Good morning all;
Cuba. A beautiful land of happy people. How is it possible that a poor nation like Cuba, can achieve health indicators on a par with the world's richer nations? Considering the question led me to think the following.
Two major contributing factors are medical education is free instead of 100k or more, and doctors are paid two to three hundred dollars a year compared to two to three hundred thousand dollars for a General Practitioner and much higher for specialists in Canada.
That being said, there is third condition in Cuba that may contribute to the higher health status of Cubans. In Cuba, although Sicko portrayed it differently, I have found Cubans have a difficult time obtaining aspirin or other drugs. Doctors there are very grateful to receive any types of medications that they can distribute to the population. Perhaps their lack of ‘drugs’ and all the side effects and interactions due to pharmaceuticals, as well as over prescribing is controlled by government and leads to better health in general. This reduces the hospitalization and deaths we experience here in Canada that creates a significant cost to the Canadian health system and the health of many people. In Canada, it costs us more for drugs than physicians do since 1997. Thousands of Canadians are admitted to hospitals for interactions yet the CMA continues to hold on to the prescribing power and individual model of treating patients with out the input of pharmacists and other health care workers.
The fourth condition is most of the social determinants of health are rather equal for most Cubans. Everyone receives their food rations, free education, guaranteed income, free dental & health care, a job (albeit some working conditions are dismal), public transportation (it may be in dump truck, or smoking school bus), housing (it may be a cinderblock tiny house with a dirt floor & not heated, nor a basement), gender equality (at least in schooling and jobs) and so on. The income gap in Cuban is very small where in Canada, it is growing steadily with certain professions or positions on a steady upward trend for income, while many other Canadian incomes are stagnant or below the LICO, or losing purchasing power yearly as the incomes do not keep pace with the inflation rate. Additionally Cuba has one of the highest literacy rates in the world.
In my view, it is about an economy where costs are very controlled and particular professions do not get a lion’s share of income, nor do corporations have free range to the population or professionals to influence the prescribing of drugs that may or may not be necessary.
I have to add that the lack of winter and all the costs associated with keeping warm are not on ledger sheet thus reducing costs for the overall economy and health care infrastructure as well.
One would have to consider how many more Canadians would go to Medical school if it were free. How many doctors would we have then? Would we have a ‘shortage’? If one removed the adverse drug costs and time from our system, would we have enough health care? If every child were given equal opportunity and a uniform to attend school, would we have a higher literacy rate?
Just a few Sunday morning thoughts on why Cuba achieves the health status for its citizens.
W G Richardson BEd, MAHSR
Apt 306- 800 Wolseley Ave
Winterpeg Manitoba
Canada R3G 1C6
204-999-1040
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Every way of seeing is also a way of not seeing. -David Silverman (2000)
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From: Social Determinants of Health [mailto:[log in to unmask]] On Behalf Of Dennis Raphael
Sent: September 9, 2007 6:40 AM
To: [log in to unmask]
Subject: [SDOH] New film on Cuban health system by a PHM member
"Claudio Schuftan" <[log in to unmask]>
Sent by: [log in to unmask]
09/09/2007 07:07 AM To pha-exchange <[log in to unmask]>
cc
Subject PHA-Exchange> New film on Cuban health system by a PHM member
From: TOM FAWTHROP [log in to unmask]
SWIMMING AGAINST THE TIDE
A Eureka Films production : the Cuban Health system
Produced & directed by Tom Fawthrop a regular participant
in PHM summits.
How is it possible that a poor nation like Cuba, can achieve health indicators on a par with the world's richer nations?
In several fields of medical research - new vaccines, new therapies, and ground-breaking anti-cancer agents- this small Caribbean nation is challenging the pharmaceutical empires of the west.
How is it possible that Cuba has achieved so much with so few resources? And that one of the world's poorer nations can offer to help the US-the world's richest-to cope with Hurricane Katrina? Cuba offered to send hundreds of doctors to New Orleans in 2005.
At a time when public health systems are in crisis and a tide of privatisation of healthcare has gripped the globe, this documentary looks in depth at one health system that is swimming against the currents of corporate globalization.
From Havana to Haiti, from Cape Verde to Venezuela, and 68 countries across the globe lives have been saved and public health systems strengthened by Cuban medical missions.
One of the batch of students from the USA studying in Cuba tells us in the film " They have Cuban doctors in so many countries but you never hear about." This unreported world is the subject of this film.
For more information contact and DVDs [log in to unmask]
SWIMMING AGAINST THE TIDE
47 min video a Eureka Films production directed by Tom Fawthrop
How is it possible that a small Caribbean nation can match and in some fields surpass western countries in the performance of their health system? In spite of the US trade embargo and many shortages of medicine,still infant mortality and longevity are on a par with the best health systems in Europe.
This documentary traces the development of the new health system from its beginnings after the 1959 Cuban revolution to the present-day.Cuban doctors from all fields- primary health care and family doctors, medical researchers and the island's highly developed capacity for the production of some of the world's best vaccines,neurologists and eye-surgeons all tell their story.
But it is not only Cubans that benefit from a system that provides free and universal health access for everybody. Around 30,000 health personnel-doctors,nurses etc are serving in humanitarian missions abroad covering 68 countries – both long-term medical aid programmes in Haiti, Mali.Gambiia, Guinea,East Timor,South Africa and the Solomon Islands. These figures also include emergency aid given to victims of natural diasasters –Tsunami and earthquakes in Pakistan and Indonesia.
Public health care systems have been generally under siege from the forces of globalisation.The private sector backed by the World Bank has expanded in the developing world,leaving qaulity healthcare unaffordable for the vast marjority.
This is the the story on one of the few nations that has defied the tide of privatisation and the logic that reduces health and medicine to just another commodities to be traded in the market.
For more information about this documentary please contact :
[log in to unmask]
EUREKA FILMS
TOM FAWTHROP
JOURNALIST
ASIA SPECIALIST
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