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Cuban Healthcare - The Myth Goes On
Wednesday, March 16, 2005   By: Juan Paxety

A Time in New England

The myth of the excellence of Cuban healthcare continues with a story published in The South Coast - a web site of The Standard Times published in New Bedford, Massachusetts.  The article is entitled "Cuba's Remarkable Commitment To Healthcare." Perhaps it's not an article, but a letter to the editor from a physician. Let's take a look:

No world leader has been so consistently demonized for so long by so many successive U.S. administrations as Fidel Castro. It was therefore a surprise to read an article in the New England Journal of Medicine Dec. 23 issue entitled "Affirmative Action, Cuban Style." 
It appears that despite our mindless embargo which includes access to medications and medical technology, Mr. Castro has invested heavily in his country's health care. This has resulted in: 

  • A doctor to patient ratio twice that in the U.S. 
  • Lower rates of infant mortality and a comparable life expectancy to ours. 
  • Since 1996, 7,100 Cuban physicians going to work in the world's poorest countries. (The proportional number from the U.S. would be 175,000 to match Cuba's humanitarian contribution.) 
  • At the Latin America School of Medicine in Havana, students from 27 countries and 60 ethnic groups are enrolled. The same free scholarships are now being offered to and accepted by students from poor and underprivileged areas in the United States. The only condition attached is that they return to practice in the same poverty-stricken areas from which they came. 
    As the editorialist at the New England Journal of Medicine remarks, "What an irony that poor Cuba is training doctors for rich America, engaging in affirmative action on our behalf and -- while blockaded by U.S. ships and sanctions -- spending its meager treasure to improve the health of U.S. citizens. Whether one considers this a cunning move by one of history's great chess players or an extraordinary gesture of civic generosity -- or a bit of both -- it should encourage us to re-examine our stalled efforts to achieve greater racial and ethnic parity in American medicine." 
    Editor's note: Dr. Kirkaldy is a physician.

I wonder if Dr. Kirkaldy has seen Val's story, with photos, covering one of fidel's major hospitals? I was going to write Dr. Kirkaldy, but he doesn't seem to have a published mailing address. That figures.

It's hard to know where to begin fisking a letter like this. For one thing, the "mindless embargo" has had an exemption for medications and food for years.  Louisiana Governor Kathleen Blanco signed a $15-million dollar deal with fidel last week.

I wonder what countries the doctor is talking about when he refers to Cuban doctors going to work in the world's poorest countries. Cuba is a poor country. fidel, on the other hand, is listed with Queen Elizabeth and The Sultan of Brunei as among the world's richest people. So rich, he can subsidize rice cookers for the women of Cuba.

Dr. Kirkaldy's statement that Cuba is training American doctors to return to the U.S. to practice in poor communities is something I've never heard before. Is it true? Would a doctor trained in Cuba be admitted to practice in the U.S? That's a question that deserves further investigation.

Update - The folks at the Florida Medical Association say they are unaware of doctors being trained in Cuba to practice in the U.S.  They say that should a doctor graduate from a Cuban medical School that is recognized by the World Health Organization, and if the doctor could meet the licensure requirements of Florida statutes and pass all parts of the United States Medical Licensing Examination, he or she would qualify for license consideration.  Now, the question is, is there such a doctor practicing in the U.S?

Second Update - Interestingly, The World Health Organization says it has no authority to grant recognition of medical schools.

Readers are reminded that WHO has no authority to grant any form of recognition or accreditation to schools of medicine or other training institutions. Such a procedure remains the exclusive prerogative of the national government concerned. WHO limits itself to publishing information on medical schools that has been provided or confirmed by the governments of its Member States.

Also, the WHO provides information on health services in the various member countries for the year 1993 (why 12-years behind, WHO?). Cuba is here.  The United States is here. Both are pdf.

The U.S. medical system has 141 medical schools producing 245 physicians per 100,000 population

The Cuban medical system has 13 medical schools producing 518 doctors per 100,000 population. Work in government service is obligatory after graduation.

Third Update - now that Google is working again, here is a story about Dr. Kirkaldy.  It seems he's been Westport, Massachusetts' doctor since 1960 - and, since he's now 77, he's retiring to Vermont and closing his practice.  He also served as a town Selectman, and here's a bit about his politics:

Dr. Kirkaldy had long been interested in politics and current events and has been writing letters to The Standard-Times since the early 1960s, addressing issues as varied as defending U.S. funding for UNICEF in 1963, favoring gun control in 1975 and supporting a single-payer plan for U.S. medical care in 1994.

The article says Dr. Kirkaldy was recruited to run for town Selectman after a Sunday service of the Friends, so I assume that means he's a member of The Religious Society of Friends, also known as the Quakers. The Friends say they have been witnesses for peace since 1660.  Some of us might say they have been witnesses for dictator appeasement.


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