-DATE-
19890505
-YEAR-
1989
-DOCUMENT_TYPE-
SPEECH
-AUTHOR-
F.CASTRO
-HEADLINE-
CASSTRO SPEAKS AT SANCTI SPIRITUS MEDICAL SCHOOL
-PLACE-
SANCTI SPIRITUS MEDICAL SCHOOL THEATER
-SOURCE-
HAVANA TV CUBANA NETWORK
-REPORT_NBR-
FBIS
-REPORT_DATE-
19890519
-TEXT-
Castro Speaks at Sancti Spiritus Medical School

FL1805160689 Havana Television Cubana Network in Spanish 0110 GMT 17 May
89

[Address by President Fidel Castro at the Sancti Spiritus Medical School
theater on 5 May--recorded]

[Text] I am very happy to be at this meeting, just as I am happy about the
fact that the party is giving all the required attention to the family
doctor program.  We are here among medical graduate students, family
doctors, students, and professors, and I think they have listened with
great interest to each one of the things that everyone has explained I
recall some of the international meetings on basic medicine that have been
held in Cuba, and I have been able to appreciate the admiration--more than
admiration even amazement--of many foreign visitors regarding this
institution.

We had no way of know how the population was going to receive the family
doctor.  We wondered what level of trust the population would have in the
family doctors knowing they were recent graduates.  That is why we first
implemented the idea with 10 doctors in a polyclinic in the capital.  For a
year, we closely followed all the developments of that experiment.  We then
applied the program to the countryside, some farms, cooperatives, and
mountains.  Based on the new results, we gradually extended the program to
the extent that now there are over 6,000 family doctors in the country.  It
is now a truly consolidated program.

However, the family doctor program was not created in isolation.  A group
of measures within the medical field were taken.  In the last 6 or 7 years,
over 50 important measures must have been taken.  One of these important
measures was the creation of the heart surgery institute.  Another was
supplying (?ultrasound) to all hospitals, and many more like this one.  An
important measure was also the new program for studying medicine, the
organization of the medical sciences contingent, and the supply of books to
all medical schools.  There was a real shortage of books.  We only had
economic policy books, and other things, but the fundamental medical books
had not been printed.  I have only cited a few examples.  The family doctor
program has resulted in the creation of a new medical detachment, a new
program, and a new specialization--general medicine [edicina general
integra].

All these measures and efforts have noticeably increased and improved
health services in the country.  Today, our country holds a high place in
the world because of its health record, and it is reaching the very top
places.

Particularly in this field of primary health care.  I am convinced that we
have found the ideal system of primary health care.  I would say that it is
the most advanced system in the world, and we are just beginning.  In a few
years, the family doctor program will be in effect in the whole country 100
percent.  In the future, all factories, schools, child care centers will be
covered by the program.

As time goes by, the doctors will be increasingly experienced.

The idea of the family doctor is the kind of idea that ends up being much
more promising than first conceived.  We could see many of the advantages
of having the family doctors.  However, as the implementation of the
program progressed, the initial concept has been enriched and perfected in
these past few years, the first few years.

We have been able to observe, for instance, that the population accepted
and trusted the family doctor.  The social function of the doctor became
evident.  The concept of social medicine emerged.  You can see that there
are an infinite number of tasks in which the doctor plays an important role
in the community.  It is very hard to find a resident of a community that
doesn't first go to the family doctor before going to the polyclinic.  In
fact, we saw this happen from the very beginning.  He would see the
specialist and when the specialist prescribed something, he went back to
the family doctor and asked him about the specialist's diagnosis or
suggestion.

So, the first big battle was winning the trust of the people, trust in the
family doctor and trust in this institution.  This has meant that virtually
all the country's polyclinics have become teaching centers.  It has meant
that the quality of the polyclinics personnel has improved extraordinarily.
It has meant that the emergency room shall become free of the masses of
people who went there and so on.  We don't know how many more new things
will come up with the institution.  The quality of the whole process went
up.

In order to have an institution such as this one, you have to start years
early.  Not only do you have to train a doctor with depth and breadth, but
you also have to train a doctor with a sense of solidarity and duty who is
able to realize the sacred nature of his mission.  He must be able to do
what our doctors have done.  They must be ready to go anywhere in Asia,
Africa, and Latin America.  I remember that when the first 1,000 were ready
to graduate, we needed doctors in their last year of study to go to
Nicaragua because they were asking us for more doctors over there.  When
all the students in their last year were asked--they numbered about
1,000--the whole 1,000 said they were willing to take on the mission.

This was also evidence of the character and quality of our young, of our
students.  There's no other country in the world where this kind of thing
is possible.  All this effort had enabled us to have many doctors to have
good doctors.

Selection became stricter with the contingent.  It will have to be even
more strict.  Less people will enroll but they will have more aptitude.
Unfortunately, fewer will enroll because this movement to train doctors has
been so strong that no matter haw extensive and ambitious our plans, there
will come a time when we will have surplus of doctors.  We are not there
yet.  We have 33,000 or rather 31,000.  We will have 34,000 this year.  We
will go as high as 75,000.  In other words, we still need some 40,000.
This includes the replacement doctors for the sabbatical year.  We will
apply this concept not only to doctors but also in other fields.  We will
do it with professors, teachers and anyone else we can.

Therefore, our estimate is 75,000 doctors.  These are possibilities.  We
have said 10,000 will be our contribution to the Third World, whose tragic
situation we are all aware of.  We have helped the world, but the world has
also helped us.  We have helped the mountain people, but the mountain
people have also helped us.  It makes me very happy to see hundreds of
Havana students returning to the capital from Guantanamo Province, Sierra
Maestra, Ganma, Santiago, etc. because they learn a lot there.  They learn
and come back with a wealth of experience when they return to the capital.
You should see how much our doctors learn when they go to a Third World
country, how much they really come to appreciate what Cuba and the
Revolution stand for.  Those who were born after the beginning of the
Revolution discover what capitalism means in the underdeveloped world, what
the underdevelopment and terrible poverty afflicting these countries mean,
what the horrible injustice those nations have to experience means.

When we help them, we help ourselves.  Our internationalist doctors come
back with more awareness, feeling more revolutionary.  If our achievements
in this field had been predicted years ago they would have sounded like
wild dreams.  If in capitalist times the development officials had been
told they would have a polyclinic the dental clinic we visited this
morning--that was really a sophisticated place!  It even had a classroom.
Twenty-eight children with their teacher, who gave them their lessons while
one by one they were examined.  They even got lunch and a snack!

Imagine if anyone had asked the development officials for something like
this under capitalism.  If they had been told that they would train
doctors.  Would anyone really have believed it?  I say that one of the
things that best expresses that spirit and capacity of the Revolution is
this institution and this health field.  Although half of our doctors were
taken away from us, there is no Third World country with better health
figures than Cuba.  There are many rich developed countries that do not
have the health figure Cuba has.  We will not allow these achievements,
this vanguard position to be snatched away from us.  If we earned them
starting with 3,000 doctors, what won't we be able to achieve with 50 or
60,000?  I think that anyone can understand that.

We are not going to let go of these truly impressive successes, the
progress we have achieved in this field.  We will not go backwards.  I feel
we are going to make even more progress.

What will Sancti Spiritus look like in 10 years' time when all of you are
specialists?  When there are hundreds and hundreds of specialists?  When
the whole area is covered?  When all the factories, schools, and child care
centers are covered?  When we have all the new experience, equipment, all
these new pharmaceutical products, the new equipment we are devising or
acquiring in full use?

These are the thoughts I wanted to share with you, comrades, on this
occasion.  I wanted to say how satisfied we are with this gathering.  I
wanted to thank you for your motivation, your successes, your effort, and
to urge you all--professors, students, doctors, family doctors--to double
your efforts and carry on so that in the not too distant future you will
feel even more satisfied and happy about the health successes that the
Revolution has wrought for the benefit of the people.
-END-