Cuban Health Care. Don Fitz
Walter Titz), Saint Lucia (Amanda Louis), Sierra Leone (Dennis Pratt), Kenya (Lorine Auma), Lesotho (Keitumetse Joyce Letsiela), São Tomé and Príncipe (Yell Eric), and Tuvalu (Jonalisa Livi Tapumanaia). Health care worker Teresa Frías, who has worked in Angola, Tanzania, Brazil, and Bolivia, guided me in my first visit to a Cuban polyclinic. At the first consultorio I visited in Havana, I interviewed Dr. Alejandro Fadragas Fernández and nurse Maité Perdomo. In the Peruvian city of Pisco, polyclinic director Leopoldo García Mejias explained to me how polyclinics function within that country’s medical system. At Consultorio No. 2 in Pisco, I interviewed Dr. Johnny Carrillo Prada and Dr. María Concepción Paredes Huacoto.
To document the work of Cuba’s doctors in Haiti after the 2010 earthquake, I spoke by phone with ELAM student Joanna Souers. Deisy León Perez talked to me about heading the Hermanos Zais Committee for Defense of the Revolution in Havana. In that city, I also chatted with Jesus Hernándes Montalvo who was both president of the Consejo Popular in his Havana district and deputy to the Asamblea Nacional. I obtained information regarding Birthing Project U.S.A.’s use of Cuban experiences from interviews with its director Kathryn Hall-Trujillo, and its medical director Dr. Sarpoma Sefa-Boakye, a graduate of ELAM. The person I most frequently interviewed was Dr. Julio López Benítez, who provided me with insights into virtually every stage of Cuba’s medical development as well as his experiences in South Africa. Cuban journalist Hedelberto López Blanch granted me numerous personal interviews and also organized interviews with others over several years, drove me to many of those interviews, and presented me with a copy of his valuable work, Historias Secretas de Médicos Cubanos.
Though my Spanish is fluent enough for me to express my ideas and formulate questions, I fail to capture all the subtleties of rapid speech. For that reason, I am highly grateful to Rebecca Fitz for translating the responses in most of the interviews. Exceptions are the interview with Dr. Piñeiro, translated by Emily Brown, and my exchanges with Dr. Martínez, in which the late Dr. Angel Chang helped me. Finally, Ivan Angulo Torres facilitated my communication with medical staff in Peru.
I deeply appreciate Candace Wolf’s making available her interviews with Dr. José Gilberto Fleites Batista, who lived through the Cuban revolution, and his son Dr. Gilberto Fleites Gonzalez, whom I quote extensively. Several staff members at ELAM supported my efforts by providing general information about the school, statistical data regarding students, explanations about how ELAM relates to the Cuban medical system, and help in contacting international students. They include the late ELAM rector, Juan Carrizo, Director of International Relations Nancy Remón Sánchez, General Secretary of Project ELAM Wuilmaris Pérez Torres, Assistant Professor of MGI Dr. Raul Jorge Miranda, and Professor Delfín Marrero.
Just before the March Against Homophobia in Cienfuegos, my wife, Barbara Chicherio, met Mariela Castro, director of the National Sex Education Center. This was during a tour organized by the Medical Education Cooperation with Cuba (MEDICC), which works to enhance cooperation between the United States, Cuba, and health advocates globally. Particularly helpful in providing insights into Cuban medicine during this trip were MEDICC coordinator Anna Dorman, MEDICC translator Georgina “Yoyi” Gómez Tablo, and MEDICC medical consultant Maricela Torres Esperón.
Conner Gorry, who is senior editor of MEDICC Review, an English-language peer-reviewed journal focusing on Cuban medicine, has discussed many aspects of Cuban health care with me and provided feedback on drafts of some of my articles. I also thank Daniel Hellinger, Steve Brouwer, Linda M. Whiteford, John M. Kirk, and Joan Roelofs for reading and commenting on early versions of many articles appearing in this book. Publication of some of the chapters as articles in Monthly Review was made possible by its staff, including Michael D. Yates, Colin Vanderburg, Spencer Sunshine, Susie Day, Camila Valle, and Chris Gilbert. Michael Albert and Lydia Sargent have encouraged my efforts by printing early versions of some material appearing here in Z Magazine.
PERMISSIONS
I thank the publications below for generously permitting me to publish edited versions of essays first appearing in them. Several chapters of this book are edited versions of articles that appeared previously in Monthly Review (MR). They include the following:
• Chapter 1, “The Three Thousand Who Stayed,” MR 68/1 (May 2016), 43–56;
• Chapter 2, “Birth of the Cuban Polyclinic,” MR 70/2 (June 2018), 21–32;
• Chapter 3, “Cuba’s First Military Doctors,” MR 70/6 (November 2018), 46–62;
• Chapter 7, “ELAM: The Latin American School of Medicine,” MR 62/10 (March 2011), 50–62;
• Chapter 9, “Cuba: The New Global Medicine,” MR 64/4 (September 2012), 37–46;
• Chapter 11, “Cuba’s Medical Mission,” MR 67/9 (February 2016), 54–61.
• A recently published article in the Cuban journal Revista Cubana de Salud Pública provides annual data on the number of doctors practicing medicine and leaving the island during the first decade following the revolution. Since that article provides more up-to-date figures than those used for the MR article (70/2, June 2018), “Birth of the Cuban Polyclinic,” Table 1 in chapter 2, is based on its data.
• Chapter 8, “Thirteen Faces of ELAM,” is an edited version of an article that previously appeared in Z Magazine 23/11 (November 2010), 37–41.
• Chapter 10, “Challenges of the Twenty-First Century,” includes edited versions of four brief articles. They include the following:
• “Revolutionary Doctors in Venezuela” was originally published as a review of Steve Brouwer’s Revolutionary Doctors: How Venezuela and Cuba Are Changing the World’s Conceptualization of Health Care (New York: Monthly Review Press, 2011) in Z Magazine (October 2011), 44–45;
• “Marching Against Homophobia” originally appeared in Links International Journal of Socialist Renewal, May 28, 2012, http://links.org.au/node/2884;
• “Combating Dengue Fever” originally appeared in Black Agenda Report, February 14, 2012, http://blackagendareport.com/content/med-school-classes-cancelled-havana;
• “Lessons of the Cuban Health Care Model” was originally published in Black Agenda Report, December 12, 2012, http://blackagendareport.com/content/why-cuba%E2%80%99s-health-care-system-best-model-poor-countries.
Portions that are original publications for this work include:
• Chapter 4, “From Policlínico Comunitarios to Family Medicine”;
• Chapter 5, “Cuban Doctors in Angola”;
• Chapter 6, “A Time of the Unexpected”; and,
• Chapter 12, “Medicine in Cuba and the United States.”