Fidel Castro Speaks at FEU Congress
[FBIS Translated Text] [Unidentified speaker] The Medical Commission broached the same issue that Nestor and you broached and it was discussed in the Federation of University Students' [FEU] previous congress. I think we must check and see how those accords are being carried out. Job placement through direct specialty, whether it is after the doctor has concluded his social service in the mountain areas, the Revolutionary Armed Forces [FAR], or in the most difficult places, or wherever the FEU sends him. It is the commission's consensus that these students have a very mature attitude.
[Second unidentified speaker] Yes, that is the commission's consensus, which came after our meeting. What I meant was not to do this in a fixed period of time because that could hinder the quality of the process.
[Castro] I have a question. The first of them -- those who went to Santiago, Guantanamo and other areas -- were going to study medicine....[pauses] were they going to work?
[Unidentified speaker] Yes, to work. They went to out-patient facilities.
[Castro] Yes, and later they returned. They could not study like the students who were back in the cities. In the cities, the other students were going to the clinics. After one year, these students could begin to study the career of integral general medicine [medicina general integral]. Those that were in the mountain areas were taxed in two ways: they stayed there during two years, then came to the city and began their studies, therefore losing one year with regard to other students. The best students would go to the mountains. The students that had gone to the mountain areas would later -- after two years -- begin studying integral general medicine. Is that going to be changed?
[Unidentified speaker] No, Commander. We have studied something and would like to ratify it during this congress, that is why I was asking Consuelo. The FEU's previous congress broached this issue -- it was even accorded -- that the students who began to study a direct specialty were to be the first to perform social services, as you said, in the mountains, in the FAR, and in the most difficult places. Direct specialty would only be studied as a second specialty because these medical students would have priority as a first ...
[Castro, interrupting] Therefore, all of them will study integral general medicine?
[Unidentified speaker] Yes, but there is a problem which we should evaluate. The Public Health Ministry says that there are new needs -- this was stated by the delegate from Havana -- in certain areas. We think that these new needs should be covered by the integral general medicine doctor and with those who were sent to do the most difficult jobs.
[Castro] Yes, because that was how this was planned.
[Unidentified speaker] That was the way it was planned.
[Castro] The student who has studied integral general medicine is going to be a better specialist. This would not be achievable if he were not as good as the others. In the beginning, direct specialties were allowed because there were no specialists in integral general medicine. This is part of an old story. There was a time that we almost ended up like the Soviets -- beginning one's specialty in the first year of study. One specialist in eyes, another in nose, another in ears; it was crazy! There was once a time when one started to study his specialty during the sixth year. Also [words indistinct] while the number of students increased because they did increase, we got rid of that. We were able to achieve a professional doctor with vast knowledge. Take note that in medicine we did not do as in agriculture and other careers. Even in architecture people began to specialize during the third year of study -- some in urbanism and in other fields. In transportation, we had specialists in trains, specialists in airplanes -- I joked by saying specialists in mules; it is also a form of transportation. All these specialties were thought up by crazy people that have been in Cuba -- and we have had quite a few. [words indistinct] have them over there and they hurt much less. Copying things from here, from there, -- quite a lot of things from over there -- but we did not copy anything in medicine. I did everything that was humanly possible to avoid copying anything. There were some things which were useful, such as preventive medicine. This a very important aspect of medicine. Here in Cuba everyone was inventing a specialty, until that was halted; if not, today we would have 80 medical specialties.
We even developed a plan, up to the year 2000, for each specialty. It was designed by experts and we created a new specialty -- integral general medicine. We converted generality into a specialty. This was done to promote equal social and economic conditions. Before this, a general practitioner was someone who had not studied. He would finish his studies; he would not study anything else and he was a general practitioner. All concepts were changed; over 50 different measures were implemented. There were even new programs, after a doctors' delegation visited the best medical universities in the world. New specialty programs were implemented, as well as many other things that had never been done in any other country. Through this Cuba has achieved, notwithstanding the special period, less than a 10 percent infant mortality rate. That seemed something impossible to achieve. Truly, I never thought that we could maintain this level today in the present situation and with our lack of resources. However, the results are there and everyone appreciates these results. That is why we must preserve this concept. The doctor...[pauses] the first specialty should be integral general medicine. For example, the surgical specialty: In the beginning it was thought that manual ability was very important, but I have heard many opinions and the best was that a good surgeon should be a good doctor. Even in those areas where manual dexterity is required, so is solid medical knowledge because if not, you will end up with a butcher instead of a surgeon -- a butcher that cuts here and there with no idea of what he is doing. If anyone should know about general medicine...[pauses] but there were no other people; there were no specialists. That is why time had to decide. I have no idea how many general practitioners we have or if there are enough to cover all specialties. There are opinions that we need more specialists in certain areas, however, that is hard for me to believe. I think it is a question of concepts and I wonder if anyone knows how many specialists are needed. In Cuba there are enough pediatricians to make candy with. Internal medicine doctors and obstetricians...[pauses] now that women are giving birth to fewer children, I do not think we need more obstetricians or internal medicine doctors. Who knows where these opinions have come from? We have been preparing specialists in those areas for a long time. That is why I do not understand that opinion. I am aware that there were the so-called anemic careers because no one liked them -- radiologist, anesthesiologist and others. There are certain specialties that do not have a direct relation with the patient, therefore people were not interested. We had to pressure people -- more than pressure -- we had to ask for volunteers, and make them aware of the need in these areas. In those areas I can understand that we need more specialists; but gentlemen, if someone tells me that we need more pediatricians, I doubt it, unless all of Cuba's pediatricians left on rafts and are now at the Guantanamo Base. I have not been informed that this has happened. [chuckles] There are not too many of that type of personnel there. It is a matter of opinion -- that should be reviewed. Less children are being born. We have created a large number of specialists; I am not obligated to believe, I must be convinced. The reality is there is a deficit due to this and that. We have 52,000 doctors already, and in the university around 20,000 students. We have reduced the amount of students admitted from almost 5,000 to approximately 2,000. We have converted universities into universities for nurses [words indistinct], medical universities where doctors can obtain more education. We do not have excess resources and I said let's change quantity into quality. The selection process is not the same for choosing 5,000 as for choosing 2,000. There was an estimate of 10,000 for missions abroad. There was an estimate of several thousand so the rest could study -- a reserve to be used during doctors' sabbaticals. Those ideas were also implemented in the area of education and were associated with Cuba's development. To be able to maintain that type of program you need an increase in the economy. You cannot implement those things during a recession or in difficult times. That was the criteria used to calculate the number of doctors -- we were going to have 70,000 doctors. We also had to bear in mind doctors' retirement, which is very difficult to estimate. You cannot make the same estimates as you would in other professions because I know of many doctors that even at the age of 80 continue to practice. They do not retire, even after 55 years of practicing. That makes estimating very difficult because you cannot obligate a doctor to retire just because he is old. That is very hard. You have no idea just how hard it is for these professionals...[pauses] and precisely when, in many areas, they have more knowledge. We have reduced the number of medical students admitted from 5,000 to 2,000. This year it was 2,000 -- is that right? That is the way we have been administering the situation.
[Unidentified speaker] There are 7,280.
[Castro] Graduates, maybe that is not enough. We have to see if they are all willing to study, even though there are many that do want to study.
What I question here is the number of doctors we need. We would need to establish this number and it should be known. Maybe in some regions there is, and in others there is not, a need for doctors; but in Havana City to say there is a need for doctors -- with all the time we have been preparing pediatricians, obstetricians, and internal medicine specialists via direct access -- it is something very hard for me to believe. I said that we had over 50,000 and we have to see how much they work. We should have more doctors so there is better health and to have health programs, but not for the doctors to work less. One of these days we should investigate how many are working and studying. I am sure that they do not work as hard as the factory workers I mentioned. There are many. Another opinion is that there should be complete teams of specialists. Also, what is the criteria to be implemented in hospitals -- all of this must be studied. I think it is fair that if you must choose between two, and one of them has studied integrated general medicine and has been in the mountain areas during those two years, he should have priority because he has fulfilled a task. I do not know what the situation is with regard to the armed forces' doctors -- how many doctors they have, or how long they remain...[pauses] How long?
[Unidentified speaker] Two years.
[Castro] Two years is very little.
[Unidentified speaker] [words indistinct]
[Castro] So he is involved during the second and third years -- the commission broached that issue.
[Unidentified speaker] Commander, they were referring to all areas not just medicine.
[Castro] Oh yes, all areas regarding education and the new concept of emphasizing patriotism, revolutionary spirit and idealism. It does not only affect doctors, but everyone -- that's good. However, it was in medicine where there were doubts and changes. By the way, have we gotten rid of the narrow profile [perfil estrecho]?
[Unidentified speaker] Yes, Commander, this was discussed in the FEU's congress of 1986. From one congress to another, especially in the fourth congress in 1990, the advances were very important. When the university was converted into a research center, with a reduction in admissions -- from that congress to today's -- and the increase in research -- which is something we are going to discuss this afternoon -- the profiles have not been too wide.
[Castro] What do you mean by profiles?
[Unidentified speaker] Profiles, widening profiles -- not narrow profiles like in the 1986 congress.
[Castro] They are much wider now?
[Unidentified speaker, interrupting] Yes, they are much wider.
[Castro] In all careers?
[Unidentified speaker] In all careers. For example, there is only one type of economist. In 1986, there were transportation economists, maritime economists,...[pauses] port economists, and many others. Today there is only one career for economists, and one for accountants.
[Castro] There is another thing associated with this. I have heard you say that an agricultural specialist had to begin by doing manual tasks.
[Unidentified speaker] The example that you gave about the complex in Matanzas -- maybe our comrades might be able to explain it better -- there was a group of engineering students who were involved directly with production. They are resolving the complex's problems and we think that this is the concept that should be implemented regarding job training. It also prepares us to resolve job placement problems. We must teach an engineer that the main thing is his job -- he is not going to start as the complex's assistant manager. During the first years of his career, he is going to begin learning directly in his job -- that is the complex's system.
[Castro] There was a time when ideas were associated with the universalization of higher education. We asked ourselves -- dreaming a little or a lot -- if it would be possible for society to prepare everyone with a high level of education, bearing in mind that the more knowledge a society has, the better it becomes. Historically, a university degree has always been associated with intellectual work. If it were to be true that one day things were going to be different -- that the difference between manual and intellectual labor was going to disappear -- we had to change that concept. We made it very easy to study here, even with directed studies, in all fields. However, it was tragic because everyone who obtained a degree only wanted to work in that field, as a college graduate. That is why those ideas -- the Revolution's ideas -- were no longer emphasized. We were saying universalization of higher education was society's ideal. If you are a tractor driver and wanted to be an engineer there was no opposition to you becoming an engineer. However, you had to keep operating the tractor, the machine, or whatever it was you were operating.
We wanted the difference between manual and intellectual labor to disappear. Was it prejudicial for a harvester to be driven by an engineer? Absolutely not. The ideal situation would be for all harvester drivers to be engineers. Now then, we have had over 500,000 college graduates; however, we did not graduate any cane cutters or weeders. I am not going to mention milking a cow because that turned in to a specialty using hoses, machines, and electricity. Later, that disappeared due to the electrical outages. Some time ago we implemented a very important change -- the technicians...[pauses] those who were not college graduates -- were medium level technicians and each one wanted to work in that capacity. The day will come when there will be no one in Cuba to do manual labor -- no one. We have had this phenomenon in agriculture. What allowed us to continue? The machines. The manual cane cutter and the oxen driver disappeared; we have seen this today. It has been very hard to implement animal power and transportation. One of Cuba's most important problems today is that we do not have manual laborers in our fields. The criteria that each one should stay in his profession continued to reign. Intellectual work and not manual labor. I know that in certain industries, engineers would operate machinery -- that was an advance; however, we have not overcome that way of thinking. I think some of the ideas that you have discussed here are important. It is what you called unconditional and how an agricultural engineer should start working. We promised to create a great number of technical schools. We used high schools, as the number of students dropped. We converted many preuniversity schools into agricultural schools to graduate qualified workers. However, the best qualified students' right to study was maintained. We established that 5 or 10 percent of the agricultural students would increase their level. I think that the best high school students kept a certain degree of privileges. I cannot remember that too well right now. This was done because we wanted to establish schools for qualified workers, but workers. Imagine all of this -- how many schools do we have now, Gomez [Education Minister Luis Ignacio Gomez]?
[Gomez] There were 55 schools when we started this idea, which by the way, came about here in the 4th FEU congress when you suggested this publicly. Now we have 165. We started off with 55 and now we have 165. There are over 45,000 students in those schools.
[Castro] We also changed the concept of those 55...
[Gomez, interrupting] I can assure you that the students have very clear in their minds that they are qualified workers. Independently from whatever may be published, they have this very clear. The 8,000 students who have just graduated are working together with the agriculture ministry, sugar industry ministry, and the Youth Labor Army out in the fields. As you say, it is an incentive for that 10 percent -- the best students -- to be considered for admission to higher education levels, once having passed an aptitude course because they do not get admitted directly.
[Castro] That is very important because a country of high school and college graduates alone does not function. Education can not be universalized if work is not universalized. This is the idea behind the concept of work and study. This was a problem that was seen very early; our Revolution saw this very early. Education's universalization had to be accompanied by work's universalization. Here we universalized education, but not work. The truth is that the level of work was decreasing. That is still true. Now we face special conditions. It hurts to see that...[pauses] we had tremendous projects in the universities -- we also discussed this in our congress -- development projects for all universities, resources, construction, education projects, Granma's famous school, and the one in Manzanillo. We had beautiful projects, no one knows just how much it hurts to have...[pauses] all of that. The outlook was really very good, before the tragedy occurred...[pauses] but we also developed the economy and technology. Socialism is the only system that can one day resolve unemployment, not through padded payrolls, but by reducing the time at work or work rhythm. It is not written anywhere that man must be an animal. I have seen man working harder than an ox, a horse, or a slave in modern industries. Man is a slave of modern machinery -- that is the worse type of slave that has ever existed. [words indistinct] is a socialist idea. I said in Copenhagen that a society which cannot resolve its problems is unsustainable. In Denmark's capital I found out just how sensitive everyone is to unemployment; it is a plague and they have several plagues. They have the seven plagues that the Bible -- I think -- mentions. One of the most important plagues they have is unemployment and the increase of violence and drugs. I say it is proof of those societies' decadence.
Now, we must be very realistic -- what Gomez was saying is true -- we must have a reserve. When we were talking about doctors I forgot to mention that we give them permission to leave. If you want to leave, leave. It is preferable to have a new intelligence entering a university to become a doctor than to have someone who has lost his values or his patriotism and wants to leave Cuba.
Let's not close any universities and deny future generations the privilege of attending class. We must consider that there will always be an exodus of professionals, doctors, and others. We can balance all of this out with the students who have been admitted. I have been debating with myself quite a bit since yesterday. I am always asking comrades: How are we doing? How are your studies? We increased the number of science students to accommodate one development project. We had to guarantee positions for many of those students after that project was suspended. The only reasonable thing to do was to cut back on admissions. We have no choice but to consider quality over quantity when deciding who should receive a higher education. This is not a whim but a reality based on our needs. In any case, don't we have quite a few students? How many full-time [regular] students do we have?
[Unidentified speaker] About 100,000.
[Castro] About 100,000. What about those in professional studies [estudios dirigidos]?
[Unidentified speaker] Minister Vecino might be able to help us here.
[Vecino] A total of 12,000 students right now [words indistinct]. A total of 2,000 more registered in the last two years. It is still a very attractive field. We have graduated about 1,000 already. There are 700 or 800 lawyers. They have authority and prestige. They are not second-class professionals...
[Castro, interrupting] Vecino, what are you talking about? What are you talking about?
[Vecino] I am talking about professional studies, the liberal courses [cursos libres]...
[Castro, interrupting] These courses have been around for 100 years. What do you mean we have only graduated 1,000 students? Tell me about the others. I want to add up the figures on both liberal and professional courses.
[Vecino] A total of 38,000 students are enrolled in what we referred to earlier as professional courses. There was once over 100,000 students enrolled in those courses.
[Castro] That's what I wanted to hear. We once had over 100,000 students. They were part of the regular courses. Vecino, you are in contact with the students...[pauses for applause] very hardheaded...[pauses for laughter] but that is something else.
[Vecino] Just like you. Just like him.
[Castro, chuckling] If it's a compliment, it's not criticism. Do you know of any lawyer or graduate of philosophy or of any other field -- those fields from which we graduated -- who is cutting cane?
[Vecino] It's possible, but I do not know of anyone.
[Castro] A volunteer worker in a contingent...
[Vecino, interrupting] Commander, I do know that this is the year...
[Castro, interrupting] Have they returned to manual labor?
[Vecino] I will give you an example...
[Castro, interrupting] What did the historian do? What did he demand when those 100,000 students graduated?
[Vecino] He prefers work as a historian. That is only fair.
[Castro] Yes, it is only fair. But isn't eating more fair? Having potatoes and jams...[pauses for laughter and applause] The problem is that once he became an historian -- we all have great respect for historians -- he had to have cabbage grown for him in the fields. He had to have all his food, milk, and everything else either harvested or imported for him. An inverted pyramid situation develops when society advances in that way, with millions of people at the top relying on few people at the bottom for everything. Let's not forget padded payrolls. Some of the organizations that were conceived here, hotels...[pauses] well, not hotels...[pauses] Hospitals and schools had two or three times the number of people they needed. Unemployment figures dropped in that area. There was a time when this could be done and maintained. Vecino, your area grew like crazy. You are an Olympic champion...[pauses to chuckle]
[Vecino] We have almost cut that in half.
[Castro] By the year 2015?
[Vecino] The number of students we had in...
[Castro, interrupting] No, I am talking about university professors.
[Vecino] No, commander. We have not reduced the number of professors very much.
[Castro, chuckling] Because they are your workers...[pauses to mumble; mumbling indistinct] You said that you reduced the number of students, yet did not mention the number of professors. If the payrolls for professors were padded then, the payrolls for professors must be way overpadded now considering there's only half as many students.
You are not the only one, Vecino. This is happening everywhere. Everyone here looked for workers...[pauses] You kept many of the best students. The problem was that they did not have professional experience. In any case, they stayed on as professors. How many university professors do you have?
[Vecino] There currently are 21,000 university professors, down 3,000 over the last four or five years. The Higher Education Ministry employs just under 8,000 professors. The overall total is 21,000.
[Castro] Overall, what?
[Vecino] We have cut 3,000. Commander, many of them are involved in research. The number is growing.
[Castro] Well, that's something. I mention this every chance I get. I was just saying the other day that we have the largest number...[pauses] I was very pleased that I could report this to UNESCO. I discovered one day that we had the most teachers and professors per capita. That is good. It is excellent that they are being put to good use and are committed to teaching and learning [words indistinct] not the ideal. I will not say in times like these, but as a human ideal [words indistinct]. We also have the most doctors per capita. This fact is tremendously important: We are even with Canada as far as the numbers of teachers and professors per capita are concerned. I told them this in Copenhagen so that they could see...[pauses] very clearly. Social development does not figure into the neoliberalist or capitalist equations. Social development is impossible today, considering all the problems the world faces. I offered Cuba as an example. I only quoted two or three facts: One of them was the number of professors, doctors, coaches, art teachers, and so many others. We were once considered the country hosting the most foreign students on scholarship -- that is, when we handed out scholarships to foreigners -- per capita: There were 80,000 in the USSR and 25,000 in Cuba, but the USSR was 28 times larger than Cuba. No developed country, not even the United States, could match that. It's the same with the children from Chernobyl: We have helped more of these children than the rest of the world put together. That statement has great impact. It is an irrefutable argument. If a Third World country has done this...[pauses] Social development does not lie in addresses and resolutions. The social development summit was most unreal, resembling a communist, Bolshevik congress. Everyone was talking about poverty, hunger, misery, unemployment, illiteracy, and poor health care. They spoke so cheerfully about all of this. It is important to remember that capitalism created all of that and that neoliberalism terminated education and health care budgets everywhere. Thousands of teachers flock to Cuba every time there's an educational conference. They all cry out in unison, demanding to know why school budgets have been cut. They are killing children out there. There are death squads for children and other similar things. The public health sector has raised the roof because everything has been taken away from them. The most hypocritical thing about that summit was that neoliberalist and imperialistically hegemonic governments were discussing social development. Everyone is convinced of that, especially the honest people of those developed countries. How could this little country have all of this -- we still have it today -- without industrial development and with almost no energy resources? Cuba is not lucky enough to be floating on a sea of crude oil. No other country has accomplished as much, not even the developed capitalist countries. I will not even mention other countries, for they are far behind.
Therefore, the idea that there cannot be true social development without socialism...[pauses] The others have so much money. They have raided the world and continue to do so. They sell stuff at high prices and buy stuff cheap. They have enough resources to obliterate poverty yet spend only a little money to help those who are unemployed and very humiliated. The rest of the world -- 4 or almost 5 billion inhabitants -- does not have these kinds of resources. This is true. We should not feel ashamed of what we have accomplished, regarding these per capita figures. We must use what we have wisely and adapt to our reality. I prefer that you continue with those professors. Yes, I prefer that. I [words indistinct] recommend to take the professors out; undoubtedly, we cannot continue to admit more and more students. We must adjust admissions to our true possibilities today. This is not about the economy but about providing every college graduate with a job. That is what we have been discussing here. We must adapt in that manner [words indistinct] everything else. We are keeping...[pauses] We have not closed any medical schools. We have regulated them. We need nurses. We must increase the number of nurses. Regarding what was mentioned here...[pauses] excess currency...[pauses] Many people quit their jobs. There have been other problems. We have been improving on these situations. The demand for work grows. Patriotism has motivated the majority of our people to work over these years; however, not everyone has the same attitude. Many decided that they would not use the bus or fight traffic to get to work and caused considerable harm. Schools began to suffer from lack of teachers and services, hospitals were without nurses and services, and many other things happened. [applause]