Latin American Network Information Center - LANIC

-DATE-
19820314
-YEAR-
1982
-DOCUMENT_TYPE-
SPEECH
-AUTHOR-
F. CASTRO
-HEADLINE-
ADDRESSES MEDICAL STUDENTS
-PLACE-
HAVANA'S KARL MARX THEATER
-SOURCE-
HAVANA DOMESTIC TV
-REPORT_NBR-
FBIS
-REPORT_DATE-
19820330
-TEXT-
FIDEL CASTRO ADDRESSES MEDICAL STUDENTS

FL160315 Havana Domestic Television Service in Spanish 2007 GMT 14 Mar 82

[Speech by Cuban President Fidel Castro to the first contingent of the
Carlos J. Finlay Medical Sciences Detachment established during a ceremony
at Havana's Karl Marx Theater on 12 March--recorded]

[Text] Comrades, we were all a bit impatient for this moment to arrive, the
establishment of the first Carlos J. Finlay Medical Sciences Detachment
which is taking place precisely this 12 March, on the eve of the glorious
anniversary of the attack on the Presidential Palace, a heroic page in
history written by our students. We had first thought of establishing the
detachment on 13 March, this first detachment. But, since it coincides with
tomorrow's celebrations, we decided to schedule it several hours ahead. But
we did choose this date in honor of 13 March.

We have held many and very important ceremonies in this theater. Many of
them historic, We have met with students many times. Sometimes, when a
detachment is set up. Other times, when the students graduate as was the
case with the pedagogical detachment. Sometimes because they graduated in
the first group, and other times because they graduated in the second
group. At times, the new detachments coincided with the graduation of those
from the first group, the graduation of those from the second group. Of
course, each one of those moments has been filled with a lot of joy, has
meant a great thrill for us.

But I had the feeling that today was going to be a truly special day. Not a
few people have been working hard for whole months to get this result. We
could say thousands--state, party, youth and student cadres--spent a lot of
time and dedication on the task of establishing the detachment. I believe
that never was a selection process preceded by so much dedication, so much
effort. They all gave this task its true importance. The results, the
fruits that this effort will bring to our country...it was not easy to set
up the detachment but it was essential that we do so.

It is a fact that all ideas are preceded by other ideas. The idea preceding
the establishment of this medical sciences detachment was the pedagogical
detachment, which helped the country to solve a very difficult problem when
there was an explosion in the number of middle-level students. We have
spoken of this on other occasions. We recall those days when we faced the
prospect of hundreds of thousands of middle-level students, when there were
the first indications of the results of the revolution's educational
efforts, when there were hundreds of thousands graduating from sixth grade,
when we had only a few hundred of teachers in the universities at the
time--200 or 300. We could say that the teaching vocation had been lost
then. The pedagogical detachment was a movement that arose from our youth
and our students. It came to be a brilliant answer to the need that arose.
Without that effort, without that detachment, we would not have teachers
for our secondary and pre-university schools.

At the time, we still could not say that 100 percent of the teachers had
teaching degrees. There were times when 70 percent had no degrees. The
creation of the detachment generated a great movement toward improvement
and study. The number of students joining the pedagogical detachment rose,
first those with 9th grade, later with 12th grade education. I do not
remember if it was 9th or 10th grade. Afterwards, the ones with 12th grade.

A large number of elementary school teachers also began to study, to become
secondary school teachers. Thanks to them, we now have tens of thousands of
middle-level teachers. We have enough personnel to organize improvement
courses, enough personnel to give internationalist assistance in the area
of education to other countries. Our educational system and our revolution
owes a great deal to the pedagogical detachment. We have bad experience in
this kind of thing.

We were seeing in the area of medical education that it was necessary to
enroll a high number of students because of the country's growing needs
both nationally and internationally. Our youth has always liked a medical
career. It enjoys great social esteem. It has a lot of prestige. It was not
difficult to recruit students for a medical career. The number was high but
the selection was not the best. Since there was a large number of vacancies
for a medical career, there were some students who applied for other
curricula first and listed medicine as their third choice. When they were
not admitted into the other curricula, they enrolled in medicine. Sometimes
students with low academic averages enrolled in medicine. And there is no
doubt that to study medicine you really need vocation, a strong desire to
study medicine, a preference for medicine over any other career. And, of
course, 4,000 enrolled and then they came up against the courses which
required study, dedication. What is known as academic mortality began to
occur. We found that in the first 2 years, sometimes there was a 30 or 40
percent academic mortality rate; a high drop-rate. Of course, the really
good students stayed, those who had a higher average, more will, more
dedication to their work. But, in the end, less than 50 percent of the
students who enrolled in medical school graduated.

Added to this was a growing demand for doctors in our country and outside
our country. This country still has a big demand for doctors. You know that
we have asked doctors to give up the post-duty rest and work the maximum
number of hours. In addition, the doctor is the kind of professional which
we will hardly have too many of. I believe that there can never be too many
doctors. It is logical that each merchant ship has its own doctor. It is
logical that each factory has its own doctor. It is logical that each
school has its own doctor. In fact, in my opinion, it would be logical that
each block had its own doctor. Everyone feels safer when they have a doctor
nearby. Everyone. I bet there is a doctor here tonight. Every time there is
a public ceremony, there are doctors, ambulances, etc. When a delegation
leaves the country, generally, if possible, it takes a doctor along. We
have seen many delegations and whenever possible they travel with a doctor.

So, there will never be too many doctors. But our problem is not just that.
We are a revolutionary country, a country that belongs to the Third World,
a country which increasingly develops relations of cooperation with those
countries of the Third World. Sometimes cooperation is on an economic basis
because they ask to acquire medical services from us. But since they are
very poor countries, they often request assistance in the form of a
donation. That is why our country at present has more than 2,000 health
workers, more than 2,000 doctors, helping in 26 countries. And the demand
grows. Our country has been asked for thousands and thousands of doctors
for one reason or another, and we really cannot meet that growing demand
for doctors.

And there are even some developed countries that need doctors; rich and
developed countries that need doctors. Even the United States, which is
considered the richest country in the world, takes away doctors from other
countries every year. We have the case of many doctors who get their
degrees in Latin American countries who then do not render services in
their own countries and emigrate. Despite this, there are places in those
developed countries--peasant, rural areas--which do not have doctors.
Unfortunately, many African students who study in Paris, London, Portugal,
etc., do not return to their countries.

The need for doctors in the world is enormous, even in developed countries.
Because it is not a matter of the number of doctors only, it is a matter of
the kind of doctor. There were not a few doctors in this country at the
triumph of the revolution. There were around 6,000. Many of them were
unemployed and they emigrated. There was total lack of health care in the
country. Therefore, there were not many job opportunities. Rural medicine
did not exist at all. Most of the doctors were concentrated in the capital.
Of course, there was only one school of medicine, that of Havana, and many
of those students who came to Havana did not want to go back home in any
case. The doctors were concentrated in the capital. Numbers are not enough.
It is the kind of doctor that counts, whether he is a doctor willing to go
to the interior, to go to the rural areas, to go anywhere he is needed. And
I feel that in general the world has not solved that problem. The socialist
countries have. The rest of the world has not. They often do not have the
kind of (?doctor) they need within the country itself, although they might
have doctors living in the capital. But nothing can get them to move to the
interior.

Therefore, the demand for medical services is one of the greatest in the
world and, in addition, one of the most (?felt) because the infant
mortality rates, the rates that reflect the state of health in the world
are terrible. It is hard to think of a science, a profession of which there
is more need in the world today. Our country has really fulfilled glorious
tasks in this field. Of the 6,000 doctors, as you probably have heard, only
3,000 stayed on. The others emigrated. We had to face the task of training
new doctors. Despite this, our country's health index today is the best in
all the Third World--and they are more than 100 countries--and as high as
in any of the developed countries of the world. An indication of this is
the drop in infant mortality rates to less than 19 in the first year of
life. Our achievements are really impressive. It is a source of pride for
our people a and our revolution that our health workers are serving in 26
countries. The growing prestige of our doctors is a source of pride for our
fatherland.

But should we be satisfied, if we are fully conscious that we can give our
people much better medical services? If we are fully conscious that we can
give the most suffering of mankind important medical services? If we are
fully conscious that we can develop medical science? If we are fully
conscious that in the area of tropical medicine, in the area of medicine
and disease affecting most of mankind, we could accumulate as much or even
greater knowledge than any other country of the world? Then, we cannot feel
satisfied with what we have achieved so far.

It is precisely our patriotic consciousness, our socialist consciousness,
our communist consciousness and our internationalist consciousness which
requires the effort that we are making. We summed this up at the health
workers congress in recent months in a single phrase: that our country
could become a medical power. But this is not a matter of human vanity,
chauvinism. It would not be worth our efforts. The purpose would be for our
country to have, first of all, one of the best health services in the
world, Secondly, to give augmented cooperation to other nations. Or, if you
want, we can put it into different terms: to give augmented cooperation in
the area of health to the world and at the same time have one of the best
health services in the world for our people. Because, undoubtedly, if we
become a world power, the first beneficiary will be our own people.

Of course, this requires an enormous effort. The establishment of the
detachment is only part of an enormous effort in all areas. It implies a
great effort in the development of all branches of medicine in our country
without exception. It implies a progressive improvement of all our
country's medical services. It implies a great teaching effort, not only at
the university level but at the post-graduate level, the training of the
specialists. And this is not all; there is even the possibility of advanced
studies for those who could be considered already full-fledged doctors.

An example would be cardiovascular surgery. Many Cubans still have to go
abroad every year because cardiovascular surgery facilities are not
sufficiently developed in our country. And we propose to develop
cardiovascular survery to the utmost. There is a [word indistinct]
percentage of children who are born with certain problems, persons who have
problems--they must be taken care of. Another very important field is
ophthalmology. To the extent that we master the most modern techniques and
study ophthalmology in depth and that we can give service to other
countries, it means that our country will make a great deal of progress in
that branch of medicine. It would mean a great benefit for our people. I
have only cited two examples. I could cite 20, 30.

Medical science is constantly developing as a result of experience,
research, new methods and new techniques. We have to learn those
techniques. It requires a great effort in international relations and
exchanges, so we can find out what country is more advanced in this, what
country is more advanced in that, and have ongoing exchanges just so that
we can assume vanguard positions in each of the branches of medicine.

However, we have an advantage. No other country has the number of doctors
which Cuba has working in the Third World and in such a variety of
countries. Well, Cuba has more doctors working in the Third World than the
World Health Organization. It is logical that we have been able to acquire
a lot of experience in everything related to tropical medicine. And we
already have a tropical medicine institute in full development, and
undoubtedly it will become an important center in the world.

For this reason, I said that a great effort was necessary in many areas to
achieve these objectives. However, it was also necessary to make a great
effort in the teaching area. How were our doctors being trained? If we want
to have vanguard doctors, it is necessary to have a vanguard training,
education and teaching. Of course, the revolution has established the
practice of having teaching be linked to the medical services. Practically
all the main hospitals in the country are teaching hospitals. This helps to
improve medical services, since in each hospital there are university
professors. When a hospital becomes a teaching hospital, then our doctors
are trained with a great link to medical practice.

This is an interesting experience which has helped us, but in this area
there are still many points which can be improved. One of the tasks that
was being done was a meticulous and thorough analysis of everything related
to medical teaching in our country. Thousands of persons participated in
this analysis, thousands of persons. Talks were held with thousands of
doctors and professors. All aspects of medical teaching in our country, all
the problems, all the difficulties were analyzed. This analysis was
recently ended. Now we have to study the study; we have to analyze the
analysis and the conclusions of all the comrades who worked on it. We plan
to benefit greatly from it. This means that we are analyzing everything,
for the purpose of placing medical teaching in our country in first place
and in a vanguard position. This study helps us greatly to see all the
kinds of problems, all kinds: regarding the programs, materials and
situations; the procedure of teaching in hospitals; the care given to
students and how it is carried out; the role of the youths and the role of
the Federation of University Students, and so on; all problems in general,
including the problems of materials, the situation in the laboratories, of
the texts, audio-visual means and so on. This means that from such a study
we will reach many conclusions and many ideas regarding the improvement of
medical teaching.

However, there is a fundamental question: The selections of the students
who are going to study medicine. We began by stating that there were two
activities which had a great importance for society and for the country:
education and health. A teacher and a professor have a great
responsibility. However, a health worker and a doctor have an even greater
responsibility. A doctor deals with human life, human health. A doctor has
the immense, the infinite responsibility of taking care of the lives of
human beings, of a child, of an old person, of a youth, of an adult, of a
woman and of a man, who places himself in the doctor's hands to find relief
from a pain or an illness or to save his life. This is a great
responsibility. It is difficult to find a greater responsibility than that
of a health worker and a doctor. The same is true of those who make the
analyses in laboratories: if he makes a mistake in the analysis, if he does
not make a correct analysis, if the analysis is no good. Despite all the
means which medicine has to fight illnesses, if the necessary quality is
not there, then the diagnosis may be mistaken and the results will be
catastrophic. All the health workers have a great responsibility, but the
responsibility of a doctor is even greater, because he is the one who: has
to guide all the efforts, he has to analyze all factors, he has to make a
diagnosis and he has to act to solve a problem.

Therefore, it is necessary to choose among the best of our students, the
ones having the best qualities--intellectual and academic, political and
moral, yes political and moral [he repeats himself] qualities--to study
medicine. A lumpen cannot be a doctor, neither can a delinquent or a person
capable of committing fraud, capable of deceiving. That is to say to be a
doctor, it is necessary to have an exquisite sensibility, a great human
quality, a great intellectual ability, and an unyielding morality. In this
area no kind of concessions can be made. If we say that the university is
for the revolutionaries, then the medical student must be especially
revolutionary, because if it were not so then society could not put its
sons, its relatives, its citizens in his hands. This was a basic idea in
the question of the training of the detachment. We wanted to make a good
selection. If we have not made a good selection or if we do not make a good
selection, then we have failed.

We believe we have made a good selection, but it was not easy to make a
good selection. And do you know why it was not easy? Not because there were
many bad students, but on the contrary, because there were many, many good
students with magnificent qualities. It is difficult to choose a number of
students among many good students. That was the situation we experienced.

In the first place, as a beginning after the appeal to form the detachment,
many students volunteered themselves, demonstrating again the attitude of
our students and their spirit. In our judgment, this is true of our youths.
In our judgment, they are in the vanguard in the revolutionary struggle,
for our satisfaction, fulfilling the desire that the new generation be more
revolutionary than the past generation. The students gave the expected
response, and 14,271 out of 40,979 pre-university students volunteered to
join. And we had to choose less than 4,000, to choose 3,800, around 3,800
students.

You all know the process. The first necessary requirement was made:
academic standing and record, average grades. This was a necessary
requirement. We had to begin to choose out of the 14,271, which is more
than one-third of the total of pre-university students. Meetings were
organized in the classrooms, meetings to evaluate the political and moral
qualities, and of course to evaluate the academic qualities also. Of these
14,000, 6,000 were not recommended for the simple reason that they had less
than a 90-point average grade. We began by excluding those students who had
an average grade of less than 90 points. There were around 6,000 such
students. For other reasons around 900, about 982 students were excluded.
The comrades in each classroom themselves evaluated the students in the
meetings.

A more democratic method cannot have been chosen, because not one student
has been chosen at random, not one. The students evaluated their classroom
comrades. Now, the majority of those not evaluated, I mean not
recommended--they were evaluated but not recommended--was because they had
an average grade of less than 90. In this manner, 90 became the minimum
limit to enter the detachment. For other reasons 982 were excluded.

After the evaluation process came the individual interviews. Thousands of
doctors in the country participated in the individual interviews to analyze
the vocation and the qualities of each student. In this way, of the 6,640
students accepted, who passed the past process--I mean of the 7,289
recommended students who had to pass the interview and analysis, 411 were
not chosen. The majority of them were not chosen because of a lack of
vocation or because of bad political training. In this manner, 6,640
remained who passed all the tests, and of them we had to choose 3,807, that
is practically half still had to be chosen. Therefore, it was the record,
exclusively the academic standing which determined the selection. You must
understand that in those more than 3,000 cases, around (?3,000) who were
not chosen, there were great students, very good students with a very good
record and with very good political and moral qualities to be a doctor. We
have chosen 3,807 out of 6,640 who had all the necessary requirements.
However, it was necessary to consider one element, and that was the
academic standing. The detachment was chosen in this manner.

However, I still have to explain one point which had an important role in
the selection. Perhaps it was the point which caused us the most trouble,
which made us think more, which concerned us most. This was a situation,
which is the following: there is a majority of girls in the pre-university
schools, in the first place. In the second place, there is a majority of
girls who prefer, who have a vocation for medicine and prefer medicine. And
in the third place, girls usually have a better record than boys. When we
saw the good records of these 6,640, we found a phenomenon which is quite
worrisome: which was that sticking exclusively to the numbers, 67 percent
were women and 33 percent were men. This was the first great surprise. This
problem was thoroughly examined.

It was not a matter of training doctors only for our country. I say
sincerely that if it had been a matter of only this, we would have been
happy with the 67 percent and the 33 percent. However, it was a matter of
the training of doctors, not only with our needs in mind, but also with
international cooperation in mind. We need doctors for the armed forces,
and we need doctors for international cooperation. It is not that women
will not participate in international cooperation, but in truth, it was
worrisome that about 70 percent of the doctors compared with 30 percent
would be women. This was greatly analyzed, greatly analyzed and we reached
the conclusion that the ideal would be that there be a more or less equal
proportion of women and men.

Taking into account all the objectives which our country's medicine has in
mind, we reached that conclusion. Therefore, the principle of absolute
equality was not adopted among the students who were to be chosen. It was
necessary to establish quotas, because if we stuck only to the records,
then the women were in the majority, This is good on one hand, if we
consider that a majority of the students at the higher level are women, and
if we analyze the role which women are achieving in our society. It was
decided to establish a quota to select the 3,807 of the 6,640, and this was
a quota of 55 percent women and 45 percent men. In this manner women were
still in the majority with around 20 percent more. Don't go by the numbers
of 45 to 55, Figure it out correctly. This means that there are around 20
percent more women. The quota was like this: to try to be the most just
possible within realities which could not be ignored, within the needs of
all the objectives of our medicine, to seek more or less an equal
proportion of men and women in medicine. For example, let us look how the
proportion of doctors who are men and women is in some countries. In
Czechoslovakia 58 percent are men and 42 women; in Sweden 80 percent are
men, 20 percent are women; in Japan 90 percent are men and 10 percent
women, in the FRG 79 percent are men; in Poland 52 percent; in England 80
percent; and in Yugoslavia 65 percent. At present in Cuba it is 64 percent
men and 36 percent women.

I think that these measures we have adopted will tend to make equal in the
future the number of men and women. The ideal, even, would be to send
married couples who are doctors to fulfill internationalist missions,
However, I do not become involved in this. [laughter] I only say [shouts of
"tell us"]..I only say that this would be the ideal thing. But we do not
become involved in this. I only say that an equal proportion is necessary.

Of course there is the fact that women have obligations and tasks, above
all related to the family and children, which men do not have. That is
because they have the task of human reproduction, a very fundamental role.
Experience shows that they have greater difficulties in determining their
tasks. And for this reason we thought it would be more convenient to have a
more or less equal number of women and men students.

Now we are going to follow closely, we are going to investigate how girls
study in the university, how the boys study, how the women doctors
work--women doctors I guess you call them, it is probably necessary to
clear this up also--how the men doctors work. I have already heard said
that there is a better doctor-patient relationship with women doctors. We
have heard this. We must continue to study all this. But there arise a
greater number of major problems, because as you all know despite the
family code, when a child becomes ill, and so on, it is the mother who
takes care of him, and when the maternity period begins, the man doctor
continues to work and the woman doctor goes to the hospital. This is a
reality. And our revolution consists in helping to make inequalities
disappear. For this reason we have even proposed that women should have
privileges--to call them something--which will help them to have equal
conditions.

Now you are saying 55 and 45, that means that out of the 3,000--I'm looking
for the numbers that are around here somewhere--1,963 women were chosen and
1,604 men were chosen. But now there is a masculine reinforcement by means
of those who leave military service--as you know many comrades finish their
secondary education and go to serve in the armed forces.

The principle of giving an opportunity to those youths to enter the
university was also established. Others entered directly because they had
good records, others fulfilled their military duties. It seemed to us that
it was highly appropriate to give a second chance to study to those youths
who complete military service. We believe that it is unobjectionably just,
above all, for those who demonstrate having an interest, vocation, will,
behavior, that is why there are 200 openings reserved for youths who
completed their service in the revolutionary armed forces
ministry--MINFAR--who are males, because women are not included in the
military draft law--a small privilege. I know that they protest, but they
serve in the militia, above all in the territorial troops militia. Not only
is there a large number of women in the territorial troops but they are
younger than some of the militia members because the others are in the
regular units. Some of the men get tired, not the women. But there is
reason for that, they are 20 or even 25 years younger. [laughter]

So that there are reinforcements which we estimate to be 200, the comrades
are present here. They are going to take a 3-month refresher course, in
physics, chemistry and Spanish, [laughter] very important subjects in order
to become good doctors. They are going to begin to study now. There are 200
openings. There may be a few more or may be a few less, depending on how
they learn, but they are good comrades, of good reputation. They have all
the moral and political qualities. They have established excellent military
conduct. They are young and desire to study medicine. As a result they have
their quota here. Now according to the way in which they study, pay
attention in class and distinguish themselves, they will attain their
place. All 400 are here. At least half will enter the detachment. They are
going to receive good support and good discipline.

There are also a number of openings for the workers. We have established
the right of the workers to be able to study. But in the field of medicine,
which is not like engineering or other fields, there will be some
prerequisites established. There will also be the opportunity to enter the
detachment from the ranks of the health workers. But this will have some
limitations. These limitations will not be established this year but will
be established next year. Some limitations such as age which up to now is
34 or 35 years of age and still appears to me to be too old to begin the
study of medicine, considering 6 years in studies and then the
specialization. It would not occur to us to sent a 35-year-old man to cadet
school, because by the time he graduates he would not be able to go to war,
[laughter] because he would lack the energy for it. We must establish a
limit and the limit is going to be 25 years of age, not including this
year, because this year there are workers who have already devoted their
efforts and we are not going to stop them. Of course [after that] those
older than 25 will not be able to enter the detachment.

Twenty-five will be the age limit for entering the detachment. This
requirement has been established. Now, it will not just be any worker. We
are going to establish the steps leading to the study of medicine. For
whom? For those who one day decided they wanted to become doctors and just
because of that they want to be doctors? There must be some limitations, it
cannot be avoided. Beginning with the next course, enrollment in the school
of medicine will be limited to intermediate level medical technicians. They
have the right. After graduation as medical technicians, and after 2 years
at the working level--and the same as those completing military
service--entrants must pass a prerequisite examination. Because there is a
question in which we cannot compromise, and that is academic level. We
cannot compromise this in the very least. That is why we must test all
discharged servicemen. And beginning this year, workers who want to fill an
opening must test. And these openings will be limited to I repeat,
intermediate level medical technicians in the future. After graduation
after 2 years at the working level and after passing a prerequisite
examination, we believe this to be the proper manner of entry and it will
be adhered to.

We cannot confuse medicine with sports or baseball. Almost anyone may play
softball at the age of 50 and may even get a hit and a run--they say the
base paths are shorter. But medicine is not a sport or a hobby. It is the
most sacred of all professions. We cannot play with it. As a result, in the
future, enrollment in medical school will be limited to very outstanding
students or as discharged veterans of military service after passing the
examination or as intermediate level medical technicians, who first of all,
have the political and moral qualities, the required academic level, have
passed the prerequisite examination and are not older than 25. Those will
be the requirements for entry into medical studies. And we hope that you
all understand that if we want to accomplish a responsible and quality job,
it cannot be any other way. And of course, political and moral qualities
and academic level cannot be compromised in the least.

This is a good route for the medical technicians, because it still gives an
opportunity to some of these students who have a real obsession to become a
doctor, who scored higher than 90 but were still lower than others who were
accepted. There are some girls who scored up to 92 in some provinces and
they are not in the detachment. But now, say there is a girl that has the
desire to be a doctor anyway, and she was not selected to enter the
detachment, but has the political moral qualities, academic standing, she
has a way. She can become an intermediate level medical technician, such as
nurse or any other intermediate level medical technician. It could be done
in 2 years. At this time they enter from the ninth grade but we are hopeful
that in the future intermediate level medical technicians may enter from
the 12th grade and instead of studying 3 years, they could do it in 2
years, We hope for that, because they already have that preuniversity
level, they can become intermediate level medical technicians in 2 years.
We are as a rule considering this. This girl can, after graduation, work
for 2 years, take the examination, and would then have a way to enter the
detachment.

Yes, there is an opportunity for the many young people who were not able to
enter the detachment. There is an opportunity and whoever has a true
calling and wants to, can take advantage of it and gain entry into the
detachment later. These were the principles which were followed. Now, no
one, absolutely no one, among these 3,800 students was picked at random.
Strict and rigorous rules were imposed and they were met. And we understand
that the requirements were high because there were many very good students
with a real calling who were not able to enter the detachment. However,
these people still have an opportunity to enter through the route of
becoming intermediate level medical technicians.

As a result of applying these rules, we have the average of the students
accepted for the detachment. And not one has an average less than 90
percent. The women's academic average was 92.51 percent. As a matter of
fact in some provinces the average was higher and in others less. The men's
average was 91.5 percent. There may be a student with 80.5 or 90.4 percent.
We are talking about the average. Not one score was lower than 90 percent
whether man or woman. But the average of the women was 92.51 percent and
the men 91.05 percent. This simply means that despite the fact that there
are 1,983 women and 1,604 men, the selection has been better with the
women. This means that, from the point of view of the academic level, it
would not be unusual that in the future, if the men do not make a better
effort, women will be better doctors than the men. We felt it important to
make this explanation, that you may pass it on to your comrade students and
explain all of the rules used to select entrants for the detachment.

I can tell you that we may feel very pleased, really pleased with the
quality of the young people gathered here to make up the detachment. I am
even going to say that I believe that a better job has never been
accomplished. And in this we must give special acknowledgement to our
communist youth, to the FEEM [Federation of Secondary School Students], to
the FEU [Federation of University Students], to the Ministry of Public
Health, to the Ministry of Education, to the Ministry of Higher Education,
to the health sectors of the people's government, and to all those who
worked in this process to make it a very responsible task of extraordinary
quality. And you see what can be done.

This year, because it is the first year, and the idea of the detachment is
relatively new, it was made up of 12th grade students. But the next
detachment will be made up of 11th grade students. In other words we will
begin selection for the next detachment this year. The selection and
evaluation will be made. And the detachment will be formed before the end
of the year, because one of the objectives of the detachment is to begin to
work with the selectees, begin to familiarize them as much as possible with
the studies they are going to be involved in and work with them. And that
is why we must select them from the 11th grade. That is, to begin to select
them from the 11th grade and form the detachment in the first quarter of
the year. That is what we propose to do for next year.

What can be done has been demonstrated here with the pioneers. What Luis
Orlando Dominguez was explaining to me is that the pioneers already have a
vocational movement toward public health work where some 30,000 pioneers
are involved. Imagine, we begin to develop the work with the pioneers and
then we select them in the 11th grade. It is fabulous what can be done in
this area for the objectives which we seek. The vocational activities which
the pioneers are engaged in are important too, because perhaps from this
experience in medicine we may learn and obtain useful ideas of how the
selection of university students should be carried out. And fortunately, we
believe that we have real success in the way in which we have formed the
detachment and in the potential offered by the work we have accomplished.
We are very optimistic at this time.

As a result of this we naturally expect that the academic retention rate
will increase considerably, and that the 40 percent failure rate will not
repeat itself. Now it is very important to follow closely the
implementation of everything. What is the retention and promotion rate per
year? It has been improving in the last few years but still needs to be
improved. Without a doubt it has not been easy to get into the detachment.
When 14,000 applied and 3,807 have been selected, it is a great honor for
any young person to have been accepted for entrance into the detachment.
But of course, it is no small thing to enter the detachment, it is a hard
task. To be a member of the detachment, be promoted and become a doctor is
a hard task, because the detachment will have its rules. And they are not
even going to have the same rules as the rest of the students. The rules
will be more stringent for the student of the medical sciences detachment.

I understand that all the activities are important and all the careers are
important. Because if a comrade is an agronomist and he makes an error it
could be that the harvest will be less and affect the economy of the
country, but if a doctor makes a mistake then we have a loss of life or we
could have a loss of life.

We are very interested in our veterinarians. I believe it would be tragic
to receive the news that Ubre Blanca [famous milk-producing cow] has died
from poor veterinary care. [laughter] It would be tragic, wouldn't it, if
our great champion [cow] should die. If our doctor should make a mistake a
human being would die and because of that we must make greater demands from
medical students. Can we allow any fraud from a medical student? Is there
anyone among you that would allow a loved one to be treated by a doctor who
has committed some fraud as a medical student? We would not allow it. Of
course, in these matters we must be mare demanding. We would not dream that
any student charged with fraud would be allowed to return to the study of
medicine.

We are going to ask for more discipline and make more demands from the
detachment's medical students. We will demand complete dedication to their
studies. This does not mean that they cannot attend a party, participate in
sports or not be happy young people. That is not our [words indistinct] to
their obligation. Yes, their studies and obligations must be above all
other things. That is the intent and I want to tell you tonight that we are
going to be demanding with the detachment. And that demand, that discipline
and that performance must be given at the level of the selection made and
at the level of the detachment's prestige. Ah, you will be wearing a
uniform. You saw it around there at the entrance. [negative response] You
did not see it? [negative response] They told me there was a photograph. If
you did not see it, I saw it. I saw the uniforms twice. We took a poll with
the students, considered the colors, the type of uniform and all the
problems.

It is not going to be a short-skirted uniform. It is a well-selected
uniform. It was very well selected. I am not saying that it was not. But
this is a different type of uniform. It includes in the first place, the
doctor's robe is not very long. Don't be afraid about the robe. It is
beautiful, elegant, has its pockets, and has everything. It is made of
polyester, so it will be crease-resistant. [applause] Look at the way
things are: we made a survey, [in English] a survey--looks like my English
is not very good. [laughter] Then the members of the detachment wanted to
have a uniform. The advanced students said no. So I said to the advanced
students, who told you you would have uniforms? Nobody. [laughter] No one
thought about that. They did not want it because I don't know if they feel
like they are almost doctors already. [laughter] So they do not want it.

But really no one thought about the current students. The idea about
uniforms came about because we remembered that the pedagogic detachment had
a uniform. Therefore the detachment will be the only uniformed university
students. But without a doubt it will be an advantage. It is an advantage.
What I would not want is for you to go to a party wearing the uniform.
[laughter] Or for you to go to the movies in uniform, eh? When you get to
your homes, you change clothes. But it does make it easier for the [upkeep
of the] student's clothing. We believe that the robe will be the basic
distinguishing characteristic. We talked about whether some emblem should
be placed here, etc. After much deliberation we decided that with the
problems of sewing it, dying it, washing it, all of that, the emblem was
not necessary. It would detract from the elegance of the uniform. It has no
emblem because the emblem is the uniform itself. For a time we also
considered whether to put some hash mark or something that would indicate
the year. We decided against that as well. We are not going to make any
distinction between the first, second, third [years) etc.

Don't think we didn't do this rationally. You may trust all of us who have
worked on all this, that we have thoroughly studied the problem. There will
be no insignia or hash marks. [laughter] Now, you cannot deny that this
flag, for example, is not a beautiful flag. Do you agree or not? [positive
response] It has yellow signifying medicine and the red signifying
internationalism. [applause] The robe is white. The pants or the skirts are
the same color as those of the pedagogic detachment, dark blue. It is a
beautiful color, one of the most beautiful of all the uniforms we have
made. Very well. The girls may choose between wearing pants or a skirt.
[applause] The same flexibility as the nurses. So that you already have the
polyester robe, the skirt or the pants for the women and the pants for the
men. The men have no choice about wearing skirts. [laughter] There will not
be ties. Ties are for the parties. One problem remained. What to do when it
got cold. That was the problem. What to do?

Many taxed their heads in order to resolve that problem. Well if we also
provide a jacket--as it is the robe has been sized--the jacket would have
to be longer than the robe. [laughter] Then if the person wore the jacket
over the robe, while practicing medical sciences he would have no robe
because it would be under the jacket. [laughter] If the robe were over the
jacket then the student would appear fatter. That was a very difficult
problem to resolve. Then the idea of a pull-over [in English] emerged.
Someone got the idea of a pull-over [laughter and applause] and it appears
that the pull-over was about to become the style. Then [the question arose]
short-sleeves or long-sleeves? They would say, well if it has short-sleeves
it will not protect one from the cold. If it has long-sleeves they said
they would look. like baseball players. [laughter]

We had to see it being worn; the color of the pull-over, many colors were
tried, etc. Then a light blue color was chosen for the pull-over.
[applause] It has long-sleeves and it really looks very elegant. And it is
a high collar pull-over; [applause] a high collar which is really very
elegant. And it is a heavy pull-over to protect one from the cold if in
fact it is cold. [laughter and applause]

Don't think that this was chosen by one or two persons. There was a wide
representation of students, of the detachment, of the youths, of the FEEM,
of the FEU, of the Institute of Domestic Demand, of the garment industry,
and also of a lot of comrades experienced in these matters, such as Comrade
Fernandez, Comrade Machado, Comrade Pedro Miret, Comrade Sergio Del Valle,
there were many comrades experienced, "very experienced"--in quotes,
[laughter] thank you very much--in these questions. [applause]. There were
many more people. There was a select jury looking at all the pros and cons
of everything. Of course, it was clear that we could not do the exhibition
here, because among other things we did not have the material. It still has
to be made. The material there was, was used to make some models. But we
saw what we wanted to see. We chose the uniform using wide, practical and
rational criteria.

I still have not talked to you about the shoes [laughter], the
moccasin-type shoes. [laughter] Look, it is more a platform shoe. [applause
and laughter] These are the ideas, and of course all the comrades of the
light industry, all those who have to deal with this are working in order
to achieve that when the course begins you will have your uniforms already.
Really, it will fit beautifully, I'm sure. Now you can picture it with your
imaginations, when you are dressed in your uniforms. You will find them
very beautiful. It is a study uniform, a work uniform. It is practical. It
does not require you to use your house clothes or your street clothes to go
to the hospital or to go to school. And when you go out, please you have to
take it off [laughter], because it is not for going to the movies or for
going to parties. You understand. Then are going to give you, we hope, four
robes the first year--they are white and will get a little bit more
soiled--and three uniforms. Any girl can choose one skirt and two pairs of
pants, or two pants and one skirt, or three skirts, or three pairs of
pants. [applause] You all choose. There will not be long or short stockings
for the uniform. We made a small survey and asked several girls, and they
said that they would choose two pairs of pants and one skirt. [laughter] It
looks as if this criterium has been quite analyzed. But the uniform is
flexible and very practical.

Therefore, after this there will be an additional handing over of uniforms.
I believe you all have grown now and will not grow much more [laughter],
perhaps two millimeters more at 17, 18 and 19 years of age. Don't gain too
much weight [laughter], because it will be a problem. We will have to
prohibit the detachment members from gaining too much weight, because we do
not have a solution to the problem. [laughter] You can lose weight because
it is easier to narrow the skirts than to make them wider, or the same is
true for pants. [laughter]

We want the uniformed detachment to be known, distinguished, honored and
respected. And this will depend a great deal on the prestige which you
achieve.

I want to say that we have difficulties with the materials for the
faculties. The country is building faculties of medical sciences in all
provinces, and some lie [word indistinct] have the equivalent of two.
Holguin will have two, so will Villa Clara, Havana will have from six to
eight in proportion to the population, but every province will have a
faculty of around 1,500. Work is being done, despite our economic limits;
the country is doing a great effort in the construction of the university
faculties. Some of them are still to be built, but progress is being made.
Therefore, in a realistic manner we must realize that the facilities and
the material circumstances are not the most favorable, in the lodgings
especially. You will all have to be prepared for the conditions you are
going to find, which I repeat are not the best, but you will be certain
that work is being done intensively to create the best conditions of work
for the medical sciences detachments.

You must be aware that there are material limitations of different kinds,
which include books, facilities, laboratories and so on. We propose
precisely, taking into account the study that has been done on all the
problems, to work to solve all these problems, beginning of course with
textbooks. We will find a solution. Regarding the facilities, the
audio-visual means and the laboratories, we propose that you have the best
conditions for studying. This does not mean that we will have this the
first year. However, I want you to know that we are planning to do the
greatest effort to solve all the problems regarding facilities for study,
especially regarding all related to the textbooks and laboratories, but
also the construction of lodgings, and so on.

However, you must be aware of the fact that we have material limitations,
and we cannot wait to have all the conditions established to undertake this
teaching effort. Think you will be doctors within 6 years; you will be
doctors in 1988. That means that this is a long-term project which the
country has to undertake. The benefits of this detachment will begin to be
seen after 1990. I believe that the new generations will be seen in 1990,
2000, 2025 and 2030. I believe that with you, we will have doctors for a
long time. Therefore, it is an effort for the future.

We are planning to have you be doctors with a very solid and wide
foundation, independent of the specialities. This is topic related to the
studies on the teaching aspect, in which there is still a lot to be
analyzed and discussed in order to achieve the objective of having doctors
with a wide foundation, who have solid knowledge, independent of the
specialities. However, we are thinking of a future in which even the
general doctor should be a specialist. There is talk of specialists in
surgery, ophthalmology, and so on and so on, yet the general doctor has a
very important role. A general doctor is not regarded as a specialist. We
are analyzing the idea of regarding the general doctor as a specialist,
whose specialty requires the levels and training of a general doctor. He
can also do his residency. We are hoping that everyone will have a wide and
solid knowledge, and will also have his specialty. I think that one of the
most important doctors is the general practitioner, yet he is not
considered a specialist. A specialist is considered to be one who did his
residency in some area or other. There are many ideas regarding this which
still have to be developed and completed.

We propose to have you graduate as first class doctors, in the areas of
science, politics and morality.

However, we did not resign ourselves only to the idea of organizing this
detachment. We thought a lot about the present medical students and the
importance for the country of the present medical students. There are
around 17,000 students of medicine and dentistry. A long time before you
all become doctors, they will have already spent years providing their
services. Naturally, there was in this case a natural selection, the person
who did not have a good record, who did not have the determination, who was
not devoted to study was left behind. We have a large number of medical
students at present. We have the news that those in the first years are of
even better ability and that those who remained in last years have great
ability. [applause] The ones who are in the 6th, 5th and 4th year have
passed the test, the difficulties of several kinds and problems with the
texts. The best remained logically.

In the most recent years it is said that as a group they are the students
with the highest grades. Now, you are entering these studies. I believe
that the detachment will be an emulation, it will create an emulation with
the present students, with the frontline students, with the Mario Muniz
frontline students. I believe that an emulation with the present doctors
will also be created. I believe that all this policy that is being
implemented in the training and medical teaching will encourage the present
doctors to study and do better themselves. Sometimes we regret that we did
not have the idea of forming this detachment before. We should have done it
before. Of course, the country could not have done this in the beginning.
In reality, it is now much easier than when the revolution was victorious.
For example, there are doctors who graduated during the years of the
revolution. There are 16,017, without counting the ones who are going to
graduate this year, which are about 1,000. In the beginning of the
revolution there were not even secondary schools for medical sciences. A
great effort was made in 1962 when the Institute of Medical Sciences, of
basic sciences, was established. The victory of Giron school in 1962. Those
were the days before the October crisis. Progress was made. The moment was
reached in 1964 when we were graduating more than 1,000 doctors. Then came
a period when the lack of secondary schools made it necessary to reorganize
with other university faculties. For this reason in 1968 only 569 doctors
graduated; in 1969 only 683. Less than 1,000 graduated every year until
1981.

We hope that this will now be a difinite policy. The revolution is
gathering the benefits of its educational efforts. Today we have been able
to select in this detachment among more than 40,000 students of the 12th
grade. We could not even dream about this in other times. This is the
result of the efforts made in education, in the medium-level schools, the
secondary schools, the pre-university schools, and of the work of our
professors and of the teaching detachment. Now we are reaping the benefits.
Perhaps we would have been able to do this 2 or 3 years before, but we have
done it now at the opportune time, making the most of these advantages
which we have today, which we could not even have dreamed about before. To
ask for volunteers to study medicine and to have 14,000 volunteer students
of 40,000 is a great success, and has enabled us to choose the quality
which we can show in this detachment.

The present medical students are numerous already. It is to be supposed
that this year about 1,000 medical students will graduate. Next year, in
1983, around 2,000 will graduate, in 1984 there will be a slight decrease,
less than 2,000 will graduate. However, in 1985, 1986, 1987 more than 2,000
will graduate every year. Now we will have to see in 1988 what percentage
of the students of the detachment will graduate as doctors. The results of
our efforts and of our efficiency will be demonstrated by that percentage.
Around 4,300. Between 4,300 and 4,500 will enter the first year to study
medicine and dentistry, including some foreign scholarship students.

Now we have to follow closely the emulation of the faculties of the
different provinces, the graduations, the behavior of the persons leaving
military service whose discipline and devotion to duty we have faith in.
The behavior of those who enter from the ranks of workers will interest us
every year. How many entered, how many passed the 1st, 2d and 3d year, how
many graduated? It is to be supposed that when this detachment graduates we
will be graduating every year more than 3,000 doctors. That is to say that
as many doctors as imperialism left us here will graduate every year. We
hope that on that date more will be entering medical studies when the
faculties which are presently being built are finished.

I'm trying to recall if I have forgotten something. We have practically
discussed everything. It seems to me that I am interpreting the feelings of
all the comrades here present in the presidency of this ceremony and of all
the revolutionary comrades if I tell you that we are satisfied at this
time, we are optimistic, we have faith in you. The news of the creation of
the detachment was received with happiness by the people. It was received
with happiness by the [word indistinct], by everyone. It is a fact which
awakened many hopes in our people and in all our revolutionary comrades.
For the revolution the most sacred thing is the health of the people, the
life and well-being of the citizens. The revolution is proud of what it has
done for our compatriots, for the successes achieved in public health,
because we have seen what can be achieved. See how the life expectancy on
being born is already 72 years in our time. We are at the level of the
developed and wealthy countries in this sense. How much more can we do? It
is not easy to reduce infant mortality when you are at the level of less
than 19, but we have to struggle to continue reducing it. Who knows what
science can do to increase life expectancy still?

However, the most important thing is not that, it is not to prevent a child
from dying. It is very important to prevent this, but it is not just a
matter of prolonging life, but that the years you live will be years of
well-being and health for the human being, of confidence, of security and
of tranquility. The first thing a doctor causes is tranquility for all
citizens even if they are healthy because they feel secured, they see the
doctor as a life insurance, as a health insurance for them and their
children, for their relatives and for all.

Someone said that it was not a matter of adding years to life but of adding
more life to the years. That is going to depend to a great extent on our
doctors.

Our education today is considered as one of the biggest achievements of any
nation. The same is said about our public health. They are taken as models
for the Third World. And yet, we can do much more and we shall do much more
along these lines. We can be useful to mankind in many ways and in many
fields, but there is no field in which we can be more useful than the
medical field.

The members of the Mario Munoz student vanguard demonstrated during the
epidemic last year that they could help the people, they demonstrated their
class. And I can remember those days when the pediatric hospitals were
full. The hospitals were full of sick people. I remember the gratitude with
which the relatives spoke of the students' work and what a great
contribution they made to the victory over the disease, We can not only do
a lot for mankind, we can do a lot for our own people in this field.

And, I repeat, I am convinced that we cannot help mankind more than in the
field of medicine. Yesterday we were talking to our friends, our brothers
from the Republic of Guinea-Bissau. A group of our doctors work over there,
around 30 doctors. Guinea-Bissau has nearly 1 million inhabitants. They
only have 11 doctors; eleven Guinean doctors. There are Cuban doctors,
doctors from other friendly countries and the total number of doctors is
104. I asked them what was the infant mortality rate. They told me 200 for
each 1,000 during the first year of life. They told me 400 from birth to
age 5. You can see what colonialism left behind in those countries. Eleven
doctors! And 200 children dying before age 1 and almost 50 percent before
age 5. I think these figures will give you an idea of the great
revolutionary value, the great human value the development of medicine has.
Countries are asking for our help, they desperately ask for our help in
this field. In Nicaragua, where 200 Cuban doctors work, the Nicaraguan
comrades are asking us for 100 more. They want them now. More than
agronomists, civilian engineers, what the countries are asking for, and it
is only logical, are doctors, above all.

That is why we need that kind of doctor that you described in your oath: a
doctor ready to fulfill any mission, anywhere. The imperialists do not
quite understand how Cuba can develop such broad relationships and how it
can give the help it does. The explanation is that we have the human
resources. We have the men and women capable of undertaking these missions.
Before, we did not have doctors willing to go into the Escambray or Sierra
Maestra or Baracoa. In fact, not even Holguin, much less Baracoa, or Santa
Clara or Ciego de Avila. Today we have doctors who go to Vietnam,
Kampuchea, Laos, Yemen, Ethiopia, Mozambique, Angola, Sao Tome, Congo,
Guinea-Bissau, Guyana, Grenada, Nicaragua--anywhere. It is really a source
of pride for any nation to be able to say that it can count on this kind of
men and women, [applause] like our teachers, construction workers,
combatants, like our armed forces, always ready for any mission wherever
they are sent without the least hesitation. It is a source of pride for our
people. I am sure that it has to be a source of pride for you, to feel part
of this nation, children of this nation, participants of this struggle,
this history, to know that you among these people are called upon to become
the vanguard, the standard bearers of this revolutionary and
internationalist spirit. [applause]

Several years of revolution have passed. There have been many ceremonies,
many contacts with the masses. You know that we do not tell lies or employ
demagogy--ever. We do say what we see and it is impossible not to feel joy,
optimism, great satisfaction when our fatherland can organize and deposit
its entire trust on a group of young people such as you are. I know that a
real representation of the best young people, the best students in our
country are present here today, young people of great caliber in all areas.

When we began there were only a few, We were only a handful in 1952. Men
with optimism, good faith, willing to wage the struggle. We spent time in
prison, we fought. We were few at the beginning yet, the will, readiness,
confidence in the people of that handful of men demonstrated that we could
go far. We have reached this day. We are no longer a handful. We are
gathered here with thousands of young people of your caliber. I feel that
we can achieve whatever we set out to do. We can attain any goal, because,
when a nation can count on youth such as you, nothing is impossible. We
leave today's ceremony with the conviction that our fatherland will become
a real medical power at the service of our people and mankind. Thank you.
Fatherland or death, we shall win! [applause]
-END-


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