care? Medical products have been technically exempt from the embargo since the passage of the 1992 Cuba Democracy Act. But the law does stipulate that U.S. companies need a license in order to sell to Cuba—and critics are correct to point out that this requirement adds red tape to the process. Total U.S. health care products purchased by Cuba from 2003 to 2021 averaged a mere $1.4 million annually, in what should be a $50 to $100 million market. But it's not the licensing process that accounts for such paltry sales; companies would gladly obtain permission to sell their products to Cuba if they could earn enough money to make it worth the effort. Cuba has a severe foreign currency shortage because it produces little in the way of goods and services that the rest of the world apart from the U.S. wants to buy.
Promoters of Cuban health care often cite the country's infant mortality rate as evidence of its success. "How is this possible" that "an American infant is, by official statistics, almost 50 percent more likely to die than a Cuban infant," wrote Nicholas Kristof in a 2019 New York Times column that looked at one of the most often repeated figures in support of the claim that there's something exceptional about Cuba's health care system.
While conceding that "the figures should be taken with a dose of skepticism," Kristof chose to interpret them regardless in support of his priors: "Cuba has the Medicare for All that many Americans dream about."
Cuba has a variety of strategies for manipulating its infant mortality rate, such as seeing to it that fetuses less likely to survive outside the womb never get the chance. There's significant evidence that Cuban doctors coerce women into aborting fetuses shown to have abnormalities after routine ultrasounds.
Vincent Geloso, who's an assistant professor of economics at George Mason University, co-authored a 2018 paper arguing that Cuba's low infant mortality rate is the result of misclassification using a different indicator known as "late fetal deaths."
Despite reports early in the pandemic that Cuba was an outlier in its success in combating COVID-19, by August of 2021 The New York Times was reporting that Cuba's health care system was "reeling," with oxygen supplies running low, a shortage of syringes, and mortuaries and crematories "overwhelmed." Cuban President Miguel Díaz-Canel blamed the U.S. trade embargo.
Sánchez thinks that, as the Castros' health care myth crumbles, ordinary Cubans are beginning to realize that they are not threatened by foreign enemies, as the regime propaganda machine has claimed for decades.
"The only enemy of the Cuban people," he says, "is the Cuban government."
Written and hosted by Daniel Raisbeck and Jim Epstein; narrated by Daniel Raisbeck; edited by John Osterhoudt; camera by Epstein, Osterhoudt, Isaac Reese, and Meredith Bragg; graphic design by Nathalie Walker; animations by Reese and Osterhoudt; additional editing support by Regan Taylor; additional research by Alexandra De Caires; translation assistance by María Jose Inojosa Salina; English subtitles by Caitlin Peters.
Photo credits: KRISTIN CALLAHAN - ACEPIXS.COM/Newscom; KEYSTONE Pictures USA/ZUMAPRESS/Newscom; United Nations Photo/Flickr/Creative Commons; Claudio Furlan/ZUMA Press/Newscom; Ipa/ZUMA Press/Newscom; Ipa/ZUMA Press/Newscom; Claudio Furlan/ZUMA Press/Newscom;United Nations Photo/Flickr/Creative Commons; */Kyodo/Newscom; RG72/wikimediacommons/Creative Commons; IAEA Imagebank/Flickr/Creative Commons; Sandrine Huet / Le Pictorium/ZUMA Press/Newscom; Jonathan Alpeyrie/Polaris/Newscom; Angelo Cozzi/ZUMA Press/Newscom; Ernesto Mastrascusa/EFE/Newscom; Eye Ubiquitous/Newscom; Eye Ubiquitous/Newscom; Kike Calvo/ZUMA Press/Newscom; Eye Ubiquitous/Newscom
https://reason.com/video/2022/04/18/the-myth-of-cuban-health-care/
Artists at Risk Connection, April 14, 2022
Event
“Cuba will be free. I already am": Remembering Reinaldo Arenas and a vigil for detained artists in Cuba
New York
Thursday, April 21, 2022
6pm EST
Father Duffy Square
7th Ave &, W 47th Street
New York, NY 10036
In-Person Event - Free!
Join us with PEN International and the Times Square Arts for an outdoor evening of poetry to celebrate Cuban artist Raúl Cordero’s public art installation titled THE POEM, and the poetry community in New York City.
THE POEM is a large-scale sculptural tower featuring illuminated text inside a landscaped space of sanctuary. THE POEM is both inspired by and dedicated to fellow Cuban and poet Reinaldo Arenas, who was forced into exile by the Cuban government.
The evening will feature short readings from poets Jaime Manrique, Eloisa Amezcua, Melissa Lozada-Oliva, and Maya Pope. There will be a vigil following the reading in solidarity with artists targeted by political persecution amidst the ongoing crackdown on creative expression by the Cuban government.
Speakers
Jaime Manrique was born in Barranquilla, Colombia, in 1949. He began writing poetry in his teens, and at age seventeen he moved to Florida with his mother and sister. He received a BA from the University of South Florida in 1972.
In 1975 Manrique was awarded Colombia’s “Eduardo Cote Lamus” National Poetry Award for his debut poetry collection, Los adoradores de la luna (Instituto de Cultura y Bellas Artes, 1977). He is the author of several books of poetry, including El libro de los muertos: poemas selectos 1973–2015 (Artepoética Press, 2016), Tarzan, My Body, Christopher Columbus (Painted Leaf Press, 2001), and My Night with/Mi noche con Federico García Lorca (Painted Leaf Press, 1997).
Manrique has also published several novels, including Our Lives Are the Rivers (HarperCollins, 2007), winner of the 2007 International Latino Book Award in historical fiction, as well as the essay collection Eminent Maricones: Arenas, Lorca, Puig, and Me (University of Wisconsin Press, 2002). With Joan Larkin, he translated Sor Juana’s Love Poems/Poemas de amor (University of Wisconsin Press, 2003) into English.
Manrique has received fellowships from the Foundation for Contemporary Performance Arts, the Guggenheim Foundation, and the New York Foundation for the Arts. He currently teaches at the City College of New York and lives in New York City.
Maya C. Popa is the author of American Faith (Sarabande Books 2019), recipient of the 2020 North American Book Prize, and Wound is the Origin of Wonder, forthcoming from W.W. Norton in 2022. She is the Poetry Editor of Publishers Weekly and teaches at NYU and elsewhere. She is a PhD candidate at Goldsmiths, University of London writing on the role of wonder in poetry.
My name is Melissa Lozada-Oliva. I’m a Guatelombian (Guatemalan-Colombian) American poet and screenwriter living in Brooklyn by way of Massachusetts. My book peluda (Button Poetry 2017) explores the intersections of Latina identity, feminism, hair removal & what it means to belong. My novel-in-verse Dreaming of You is about bringing Selena back to life through a seance & the disastrous consequences that follow & it’s coming out October 2021 on Astra House. I am the co-host of podcast Say More with Olivia Gatwood Who Is a Massive Bitch where we dissect the world through a poetic lens. I am currently working on a pilot about a haunted book store. I’m interested in horror because I’m scared of everything. I like when things are little funny so that I have space to be a little sad. My work has been featured or is forthcoming in REMEZCLA, PAPER, The Guardian, BreakBeat Poets, Kenyon Review, Vulture, Bustle, Glamour Magazine, The Huffington Post, Muzzle Magazine, The Adroit Journal, and BBC Mundo! This photo of me next to the leg was taken by Don Calva.
Eloisa Amezcua is from Arizona. She is the author of From the Inside Quietly (2018). A MacDowell fellow, her poems and translations are published in New York Times Magazine, Poetry Magazine, Kenyon Review, Gulf Coast, the Academy of American Poets Poem-a-Day series, and elsewhere. Her second collection of poems, Fighting Is Like a Wife, is forthcoming from Coffee House Press in April 2022.
