Bookmarkers beware: Bookmarks to pages other than the home page may not work after we change our server in April Editor's Choice | This Week in BMJ | Press releases BMJ No 7130 Volume 316 News Saturday 14 February 1998 Cuba shows health gains despite embargo Recent official statistics from Cuba's ministry of public health show significant gains in some important health status indicators despite the trade embargo imposed by the United States. Infant mortality in Cuba by the end of 1997 had reached an all time low of 7.2 per 1,000 live births, compared with 7.9 in 1996. Cuba now ranks among the 25 countries in the world with the lowest infant mortality. A reduction has also been observed in maternal mortality, which fell from 23.5 per 100,000 live births in 1996 to 22.0 in 1997. In addition, in 1997 several diseases, such as congenital syphilis, meningitis, tetanus, and typhoid fever, reached their lowest rates ever. These significant advances happen at a time of continuing restrictions in food and medicines as a consequence of the embargo imposed by the United States. In 1989 Cuba entered into a "special period" of limited spending on health and social services after the collapse of the socialist bloc. Infant mortality in Cuba has reached an all time low Photo: JONATHAN PILE/IMPACT These restrictions became even more stringent after the US blockade expanded in 1996. To cope with this situation the Cuban government implemented a series of reforms, keeping health and education as priority areas. A 1997 report from the American Association for World Health, which conducted a study of the effects of the embargo on the health of Cubans, stated: "A humanitarian catastrophe has been averted only because the Cuban government has maintained a high level of budgetary support for a health care system designed to deliver primary and preventive health care to all of its citizens. Cuba still has an infant mortality rate half that of the city of Washington, DC. Even so, the US embargo of food and the de facto embargo on medical supplies has wreaked havoc with the island's model primary health care system." As a result of the blockade, more than 300 medicines and basic medical supplies are currently lacking in Cuba, as well as some laboratory, surgical, and radiography materials. The number of laboratory tests carried out in the 273 hospitals throughout the country declined by 45% from 1990 to 1993, while the number of x ray examinations also fell by 70% during the same period. Surgery is currently carried out only in selected cases, and there are severe limitations on ambulance services and biomedical research. Lack of soap is associated with epidemics of pediculosis and scabies, which reached their peak in 1994. For most of the population only the most basic foodstuffs are available and these are in short supply. Nutritional deficits were responsible for an epidemic of optical neuropathy that by 1993 had temporarily blinded over 50,000 Cubans. Cesar Chelala New York Home | Current issue | Past issues | Classified ads | Career Focus | Feedback Collections | About this site | About the BMJ | BMA | Medline