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This month:

Cuba health system

The e-mails published reflect the balance of opinion received.

Cuba health system [Tuesday 1 August]

Dr Ana Maria Fuentes, talks to John Harris in Jaruco

Oxfam watched with great interest Newsnight's comprehensive piece on the Cuban government's commitment to providing free and high quality health care in the country. To support Oxfam's health care workers and teachers campaign, Oxfam will release a report on 1 September which gives combines strong analysis and excellent examples of rich and poor countries provision of public services around the world. It also outlines what governments of the North and South need to do to reach the Millennium Development Goals and address chronic inequalities of access to public services in poor countries. To assess government performance, Oxfam has devised an Essential Services Index. This ranks countries in four social areas - child survival rates, schooling, access to safe water, and access to sanitation - and compares their performance with per capita national income. The comparison shows that some governments have consistently punched above their weight. Sri Lanka is one of the world's poorest countries, yet its maternal mortality rates are among the lowest in the world. When a woman gives birth, there is a 96 per cent chance she will be attended by a qualified midwife. If she or her family need medical treatment, it is available free of charge from a public clinic within walking distance of her home, staffed by a qualified nurse. Her children can go to primary school free, and education for girls is free up to university level.

Sri Lanka has 60 per cent less income per capita than Kazakhstan, but a child in Sri Lanka is nearly five times more likely to survive its first five years than a child in Kazakhstan and is far more likely to go to school, drink clean water, and have the use of a latrine.

Building strong public services for all is hardly a new idea: it is the foundation upon which the UK and other rich country societies are built. In the twenty first century, it is a scandal that anyone lives without these most basic of human rights of clean water and free health care and education. Newsnight's exciting new series puts the importance of these basic public services, taken advantage of by some but a luxury to others, at the center of the development debate.
Nicky Wimble, Oxfam GB

It's a real shame that the whole story never gets told when journalists report from Cuba
Sanchez Manning
I am married to a Cuban lady and we live half and half between England and Cuba. While it is true that the report only shows what the Cuban government would like us to see, it is not right to dismiss completely the claims made. Compared to other Latin American countries Cuba has a good standard of healthcare. It also beats the UK and other first-world countries in some respects, while failing in others. For example, my wife was amazed that when she went to a doctor here they told her it would take several weeks to get the results of some blood tests, and two months for her smear test. She was told she would have to wait nine weeks for an ultrasound appointment. In Cuba she can walk into the clinic at the end of the street where she will be seen immediately. All tests including ultrasound are done there and then, normally with the results given within a day. The NHS simply cannot compete with this. Cuba has far more personnel resources than we do here, particularly working in first-line treatment and disease prevention. However, what it lacks are often the most basic medicines such as simple painkillers and antibiotics. Hospital wards are not as clean as they are here and there are many instances of people dying from infections after routine surgery, simply through lack of amoxicillin or whatever.

The Cuban government traditionally blames the lack of medicines on the embargo, but the reality is that the economy does not have enough money to buy what it needs on the international market. Anything produced locally is generally available, and Cuba does produce some world-leading medicines, but every time we go out there we take a few thousand Ibuprofen and similar tablets with us. On the one hand Cuba suffers from the common problem of a lot of third-world or developing nations who cannot afford the high prices charged by international drug companies, but on the other it desperately needs to reform its political system to create opportunity of building real wealth for its people and society.
Keith Johnson, Isleworth, UK and Las Tunas, Cuba

I was in Cuba in January and found it to be more socialist in regime than communist (as do many of its inhabitants). I liked the report on the health-care last night on Newsnight. Perhaps those keen to see US influence on the island should also be made aware of Cuba's free education system, free housing system, and lack of drug and racism problems. These horn-honking Cuban Americans in Florida worry me deeply. Keep showing the other side of this "repressive" regime.
Elaine Peeling, Cambs

RE: Keeping Cuba Healthy. Is this for real? Did your correspondent bother to talk to ANY Cubans who live outside Cuba? Maybe he should have before reporting on this subject. While I agree that preventive medicine should play a role in healthcare, Cuba's system is definitely not one that any part of the world should emulate.
Laura Bhat, Chicago

I hate to say this because I have a lot of respect for Newsnight, but the report you just ran on Cuba did not tell the real story. Last year I conducted extensive research into the medical system - below the government's radar - and much of what I uncovered directly contradicts your report. For instance, although the Cuban health system is still very good, many Cubans are increasingly unhappy with the standard of service they are receiving from the large numbers of "student" Venezuelan doctors practising in Cuban hospitals. During my time in Cuba I heard numerous stories of people who had received shoddy treatment from inexperienced Venezuelan doctors - including some Cubans who believe their relatives had died prematurely as a result.

Also, just from my own experience of living in Havana I can tell you that old people are not as well looked after as your film suggested. Yes they are given enough sustenance to keep them alive, but I often saw elderly people so thin that it was quite disturbing. And as far as most Cuban's having a balanced diet goes - this just is not true. People may not be starving in Cuba but in the cities in particular where food is more expensive and less available, the government rations are no where near enough to keep people going. This is why a lot of Cubans have to try to make extra money any way can just to feed themselves and their families. However, in doing this they are taking a serious risk because they are acting outside government restrictions. I am well aware of difficulties of reporting the real situation in Cuba because of the government's control of the media. But it's still a real shame that the whole story never gets told when journalists report from Cuba. In a way I'd rather no reports about Cuba at all than a misleading half truth. Sanchez Manning
Sanchez Manning, London

Nothing in Cuba's health service is in any way superior to what is available on the NHS
Eric Potts
Why does Newsnight continue to get inappropriate people to make films about politics? Having music journalist John Harris make a film about healthcare in Cuba (two subjects in which he is not a specialist) is not very illuminating and devalues Newsnight's reporting. You should reserve him for Review and get proper journalists to cover important subjects.
Matt, London

Your programme on Cuban health is just propoganda on behalf of a communist dictatorship. Nothing in Cuba's health service shown on tonight's programme is in any way superior to what is available on The NHS in the UK. A lot of pretentious nonsense put out by people who do not have the least idea how to differentiate propaganda about and the truth of a political situation. Pathetic, time wasting nonsense on our licence fee.
Eric Potts, Co Durham

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