-DATE-
19920419
-YEAR-
1992
-DOCUMENT TYPE-
-AUTHOR-
-HEADLINE-
Castro Speaks at Havana Hospital Annex Opening
-PLACE-
CARIBBEAN / Cuba
-SOURCE-
Havana Cuba Vision Network
-REPORT NO.-
FBIS-LAT-92-078
-REPORT DATE-
19920422
-HEADER-
=======================================================================
Report Type:         Daily report             AFS Number:     FL2104145592
Report Number:       FBIS-LAT-92-078          Report Date:    22 Apr 92
Report Series:       Daily Report             Start Page:     3
Report Division:     CARIBBEAN                End Page:       7
Report Subdivision:  Cuba                     AG File Flag:   
Classification:      UNCLASSIFIED             Language:       Spanish
Document Date:       19 Apr 92
Report Volume:       Wednesday Vol VI No 078

Dissemination:  

City/Source of Document:   Havana Cuba Vision Network

Report Name:   Latin America

Headline:   Castro Speaks at Havana Hospital Annex Opening

Author(s):   President Fidel Castro at the inauguration of a clinic and hotel
annex at the Frank Pais Orthopedic Hospital in Havana on 17
April-recorded]

Source Line:   FL2104145592 Havana Cuba Vision Network in Spanish 2308 GMT 19
Apr 92

Subslug:   [Speech by President Fidel Castro at the inauguration of a clinic
and hotel annex at the Frank Pais Orthopedic Hospital in Havana on
17 April-recorded]

-TEXT-
FULL TEXT OF ARTICLE:
1.  [Speech by President Fidel Castro at the inauguration of a clinic and hotel
annex at the Frank Pais Orthopedic Hospital in Havana on 17 April-recorded]

2.  [Text] Comrades: This is why I do not allow myself to be caught easily
[laughter] with invitations to all of these ceremonies, which we have so many
of in the country each day-inaugurations, I mean. But, well, here I am.  What
can I say to complement the words of Comrade [hospital] Director Dr. Alvarez
Cambras? I can add a few ideas, explain certain things.

3.  Well, first I am going to talk about Aladdin's lamp. I hope there is an end
to Aladdin's lamp [laughter] so far as building goes-but not regarding
innovations and new contributions-because, for example, we did not have to
build anything to introduce percutaneous (?discectomy), which is a truly
revolutionary treatment of hip problems.

4.  Investments did have to be made. Yes, something had to be invested. We had
to coordinate things. We had to, above all, negotiate, or not exactly
negotiate. Actually the French, and the inventor of this technique, have
behaved wonderfully, in a friendly, generous, cooperative manner; and it has
been easy to reach an agreement with them about their technique; and of course,
with the payment of a royalty [preceding word in English].

5.  We Cubans always treat decent people decently. I am of course talking about
decent people who deal with us.  There are decent people who, out of fear, do
not deal with us. Well, such people are already not so decent, and [chuckles]
we are therefore not morally obligated to treat such people so decently.

6.  I was thinking-I do not know if I should say it-but, well, these things
will be among the few things that will not be copied. Because I mean the Third
World has to copy. Not only has the Third World copied, but the so-called
capitalist world has done a great deal of copying. It is said that certain very
highly developed nations have accomplished nearly everything they have done by
copying. It is natural that we would not be able to invent everything anew. We
often know that work is being done in one direction, and we ourselves set to
work in that direction as well. We often know that something has been achieved,
and we set to work to try to achieve the same thing. That often happens.

7.  Many times we achieve something new in a different domain. I am not talking
only about medicine here. I am referring to the field of research and science
in general.  However, we also need to use everything useful thing there is in
the world, and when we are embargoed, and there is an attempt to prevent our
having access to technologies, we also have to try to open a path for ourselves
in one way or another, and use our people's talent to be able to benefit from
that common legacy of human intelligence.

8.  So, as this matter of percutaneous (?discectomy) shows, there is room in
that field for us to do a lot of things, every year; for us to make great
strides, not only by building new installations, but by using the existing
installations. The hospital should be increasingly modernized based on
technology, the results of its research, and the application of research
conducted in other countries, such as in the very case we are seeing here. 
That is going to be the great path. In that regard, I think that the [word
indistinct] is going to be a survey of the new things that have been introduced
at the hospital.

9.  I believe we must maintain what we have. That is very important. I was
noticing this theater. It looks terrific. I feel we must maintain this
installation. I have not seen the apartment-hotel, but we must maintain it. We
must also maintain the hospital installations. Every time I visit the hospital,
I take careful notice of everything: the condition of the roof, the air
conditioner-in short, the current conditions, because we have a shortage of
resources.

10.  I was very worried over a mistake we made-having built an excellent
building, we installed some elevators not of the quality required. It appears
that, at some point, elevators were purchased for several different hospitals
from certain countries that I do not want to name here to avoid causing anyone
to lose prestige.  [chuckles] I do want to say that the elevators are not
Soviet elevators. [laughter] They come from other countries. I would not like
anyone to think....[pauses] No, not only the Soviets produced bad elevators. I
can tell you that there are Western capitalist countries that produce really
bad elevators. I can tell you that.

11.  Well, some of the elevators we had here were [words indistinct] and others
are semi-Western. Nevertheless, we did make the big investment and, in the
expansions we inaugurated the last time, things as essential as elevators were
bad. We are of course correcting that. The appropriate elevators for the
hospital have been purchased and are being installed. We have to watch out with
all these things-what works, what does not work.

12.  A battle was waged to complete these projects, which had been delayed a
long time. The rectification process was begun. During the rectification
process, we accelerated all the projects. We created a contingent and finished
the work on the hospital. So now the hospital must be given proper maintenance
always, and its equipment and technology continuously modernized. That is the
path we must take, because we already not only...[pauses] if we want to obtain
more, not only would we need Aladdin's lamp, but also Genghis Khan's army...
[laughter] I mean, in order to occupy new territory [chuckles] because there is
no more room in which to expand here.

13.  Of course, there is a neighborhood near here, a neighborhood that is not
too rich. Well, we had to move some of the residents, but they were happy about
it because better housing was built for them. Because there was a semi-indigent
neighborhood nearby. If we wanted to and if a great need were to arise-although
I do not foresee such a need at this time-we could always look for space, but
it is no longer so easy to build new buildings. I do not know what they are
using the famous school for. It had to be built anew. When the hospital was
expanded, there was a primary school almost inside the hospital. A new school
was built. What was done, finally, with the installations of the....

14.  [Unidentified speaker] The school is in the factory of [words indistinct].

15.  [Castro] Yes.

16.  [Unidentified speaker] The other is in the center for [words indistinct].

17.  [Castro] So you also made it into a factory, and a laboratory and all
that? Are you using all the installations?

18.  [Unidentified speaker] The other one is in [words indistinct]. The other
one is in the [words indistinct].

19.  [Castro] Oh, good. I am glad.

20.  [Unidentified speaker] The other one is in the vicinity of the [words
indistinct].

21.  [Castro] So they put it to good use?

22.  [Unidentified speaker] They put it to good use [words indistinct]

23.  [Castro] Of course now, as was explained here, that apartment-hotel was
not anybody's idea, actually. We were building a number of tall buildings in
the city. I realized that this building was on the hospital grounds, this
12-story building, right? It had been under construction for some time, and I
felt the best use to which it could be put would be to make it into housing for
the workers, and that was the purpose assigned to it. A solution was sought via
the minibrigades. Some of the apartments were to be state property. Others were
going to be for those who were building them. A solution was sought, and the
entire building was left for the hospital.

24.  What is perhaps the most beautiful thing about all this, however, and the
most encouraging, is that if there is today an apartment-hotel here which
expands the hospital's options and improves its services, it is thanks to the
workers who chose to have the building used for hospital facilities or the
equivalent. Because it so happened that many people, especially foreigners,
would come from thousands of kilometers away, and as orthopedic treatments
sometimes take months, long periods of time, and those patients were taking up
the hospital beds for all that time, earmarking this building for hospital
services frees up a huge number of beds. There are many patients for whom it is
not even good, psychologically, to remain in the hospital and who are ready to
be moved to some kind of residence so that all their treatments and
rehabilitation therapies can be continued. Thus, by inaugurating this
apartment-hotel, we are also inaugurating a lot of beds within the hospital
that were being occupied by patients.

25.  Of course the relatives also had trouble. Not all patients come with
relatives, but for a relative to have the opportunity to lodge in the immediate
vicinity of the hospital is also a great advantage. That is why it can be said
that this hospital complex is greatly enriched by this facility that is being
inaugurated. I also think the international clinic has been a very good idea,
right? For international services.

26.  I must explain to you that this is an attempt to meet a need that is not
easy to meet-that is, the growing requests for medical services that our
country receives. It is a known fact that our country takes care of many people
who do not have a single centavo, who do not have the means to have a medical
problem treated. Our country has been generous in that and will always continue
to bear in mind, with humaneness, the dramatic situations of people whose only
salvation might be through help from our country. But there are also many
people from Latin America and elsewhere who go to the United States and pay
huge sums of money and yet do not get the medical services that are provided in
our country. There are many people who can pay for such medical services
abroad. So that is what we are referring to when we speak of health care
tourism. We mean those cases of people who pay for the medical services.

27.  So the demand for paid medical services is increasing greatly. I can tell
you, for example, that regarding retinitis pigmentosa, the nation's
capabilities cannot meet the demand for services. A new hospital has been
adapted to that end...[pauses] or an old hospital has been modernized. It is
the former Camilo Cienfuegos Hospital. It may be that in a while, even those
services ...  [pauses] those capabilities will not suffice.

28.  Not long ago, the neurotransplant and nerve rehabilitation service was
expanded by more than 120 beds. Of course, both Cuban patients and foreign
patients are treated there. But the foreign demand is so great that that
facility is at full capacity, and we are inventing, seeking formulas and
solutions to see how to meet the demand.  There is also a growing demand for
orthopedic services, and in like manner, the demand is increasing in many
fields of medicine.

29.  We have been living through a special period, and we have asked ourselves
what we can do to continue our progress in medicine, to prevent our medical
development from stopping, and what new goals, new objectives, we can achieve.
For many hospitals, for some of these facilities, we have established the
principle of trying to get them to pay their own way, in hard currency. We do
not insist upon it 100 percent.

30.  Some can obtain more, and they can help others, but our hospital system
needs to generate a certain amount of income because the cost of our hospital
services is really very high, the cost of equipment, the cost of maintaining
the equipment, the cost of the medicines, despite the efforts we make and are
making to develop our pharmaceutical industry and to produce new medicines. It
is extremely costly, and it would be exceedingly difficult for the country to
maintain those services. So we have been promoting it in many hospital
establishments. We have said that to a number of different hospitals in a
better position to do this, including new hospitals. We have told the Villa
Clara Hospital they could earmark some 200 or 300 (?out of their 900) new beds
to health care tourism.

31.  We say to the comrades in Santiago de Cuba: You have an extremely modern
new hospital, you have almost 1,000 beds, and 200 or 300 beds can be earmarked
for health care tourism. Thus we have been trying, wherever the necessary
conditions exist, to encourage the idea of having those institutions generate
income to cover their costs. We have also told the CIMEQ [Center for
Medical-Surgical Research] this: You must try to generate income to cover
costs. Thus, this is one of the ways by which we can maintain the rate of
development of our medicine under the conditions of the special period.

32.  It is very important to explain that, because it has become a vital issue
to our medical facilities and to the medical services we provide for our people
because, actually, it could be proven that a hotel produces more income than
any hospital in that a hospital may possibly cost three or four times per room
what a hotel does.  Hospitals are very expensive, because of all the
construction and all the specialized facilities. It would not be good business
as such, it would not be a better business move to build hospitals rather than
hotel rooms, as a business. Even a single hospital is a much more complex
matter and requires far more specialized personnel and far more people.

33.  But in any case, within our capabilities, with the facilities we already
have, it is possible for our hospitals to produce at least some income. Now,
the fact that these housing units I was talking about have been made into an
excellent apartment-hotel-which I have not yet seen, but which according to
what I have heard here, is very nice-shows that all kinds of things can be
done. That housing, rebuilt, remodeled, suitably equipped, can become a hotel.
I also say that at certain times, a hotel can turn into a hospital. Because,
well, also, under certain circumstances, if there is a very great demand for a
particular service-looking not just at the commercial aspect of the matter, but
also from the point of view of humaneness-certain things can be turned into
other things.

34.  For example, we have built a new technological school, siting it where it
ought to be be sited: next to the Food Industry Research Center. It has been
under construction for a while and is being finished up now. It will be
finished within the next few months. Now, we have freed up an academic
establishment that has excellent conditions, and it can be converted into a
research center or a center for important medical services. Indeed, we are
already doing that, in view of the increasing demand.

35.  I am going to cite another example, from the time that the collapse that
was mentioned here took place. There used to be a school here where languages
were taught, languages that today appear a bit exotic. Our young people studied
there. It was not a bad idea. Some studied Czech, others German, others
Hungarian, others Russian. Suddenly, we noticed this enormous building, which
had in the past been a well-built school, one of the upper middle class's best
schools. We began remodeling that building a few months ago, and now there is
already a scientific research center installed there, and within a few months,
there will be another. There will be two scientific research centers in that
building.

36.  We can give the example of the school for economic management cadres. We
streamlined it. We put it together with the political school of the Central
Committee of the Communist Party of Cuba, the national school. We freed up
those buildings, and that is where the School of Pharmacy is now located.

37.  It is a new school, but it is not really a new school, but rather a great
expansion of the one that already existed on the university campus. There are
hundreds of students who are very happy and are carrying out their
pharmaceutical studies under very good conditions, training as cadres who will
support the great development of our pharmaceutical industry. We will not
always be building new facilities, but we will be using the existing ones and
streamlining them. Without having to build, we are creating all kinds of new
institutions. That is what we should be doing under these circumstances.

38.  We are demonstrating that even in the special period we can continue to
develop our medical system. We are also demonstrating that in the special
period we are developing our sciences more than ever. This has great
importance. I do not know if everyone understands how important this is. It is
very useful, not only in the economic sense, but in the human sense as well. We
have proof of it every day. For example, we now know that the cholera epidemic
(?has arrived) in this hemisphere. No one knows when cholera will disappear
from this hemisphere. Our research centers are working very hard to develop an
effective vaccine against cholera.

39.  They are working on other types of vaccines, many vaccines. Some of them
already exist, and others do not exist. Just look at the importance of this
activity. I will give you another example, which is quite dramatic- meningitis.
There was type B in the country. There were vaccines for types A and C, but
there was no vaccine for type B in the whole world. There was none then and
there is none today, except for the Cuban vaccine. It has passed all tests
successfully, not only in Cuba but in many places.

40.  The number of cases or the incidence of meningitis type B was very high,
and it was increasing. It was the terror of the family. Whenever a mother,
grandmother, uncle, or brother saw a child with some illness, the first thing
they thought about was the possibility of a sickness of that type. It was the
terror of the family. The vaccine was developed, and today we practically have
meningitis type B controlled. We have it controlled. The incidence was almost
14 out of every 100,000. With the vaccination program we have practically
eradicated that sickness. We still have not eradicated all meningitis.

41.  There is another type of meningitis that is called hemophilic influenza
[hemofilo influensae], I think. It is as aggressive or more aggressive than the
other one. When the other one disappeared, this one remained. It is true that
the incidence is lower, but it has tended to increase.  It is a phenomenon.
That type of sickness is terrible. It takes hold almost all of a sudden, in
just a matter of hours. It needs to be diagnosed as soon as possible. The
appropriate treatment needs to be applied. It could arise in the capital, in
the eastern provinces, or in any other place. We need a good understanding of
that sickness and of the technique to treat it.

42.  But we have seen it increase in the last five-year period.  We have
observed a high mortality rate. Therefore, it requires our attention. The
Carlos J. Finlay Institute is working on a vaccine against hemophilic
influenzae meningitis. They have solid reasons to hope they will find an
effective vaccine. It is hard and complex. Such a bacteria attacks, above all,
newborn babies and small children only months old. It attacks children at a
very early age.

43.  They are studying everything that has to do with that illness. They have
already done important research.  They have made considerable progress. It is
possible that before they obtain a vaccine, they may already find an effective
medication. That is, a....[pauses] What is it called?

44.  [Unidentified speaker] ``Immunoglobulin.''

45.  [Castro] What is it? Immunoglobulin. There is a specific immunoglobulin
against meningitis type B, for example.  You know, it is possible by simply
vaccinating adults and later drawing blood from them. Then that blood, which
has antibodies, a high number of antibodies against that illness, is used to
make a medication. If you come across a child who has a case of meningitis type
B, you apply that specific immunoglobulin.

46.  Well, to give you an idea of the results obtained, in cases where children
had six adverse factors-that is medical terminology, factors which worked
against the children's recovery-only 20 percent recovered. With the application
of that specific immunogloblin, the recovery rate increased to approximately 90
percent. That is with the six adverse factors.

47.  This means that not only do we have a vaccine to prevent the illness, but
with the vaccine and our scientists, we can develop a product to fight the
illness. They think that they are going to achieve, as part of...[pauses] at a
certain point in the production process of the vaccine, they will achieve a
certain capability to produce medicines against this illness, the hemophilic
meningitis bacteria, medicines to fight it even before they have obtained a
vaccine.

48.  These are not simple problems, because the highest rate is among infants.
Sometimes it strikes only a few days after birth. Scientists are also thinking
of the possibility, or the possible appropriateness in certain areas, of using
a product on pregnant women that increases the number of antibodies in the body
of the child. That way, when the child is born, he has a certain survival
period before the vaccine can be used. They are studying all the angles and
aspects. This is an illness that attacks very young children. We could say that
it is another scourge, another plague, and another terror.

49.  You can imagine how a family feels when they receive news that a child, a
member of the family, has that illness. But today we have a resource. We
already know how to combat that illness. We already know what the doctors or
pediatricians who are going to handle the cases should know. We know what they
should know. We already know how it should be diagnosed as soon as possible. We
know what elements should be used in that diagnosis to guarantee it. We know
what medications we should use. Intaglobin, for example, is being used.

50.  Intaglobin is being produced here. The demand is high because there are
doctors who want to use intaglobin for the flu. Intaglobin must be used in
cases such as the one I am referring to. Intaglobin is frequently used in
pediatric intensive therapies. Now we are studying ways to increase the amount
of intaglobin because it depends on the amount of donations we receive. We are
looking for ways to be able to have a larger supply of that product.  But, we
already know what treatment needs to be given, and we are working very hard,
very hard, to find a solution.

51.  Now, I can say without hesitation that I believe that in no other country
are steps taken as fast, as urgently, and with as high a priority as in our
country to solve such problems. The response of our scientists has been
extraordinary as they seek solutions to the problems. I have given you these
examples to underscore the importance of scientific research and innovations,
and where our path lies, in the midst of difficult conditions, in order to
continue to develop our health care system and our medical system. We do not
lack personnel. That is something we all know. We have more than 20,000-and I
am giving you a conservative figure-medical students in our universities. By
the end of the year, we will have how many doctors...Teja? [words indistinct]
46,000 doctors, between 45,000 and 46,000 doctors by the end of the year. (?So
we have the personnel), the auxiliary personnel, who have university degrees.
Nurses now enroll after completing secondary school, to study five years in the
medical schools to become nurses. We can constantly improve the capabilities of
our personnel, and thus improve the health care services.

52.  We can intensify our efforts in the research field. As Alvarez Cambra
said, this hospital belongs to the scientific pole of western Havana. That has
been another very important step: associating all these institutions that are
developing rapidly and getting them to mutually support one another. We cannot
imagine what we can achieve from the cooperation among all these institutions.
That is something capitalist society does not and can not have.  In capitalist
society, all such institutions generally depend on individuals, on private
businesses. They are in competition. They are at war with one another. In our
case, we can unite in one pole all these institutions and they can give one
anther great support, which multiplies the potential of all these institutions.

53.  Among the most prestigious institutions of this scientific pole is
precisely the Frank Pais Hospital. It is the founder of this institution, which
we first began to situate geographically. In this area there was a group of
hospitals. Later there was a group of research centers. We have already grouped
them basically by the criteria of whether they have to do with biology,
biotechnology, or medicine. We have grouped all such things together in a very
strong movement. I believe that the presence of the Frank Pais Hospital in that
scientific pole is one of the pillars of that movement.

54.  This hospital has great momentum. This hospital has not only won prestige
for its service to the country, but also for its international services. This
hospital has many examples of internationalist comrades, brave comrades.  Many
of the workers in this center have fulfilled internationalist missions, and on
occasion have had to behave in heroic ways. We can remember well that when the
famous Iraq war broke out, our cooperation workers were there providing their
services, free. That had been going on for many years. It started as a paid
service.

55.  When wars began to break out in that region, as a moral issue we did not
want to charge them for the services of our medical personnel in the midst of
war. So our (?doctors) there had been providing free service for more than 10
years. When war became imminent, everybody left. We saw it as an ethical
problem. How, in the midst of war, or on the eve of a war's outbreak, when
doctors are needed the most, can the doctors leave? On their own, our doctors
took the attitude of not leaving in time of danger. We supported the position
of our doctors, which seemed very brave and noble to us. Many of them were from
this hospital, right? Almost 50 percent [words indistinct].

56.  With that I want to point out that this hospital has won great scientific
prestige, great prestige because of the service it has provided to this
country, and for the services it has provided in many countries. We truly feel
great satisfaction to be able to have such an institution in our nation, to
have such a group of workers like you. But as Alvarez Cambra said, this is no
reason for us to boast or to rest on our laurels, but rather it is a reason for
us to commit ourselves not only to maintaining this historic record and
prestige, but also to enriching and increasing it.

57.  Therefore, with inaugurations or without inaugurations, with Aladdin's
lamps or without Aladdin's lamps, with Genghis Khan's army or without Genghis
Khan's army, the Frank Pais Hospital will continue forward and will continue to
become a better institution. It will continue to become a more scientific,
prestigious, revolutionary, socialist, and communist center. [applause] Because
only with the spirit of revolutionaries, only with the spirit of communists, is
it possible to do the things that you have done, or possible to accomplish the
heroic deeds that you have accomplished.

58.  Therefore, I join the chorus of those who are congratulating the Frank
Pais Hospital today. I join the chorus of those who remember the historic date
of 17 April. I join the chorus of those who feel a special satisfaction in
seeing how we honor our martyrs with acts, not with words, how we honor our
martyrs with a revolutionary project, which is ever more revolutionary, with a
patriotic spirit that is ever more patriotic. I am completely convinced that
this institution will continue to develop.  I am sure that maybe on another
occasion-I am beginning to give way [laughter]-on some other occasion I will
return [words indistinct] with you. [applause]

59.  [Unidentified speaker] Socialism or Death!

60.  [Castro] Fatherland or death, we will win! [applause]

-END-