Latin American Network Information Center - LANIC
FBIS-LAT-94-128 Daily Report 1 Jul 1994 CARIBBEAN Cuba

Castro Speaks at Closing of Family Medicine Conference

FL0107235594 Havana Radio Progreso Network in Spanish 1100 GMT 1 Jul 94 FL0107235594 Havana Radio Progreso Network Spanish BFN ["Fragment" of President Fidel Castro address at the closing of the First National Congress on Family Medicine at the Convention Palace in Havana on 30 June -- recorded]

[Text] Even today we continue to build outpatient clinics and houses, the so-called low income houses, although not in the main cities, the capital. We are still trying to resolve the problem, and one day we will undoubtedly be able to continue the program for the construction of family doctor clinics and houses, slowly but surely. We had advanced so much in this program that a contest was held among architects to design not just one model, but 12 models of houses for the family doctor. There were prototypes of the houses in Diez de Octubre Municipality. They were what you might call luxury models concerning the construction of family doctor and nurse houses. We have advanced; it was being accomplished, and we would have continued if the socialist bloc catastrophe had occurred four or five years later -- let us say six years later -- if it had not occurred when it did, when all of our programs were at their peak. This left us without markets, essential raw materials, fuel, large quantities of food, raw materials to produce food, spare parts, steel, and lumber.

If this had happened a few years later, many of our most promising social and economic programs would have been completed; and we would have completely finished the family doctor program [chuckles] in a few years. Despite the bitterness provoked by the interruption of many things within this program and others, we can say the fact that we have such a movement, with 22,000 family doctors and nurses, is now a source of satisfaction and true pride because it represents a feat accomplished through our efforts and determination. We have 22,000 doctors, and I imagine we also have 22,000 nurses working with those doctors.

I truly believe, without exaggerating, that our people achieved an extraordinary feat by being able to continue developing this program during the most difficult years of the special period. In my opinion, it seems that this program was designed for a special period. What would the condition of our public health and our people's medical care be today without those 22,000 doctors and 22,000 nurses who render their services in this program, not only in towns, but also in factories, schools, and polyclinics despite all the problems we have in the transportation sector as has been stated here; the problems with ambulances and medicine; and all kinds of problems? How could this level of medical care have been maintained without the family doctor and nurse program? There have been many brilliant ideas and solutions to these difficult circumstances, aimed toward improving transportation and the problems with medicines.

The current medicine distribution program was mentioned here because obviously, there was so much speculation over the medicine purchases. This resulted in certain situations, for example, if two... [pauses] any amount of aspirin that arrived would last only a few days because of the excess currency in circulation and the activities of unscrupulous people who bought whatever medicine they could on the open market. There was no way to prevent this -- a whole shipload of aspirin would last only a few days. It was expedient and possible to do this within our system because of the Health Ministry's organization, and family doctors' cooperation.

The idea of using traditional medicine, or herbal medicine as you call it, meaning plants, was also mentioned. We must develop all this, but those 22,000 outpatient facilities have been decisive in endorsing this type of medicine. Today we must resort to all these methods. If we remember our forefathers and the war of independence; if we remember the times of Maximo Gomez, Ignacio Agramonte, Carlos Manuel de Cespedes, Antonio Maceo, we will realize they had absolutely nothing. They cured people -- and they had many people to cure -- although they did not have the resources, the doctors, and the talents we have today. They solved many health problems with available natural resources. The situation is not exactly like that, but it somehow reminds us of it. We have been compelled to consider all the possibilities. A great effort is truly being exerted, I assure you, in the constant struggle to acquire or manufacture the necessary medicine and to distribute it in a more rational, equitable way.

We are also striving to acquire some of the components that have rendered ambulances inoperable. A comrade outlined the situation he faced. I think it involved batteries and tires. Comrade Teja explained that we would get a number of batteries and tires within three months to repair the ambulances. All of you who work with the rank and file know how difficult these hours, days, months, and years have been for us. You know how difficult the circumstances are. No one knows it better than you because you are there, waging that battle for the people's health, life. We must bear in mind an important thing, a very important thing. I have not seen you lose heart, regardless of the problems. I have been able to observe during the hours I have spent here that morale is high among family doctors and nurses; it is the morale that is required in these times.

I believe it is fair to call this an historic congress given the successes achieved, the experience acquired, and the circumstances and time in which the congress takes place. I am sure these years will be remembered as one of the most glorious pages in the history of Cuban medicine. The fact that we have reduced the child mortality rate to nine... [pauses] to less than 10 [per 1,000 live births] in 1993 is truly a great feat. I thought the goal was impossible, to reduce this figure to less than 10 during one of the hardest years of the special period. I wonder if this would have been possible without the family doctors' work. How could we have maintained the general health indexes, how could this have been possible without the family doctor's work -- the doctor and the nurse? But I am not going to constantly repeat this because I will run out of time. How would this have been possible without your work? We can say that no Third World country, or even First World country, can offer what we have in the health care sector during these difficult years.