Education And Debate

Letter from Cuba: Cuba: plenty of care, few condoms, no corruption

BMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.7010.935 (Published 07 October 1995) Cite this as: BMJ 1995;311:935
  1. Hans Veeken, public health consultanta
  1. aMedecins Sans Frontieres, PO Box 1001, 1001 EA Amsterdam, Netherlands

    The health system in Cuba guarantees accessibility to the entire population, is free of charge, and covers the spectrum from vaccinations to sophisticated interventions. The results are impressive: Cuba's health figures are on a par with developed countries that have 20 times the budget. The country is experiencing a difficult period because of the collapse and loss of support from the Soviet Union; over 30 years' trade embargo by the United States; and the gradual change from a centrally planned economy towards more of a free market system. Shortages are experienced in every sector, and maintaining health care services at the current level is too expensive. Doctors and nurses continue to work towards the goal of health for all Cubans, even though their salaries are minimal. Signs of negligence or corruption, often seen in other socialist countries where incentives for output are lacking, are unknown. Topics such as family planning and AIDS deserve immediate attention.

    “Cubans were the first ‘medicos sin fronteras,'” the government representative answers with a smile when we introduce ourselves at the Ministry of Health. “We have always exported doctors to places where they are needed; at one time there were 5000 Cuban doctors abroad. No, doctors we are not short of, but we could use some help with drugs and supplies. The recent economic crisis makes it difficult to buy them and health should remain a priority for our people. Our system guarantees total accessibility, is free of charge, and covers the whole spectrum from vaccination to heart transplantation,” he continues. “We started with 6000 doctors after the revolution; 3000 of them immediately left for the States. Now we have 60000 doctors, one for each 200 inhabitants,” he says proudly.

    Care in Cuba

    Each year around 4000 students start their medical training at 23 different universities. The Cuban health …

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