-DATE- 19821203 -YEAR- 1982 -DOCUMENT_TYPE- SPEECH -AUTHOR- F. CASTRO -HEADLINE- INAUGURATION OF THE CENTRO HABANA HOSPITAL -PLACE- HAVANA -SOURCE- HAVANA DOMESTIC SVC -REPORT_NBR- FBIS -REPORT_DATE- 19821207 -TEXT- CASTRO INAUGURATES CENTRO HABANA HOSPITAL FL040015 Havana Domestic Service in Spanish 2244 GMT 3 Dec 82 [Speech by President Fidel Castro at the inauguration of the Centro Habana Hospital in Havana -- live] [Text] Distinguished guests, doctors, health workers in general, construction workers, students, neighbors of Centro Habana whom I imagine are also represented here [applause], countrymen: We all recall the hundreds of times when we passed by the Malecon Boulevard -- most people at one time or another have passed by Malecon, so me people just walked around here, others passed by San Lazaro. We have always seen a building under construction here. This building is an inheritance. We inherited this building at the time of the victory of the revolution. A building for the national bank was being built. If we go back many years, we will recall that the famous Beneficencia [Catholic Church asylum for abandoned children] was located here. That is no longer here. I do not know if this is good or bad. I am saying this in an architectural sense, not in a social sense. Perhaps if the Beneficencia had remained here a few more years, the National Commission of Historic Monuments would have said: This cannot be touched, this cannot be touched. [laughs] Well at that time there was no National Commission of Historic Monuments -- which has a very important responsibility -- so our historic Beneficencia disappeared. The building was demolished. Some business deal was probably made, because in those days no project or building was ever built without making a deal. A decision had been made to build a bank here. When the revolution triumphed, the building was on its foundations, perhaps the first or second floor. Just think of those days when all construction was in the hands of private companies, and many of these companies were owned by the tycoons in government. Therefore, practically all of the construction work came to a stop. There was unemployment. The workers applied pressure to continue constructing this building. The truth is that the government did not leave any money behind but it was indeed building a bank. The construction of the building continued for some years. The building was already 14 or 16 stories high. The construction work then stopped because there were other projects with a higher priority. At one time even the scaffolds of the building caught on fire. That is, for many years we have seen the construction of this building which was going to be a bank, but me day we pandered if building a bank was really a priority. Although the project was designed for a bank, we decided to talk to the architects and engineers and ask them about the possibility of converting this project into a hospital in view of the need for a hospital in this area and Havana in general. They took on this task with great responsibility. It was not easy. We must say here that the first big credit goes to the engineers and architects who adapted the project to a hospital. Work then began on the new project. It is more complex to work on a building which has to be remodeled, in a remodeled project. Many changes had to be made. The work was slow. The idea was, above all, to preserve the quality of the building, to build a hospital of high quality. This is why the workers have been working for years. The building required all kinds of materials. For example, the rocks. Jaimanita rocks which cover the outside of the building had already been used in some parts of the building and were part of the original project. These rocks must be handled one by one. This construction, due to the complexity of the project and the materials needed, required time. It also required financial resources, It required foreign currency. It was not possible to assign all the resources needed at one time. It was necessary to assign resources every year delaying the completion but preventing it from coming to a stop. It was then necessary to purchase the necessary medical equipment and finally install it. This is the history of the construction of this hospital which we are now looking at as a finished building. I want to take this opportunity to talk about the great responsibility and headaches which our director Raul Gomez Cabrera is going to have to run this hospital. This is serious business. We can look at and appreciate this building from the outside but we have to look what the building is like from the inside. We do not want people to tell the director the day after tomorrow that the hospital is not working after it was inaugurated on 3 December. A hospital does not begin to operate from one day to the next. The hospital began to operate with the outpatient clinic, the clinic of specialties. This is exactly where you are all located, on the roof of the out-patient clinic. This began to operate a few months ago. The operation of a hospital requires at least a year, that is, a complete program must be fulfilled. An inauguration had to take place on 3 December when the outpatient clinic was already operating along with five other clinics in Centro Habana and Old Havana. In January, other clinics will be operating, other sections of the hospital will begin to operate and this will continue in February and March. In March 1983, the intensive therapy section will start operating. In April, bed use in the clinical services will be increased by 60 percent. In July, the nephrology, hematology, burn center and endocrinology services will begin to operate. In September, the emergency service and 80 percent of the beds will be operational. By October 1983, we are already planning to put into operation the cardiovascular surgery section. In November and December 1983, 1 year from today, we will have the hospital in full operation. It is impossible to get this giant going in just 1 week. If we want to do it correctly, we have to do it little by little. So area residents should not be impatient. If it has taken us years to build, we can well wait 1 year to get it going at full capacity. This is a special institution, this hospital does not look like or will ever look like the rest of the hospitals in the country. Its functions are, primarily, to provide services. That is, it will offer services of the highest quality, at a level of the best in the world. This is going to be its fundamental function, an essential function, excellent services. But this hospital is going to provide many other services. It is going to be a model, a development center of medical technology, a resource center -- as the chief of the pathology department explained to me. When a puzzling, complicated case comes up anywhere, in Baracoa, in Santiago de Cuba, in Holguin, anywhere in the country, then we will have a committee here made up of not only the best specialists in the hospital, but in the province, to analyze, to offer an opinion, so this hospital will become a center for providing services to all other hospitals in the country. It will be a center of consultation for all the hospitals in the country. But, it will also be a center of education, a training hospital, different from most of the other hospitals. All our hospitals train students. This hospital will be a training center in two senses. Interns from the school of medicine will not study here. We will only have graduate students. There will be two types of training. One will be highly specialized training. What does highly specialized training mean? That means that specialists from any part of the country will come here, specialists from Baracoa, Guantanamo, Sagua, Mayari, Santiago de Cuba, any province, to gain experience in new medical techniques, in new medical equipment, in new medical procedures. This means we will have to continue to build. An important building must be added to this hospital. That building will have more areas for laboratories, more areas for repair shops, libraries, information, and also areas for those physicians coming from the interior of the country to train for a period of months. That way they will have areas where they will reside during that time. It will be a center of higher medical training for the entire country. It will train in topics, professional knowledge, general knowledge, international circles of study for specific topics. National and foreign specialists will be able to participate in the various courses of training that will be offered here. Some of those courses will probably begin immediately, others later on. This hospital will also have resident physicians to train graduate students as specialists. There will be residences in all clinical-surgical and diagnostic specialties. Thus, this center will become a university of higher medical studies. The hospital will also offer scientific degrees taught by center physicians and from other units of the national health system. This center will also do research work, will participate in the research branch work of the Public Health Ministry, will cooperatively participate in scientific research work of research institutes, will conduct exclusive research work, will conduct joint research work with international scientific groups. The scientific projects generated by the institution's personnel, before being published or before being submitted to national or international events, will have to be approved by the institution's scientific committee for the purpose of meeting methodological requirements. Scientific research work conducted here will be given preferential attention. The hospital's resources are 950 beds in 300 rooms; of these, 18 with one bed, 88 with two beds, 20 with three beds and 174 with four beds. They are magnificent rooms. I am sure that this is so, at least from what I have seen and I do not recall ever seeing a hotel better than this hospital, in all senses. The beauty, the finishing touches, the details, the view which is impressive, the Malecon Boulevard and the sea. From those windows you can see the sea at your feet. Because it is 24 floors high, it has a very impressive view. These are rooms with fewer people. These conditions are more humane for the ill. The hospital will have 30 specialized services. I will not read them all because they are many. Moreover, there will be six consulting specialties, such as genetics, immunology and so forth. The hospital has three intensive multipurpose care units for burn cases and an emergency section with 20 beds. It has 25 operating rooms, 17 rooms for major surgery and 8 for minor surgery and endoscopy. These rooms have excellent equipment, the best in the world. It also has 50 rooms for doctor offices for the care of 1,500 patients a day. It also has 17 x-ray units and emergency rooms with a capacity for 800 patients a day. As Dr Gomez Cabrera said, the hospital has a very advanced technological equipment. For example, it has computerized axial tomography to provide service nationwide, This is a new equipment introduced in Cuba. It is expensive. It costs more than $1 million. It is very complex and very effective, capable of locating problems no matter how small. Of course, this is the most modern equipment of its kind in the world. This equipment does not miss anything, this equipment is combined with the ultrasonic diagnosis, another very modern piece of equipment which does not use the x-ray pictures, an equipment which examines the body using a different technique. The hospital also has nuclear medicine diagnosis, a high technology for ophthalmology, modern equipment for physiotherapy, microsurgery for different surgical specialities, modern equipment for intensive care therapy. In the near future, the hospital will also have automatic and computerized equipment in the laboratories, immunological radio tests, fast diagnosis using microbiology, clinical immunology and enzymology, clinical genetics, electronic microscopy, immunochemistry. Some of these words are so unfamiliar to you as they are to us, with the exception of those who understand them like the doctors, technicians and perhaps some students in the detachment -- not the detachment but the vanguard, because those students of the detachment are beginning just now. They are still not familiar with these technical names, names which reflect the enormous progress made by medical science in the last few years. This is the equipment of the hospital. New equipment will be added constantly in accordance with developments. I would like to stress the quality of this equipment. If one visits the ophthalmology department, one sees so much equipment, what precision, what perfection, what effectiveness. We have never seen this equipment in our country before, not even in our dreams. It can be so beneficial to our population. There is also something else to which we have given a great deal of attention, even more attention than to the equipment. It is the personnel who are going to work in this hospital. This hospital has become a large center of employment, one of the largest in our capital. It will have more than 2,000 workers. It may even have 2,300 or 2,400 workers, even more. It will depend on the situation. A thorough study is being conducted about the personnel, about the specialists because we hope that the personnel working here will be highly capable. We want to save. If we can avoid having 3,000 workers we should. Three thousand workers means more dining areas, more food, a greater use of elevators. If we can operate with 2,500 workers, that is fine, but the hospital will certainly have the necessary workers to operate at an optimum level and will be kept at an optimum level. The final number of workers has not yet been decided. It will be decided after we learn from experience and after the hospital is operating at full capacity. This is a large center of employment which helps in providing jobs for our population at a time when we read that the world is suffering from growing unemployment. In Havana we have a problem in reverse. Many times we do not have enough people to fill many vacancies. Of the total workers in the hospital, approximately 15 percent will be professionals and, of these professionals, 18 percent will not be physicians but engineers, biologists, microbiologists, biochemists, chemists, cybernetics specialists, psychologists and so forth. This equipment needs many engineers for maintenance. This kind of hospital no longer requires only physicians but also needs a large number of professionals who are not physicians to operate all this sophisticated equipment. Everyone in these special services has a chief. There is also a chief on every floor. The operating rooms have chiefs. The intensive care units also have chiefs. Every specialty also has chiefs and there are 30 special services. The comrades in the ministry have done their best in choosing the specialists of greater prestige and authority, of greater experience and knowledge to put them in charge of every one of these specialities. It would be unfair to say that the best are here because there are very important institutes and hospitals in the country which have very good and capable specialists. But, it must be said that the chiefs of these services are among the best specialists in the country. [applause] The rest of the medical personnel was or will be selected in competitions. The continued incorporation of a higher and more complex technology into the field of medicine makes it necessary for an increase in the number of nonmedical professionals. That is, the personnel supporting the specialized services also has to be selected. The policy observed in the competitions has been the search for young personnel with talent, political integration and personal merits. That is what we are looking for in these competitions for the selection of the rest of the medical personnel. The part in the selection of the physicians and the rest of the personnel in which the party has had an active participation has been the search for quality. It was very satisfactory for us to find that among the nurses some are already university graduates, licensed in nursing, a professional recently created in our country. [applause] To give you a clearer idea of the quality of the medical personnel in this hospital, we can say that in its payroll this hospital has 12 percent of the doctors in medical sciences in the country. That is the highest degree, doctor in medical sciences. It has 12 percent of all the doctors in medical sciences. Ninety eight percent of the chiefs of services have achieved the category of professors. They are professors. Population to be cared for: The residents of Centro Habana [applause] -- apparently most people here reside in Centro Habana -- and old Havana [applause]. A total of 270,000 will be privileged users of this institution. Approximately 30,000 residents in the Cerro Municipality who are being cared for by the (Van Troi) polyclinic will also be users of this hospital. This hospital will care for the users of a total of nine polyclinics. But they are not the only privileged users. The Centro Habana clinical-surgical hospital will also be a national hospital. [applause] It will accept cases sent from the most remote corner of the country which, because to the characteristics of the pathology, requires the use of the institutions' diagnostic or therapeutic equipment. For this service, the hospital will assign 15 percent of its capacity, that is, approximately 145 beds. The equipment which we called computerized axial tomography, commonly called Somaton because it is the patented name... [leaves thought unfinished]. Dr (Valls), chief of that service and an extraordinary enthusiast of these techniques and of the ultrasonic diagnostic techniques, explained to me the plans to organize the use of the equipment in three shifts so that it will offer its services to the entire country whenever it becomes necessary. [applause] Of course, we also plan to have this equipment in the eastern and central areas of the country, as we have stated before. This is not the kind of equipment that can be installed in every polyclinic of every hospital, not only because it is very expensive but because it is unnecessary, it is useless. It is only needed in certain areas for those cases which require specialized service. But we will have it in the central and eastern areas. In the meantime this equipment will offer its services to the entire country in three shifts. All emergency cases will be cared for at the hospital's emergency room, no matter the place of origin. Thus, you must know that even though this hospital will offer its services to this area of the city and its 300,000 residents, its services will be offered to the entire country in many spheres, among them as a vanguard center, a resource center, a center of technological development in health services with its research work and training programs for physicians. The entire country will benefit from this institution. Some of the construction characteristics of the hospital will give you an idea of the complexity of the project. I will simply say that it has a total of 75,500 square meters of construction. The land has been used very well because of the height of the building. The approximate value of this project is 60 million pesos and more equipment will have to be added. It has been built with tiles, marble, Jaimanitas limestone and so forth. Let me give you another idea of the size of this hospital. It has five transformers of 1,500 kw each with an electrical capacity of 7,500 kw. For example, the building having the most electrical capacity was the Habana Libre Hotel with 3,500 kw. This hospital more than doubles the electrical capacity of the Habana Libre. It also has three emergency power plants with a capacity of 2,600 kw. The entire hospital is air conditioned. It will not have to depend on the cool breeze of Malecon Boulevard. It also has four 650-ton turbo generators for a total of 2,600 tons, including three 750-hp boilers. The laundry department has a capacity for processing six tons of clothes a day. The kitchen has the capacity to produce 3,000 rations. It has 17 refrigeration chambers in addition to many sterilization equipment. I am only giving a few figures. It also has an auditorium with 342 seats, a conference room with 100 seats and 17 classrooms for 17 students each. It has a distribution system of gases for medical use, such as oxygen, nitrous oxide and compressed air, with 5,000 outlets. It has a telephone central with 600 extensions and 80 main lines. It has 50 direct telephone lines and 25 public telephones. It also has soft cold and hot water. In other words, it has everything. The hospital will also operate under a computerized system. It will have two (SI-310) machines, peripherics with 32 displays. Initially, the hospital will operate with 40 programs which will permit the automation of the hospital activities, such as registrations, discharges, transfers and so forth, as well as patient information, diet, blood donations and urgent laboratory tests. This first step, although modest, is already an important step forward because any world-level institution must move forward quickly. The system will be developed in stages with an administrative section, medicine requisitions, other means of diagnosis, scientific-technical information and automation of clinical history. A clinical history will be kept on an experimental basis for outpatients who come to see a doctor. Work will be carried out in connection with the Academy of Sciences and the Public Health Ministry -- Minsap -- information center in order to provide information to professional personnel by using bibliographical data. There are other possibilities being considered for the future. One is to provide greater support to the health areas by increasing the number of specialists in the clinics, supporting research work in clinics during afternoon and evening hours, and starting night services without being disappointed by an initial low response. We believe that we must wait for some time to educate the people. There will be a need to create in the pathological anatomy department a national reference center, a bank for organs and tissues for transplants, to develop eye and kidney transplants, an area of application of traditional medicine. Work is being conducted with the Academy of Sciences and the Minsap science and technology directorate. The new technological equipment arriving in the country should be used in a particular area so that the experience gained can be used in other parts of the country. These are the characteristics of the hospital we are inaugurating. I have not attempted to describe it. It is not possible to describe this hospital, it must be seen personally, or perhaps on television to really have an idea of what it is. Whatever is said about it is a poor description of the image, the impression or the idea of this center. The lobby is really something to see. Apparently the original project has something to do with this. It is a great hall. I believe it was designed for a stock market center. This is what it was built for because it is an extraordinary hall. This is the lobby of the hospital in addition to the lobby of the polyclinic which is adjacent to it. We have talked so much about the equipment and the personnel, which is unquestionably good, very good, as will be that to be chosen in the future. The maintenance of this hospital is serious business, very serious. This is one of the things which have a high priority. For example, it has two elevators. These elevators cannot stop running. The 25 operating rooms with all their equipment, the ultra modern equipment in the operating rooms and in all other areas require thousands of spare parts, small parts of all kinds. I talked with the comrade who was designated chief of maintenance on the need to develop a good shop with good lathe operators to produce many spare parts. There will certainly be a need to have a flexible mechanism. As you know, we sometimes have problems for getting spare parts due to the long distances and the U.S. blockade. Very flexible mechanisms will be needed in order for this marvelous hospital which we are going to put into operation to be kept in good shape -- its equipment, power plants, air conditioning, its distribution system of medicinal gases. In short, in order for this hospital to operate like a clock, it will require special attention from the ministry and state within the scope of our limitations in indispensable resources. We accomplish nothing by inaugurating a marvelous center today and in 5, 6 or 7 years have it deteriorate and most of its equipment remain without use. This will be one of the great responsibilities of the hospital's administration and of the chiefs of services and chiefs of maintenance and all workers in general. Of course, this hospital will require special attention from the state and party so that it may fulfill its functions. I believe we are celebrating this anniversary of Finlay's birthday and this day of Latin American medicine, not only with the inauguration of this hospital but with a bright future in the field of health. In the city of Havana itself, the plans for a future hospital network provide for the reopening of the Julio Trigo Hospital in a not too distant future. This will give us hundreds of more beds. Later on there are plans for building two new clinical-surgical hospitals which will be located in the municipalities of Marianao and Habana del Este. These units [applause] will contribute to the health system approximately 1,700 beds and a better distribution of this resource in the province. This will represent a 10 percent increase in the total number of beds, and at the same time will raise the number of beds per 1,000 inhabitants. You all know that we are making an important and serious effort in the field of medical training, a great effort. I do not want to use exaggerated terms, but we could justly mention that there has been an extraordinary effort in the field of medical training. During 1982 a great thrust has been given to the idea of guaranteeing the training of physicians and dentists at a more rapid pace while at the same time raising the quality. Some salient aspects in this sense are the following: The construction projects of the faculties of medical sciences are being accelerated to guarantee that during this 5-year period all those scheduled projects are completed. They are 18 faculties of medicine. The Carlos J. Finlay medical detachment was created. Some 500 of its members are somewhere around here. [applause] The Mario Munoz Student Vanguard [applause], the Manuel Piti Fajardo Rural Contingent [applause] and a foreign internship in Nicaragua [applause] and a smaller one in the Sahara [applause] were also created. Adjustments to the current study plan in the schools of medicine and stomatology have been incorporated, among them those referring to a greater bond between the student and patient, such as the practice of familiarization and modifications to the internship. Training has been incorporated in municipal, rural and local hospitals, polyclinics and even in other countries, as I said, where the conditions for it are adequate, such as Nicaragua where 106 physicians have already graduated and the Saharan Democratic Arab Republic where 8 graduated, assisted by a valuable team of Cuban specialists working there. Because anywhere you find a good specialist, there is a good professor. [applause] This constitutes a great innovation in the field of medical training. We could add it is a great revolution in the field of medical training. In this case our country is privileged to be in a vanguard position. Who would have believed that? A municipal hospital transformed into a training hospital. In the old days when we talked about a training hospital, it had to be superior to this and there was nothing like this. It is not that these hospitals can be transformed into training hospitals for all specialties. Many of those hospitals care for children. They can be transformed into pediatrics training hospitals. Others specialized in the problems of pregnancies, childbirths. They can be transformed into obstetrics training hospitals. They could not be training centers in surgery. The same is the case with a rural hospital. It could be a training center in a new speciality. One which we propose to create is the general medicine speciality. This is interesting, It is very important for the people, the fact that a municipal hospital would become a training hospital. Because then its specialists will be first class and they will also be professors and, at a rural hospital, the specialists will be first class and will also be professors, because teaching increases the quality of medical assistance due to the level of knowledge that the specialists and professors require and due to the level of achievement and study that is demanded. When we talk about a new speciality such as general medicine, what do we mean by that? I means that until now, a general practitioner studied 6 years and did not continue any more systematic studies or began a specialty and didn't complete it. Therefore, he is a general practitioner. But no sir. We will also make general medicine a speciality that demands 3 years of residency in a hospital in addition to the 6 years of university study. [applause] In other words, this means that we are marching toward a medical training, toward a future in which all doctors will be specialists including the general practitioner. [applause] All this is a true revolution in teaching, bad students [words indistinct] and good students. It is no longer the case of the worst student who gets sent to Ocujan of Turquino, Baracoa or any other hospital. The best students, the ones with the best disposition, go there, graduate and spend 3 years there. In addition, they can begin studying their speciality there, any specialty they want to study: It can be pediatrics, obstetrics or general medicine. This opens a wide field for the medical students and the doctors and a great possibility for improvement. This also results in a direct and invaluable benefit for medical services. We are working very hard in an effort to perfect study plans. Therefore, we are gathering the information on positive experiences of the main world centers in the training of doctors and stomatologists. We are collecting data on plans and programs and methods and teaching techniques for training, as well as the way to procure textbooks and other types of scientific literature and the application of new technologies. We are gathering all the information needed to draft a new plan of study adjusted to our country's specific conditions in line with the health policy outlined for the future. We are working to improve the quality of the specialists and to comply with the plan to train 5,000 during the 5-year period. We are drafting a program to begin the speciality on general medicine as we were saying, beginning with the 1983-84 term. We've held meetings to ask for volunteers among specialists and residents to go to the country's interior in order to support training plans and strengthen medical assistance. The results of this process evidenced the extraordinary disposition of our doctors, who gave a massive and positive response to this call. [applause] Because after all, none of this would have been possible: this hospital or all these training plans. Nothing would have been possible without the attitude of our health workers and without the attitude of our doctors. [applause] On a day like today, we must proudly recognize the extraordinary attitude of our doctors. We were talking with some visitors and some health leaders from other countries. They ask us: How do you manage? To us it is very simple, but very difficult to understand for others, especially abroad. We happen to manage because of our people's revolutionary spirit, [applause] political awareness and the revolutionary spirit and awareness of our doctors within our people. [applause] To us this is a very simple explanation, but perhaps we don't even realize what this means, especially if we recall that in the past it was very difficult to find a doctor who wanted to go to the rural area and if we recall that there wasn't a single doctor in the Sierra Maestra, with 300,000 inhabitants. And now our specialists just ask: Where do we have to go? I am no longer referring to a young graduate, a specialist or a resident who is completing his residency or who is done with it. They ask, where do we have to go, because they are willing to go to Baracoa, Maisi, Ocujal or any other municipality in the country, anywhere. Five years.. [change thought] and they have responded massively. This doesn't mean that we are going to send them all. We'll send a small portion. Our people have to recognize what this means. I also believe that our people, wherever these residents or doctors are sent, must do everything possible to solve their material problems, particularly the housing problems because you have to have spirit. A revolution is not only made up projects and large buildings like this one. The work of a revolution is also and above all formed of spiritual and moral works. As an example we have our doctors, teachers, technicians and internationalist fighters. [applause] Two thousand teachers have just returned from Nicaragua for a vacation. You should see the conditions in which they carry out their work there! Very difficult, truly difficult conditions. Look for the most inaccessible and difficult place in Cuba, and it will not even be a pale comparison of the conditions in which those teachers work, risking their lives, with substandard food and a total lack of comforts. What spirit. it is very rare for one of them to desert; it is very rare that one changes his mind. And what admiration is felt for those teacher! In the past there were no teachers to send to our rural areas. Today there are teachers who go to Angola, Mozambique, Ethiopia and Nicaragua. And what about the doctors! They are in the most far-off and remote places of the world with great humbleness and commitment. It could be said that a revolution is comprised above all of moral works, and those moral works [applause] carried out by the revolution, created by the revolution, are gigantic; and we see it in this response by our doctors, without whom we could not even dream about what we are talking about. And we expect even more from the detachment. [applause] In September, a total of 2,124 comrades joined the sixth course of the medical internship. They were distributed in the following way: 456 joined the priority specialities, since we have deficits in some specialities; 135 to anesthesiology; 189 to orthopedics; 30 to pathology; 126 to gynecology and obstetrics; 66 to basic sciences; 200 to Nicaragua; 262 to rural medicine; 342 to municipal hospitals; 266 to the general children's hospital; 404 to the general adult hospital; and 194 to rotating work. [all figures as heard] As we said, the first group of 106 interns already graduated in 1982, And they are currently working as rural doctors. This is possible because we have many good doctors and specialists in Nicaragua who are the professors of these interns. When these interns end their studies, if they join the medical services for 2 years, we have hopes that they can devote at least 1 of those years to the beginning of their specialization, whatever it is, including general medicine. Our country has 117 rural and local hospitals serving a population of 2,211,196 people, with a total of 3,427 beds and 350 doctors. [all figures as heard] Conditions for teaching have been created in 96 of these centers. A special program has been drafted, and in the next few days a meeting will be held with all the 262 interns in this sector. They will leave in the first few days of January for their respective centers, where they will stay the rest of the course and where they will subsequently provide medical service for 3 years. In other words, those of the the sixth year were not immediately sent. They have had 3 months of intense rotating preparation, and a meeting was held to explain to them all the problems of the rural areas and the medicine in rural areas. They will then take up internships alongside the doctors and specialists who are serving there. These interns will make up the Manuel Pit Fajardo contingent. At the present time there are intern students at 35 municipal hospitals, with a total of 4,835 beds and 835 doctors. There are 342 interns at these hospitals, distributed as follows: Rotating work, 326; children's general, 11; and adult general, 5. A structure similar to that used in Nicaragua was also applied at these hospitals, with the intern participating in activities at hospitals and polyclinics. A group of specialists has been sent to these centers and support is provided through the respective schools of medicine. This has considerably increased the scientific and assistance levels. This represents a revolution at the municipal hospitals; this injection of young and enthusiastic forces and the creation of the opportunity for a doctor at Isla de Pinos [as heard] or in any municipality in the country to become a professor. We have already talked about the Carlos Finlay detachment. We currently have 4,162 students enrolled in the first year of medical sciences, and 307 in stomatology, which gives us a total of 4,469. Of this figure, 4,124 are members of the detachment: 1,184 are male and there are 2,240 female. The remaining 345 students include foreign students, those enrolled with special permission and workers over 25 years of age who have already been studying. In the future, it will be set up so that workers' enrollments will be primarily for middle-level health technicians who are not over 25 years of age. We had cases where people up to 35 years of age were enrolling in the school of medicine. This isn't much, but it is a bit. By the time they have accumulated a fair amount of experience, some time has gone by. Well, we would all like to study medicine, but they won't let us, they limit us. We have to be self-taught. In the future, this will be one of the guidelines: Enrollment in the detachment of middle-level health technicians. They will have to study and pass their examinations, because we cannot lower the required academic level by a single iota. There are also cases of students who did not pass a course due to health reasons and who then return. If such cases meet the conditions and requirements, they will enter the detachment. We have a lot of students in medical school this academic year. We have 17,306 medical students at this time, 2,371 in stomatology and 540 studying nursing. This is a new career for male and female nurses. We mentioned this earlier. This amounts to a general total of 20,217 students in medical sciences, which is not bad. The second contingent of medical sciences will have a total of about 4,700. You are very much aware of the rigor and meticulousness with which the students of the Carlos J. Finlay Medical Sciences Detachment are being selected. This is a guarantee for the future. Between 1982 and 1990, we will graduate approximately 20,000 new doctors, about 20,000 in 8 years. [applause] We will do so with increasing demands and rigor. Our health indicators continue to improve. Infant mortality in the country in 1981 was 18.5 per 1,000 born alive and it is estimated that in 1982 it will be 17.4. [applause] In the city of Havana in 1981, infant mortality was 15.9, and it is expected that it will be 13.8 in 1982. [applause] No underdeveloped country, no Third World country has indicators anywhere near as good. We are in the very first place. We have a total of 46,169 medical assistance beds, equivalent to 4.7 per 1,000 inhabitants. In the city of Havana, there are 17,367, equivalent to 9 per 1,000 inhabitants. It must be taken into account that many patients from other provinces are treated in the capital. Nevertheless, services in the rest of the country will continue to be rapidly developed. In 1981, there were almost 50 million medical consultations and 10,512,170 stomatological consultations. Life expectancy at birth in the 1980-1985 period is estimated to be 73.5 years. These indexes place us not only in first place among all Third World countries, but at a level above many developed countries, as well. [applause] However, we not only benefit from these successes and victories but we also know how to share them with our brothers of the underdeveloped countries. Working abroad in those countries we have 1,400 doctors, 52 dentists, 560 nurses, 469 technicians and 32 health workers in other categories for a total of 2,513. [applause] They are in 26 Third World countries, in very faraway countries like Kampuchea, Laos, Vietnam, Yemen, etc. When we were talking with friends of a country which has previously given us their cooperation in the medical field, we were explaining how the cooperation and aid that Cuba receives in this field is multiplied in dozens of other countries of the Third World. What we achieve is not only for us. Those 26 countries are benefiting from our progress, knowledge and experience. This number of countries could increase in the future because we are going to have a lot of good doctors. Our scientific advances, particularly in the tropical area, [sentence as heard] Diseases abound in the tropic; in hot climates; in Latin America, Asia, Africa, the underdeveloped countries. Where hunger and poverty exist there are countless diseases. Imagine that there are countries where every year 250 out of each 1,000 children born die; 250 die. I already said that our rate here is 18.5 and even less is estimated; I think it is 17.4 for 1982. The health situation of so many friendly countries is unbelievable and indescribable. Our situation in this field will benefit many peoples. I have made a summary here. I have not mentioned everything that we are doing in the health field. I have only mentioned a part. We are doing many more things. We are doing research. We are working to develop the pharmaceutical industry; to develop optics; to solve the problems of the frames, glass, glasses; to learn how to produce in our country the glass. Meanwhile, we have programs to grind glass, to import it unground. We plan to review the situation in dentistry. Research is being carried out which is useful for our country and other countries. We are developing the medical research centers. We are also developing biology from which many solutions for medicine can emerge. We are developing our Tropical Medicine Institute. I think we will become the country with the most experience in this field because no one has more doctors and technicians working in these tropical countries. We are carrying out a number of programs of scientific development. Recently teams of eminent professors from our country have been visiting other countries. They have been visiting the world's best universities and medical schools, studying programs, teaching and evaluation methods, audiovisual methods, etc. We have wanted information from the best medical schools of the world's most advanced countries in medicine so that later we can compare that information with our texts, programs and methods and from all this to get a synthesis in order to improve our methods for training doctors. We are very optimistic about the possibilities because the essential thing in this is what we said earlier and that is of having the kind of mean, of technicians and citizens that we have. That is why any goal to which we commit ourselves is truly within our reach. It is good that we say today, as we inaugurate this extraordinary institution, that in the city of Havana alone we are working in 60 health projects. Of these, 40 are medical care centers, 4 pertain to the phamaceutical industry and 13 to medical education. In the entire country, 23 pediatric intensive-care wards have already been built. Another five are under construction and three are in the project phase. Eighteen medical science schools are under construction and in the process of being completed. Other important objectives were the recent completion of the San Cristobal and Puerto Padre hospitals. At the same time, the construction of the hospitals of Sancti Spiritus, Pinar del Rio, Villa Clara, Moron, Nuevitas and Contratmestre is being speeded up. There is not a single place in the country which has been forgotten. Construction of the Matanzas Hospital has also begun. The hospitals of Holguin, Baracoa and Marianao and the pediatric hospitals of Marianao, Sancti Spiritus, Ciego de Avila and Bayamo are in the project phase. In the near future, the projects of the Marianao and Habana del Este clinical-surgical hospitals will be begun. Within the situation of our economic difficulties -- with the sugar prices, the international economic crisis and the intensification of the imperialist blockage -- our revolution and party have nevertheless maintained the priority of the medical services as a basic principle. If we have to touch something else, we do so but we do not touch medical services. That is why with great effort and sacrifice, we plan to continue to develop our health programs with our efforts and counting, to some extent, on international cooperation. It is just that we give special recognition to the efforts of the builders of this hospital. [applause] These include the engineers, architects, technicians and the workers who directly participated in the project. They have done something really marvelous, we can use that word: Marvelous. To absolutely convince oneself, one must see the hospital. The essential work was done by former Brigade No 8 of Enterprise No. 6 is becoming famous because it has worked on some important projects. [applause] It worked on the Convention Palace, on the Cristobal Hotel, on the Karl Marx, the (Mar Azul) Hotel, on the sixth [street] on the National Theater, on Central Havana's first pediatrics ward built during the epidemic and in 24 days. They were the ones who did this. This enterprise has been acquiring much authority, experience and prestige. To a great extent we owe the excellence of the finish and the quality of this project to them. We are truly satisfied. We could say we feel proud and moved when we see what the hands of our builders can do and create. [applause] One see how we achieve quality, how we are capable of quality. It is a quality that has nothing to envy from any other in any country and I would even ask if in the United States there are many hospitals like this one, if in the United States there are many hospitals which are finished as well as this one despite the U.S. health, technology, etc. This is a real example worthy of imitation. That marble did not come from Italy; it is from here. I think there are at least 12 colors of marble, very well placed. Those tiles did not come from Europe; they were made here. That Jaimanitas Stone did not come from another continent; it came from here. [applause] The engineering and architectural solutions did not come from anywhere else. They came from here. [applause] Those excellent doctors, technicians of all kinds, those eminent heads of services, those serious and responsible men did not come from anywhere else; they come from here. They were produced and developed during the revolution. [applause] Some of them may be doctors this year, but their spirit of enthusiasm and their dedication were developed with the revolution. They inspire great confidence in everyone, in all of the citizens, who can rest assured that their own health and that of their loved ones, their relatives and comrades will be in the bands of men and women like these, the personnel at this hospital. I think that they will also stimulate the same spirit in other health centers in our country. We will not stop until all hospitals have the same assistance capacity as this one has, the human quality of this one and the techniques available here. We will not stop until we achieve this. The responsibility of the workers at this hospital, its staff and its technicians, is great, because the people expect a lot of them. It is not an easy task. It is not an easy task to direct an institution like this one, which functions 24 hours a day, which must function 24 hours a day, taking constant care of all kinds of cases, both normal or unexpected. The organization of 2,500 workers is not an easy task; it is very difficult and we realize it. But we -- the party, the union, the state -- must also be in the best position to assist it, so that they will be successful in their task. This hospital, of course, will have a very honorable name. I remember that this was an idea that arose at the very first moment, that this hospital be named after some comrade revolutionaries from here, from Centro Havana -- our revolutionary brothers, three brothers [applause], the Ameijeiras brothers. [prolonged applause] The first, Juan Manuel Ameijeiras Delgado, was killed on 26 July 1953 during the attack on the Moncada Barracks when he was only 20 years old. I understand that he was the youngest of the brothers. The second, Gustavo Ameijeiras Delgado, disappeared on leaving prison in January 1958. It is known that he was arrested while on his way to the Sierra Maestra. He was beaten and tortured, but they were not able to get a word out of him. The exact place of his death is not known. The third, Angel Ameijeiras Delgado (Machac), died on 8 November 1958, in a house located in (Oazrri) and (Goicurea) when they were surprised by the tyranny's henchmen and defended their lives at a high price. They were murdered in a vile manner once the [word indistinct] ended. Speaking of this family's ancestry, a day after Angel Ameijeiras was murdered, on 9 November 1958, over Radio Rebelde from the Sierra Maestra, I spoke the following words: Angel Ameijeiras is the third brother to be killed fighting for the liberty of his people. The first offered his life on 26 July 1953, during the Moncada Barracks attack. The second, Gustavo, was arrested on leaving prison a few months ago and was made to disappear without a trace by Colonel Ventura's hordes. The third one, Angel (Machac), was killed yesterday in the streets of Havana. A fourth brother is imprisoned on the Isle of Pines, also for fighting against oppression. A fifth brother, Efigenio Ameijeiras, [applause] disembarked [prolonged applause] he disembarked with "Granma" expeditionaries on Colorada Beach on 2 December 1956. He is one of the 12 who held the revolutionary banner high durning the difficult days of the Sierra Maestra. The Ameijeiras ancestry is a moving example of heroism, which reminds us of the Maceo family. [applause] We said this in the Sierra Maestra on November 1958. (Maria de las Angustias Delgado), that deprived Cuban mother, mother of the Ameijeiras, comparable to Mariana Grajales, raised her children on her own. [applause] She faced all of the miseries of those times and instilled in them a love for their homeland. Natives of Puerto Padre they emigrated to Santa Clara and from there they came to Havana, creating a humble home with their mother at 508 Virtudes Street. I remember that back in the 1970's, when we went to pick someone to be in charge of the project we selected Comrade Efigenio. I have not forgotten that in those days there was nothing and that everything remained to be done. That which we see today was still in the process of being created. I told Efigenio that this hospital would be named after his brothers. I think that history has something to do with all of this; everything is associated. I think that there is something of the purity of those cambatants, their heroism, their virtues, their integrity and their immaculate love for their homeland in the quality of this project. I want to tell Comrade Efigenio and the workers who have toiled on this project that they have successfully given the project the image of those extraordinary combatants. For us -- and I am sure that for all of you -- this is a moment for reflection and deep emotion, to think that on a day like today we can dedicate this project to those heroes. [applause] Without any more words, I would say that this is the only way to truly remember and honor heroes. Fatherland or death, we will win. [applause] -END-