Cuban Medical Internationalism: Origins, Evolution, and Goals [Hardcover]

Cuba is rarely assessed objectively by external critics, typically being viewed through leftover Cold War filters or dismissed as an anachronism for its continuing effort to make socialism work. This book provides an excellent survey and analysis of Cuba's deeds in the international arena of health care, disaster relief and South-South cooperation. Kirk and Erisman effectively answer those critics who see Cuba's international medical programme as having foundations in the economic crisis of the 1990s (i.e., selling medical services to keep the money flowing) and instead provide a comprehensive historical accounting of Cuba's assistance to the developing world. The case is effectively made that Cuba's global health initiatives arise from a commitment to solidarity rather than any profit motive. Of particular interest is the revelation that in situations where Cuban military or technical support has been requested (Algeria, Angola, Congo, etc.), the Cubans ensured that medical and educational staff were significant components of any agreement. One looks forward to a followup study on Cuba's activities in Haiti, as this book was published before the January, 2010 earthquake. Cuban assistance to Haiti pre-dates the disaster by a decade, and is a prime example of the enduring benefits Cuban assistance provides: Cuba's medical teams were on the ground when the quake struck, were and continue to be the largest single medical team working on the island. This is development in practice, rather than empty words.

John Kirk, Professor of Latin American Studies at Dalhousie University in Canada, and Michael Erisman, Professor of Political Science at Indiana State University, have written a most important book on Cuba's medical internationalism.

As the authors write, Cuba "has resolutely promoted public health as a fundamental human right for all, regardless of wealth, socioeconomic status, race, or geographical origin." So Cuba has a better infant mortality rate, 5/1,000, than the USA's 7/1,000. In 1958, before the revolution, it had been 60/1,000. Life expectancy then was 55 years; it is now 78, better than the USA's.

The authors note, "Cuba has devoted most of its energy and resources to developmental assistance, with health care at the forefront of such efforts. Indeed, the provision of medical aid has been a fundamental principle of the Cuban Revolution from the very beginning, a principle that has flowed from the conviction that medicine should not be perceived as a business, but rather as a right of the citizens and a duty for physicians, regardless of the ability of the patient to pay." They point out, "the Revolution's commitment to and success in building a world-class health care system on the island represents the foundation upon which Havana's medical diplomacy rests."

Cuba's medical schools graduated 83,982 people between 1960 and 2004. Cuba has provided free medical education for thousands of Cubans (it now has 70,000 doctors) and (since 1959) for 52,000 people from 130 other countries. Its Latin American Medical School, with an enrolment of over 8,000 students from Third World countries, is the world's largest medical school. Cuba has helped to set up ten medical schools in other countries.

By 2009, 38,000 Cuban medical personnel, including 17,000 doctors, were working overseas, in 73 countries, providing low-cost, sustainable primary health care, stressing preventive medicine. Cuban medical staff were caring for more than 70 million people in the world, more than the whole G8 put together, plus the World Health Organisation and Médicins Sans Frontieres. 1.5 million people owe their lives to Cuba's medical aid programmes.

In those areas of Ghana where Cuban medical professionals worked, infant mortality fell from 59/1,000 to 7.8/1,000. Its Operation Milagro has restored the sight of 1.5 million people, through free eye surgery (March 2009 figure).

In 2004, Médicins Sans Frontieres stopped working in Haiti, claiming it was too dangerous. Yet Cuba had 332 doctors working there, serving three quarters of the population, and cutting infant mortality from 80/1,000 to 28/1,000.

As the authors sum up, "This level of humanitarian solidarity is unprecedented, with Cuba doing more to assist underdeveloped and developing nations than any other country in the world." President Jimmy Carter said, "Of the so-called developing countries, Cuba has by far the best health system, and their outreach program to other countries is unequalled anywhere."