Books about Cuba





Review of ‘Cuban Health Care: The Ongoing Revolution’ by Don Fitz

by STAN COX

 

Don Fitz’s new book Cuban Health Care: The Ongoing Revolution was going to press at Monthly Review in early spring, as the pandemic was ramping up, so he had just barely enough time to slip in a postscript teasingly titled, “How Che Guevara Taught Cuba to Confront COVID-19.” The postscript puts an exclamation mark on the medical history of Cuba that Fitz takes us through in the 240 compelling pages that come before. Based on that history, one would have expected Cuba to take early, decisive actions to stem the pandemic, and Fitz says that’s exactly what happened.

The government quickly converted school-uniform factories to manufacture medical masks. They sacrificed their crucial tourism industry in order to bar all non-resident travel. They locked down hotspots, ensuring that their residents were well provisioned and that medically vulnerable people were checked frequently. They did plenty of testing and contact tracing. Medical students walked through all neighborhoods regularly, checking in on residents. All of this, Fitz writes, was no more than what Cubans would have expected of their nation in a time of such danger. He adds, “The Cuban people would not tolerate the head of the country ignoring medical advice, spouting nonsensical statements, and determining policy based on what would be most profitable for corporations.” Indeed, their pandemic response is only the latest of countless ways in which the Cuban medical system has proven superior to the US system.

The medical system that Cuba’s revolutionaries inherited from the old regime—more like a non-system—was a mess. Millions of Cubans, disproportionately rural and Black, has no access to health care at all. In the 1960s, the government began building a national system of outpatient polyclinics (policlínicos integrales) designed, in Fitz’s words, to “unify preventive and curative medicine” in communities. Each polyclinic was staffed, at a minimum, with “a general practice physician, nurse, pediatrician, OB/GYN, and social workers.” The polyclinics provided a single point of entry for each patient. They were highly successful, Fitz says, because they were established not in isolation but in the context of other developments: Cuba’s famously successful literacy campaign, land reform, improved farm incomes, improved diets, pensions, improved water supplies, schools, and housing, along with others. Having status within the national system equal to that of the country’s major hospitals, polyclinics had a high degree of independence. In the mid-1970s, the polyclinics began doing health risk assessments, incorporated specialist care, and made house calls a major part of the system. A decade later, single doctor-nurse teams began establishing small neighborhood consultarios, each tied to a polyclinic.

Internationally, Cuba’s health professionals are most well-known for their numerous, extensive missions to provide medical care and training in underserved or war-torn regions. The international work began in 1962 with a mission to Algeria, followed by other African nations, but it really ramped up with Cuba’s involvement in the Angola war that began in 1975 and dragged on into the 1980s. Fitz provides a richly detailed story of Cuban troops’ support for the Angolans’ fight against U.S.- and apartheid South Africa-supported rebels backed by South African mercenaries. The number of Cuban fighters in Angola reached a peak of 36,000 in 1976. Between 1975 and 1991, Cuba also sent more than 43,000 aid workers; among them, the number of Cuban medical workers in the country at any given time was as high as 800. Fitz relates some fascinating personal stories of doctors who served in the country, some of them for years. Cuban medical missions remained in Angola until 1991.

The Angola mission is the most celebrated, but Cuba’s service to Africa was far more widespread. Fitz list two dozen of the continent’s countries who collectively hosted tens of thousands of Cuban aid missions, primarily medical. They spanned the continent and the alphabet, from Benin to Guinea-Bissau to Mali to Uganda to Zambia. In the 1970s and 1980s, Cuban doctors also went to serve the revolutions in Nicaragua and Grenada. In the wake of the 1986 Chernobyl nuclear disaster in Ukraine, the Cuban government flew in 25,000 victims, mostly children, for treatment. In all, 164,000 medical professionals have served in 154 countries. Cuba provided medical teams in the wake of Hurricane Mitch, which hit Central America in 1999, the 2010 Haiti earthquake, and other disasters. They assembled a team to go to the US after Hurricane Katrina in 2005, but George W. Bush rejected the offer.

Fitz relates the Cuban medical system’s long struggle with HIV/AIDS. The disease had become serious on the island by 1986, but its cause still mysterious enough that the health system began sending AIDS patients to be quarantined in a network of sanitoria previously established for patients with highly infective diseases. Most of the quarantined were soldiers returning from Africa, so there was little notice within Cuba. The United States, always on the lookout for a club to beat Castro with, denounced Cuba for abusing the human rights of gay men. In fact, the majority of infected troops were heterosexual. The quarantine was lifted in 1989, once the disease became better understood. Cuba eventually made good progress on AIDS. The medical journal The Lancet declared Cuba’s AIDS program “among the most effective in the world.” But Cuba’s enemies continued to throw out the anti-gay trope, Fitz believes, “to distract attention from the fact that Cuba had implemented a program to combat HIV/AIDS that was better than most countries’, and, in particular, superior to US efforts.”

Fitz discusses how the collapse of the Soviet Union—which, combined with the continuing US embargo, ushered in the severe economic stresses of Cuba’s “Special Period” —placed an unprecedented burden on the superior health-care system the country had built up over three decades. The most serious health problems were a deeply inadequate food supply and shortages of drugs and medical equipment. Despite fiscal strains, writes Fitz, no hospitals were closed during the Special Period, and all regions, even in the countryside, had access to medical care. He also presents a table showing that infant mortality continued its longstanding, steady decrease through the hard years of the 1990s, and that since 2000, Cuba’s infant mortality rate has been significantly lower than that of the United States. Also in this period, the country’s huge increase in urban and small-scale food production was widely celebrated.

Over the past decade, Fitz has done much on-the-ground reporting on Cuba’s medical education system, led by its Latin American School of medicine (ELAM), and here he provides a detailed history of the system and its achievements, enlivened by extensive firsthand interviews with faculty and profiles of more than a dozen medical students.

A chapter comparing the US and Cuban medical systems features some eye-popping cost numbers: hospital stay, $1900 in US and $5 in Cuba; hernia surgery, $12,000 in US and $14 in Cuba; hip fracture, $14,000 in US and $72 in Cuba. In 2018, when the US was spending $8300 per person per year on medical care, Cuba was spending a little over $400. Fitz points out the reasons the US medical economy is so broken: insurance for profit, not health; overdiagnosis, overtreatment, over-prescribing of drugs, and overpricing; treatments that create problems requiring more treatment; the excessive salaries received by doctors and administrators; and excess profits going to owners and investors. The result: a health-care system that achieves worse performance than a highly effective one that costs 5 percent as much.

Finally, Fitz lists ten lessons to be drawn from the Cuban health-care experience, writing that “They form the basis of what I call the New Global Medicine.” Among those lessons are that health care need not be dependent on costly technology; doctors must live in the communities where they work; the medical system must be evolving and unique to each community; international medical aid must be adapted to the political climate of the host country; doctors must put healing above personal wealth; and “the new global medicine is a microcosm of how a few thousand revolutionaries can change the world.”

As the question of how to fix the US health care system resurges in the coming year, before the Covid-19 has yet passed and before new medical emergencies arise, Cuban Health Care: The Ongoing Revolution should be read as widely as possible—by lawmakers and their staffs, yes, but more importantly, by those of us who elect those lawmakers.




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A picture containing drawing

Description automatically generatedTHE REAL STORY BEHIND OPERATION PEDRO PAN
What was really behind the airlift of 14,000 Cuban children to the United States in the early years of the Cuban revolution? Was Operation Pedro Pan an urgent rescue mission or an integral part of Washington’s secret war to undermine and overthrow the revolutionary government?
This new book takes a fresh look at the multiple and complex factors driving the exodus of Cuba’s children, examining the rapid and profound social reforms implemented after the 1959 revolution that affected women, education, religious schools, and relations within the family and between the races. The author considers why Cold War anticommunist scare tactics were so effective in setting the airlift in motion, exposing the U.S. government’s manipulation of the aspirations and insecurities of more affluent Cubans.
Offering an original perspective on this still controversial episode in US-Cuba relations, this book traces the parallel stories of the generation of the Cuban revolution: the young Cubans who flew off to Miami with Operation Pedro Pan and those who stayed, including the 100,000 teenagers who also left their homes in 1961 to teach literacy in mountainous and marginalized parts of Cuba. In showing what these divergent journeys reveal about the historically fraught relationship between the U.S. and Cuba, the author also sheds new light on the nature of the deep social revolution that was unleashed on the island after 1959.

“The most complete, balanced, and best-researched book on Operation Pedro Pan. Engaging and beautifully written.”—Felix Masud-Piloto

“A fascinating, complex story. Shnookal has researched extremely widely, in the United States and Cuba alike, talking to protagonists in both countries. The thorny issue of Latin American migrant children in the U.S. has a long and tragic history, and Operation Pedro Pan is a significant part of this tale.”—Karen Dubinsky

OPERATION PEDRO PAN AND THE EXODUS OF CUBA’S CHILDREN
Deborah Shnookal
ISBN 9781683401551 Hardcover $85 reduced to $35
University Press of Florida, June 2020
University Press of Florida is offering this book for $35 and free shipping on all orders with code LASA20 through May 31, 2020.  https://floridapress.blog/2020/03/31/your-guide-to-our-2020-lasa-latin-american-studies-sale/




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What Lies Across the Water

The Real Story of the Cuban Five

Winner of the 2014 Evelyn Richardson Non-Fiction East Coast Literary Award
What Lies Across the Water recounts the events leading up to the arrest of the Cuban Five, five Cuban anti-terrorism agents wrongfully arrested and convicted of “conspiracy to commit” espionage against the United States. In response to decades of deadly attacks by Miami-based, anti-Cuban terrorist organizations, Cuba dispatched five agents – Gerardo Hernández, Ramón Labañino, Antonio Guerrero, Fernando González and René González – to Florida to infiltrate and report on the activities of these terrorist groups. Cuba even passed on information their agents learned about illegal activities to the FBI. But, instead of arresting the terrorists, the FBI arrested the Cuban Five on September 12, 1998. The five men would be illegally held in solitary confinement for seventeen months and sentenced to four life sentences in 2001. The terrorists these five men tried to stop remain free to this day.
In light of America’s supposed post-9/11 zero tolerance policy toward countries harbouring terrorists, the story of the Cuban Five illustrates the injustice and hypocrisy of this case: why were these men who tried to prevent terrorist attacks against Cuba charged with espionage against the U.S? And why does the U.S. continue to protect and harbour known terrorists?
“Provides the key information and analysis needed to understand the case of the Cuban Five”
— Danny Glover, actor, activist
“The most complete – and moving – account of the Cuban Five I’ve yet read.”
— Wayne Smith, Director, US Interest Section in Havana, 1979-82
“Far from being a boring account of deeds and misdeeds, Kimber employs eloquent prose and an enjoyable style to draw the reader into the tangled layers of terrorism and murder, espionage and deception, propaganda and myths, life sentences and impunity, meanness and hatred, love and sacrifice, romance and solitude, patriotism and delusion, good intentions and bad, and lies, lies, and more lies.”
— Havana Times
“This book removes the thin fabric of lies around the case of five Cuban intelligence agents who came to Miami to fight terrorism … This book has the detail and the analysis. Read it.”
— Saul Landau, Director of Will the Real Terrorist Please Stand Up?
“An invaluable and informative account of the last chapter of the Cold War between Cuba and the United States – a story that is alternately bizarre, surreal and ever suspenseful.”
— Ann Louise Bardach, Author of Without Fidel and Cuba Confidential

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Cuba Beyond the Beach
Havana is Cuba’s soul: a mix of Third World, First World, and Other World. After over a decade of visits as a teacher, researcher, and friend, Karen Dubinsky looks past political slogans and tourist postcards to the streets, neighbourhoods, and personalities of a complicated and contradictory city. Her affectionate, humorous vignettes illustrate how Havana’s residents—old Communist ladies, their sceptical offspring, musicians, underground vendors, entrepreneurial landlords, and poverty-stricken professors—go about their daily lives.
As Cuba undergoes dramatic change, there is much to appreciate, and learn from, in the unlikely world Cubans have collectively built for themselves.
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Cuba's Gay Revolution: Normalizing Sexual Diversity Through a Health-
Based Approach explores the unique health-based approach that was employed in Cuba to dramatically change attitudes and policies regarding sexual diversity since 1959. 

It examines leaders in the process to normalize sexual diversity, such as The Federation of Cuban Women's (FMC) and The National Centre of Sexual Education (CENESEX). 

The manuscript is written for academics interested LGBTQ issues, Cuba, and Latin America. 

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Fernwood Publishing.
Arnold August’s Third Book on Cuba.
Cuba–U.S. Relations: Obama and Beyond.

The book contains an analysis of the Trump Cuba policy.    This book could not have been more timely. With Fidel Castro’s death focusing outside attention on Cuba’s future and with Trump’s election throwing U.S.–Cuban “normalization” into question, Arnold August contests the common assumptions and public rhetoric about Cuban politics and about that “normalization.”
— Antoni Kapcia, University of Nottingham

Extract from Foreword by Keith Ellis:
What does a Canadian progressive intellectual do when a revolution made by the people of Cuba has won, because of its spirit and its achievements, his admiration and his loyalty? What does he do when this revolution, which, he shows, is the authentic culmination of a process that has involved all the salient stages of Cuba’s history, of its struggles, now finds itself in a time of unprecedented complexity and new difficulties, fed in part by the very successes of the Revolution? Arnold August brings to the task his finest gift, his superbly developed talent as a journalist, understanding this to mean the habit of assessing different aspects and representations of reality, so that he offers an ultimate fairness to the reasonable and humane reader. August constantly exhibits a related attribute: his remarkable power of analysis. The two together make the experience of reading him an enlightening one. His research work for this book, as for others on related topics, led him to live in Cuba for important periods of time, to live among Cubans and notice 1) how Fidel’s extraordinary power of analysis has been reflected in the Cuban population and 2) the impact its diffusion throughout the society has had on producing the calm, pleasant affability that underpins the stability of Cuba during times that could have been tempestuous. The people know how to think, and August has the superior skills, derived from his affinity for truth-telling, to produce a reliable picture of the complexities of their reaction to attempts to beguile them.

For nine other endorsements from Canada, the U.S. and the U.K., the Table of Contents, the biographies of Keith Ellis and Ricardo Alarcón (the author of the Introduction to the book), and how to purchase the book from Fernwood Publishing (Halifax), please click here:

http://www.cubausrelations.com/

Dear Friends,

One of the most positively commented on articles I have written recently was the piece on freedom of the press and Cuba–US  relations, published on September 9, 2015. 

The emails coming from the US, Canada, Europe and Cuba reflected a pent-up  frustration – and even a barely veiled anger –at how some of the US press deals with Cuba. Readers of the article seemed to breathe a sigh of relief that writers are not getting caught up in illusions, in the wake of the new Cuba–US relations, about the traditional media war waged against Cuba since the 1959 Revolution. Another writer, Iroel Sánchez from Cuba, took on The Washington Post for its misinformation and bias
regarding Cuba. 

My piece did not target CNN USA, but challenged one high-ranking CNN anchor, Jake Tapper.
Furthermore,it dealt initially only with his reporting from Havana of the August 14, 2015 reopening of the US Embassy and the flag-raising ceremony conducted by John Kerry.

For my full follow-up article on CNN published in CounterPunch October 16, 2015 click here:

Best regards,

Arnold August
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Two books donated to Halifax Library are now available.   

The two books are: Healthcare without Borders: Understanding Cuban Medical Internationalism and José Martí, Mentor of the Cuban Revolution.  

Both books are available for anyone who wishes to borrow them.






Cuba has more medical personnel serving abroad--over 50,000 in 66 countries--than all of the G-7 countries combined, and also more than the World Health Organization. For over five decades, the island nation has been a leading force in the developing world, providing humanitarian aid (or "cooperation," as Cuba's government prefers) and initiating programs for preventative care and medical training.
            
In Healthcare without Borders, John Kirk examines the role of Cuban medical teams in disaster relief, biotechnology joint ventures, and in the Latin American Medical School--the largest medical faculty in the world. He looks at their responses to various crises worldwide, including the 1960 earthquake in Chile, the Chernobyl disaster in the Ukraine, the devastating 2010 earthquake in Haiti and the subsequent cholera outbreak, and the 2014 Ebola epidemic in West Africa.

Kirk issues an informative and enlightening corrective for what he describes as the tendency of the industrialized world's media to ignore or underreport this medical aid phenomenon. In the process, Kirk explores the philosophical underpinnings of human rights and access to medical care at the core of Cuba's medical internationalism programs and partnerships.






"Kirk's invaluable study reveals to us, for the first time, the range and character of Cuba's remarkable achievements, which should be an inspiration and a model for those with far greater advantages."--Noam Chomsky, author of Manufacturing Consent

"Invaluable. Provides ample, detailed, and clear evidence of the whole evolution of medical internationalism within Cuban foreign and social policy, going well beyond the headlines to trace that evolution carefully and honestly."--Antoni Kapcia, coeditor of The Changing Dynamic of Cuban Civil Society





Fidel Castro Guerrillero

This booklet was prepared in homage to Fidel Castro. It contains, in English, Spanish and French, the text of a presentation by Arnold August from August 2016 on the occasion of Fidel’s 90th birthday and an article he wrote following the leader’s death later the same year. The articles in this booklet are “Fidel the Guerrilla in 2015–16 and Beyond” and 

“Fidel’s Legacy to the World on Theory and Practice.”
This booklet is offered free of charge to the public for circulation, printing or distribution.


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