CUBA-HEALTH: Still a Jewel in Castro’s Crown

By Dalia Acosta Reprint | | Print |

Dalia Acosta

HAVANA, Apr 7 1997 (IPS) - The health sector continues to figure among the “jewels” of the government of Fidel Castro, in spite of the economic crisis gripping Cuba.

Still one of the top priorities of the Caribbean nation’s social policy, public health will receive around seven percent of the annual budget this year – similar to 1996’s 126.5 million dollars, Health Minister Carlos Dotres reported. That figure is nearly double the 66.9 million spent in 1993, considered the peak of the crisis that broke out in 1990.

Cuba’s Gross Domestic Product (GDP) plunged 34.3 percent from 1989 to 1993. Although it grew 0.7 percent in 1994, and 7.8 percent last year, high-ups in the government acknowledge that the growth is too slight to represent a real improvement in the reduced quality of life of Cubans, because it started from such a low point.

Castro cautioned last week against encouraging a too rosy picture of recovery. While progress was being made, there were no short-term solutions in sight, he stressed.

The crisis has drastically lowered the living standards of Cuba’s 11 million people, and led to a deterioration in some health services, due to the scarcity of medicine and materials.

Nevertheless, the government has maintained universal health care free of cost, as well as its immunization programmes, and basic indicators of health have not suffered.

According to the Ministry of Public Health, Cuba reduced its infant mortality rate from 9.4 per 1,000 live births in 1995 to 7.9 in 1996, putting it among the 20 top-ranking countries in the world in terms of low rates of death among under one-year-olds.

The incidence of low birthweight babies, which rose slightly in the worst years of the crisis, mainly due to nutritional problems, has plateaud. In 1996, 7.3 percent of live births involved low birthweight infants, down from 1995’s eight percent.

Meanwhile, a full 99.9 percent of births take place in hospitals, maternal mortality is a low 2.4 per 10,000 births, and the mortality rate among under five-year olds is 10.6 per 1,000. More than 95 percent of mothers are nursing at the time they are discharged from hospital.

Cuba has 60,000 doctors, 21 university faculties of medicine, 281 hospitals, 442 general health clinics, 168 nutritional clinics and 11 research institutes.

The family physician programme, a system of neighbourhood-level primary care that operates in both rural and urban areas, includes close to 20,000 doctors’ offices, which attend more than 95 percent of the population.

Dotres said Cuba had “the political will, human resources, strategies and programmes” to guarantee an increasingly “universal and accessible health system.”

He added that in 1996 there were no reported cases of measles, malaria or rabies in humans, while the whooping cough and rubella cycles were interrupted. Tuberculosis, one of the reemerging diseases with the highest rates of growth in the world, is not considered a public health problem in Cuba, where only 13.7 cases per 100,000 inhabitants were registered last year.

Epidemiological controls have succesfully averted a resurgence of Dengue fever, the introduction of cholera and the transmission of malaria, the minister underlined.

But the number of detected cases of Human Immuno-Deficiency Virus (HIV), which causes the Aquired Immuno-Deficiency Syndrome (AIDS) increased in 1996. Jorge Perez, director of the Cuban Institute of Tropical Medicine, said 124 HIV-positive individuals were detected in 1995, a figure that rose by 88.7 percent to 234 in 1996.

AIDS has spread slowly in Cuba. Just over 1,500 HIV-positive individuals have been detected, 557 of whom have developed full- blown AIDS, and 339 of whom have died.