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Castro Speech at Julio Trigo Hospital

PA101836 Havana Cubavision Television in Spanish 0242 GMT 9 Sep 87

[Speech by President Fidel Castro Ruz at the inauguration of the Julio
Trigo Surgical Hospital in the Arroyo Naranjo area of Havana "over the

[Text] Guests, comrades: Meeting here is a large family of doctors, nurses,
health workers, and builders who worked here and those who will work at the
[word indistinct] plan in Arroyo Naranjo.  I see you here, in your
T-shirts.  Neighbors are gathering here.  I hope there is a family doctor
here, as a guest.  Family doctors, raise your hands.  Some of them have
come as a delegation, too. [Here are] health and construction workers, the
people of Arroyo Naranjo, and some of us, guests, who have come from other

We have come to inaugurate a project that gives us all deep satisfaction;
namely, the surgical hospital.  It is an important and necessary hospital
with 482 beds.  It was planned using the most advanced ideas.  It was
planned based on our experiences in the health field throughout all these

This place has needed health facilities since the beginning of the century.
I recently read the history of this center.  It was located in the
outskirts of the capital because the capital did not yet extend to here.
There apparently was a farm on the hill.  At that time, tuberculosis was a
most terrible scourge.  It was hard, cruel, and incurable.  A large number
of people died of tuberculousis at the beginning of the century.  In this
hospital alone, when it handled tuberculosis patients, there were
over? 10,000 patients.  Tuberculosis victims came to hospitals in great
pain to die as comfortably as possible.

And so, a hall was built early this century.  Later, another one was built.
More buildings were added.  At the time of the revolution's triumph, La
Esperanza Hospital for tuberculosis patients was located here.  It was very
isolated as tuberculosis is a contagious disease.  This building did not
exist then.  It was under construction.  The revolution completed the
building.  Together with the other installations, the revolution set up a
hospital for tuberculosis patients here with hundreds of beds.  It provided
all the necessary services and care.

Thanks to the great strides in medicine in the past decades and the
appropriate implementation of a health program in our country, tuberculosis
no longer is a dreaded disease.  The number of cases have greatly
decreased.  The disease is in the process of becoming eradicated.  The same
thing is happening with leprosy.  In the thirties, tuberculosis and leprosy
were two terrible words.  We must say they inspired a fear similar to the
one AIDS inspires.  Hospitals for tuberculosis patients are disappearing.
The [name indistinct] was built for that purpose, as were this hospital and
the Santiago de Cuba Hospital.  All gradually disappeared.  Science and
medical work are winning the war on tuberculosis and are winning the war on
leprosy.  This way, in 1977, the last patients left this hospital and went
to other institutions.  The buildings were left vacant.

At that time, some comrades in the health field decided to turn the
buildings over to institutes, such as the Institute of Work Medicine and
other institutes.  In sum, no great progress was made in renovating the
buildings.  The buildings there were not really useful for one purpose or
another.  In this way, some of these institutes were given a building, but
much remained to be built.

During the dengue epidemic, when we visited the pediatric hospital here, we
noticed these huge installations.  We thought about our hospital needs.  We
thought that although the revolution had built many hospitals in the
country's interior--which is very just and proper--it had not built many
hospitals in the capital.  We even thought the number of hospital beds was
reduced when those hospitals became research institutes.  We thought about
the advisability of using these buildings for a surgical hospital to take
care of this area of the capital where there was a shortage of beds.  So,
we persuaded those interested in research activities to find other
solutions.  Possibly in the future, buildings for these institutes will be
built.  Some institutes, however, like the Nephrology Institute, have been
moved to other hospitals.  But we decided to turn this hospital into a
surgical hospital.

We had to plan a renovation project.  At that time, our construction
process was not as dynamic as it is today.  We had to resign ourselves to
relatively long periods of time.  There was a labor shortage and we knew we
had to wait while other projects were carried out.  Construction began at a
moderate pace.  Later on, especially starting in December 1985, and within
the framework of a major program to considerably increase the number of
hospital beds in the capital, renovating this hospital was given greater
impetus.  This was not just a simple renovation job but also involved
expanding and constructing new areas.  Considering that the basic impetus
for this project began in 1985, it was completed in a relatively short
time.  Of course, the builder here talked about quality and ruling out
working at a marathon pace.  We would like to explain to our foreign guests
here that the term marathonism [maratonismo] for us refers to a situation
where projects are delayed and an effort is subsequently made during the
final months to complete them by any means.  Consequently, workers are
brought in from other sites, a large number of workers are organized, and a
final push is made.  We decided to eradicate that practice from our
construction programs.  That is why we demand that no project be delayed.
Projects must be completed on time to avoid marathons and final efforts,
which negatively affect quality and productivity.  This even causes a loss
of resources, because each project must be in sequence; some have to be
done before others.  Sometimes, those final marathons are done by beginning
with what should be the final projects.  In this way, problems and setbacks
are created in the construction process.

This is why I am saying that we are not going to set a fixed date for 1987.
We are not going to say that on I May or 26 July [a project will be
completed.] We are going to work well.  Additional labor forces must not be
brought in from other projects.  These marathons also delay all other
projects.  Thus, we end up with marathon after marathon.  We decided to
eradicate this vice and we are eradicating it. [applause] Projects are
constructed in accordance to a plan.  They are being finished without
rushing.  Work is being done intensively, but in an orderly and calm
manner, without moving one project ahead at the expense of others, and,
most of all, without sacrificing quality.  There is something more: Quality
is given priority.

For that reason, today, as I toured this hospital, I looked at the color of
each floor tile and at each square meter of that tile, its color, and how
it was polished.  I looked at the walls, the tiles to see if all were the
same color, if blue tiles were mixed with green tiles. [laughter] I looked
to see if the green tiles had a uniform hue and if the finished work was
good.  I looked to see how everything was; that is, the colors and the
paint.  I looked at every detail.  Let me tell you, I truly found great
quality in the hospital's finished work. [applause]

I walked the halls and everywhere else while talking to the director.  I
asked him about his views and if he liked the hospital, if he was pleased,
and if the hospital was functional.  A few days ago, when we inaugurated
the (?51st) children's center, I visited the area accompanied by its
director.  I asked her how long she had been the director.  She said that
she had been working as director for 10 years.  I asked her to analyze and
compare this center with others built earlier.  I asked her about its
advantages, if it was modern and functional, it is was built better, and
where the bathrooms, the pantry [preceding word in English], and the
kitchen were.  She talked very enthusiastically about all this and about
the project.  She compared it to earlier ones and felt that this one was
much better, more efficient, more functional, and that the finished work
was excellent.

It is very good to talk with someone who has spent years devoted to a
specific activity.  That person is best suited to say if the center is good
or bad.  He can tell if it is better or worse.  In this case, the comrade
director said that it had all sorts of advantages.  We left that project
truly pleased.  Now I wonder if in the centers for 1988 we will also find
small details that can be improved.  Those centers will have solar heaters;
they will have 18-meter panels to collect solar energy to heat all the hot
water needed in the bathrooms and everything else that this hospital -- I
mean, this center -- has.  We are already thinking about this project.  It
may save the center 20 tons of fuel.  If there are 50 centers, 1,000 tons
of fuel may be saved by the solar heaters.  There would be no problems if
there were an electricity blackout, and there would be no lack of fuel,
because the solar heaters do not fail.  They take advantage of the energy
that nature so generously give us.

We hope some day the buildings in that community will also have solar
heaters.  I also wonder if this hospital some day will also have solar
heaters to save dozens, perhaps hundreds of tons of fuel per year.
However, we will do things little by little.  We have had the privilege of
inaugurating two high-quality works.  The first one was built by the
microbrigadists, and this by MICONS [Ministry of Construction] enterprises,
with the people's help.

In my opinion, it was an excellent idea.  Today, more than ever, I am
convinced that [words indistinct] the quality.  We have completed the
project without any rush, within a reasonable period.  The director has
announced his program.  He wants to test everything; the boilers, air
conditioners, and other equipment must now be tested.  We have been told
that there is a program for commencing hospital activities.

As I mentioned before, this hospital was designed with the most advanced
ideas.  It has very modern equipment and all the necessary supplies.  It
has the best our country could obtain in equipment, such as technical,
X-ray, ultrasound, and operating room equipment; and other types.  It will
have beds for intensive care, which is a new concept we are introducing in
all the [word indistinct] hospitals.  This concept did not exist [words
indistinct].  I recall that during the dengue epidemic, Borraz Hospital was
the only hospital we had with a pediatrics intensive care unit, which -- by
the way -- did not even have a separate area for infectious cases.  I
recall that when we visited those two [as heard] pediatric hospitals and
saw that there was only one ward in the midst of an epidemic, we decided to
build pediatrics wards.  Today, we have 31 pediatric intensive care units,
where the lives of thousands of children have been saved. [applause] All
the sophisticated equipment and the highly specialized personnel are
necessary to help medicine work when a child is on the verge of a heart
attack, cannot breath, or is affected by some other problem.  This
equipment, specialized personnel, and their special and diligent attention
are determining factors.  I have seen with satisfaction the albums where
pediatricians have opportunely compiled the photographs and medical
histories of the most serious cases.

They now happily tell the story, the number, and the contribution of all
the children who have been saved in each of these intensive care units.

Before, our clinical surgical hospitals did not have those units.  Now they
are being incorporated into all our hospitals -- the new ones under
construction and the ones that already exist.

Similarly, we are introducing intensive care units to maternity hospitals
to provide intensive prenatal care to both mother and child.  That will
provide greater safety for women during delivery and will reduce the child
mortality rate during the 1st year of life.  That is a very serious program
being progressively carried out throughout the country.  We have to
alternate, but we are providing great quality to our medical services.

In addition, a new concept is being introduced in the area of (El Lebredo),
where there are old buildings that used to be hospitals struggling against
tuberculosis.  We will establish a maternity room of almost 400 beds.  We
have been specializing medicine little by little.  We have a network of
specialized hospitals -- our surgical, maternity, and pediatrics hospitals.
Recently, we have been discovering the advantages of combining maternity
and surgical hospitals, because the latter provides excellent services,
which is almost impossible to provide at a maternity hospital.

In Santiago de Cuba, where the maternity and surgical hospitals are so
close, we will associate them, which will create a maternity hospital's
association with a surgical hospital.  They will follow the same path and
will have the same objective as a single hospital.

The Julio Trigo Hospital will not only be a maternity surgical hospital; it
will be a general hospital, with all the services offered by surgical means
[words indistinct].  It will also have an intensive care unit and the
[words indistinct] intensive services I mentioned before.  This institution
will operate with the most advanced ideas and the most modern equipment.

In this area we have the [name indistinct] hospital, another important
pediatrics institution, in front of us.  In this case the children will be
on that side, the mothers on this side.  The adults will be in the
installations we are inaugurating today. [laughs] It will be for adults --
men and women -- except in the case of maternity problems, because nature
has spared men from having to go to a maternity hospital. [laughs] They
must help in child care though, [laughs] even in the [words indistinct].

This hospital has filled a vacuum in a municipality of almost 180,000
inhabitants, who had to go to other municipalities to receive these
services.  In reality capitalism had not developed such a [words
indistinct] distribution.  Under capitalism there were no hospitals for the
poor people [words indistinct].  There were some private hospitals, but
public hospitals were a big calamity -- you know that.  (?All of you know
that).  Today we have a network of hospitals, which includes old and new
hospitals.  As I said, we had not built many new hospitals in the capital.
We had built many in the interior of the country, but not in the capital.

We have built an excellent, extraordinary hospital--(Hermana Mercedes)
Hospital.  It is already prestigious in Cuba and throughout the world.
However, it had not even been originally planned to be a hospital.  It was
supposed to be a [word indistinct] but since we had no money, we said:
Would it not be better to make this building a hospital? [crowd chuckles]
We adapted it, remodeled it, redesigned it, [general laughter] added a few
floors to it [crowd chuckles], and it is now a hospital that is the pride
of Cuban medicine.  I could say something else: It is the pride of Latin
American and Third World medicine. [applause] Or we well had left many
large areas empty; we are still studying these empty areas. [sentence as
heard] Of course, this municipality and Calabazal, which is close by, will
receive the benefits of this excellent hospital.  Arroyo Guarano now has a
great surgical hospital, and in a few more months will have the maternity
and pediatric service as well as the medical school.  This will be the
seventh medical school in the county's capital.  It is now under

Within 16 months...[changes thought] and I make this clear because I have
seen a little report somewhere [crowd chuckles] that said the maternity
ward will have been remodeled and [word indistinct] within 18 months; I
talked with Comrade Lezcano, who gave a figure that is not acceptable.
This is according to a little report over there, which said that it was
within 18 months.  I warn the builders, particularly those from Sancti
Spiritus who are here, [laughter in crowd] that they have 16 months minus 5
days [laughter in crowd] to complete this service, because this is in the
program [words indistinct]. [applause] No delays of I month, I day, I hour,
I minute, or even I second are allowed in these health programs.  If you
deliver these buildings I second after midnight, 31 December, you will have
failed the revolution. [applause, shouts]

This is a matter of principle; therefore, no exceptions are allowed.  No
exceptions are allowed because this is a principle.  We have to correct
poor habits such as delays in works.  So, work has to proceed quickly from
now on, so there will not be any last-minute rushes or marathons, because
this will not be allowed.

After this, we have to build the outpatient clinic.  No final date has been
set for the construction of this building, which will be the third such
building.  However, we do have a date for the former.  This is in the
(DECAP) program for 1986-88.  However, we are in a 5-year period, so there
will be time.  We are in the 5-year period.

Therefore, we have plenty of time to construct those buildings.  Progress
will also be made with the medical school, which is very important and will
have a hospital base for training purposes.  Therefore, there will be a
full medical-educational-scientific complex for service to the people,
especially to the state in this municipality of Arroyo Naranjo.

Is this the only thing that will be left in Arroyo Naranjo?  No.
Polyclinics are being built in Arroyo Naranjo.  How many works are lacking?
Two...[interrupting, unidentified person tells Castro one would be
lacking].  And we would lack... [changes thought].  The network of adequate
polyclincs and installations would be complete with a third polyclinic.
Well, those three exist, but they lack the appropriate installations.
[murmers in crowd]

However, with the works that will be inaugurated in October, Arroyo Naranjo
will have one-third of the family doctors it requires.  It will have 101
family doctors, and (Los Sibilines) will have approximately 300.  So, I
expect it to catch up with (Los Sibilines) by 1991 or 1992 at the latest.
We have given priority to these suburban districts insofar as services of
family centers are concerned. [applause].

In Arroyo Naranjo we are going to build the first 12 new family practice
clinic prototypes.  They will include the nurses' quarters.  This year
there will be 12, but [words indistinct] for 1988-1989, but already in
1987-1988 we have projects.  We want to extend these projects throughout
the country in the shortest possible time.  We will build these clinics
using the same model we used this year, but Arroyo Naranjo already has its
12 prototypes.  They will have an exposition to show their new quality
family practice clinics.

We are not only working in the health sector.  Today at 1600 we will
inaugurate a new village built by the neighbors themselves. [passage
indistinct] We had the pleasure of building this community, which will have
84 houses, and which will lead the way to the eradication of our 62
unhealthy neighborhoods; 61 are located in the capital.  We will eradicate
them all using the same formula and methods.  We will not only build homes,
we will also build other facilities in municipalities as well.  We will
organize the neighbors in the unhealthy neighborhoods -- a total of about
50,000 people -- to find out how soon--we do not want to set a date--we
will wipe out the 61 unhealthy remaining neighborhoods in the capital.  Let
us see if we can establish a new order, since these unhealthy neighborhoods
start because of uncontrolled migration.  We are building new housing
developments and industries throughout the country.  The already-large city
with more than 2 million inhabitants, plus the 700,000 more in the rest of
Havana Province -- nearly 3 million, on a piece of land 40 km wide -- where
water has to be supplied to towns, industries, hospitals, as do all
services and agriculture...[changes thought] 3 million inhabitants becomes
a considerable amount, so plans are established taking into consideration
needs and obligations to legislate on this topic, to avoid uncontrollable
movements of people.

This, of course, would be arbitrary if a great effort was not made to
develop the interior provinces.  You all know that great efforts have been
made in these years of the revolution and that the faces of the capitals of
the provinces have changed much more than has Havana.  An enormous
construction effort is being made in the capital.  You know that this not
only means building 250,000 houses in 14 years, which will be enough homes
for 1 million people, but also reconditioning and remodeling a great
number of houses.  Therefore, estimate that three-fourths of the population
in the capital will benefit in this period and at the end of this period we
shall have essentially resolved the problem of housing in the capital
unless we make another 1 million people [words indistinct] capital.

I feel that carrying out this policy is perfectly understandable.  We
would gain nothing by wiping out an unhealthy neighborhood if it just
springs up again.  That is why we prefer that people not come from the
interior and build houses which can be built in the capital with our own
manpower.  This is why the microbrigade movement has emerged with so much
dynamism.  These brigades will have some 30,000 workers by the end of the
year in the different types of microbrigades.  The movement marches on with
great force and by now it is unstoppable.  Our problem now is the project.
A few days ago we had a meeting with the enterprise in charge of the
project -- architecture, housing, hospitals, etc. -- as we have to address
this construction explosion resulting from the people's display of energy.
By the same token, we have to offer solutions to the construction material
industry, to all their needs, and help them out.

We have here with us 62 workers -- 60 men and 2 women, very few women for
this highly mechanized collective -- to build roads in Arroyo Naranjo.
What could be used here are picks and shovels. [applause] Now you have an
asphalt-laying machine -- today a street was repaired -- front loaders,
large payloaders, rollers [cilindros], levelers, bulldozers -- all that may
be necessary to build whatever streets are needed here in the Arroyo
Naranjo municipality. [applause].

By the same token, many houses [words indistinct] will be built. [applause]
Bread stores, shops, and so on -- all that is needed in Arroyo Naranjo.  As
you know, you do not work alone in this municipality -- all 15
municipalities work, but as this is one of the more backward, or, rather,
was one of the most backward and is one which needs the most priority.
[laughs, applause] There is a saying that says: Work with love and don't
smell the fox. [Obra con amor y no huele la zorra] [laughs][Play on words
Obra con amor y vuelan las horas, work with love and time flies] Is that
it?  Did I say it right?  These projects are more than just words.  Facts
are worth more than promises. [loud applause]

While inaugurating this health center what logically comes to mind is what
we are doing in the field of health in our country.  We are really working
hard, seriously, and in depth to make our country a medical power.  Our
country is already becoming a medical power.

These are not just words but facts.  Our infant mortality rate is less than
14 per 1,000.  The rest of Latin America averages 70 or 80 -- some more,
some less.  Our infant mortality rate is the lowest among all Latin America
and Third World countries, and lower than some developed countries.  We
hope that by 1992 -- in 5 years -- we will lower the infant mortality rate
to 10 [per 1,000].  These are not just words.  This is based on hard facts.
Among these facts I shall mention a few: genetic prenatal care that will
allow us to...[changes thought] We will speak a bit more about this later
as we are going to open an immunity center, which is a place to treat
prenatal genetic [words indistinct].  We will be able to detect Down's
syndrome, determine if there is a congenital spinal cord deformity, or any
other type of deformity, or if there is hemophilia.  If today we asked at
our clinic how many deaths have occurred, the reply was two.  What were the
causes?  Well, two cases of incompatibility with life [as heard].  If this
could have been found out earlier the family could have been spared
the anguish.  All sorts of congenital malformations happen -- some live
months, others live years under these terrible conditions.

Others die as soon as they are born, destroying all the hopes and illusions
that the parents placed in this child-to-be.

With this program of genetic prenatal care we will have tremendous
security, we shall be able to avoid these tragedies, and at the same time
ensure viable births.  This same system will be used by our infant cardiac
care center.  Using the very modern equipment there, specialized personnel
will be able to detect potentially fatal congenital cardiac deformities.

All this will therefore reduce our mortality rate.  Prenatal intensive care
units will prevent, will reduce the death rate during the first week of
life.  Infant mortality can also be reduced.  I believe that in no more
than 3 years we will establish prenatal intensive care units in all
children's hospitals.

We have infant cardiovascular surgery that should save a number of children
with congenital deformities that can be lived with if they are diagnosed in
a timely way and resolved through surgery.  This service is located not
very far from here.  Perhaps I shall speak about this service later.
Lastly, there is the family doctor practicing preventive medicine,
educating, supplying sexual education, and preventing premature pregnancies
and other calamities.  This has been proven, for example, in the Sierra
Maestra, where there are whole areas with fewer than 10 deaths per 1,000
live births due to the work of the doctor in the mountains because he has
educated and prevented premature pregnancies with its consequences; because
he has educated the people, teaching them to avoid accidents in the home,
so parents do not sleep in the same bed with the baby and wake up with the
baby smothered because the parents turned over in their sleep during a
nightmare.  The mother and father smothered the child and killed it.
[sentence as heard] [laughs]

These are four programs.  I am no longer talking of what all these medical
services mean -- the improvement of medical services, living conditions,
housing, etc., which we are carrying out.  These four programs alone should
lower our infant mortality rate to below 10 [per 1,000].

We have figured 5 years.  We expect that in less than 10 years life
expectancy will rise to more than 80.  These are facts and not just words.
These are facts and not just good reasons.  Please compare the average life
expectancy before the revolution and you will see that the people's life
expectancy has increased after the revolution by about -- well we would
have to figure it out -- more or less about 30 percent.  The revolution has
raised life expectancy by nearly a third.  A mathematician could calculate
-- 54, 55, when we reach 80, maybe more -- about 40 percent of the increase
in life expectancy is due to the revolution's health programs.

There has been talk about prenatal genetic work with highly productive
Cuban equipment that is very economical because it operates with reactors
[reactivos] made in our country.  Now we can diagnose, as soon as the child
is born, if the child is genetically allergic.  According to statistics, 20
percent of all children are born with allergies.  The diagnosis can
immediately determine what measures should be taken so that the allergy
does not turn into a disease.  Perhaps the child will have to have mother's
milk for a year, and good advice will be necessary to determine what
treatment the child must receive.  This way a child having a genetic
predisposition to a disease will not develop it.  No one can tell how
important it is to be able to tell a mother whether or not her child is
allergic.  This comforts her and also helps to avoid harmful situations for
the child.

The same thing happens with hypothyroidism.  There is a certain percentage
of children who are born with this problem.  If no diagnosis is made the
result is mental retardation and the disease leads to idiocy if it is not
discovered and stopped in time.

Maybe we are talking about I child out of 8,000, according to what
statistics say, or 20 in 160,000, but the important thing here is that all
mothers and families will know that the child will not be born an idiot,
that he will not have hypothyroidism, because if a child has it he will be
treated, and if he does not have it all concerned will be reassured.

The child will not be deaf either.  Equipment developed by our research
center, a machine called neuronica can detect if a newborn has hearing
problems, the degree of the problem, and how to resolve the problem.  There
is always something that can be done even in cases of total or near total
deafness.  Today, there is technology that helps a deaf person perceive
vibrations.  This particularly helps children with total deafness, and this
avoids mental retardation because the consequences of some of these
limitations is mental retardation.

We are going to be providing this service throughout the country.  There is
better news yet.  There are excellent signs that the vaccine against
meningococcus meningitis, a vaccine that was developed in our country, is
effective. [applause]

There are great hopes.  Not only have we measured the number of antibodies
in people who have been inoculated, we have saved, with serum extracted
from those people, the lives of children who were in critical condition
because of meningococcus meningitis.  That is, with serum, with antibodies
produced by inoculated people, we have been producing medicine that has
been effective on people with the disease.

We have tens of thousands of inoculated people.  Some were inoculated 18
months ago.  And there is a high honor in this: A distinguished group of
admirable comrades worked with live microrganisms.  This is, possibly, how
the important advances were reached, and they inoculated themselves first
and will make it possible, as soon as we have the final scientific results
of the investigation, to produce the vaccine en masse.

If we can do this, we will be the first country in the world to produce an
efficient vaccine against the Zero type B meningococcus meningitis.
[applause] This has been a considerable advance.

As you know, the Julio Diaz Rehabilitation Hospital is being built.  The
director of that hospital, Comrade Martinez, is around here.  A
rehabilitation center has been built with the cooperation of Comrade Ordaz.
This made a large room available.  The workers of the hospital for the
mentally ill, with cooperation from some patients for whom work is therapy,
increased the hospital's capacity by 60 beds.  In a few weeks minibrigades
composed of a contingent selected by the party will be delivering 200 new
beds to the Julito Diaz Rehabilitation Hospital.  They were built in a few
months.  The minibrigades will begin work on a 17,000-square-meter
rehabilitation center that will be the best in the country, and the best,
without a doubt, in Latin America.

The hospital's capacity will be doubled and it will have an excellent and
very modern rehabilitation center that will help people facing traumatic
situations, such as those with vascular and other problems, some of which
they may have had from birth.

We are working hard on the expansion of the Frank Pais Orthopedics
Hospital.  This work will be concluded during the first few months of next
year.  It will be able to produce prostheses and related instruments --
internal and external devices, etc.

Rehabilitation therapy will be available at polyclinics so patients do not
have to go to the Frank Pais or Julio Diaz hospitals for relatively simple
therapy.  The people of Guanabacoa will have their own polyclinic so they
do not have to travel.  They will have a rehabilitation center at municipal
polyclinics.  This is even better.  We are experimenting with therapeutical
exercises under the supervision of the family doctor.  As you know there
are tens of thousands of people--retired, on pension--who are over 60 and
who exercise in the capital.  The results have been excellent.  They feel
much better.  Many of them have been able to stop taking medicine.
According to scientific research, exercise, even by people who are 70, can
increase a person's heart capacity by 35 percent and oxygen transport
capacity--a vital element for life--by 28 percent.  Exercise is becoming
common among senior citizens and sedentary, overweight people.

With the enormous network of family doctors at the center of this effort,
along with the work of physical education professors, we will
unquestionably achieve one of the highest life expectancy rates in the
world.  In other words, we will not only achieve a reduction in infant
mortality.  Not much is left to be reduced but there is still some
improvement to be made because in the struggle to reduce infant mortality
we perfect our health system and improve our pediatrics and maternity
services.  The increase in life expectancy will depend on having men live
longer.  Not only longer but in a healthy and robust way.

As you know, only 1 year ago on 25 August, we opened the first children's
cardiovascular surgery center in our country.  It is an annex to the
William Soler [Hospital], not very far from this hospital.  I can say with
deep satisfaction that the doctors there have totally fulfilled the hopes
that center had.  In less than 1 year they performed more than 300
successful surgeries, with a very high survival rate.  The center is being
expanded.  A building is being constructed with 30 rooms so the children
will spend the least amount of time possible in the hospital after surgery.
A child from Guantanamo, Baracoa, and Tunas would have to be brought back
and forth to the hospital, but this way beds are freed.  The William Soler
Hospital's polyvalent therapy was developed there.  What we are going to do
is to establish polyvalent therapy in another area and transfer the 21 beds
of the intensive polyvalent therapy to the children's cardiovascular
surgery service.  In this way, our hospital will be able to perform 1,000
surgeries a year.  Young and eminent surgeons are being trained in that
specialty in Cuba and abroad.

Families from many places and even from other countries go to that center.
Twenty Nicaraguan children have already undergone surgery in that center.
Thinking about the future, another such center will have to be built in the
country's eastern region.  We have to bear in mind that requests are made
from other countries.  We cannot limit ourselves to only our own estimates
and forget that people who have no other solution come to our country.
What can we say?  That no, we cannot help them, we condemn a child to
death.  As much as possible, we must share this dramatic progress in
treating diseases.

According to statistics, approximately 8 out of 1,000 newborns have some
type of congenital heart problem that requires surgery.  Some can wait
longer but half will die in their first year if they are not treated and 80
percent of those could be saved.  Perhaps later 100 percent can be saved
because by using prenatal genetics we can detect congenital deformities
earlier, in an early stage so that the birth can be interrupted.
Therefore, those services are of extraordinary value.  These are
considerable advances in the health field.  They encourage our work.

Our country already has a medical school in each province.  In some
provinces, there are two and in the capital there are six.  Approximately
5,500 selected students are entering approximately 20 medical schools.  We
are graduating approximately 3,000 doctors a year.  We will graduate 3,200
in 1988, 3,600 in 1989, and 4,000 doctors in 1990.

The family doctor program is being extended.  It is unique in the world.
We can say with satisfaction that it is unique in the world among all the
developed, developing, and underdeveloped countries.  In 1992, the capital
of the Republic will have a complete network of family doctors.  There are
mountainous areas where the network is complete, such as in Granma and
Guantanamo.  This year, with the support of recently graduated doctors from
the capital, all of the mountains in Santiago de Cuba will be covered.

The capital has been generous in giving aid to the eastern provinces; next
year it will be receiving 140 mountain veterans, who will begin work as
family doctors in the capital and will study general medicine.  They will
become specialists.  Now we will have to start limiting enrollments
according to the needs in each province.  Enrollments will have to be even
more selective in the capital, because it offers the most advanced medical
training.  Those who enroll in 1988 will be graduating in 1994.  By 1992 we
will already have the entire network of family doctors covered, including
to some extent Havana Province--not only the city of Havana, but also
Havana Province--and the Isle of Youth Municipality.  The other provinces
will also be covered, and in 8-9 years, all provinces in the country will
share in this network of family doctors.  There will be 20,000 doctors in
this network.  Imagine these doctors working in close coordination with the
polyclinics, the hospitals, the health programs, and the mass
organizations.  What a tremendous medical network.  What security for the
citizen who knows he has a doctor right there beside him.  In an emergency,
in a matter of minutes he will have the doctor who lives right there in the
community.  Not even millionaires in capitalist countries have such a
privilege.  Thus, we are facilitating services that not even
multimillionaires enjoy in capitalist countries.

Our scientific research program is progressing.  Two factories that will
manufacture medical equipment are being completed this year, one in
Santiago and another in Havana.  Our genetic engineering center and our
immunoassay center are advancing at an excellent pace.  I believe we can
feel satisfied, proud of these advances.  I feel that the most important
factor is neither the buildings nor the excellent and sophisticated
equipment: the most important factor is the men and women dedicated to the
people's health. [applause] They are the key, and I know how they have
responded to the call of the revolution.  I recall that in August 1985
there were some complaints, and I recall our meetings in December 1985 with
the directors of all the capital's hospitals and institutes.  Many of them
are here today.  I see that they were invited to this event, and I am very
pleased to see them here.  They are witnesses of how long we spent
discussing matters in those days, when we discovered there were not only
subjective factors, but also objective factors.  The new program in the
capital stemmed from that meeting; this program increased the number of
beds by half; that is, it increased available beds in the capital by over
20,000.  We made careful analyses, we discovered problems--while any little
guy could come here from a province and freely buy materials to build a
house, we found that hospitals lacked the materials for necessary repairs.
That situation has changed.  There is a great maintenance effort in all
hospitals; the resources are there for them to do it--a program to expand
hospitals in the capital and to construct new buildings, such as the one we
are in right now.  It was decided to renovate and expand Miguel Henriquez
[Hospital], and to increase the number of beds from 450 to almost 1,200.
That means that this hospital, which renders a great deal of services to
the eastern part of the capital, was enlarged practically three-fold, with
new installations.  It was decided to practically double the size of
Albarran [Hospital], where nephrology services are located.  It was decided
to expand Finlay Hospital, and the hospital we call the Naval Hospital,
also called Diaz Soto [Hospital] here in the eastern sector of the capital.

It was decided to expand Julito Diaz [Hospital].  The plans to [words
indistinct] Julito Diaz stemmed from that meeting.  It was decided to
accelerate the expansion process and to complete the Frank Pais [Hospital].
It was decided to accelerate the completion of Marianao Pediatric.  It was
decided to rush the construction of the Tropical Medicine Institute.  From
here stemmed--and I am not going to mention all the works one by one--a
very ambitious program that is being carried out, involving over 4,000
beds, I can say almost 5,000 beds.  This is one of the most ambitious
programs ever attempted, and it will complete our network of hospitals and
meet our capital's needs.  In addition, we will have a new Almejeira
[Hospital]--to call it by some name--in the western part of Havana, near
the Genetic Engineering Center and the Faculty of Basic Sciences, and a new
Almejeira [Hospital] in the eastern part of Havana; one to the west and one
to the east, with approximately 900 beds that will include a certain number
of maternity beds, in accordance with the concept I have referred to above.
I here will also be a new pediatric hospital, which is what we lack in the
eastern part of the capital.  The last three projects I have mentioned will
break ground on 1 January 1989.  Construction will last 3 years. [applause]

These projects are being given much attention, as is the project to expand
the Neurosurgery Center, the Neurosurgery Institute--an important and
essential expansion.  The first neurological transplants have been done
there with good results and with much promise for the future.

The Gonzalez (?Toro) Hospital will be expanded and modernized, and it will
be like a reference center for maternity and pediatric hospitals.  The
Cardiovascular and Cardiovascular Surgery Institute will be expanded.
These are our programs for the capital, and they have excellent prospects.
These programs are being carried out with willingness, with resolve, with
firmness, and, above all, with confidence.  This work we recognize today
confirms that confidence, as well as the imminent opening of the new
buildings for Julio Diaz [Hospital], which entails an increase of 200 beds,
also built with great quality.

This, of course, requires great effort.  To triple the capacities of
Miguel Henriquez [Hospital] is not easy.  It has been necessary to make
more than 800 drillings with Benotto machines to find the subsoil, to find
firm ground--over 800.  Five Benotto machines have been working intensively
for months, and the groundwork for the columns has been laid; many of those
columns have been built.  The work must proceed at a rapid pace.  This has
been one of the greatest challenges.

Of course, we already have told the companeros who are building this that
they must finish not a second after 31 December 1988, because that is the
deadline.  There are 16 months left, so we have to work hard, but we have
taken all the steps concerning the projects and the building itself.

This is a worthwhile program.  We are not here to open an isolated work; we
are here to show that this is one of the pillars of an ambitious and
extraordinary health program.  That is what we are doing today.  This will
allow our people to see here, in a concrete and precise manner, the work of
the revolution in this field, as well as work in many other fields.

We will have to discuss these health issues again in a few days, when we
open a work that is a veritable jewel, a source of pride for our country:
the Institute, or rather the Immunoassay Center.  I have nothing else to
add regarding that, because--as I said--I will have to talk about it again
in a few days.  This work is not being done in the capital alone; it is
being carried out all over the country.  What better proof of this is there
than the fact that the municipalities first saturated with family doctors
were in fact the mountain municipalities?  No additional proof is
necessary.  No additional proof is necessary to demonstrate how the
revolution distributed its work throughout the entire country.  It is true
that in some ways the capital was left behind; however, soon, in a very
short time, health conditions in the capital will equal those of any
capital in the world. [applause] This is, companero builders, the
significance of your work.  This is the significance of the high quality
of that work.  We have to thank you, not only for the efforts exerted, but
also for the quality with which your efforts were carried out. [applause]
This demonstrates that it is possible to have high-quality constructions.
We also have to thank you because the success you have achieved is an
encouragement for us all.  Eight hundred and fifty-nine health workers will
serve in this field, in the clinical-surgical field.  Today, I had the
opportunity to greet many of them, and I have seen how carefully the
personnel have been selected.  I repeat, the most important thing is
neither the equipment, nor these excellent installations; the important
factor is the men and women who are going to serve here.  I want to ask
them today the same thing I asked the doctors, technicians, nurses, and all
workers of the Cardio Center, to dedicate themselves to that task.  To the
director, to the Julio Trigo Hospital collective, I ask--in the name of the
people and in the name of the revolution--for them to dedicate themselves,
heart and soul, to the noble task of making this center one of the best in
the country.