U.S. medical students spend first week in Cuba learning Spanish and visiting tourist sites

Castro's exported doctors are human beings whose lives and skills belong to him and are his to barter. They are Castro's slaves.

Ambassador denounces anti-Cuba campaign in Venezuela*** ``Revolutions cannot be exported or imported like merchandise. They are born from the stomach of each country,'' he said in a Friday interview with Caracas daily El Universal. He said the campaign is funded by Miami-based anti-Castro groups. An energy pact signed last year allows Cuba to pay for some of its Venezuelan oil imports with goods and services. The communist island has sent 178 doctors and 323 sports trainers to Venezuela under the pact, and Chavez has sent more than 500 Venezuelans to Cuba for free medical treatment.***

***Thirty Cuban doctors also arrived in Caracas Wednesday to serve the needy in rural Venezuelan provinces. It's part of a deal in which Venezuela sells Cuba oil at preferential rates in exchange for Cuban expertise in tourism, sugar, medicines and other areas. Venezuela provides Cuba 53,000 barrels of oil a day - by some estimates worth $500 million a year. Cuban ambassador German Sanchez Otero said Cuban trainers work at schools and with athletes in 20 of Venezuela's 24 states. He stressed a ``synergy'' between Fidel Castro communist Cuba and Venezuela's leftist government.*** Venezuela barters oil for Cuban doctors

How Dr. Cordova escaped Castro's tyranny in Zimbabwae

American students attending medical school in Havana, Cuba are seen Tuesday Aug. 27, 2002. From left: Donniele Marshall, 21 from Delaware, Pierrecharles Serge, 23, from New York, Cuban professor Andres Rodriguez, Sitembile Sales, 22, from New York, Janell Lowe, 23, from New York and Narciso Ortiz, 26, from New Jersey.(AP Photo/Jose Goitia

Fidel Castro - Cuba

Presumably the students will be visiting Castro's AIDS/HIV isolation facilities, to learn why Cuba has the lowest infection rate of any country on the planet where the virus was introduced more than twenty years ago.

Right?

They are Castro's slaves.

And lousy doctors too

more than 6,000 students

That is an incredible number...more than 1000 per class year. Hard to believe they could be exposed to enough clinical material to get a decent education.

Bump!

Imagine these knuckleheads coming back to the US with their MD from Havana...I can hear the hollering now about discrimination because they won't be allowed to empty bedpans in the USA.

Cuban Medicine Today

Dr. Hilda Molina

Since I joined the health sector in 1968, the Cuban government has repeatedly asserted that "a central objective of the Revolution is the entitlement of free, quality medical care for everyone." The government systematically rejected the use of medicine as a means of making money. In 1989, Fidel Castro told me that he was "roundly opposed to charging for medical services," and that he "would even prefer that such services be given free of charge to foreigners who need them."

But, beginning in 1989, 1 began to notice an unfortunate change of attitude. Cuban authorities have established mechanisms designed to turn the medical system into a profit-making enterprise for the government. I witnessed this firsthand at the International Center for Neurological Restoration, which I directed from 1990-1994.

Beginning in 1989, Servimed (Servicios Médicos) of Cubanacán was strengthened to market "health tourism" and medical services to bring in additional foreign currency. Its representatives were toured worldwide to form relationships with international tour operators and doctors. These foreign associates were encouraged to recommend that their patients seek medical attention in Cuba, at a cost of roughly 10 to 20 percent of what it would cost in their own countries.

Cuban hospital directors who had sufficient facilities to treat patients from other nations were urged to accept foreigners' applications for treatment. Though the government, not the hospital, received the foreign patients' medical payments, the hospital directors were encouraged to devote a specific percentage of their budget (normally between 30 and 60 percent, depending on the time of year) towards this end.

II. Cuban Medical Services for Foreign Income

There are several significant flaws in this new Cuban medical system. Foreign patients are routinely inadequately or falsely informed about their medical conditions to increase their medical bills or to hide the fact that Cuba often advertises medical services it is unable to provide. Patients are often forced to pay intermediaries fees in excess of the 10 to 20 percent benchmark established by the Cuban government. There is also a deficiency of medical attention for both foreign patients and Cubans.

The lack of adequate professional qualifications, the absence of medical ethics, and the drive toward financial enrichment also characterize Cuba's medical system and often yield unfortunate results.

At present, all the medical institutions that government leaders believe are minimally equipped to treat foreign patients have been informed that the government will no longer provide financial support. Instead, they are expected to support themselves by selling their services. With the exception of the International Center for Neurological Restoration, these hospitals have not yet raised enough resources to cover their costs.

The driving force of this shift away from traditional primary healthcare goals towards making a profit has been Servimed's bureaucratic supervisors, who often have scant medical background and whose primary responsibility is soliciting foreign income. Servimed has associated itself with tour operators (some with questionable reputations) who also do not possess any medical qualifications. Fraudulent and corrupt relations exist between Servimed's authorities and their foreign correspondents, who are both illicitly enriched at the expense of sick people.

Authorities are careful not to distinguish individual Cuban medical specialists, but instead keep everything anonymous ("The quality of Cuban medicine is in its totality an achievement of the Revolution"). This ensures that foreign patients are channeled through Servimed, rather than directly to the hospitals, and facilitates the Cuban government's collection of foreign currency while scoring propaganda points abroad.

Foreign income earned from the sale of medical services goes directly to the Banco Interno de Cubanancón, a state agency. According to the Bank's director, this money is generally used to finance foreign trips by Castro and high-ranking functionaries. While in theory, the hospitals responsible for raising this money are authorized to draw between 30 to 60 percent of their contributions from the Bank, the reality is that the government often denies these financial transfers, demanding self-sufficiency.

I OPPOSED THE EFFORTS OF DR. OBESO TO EXPORT FETAL TISSUE FOR EXPERIMENTAL USE. IN ORDER TO GET FETAL TISSUE, UNWITTING DONORS WERE DECEIVED INTO HAVING CESAREAN SECTIONS, AND THEN EMBRYO'S DESTINY WAS HIDDEN FORM THEM.

The government's myth that Cuba is on healthcare's cutting edge attracts desperate patients whom Cuban hospitals are not actually in a position to help. It is common for Cuban hospitals to advertise services that they do not have the resources to perform. Moreover, they are incapable of guaranteeing results superior to what patients might expect in their own countries. As a result, patients are often inadequately or falsely informed about their condition and steered toward services they may not need.

For example, all hospitals are under orders to prescribe Cuban-made drugs to patients, including PPG (the so-called Api-farmacos), and products manufactured by Labiofam and by the Center of Hemoderivados, even when they are not needed. Each hospital keeps scrupulous monthly sales records of these products and hospital directors are required to give an explanation when sales do not reach quotas.

In hospitals that treat both Cubans and foreigners, there is an enormous disparity in the quality of healthcare services. Medical services are often immobilized by a lack of resources, so the government is sometimes forced to authorize budgetary allotments as rewards for hospitals that give priority to foreign patients over Cuban.

The Orthopedic Hospital "Frank País"
Although this hospital is open to both Cubans and foreigners, enormous differences exist between the quality of care offered to each. The foreigners are assigned the highest priority, followed by government functionaries and their families, followed by athletes with good records of performance, then dancers, and lastly, ordinary Cuban patients.

Foreign patients are often pressured to have unnecessary operations and treatments to increase the hospital's earnings. In the drive for capital, doctors also feel obliged to perform surgical procedures that they have not fully mastered or that lack scientific backing, such as nerve transplants to the spinal medulla in patients with medullar lesions. Casts and numerous orthopedic devices manufactured at this hospital, and prescribed for foreign patients, are also often unnecessary and sold at excessively high prices.

Dr. Rodrigo Alvarez Cambras, the hospital's director, claims to have developed the transposal of the Omentum Majus to the spinal medullary in patients with medullar lesions, though its originator was the American professor Harry Goldsmith, who introduced the technique into Cuba with me in 1987. Far more serious, Dr. Cambras carries out the procedure erroneously, due to a lack of knowledge of its underlying principles. The result? It does patients more harm than good.

Unfortunately, Dr. Cambras's close friendship with the Minister of Public Health has allowed him to live in a state of near-total impunity in Cuba. The hospital has failed to be self-sufficient because of its excessive costs and mismanagement, and because initial investment and subsequent improvements were excessively costly. Costs have also been increased by administrative disorder and Cambra's habit of traveling abroad at government expense with members of his family.

This institution is replete with large numbers of professionals and technicians who have limited qualifications, resulting in lack of attention to patients and inefficient rehabilitation. Paraplegia and quadriplegia cause enormous psychological problems in patients, many of whom become suicidal. Others lose all sense of control. Unfortunately, hospital authorities take advantage of these dire circumstances; these patients can be found consuming alcoholic beverages (boosting the government's profits on liquor sales) during the hours that they should be spending in physical therapy.

In many hospitals, either with the indulgence (or ignorance) of hospital authorities, the following kinds of incidents often occur:

Hospital workers demand extra payments from patients in exchange for better service.

Hospital workers have sexual relations with patients (including the handicapped) and/or those traveling with them, in hopes of obtaining bribes and gifts. There is also prostitution on the part of both sexes.

Hospital workers sexually abuse some patients.

Patients are pressured to obtain permission and money for hospital workers to leave Cuba in exchange for low cost medical services in the patient's home country. Recently, hundreds of hospital personnel (nurses, rehabilitation specialists, doctors, service personnel) have successfully left Cuba this way. Often, their patients are then abandoned.

Patients' and companions' money and personal effects are stolen.

Patients are obliged to pay prearranged ranged fees, then fail to receive the services promised.

Patients suffer avoidable complications such as dermatological infections or gastroenteritis (because of insufficient sanitary precautions in food preparation).

Patients show no improvement after their treatment or even worsen because of misdiagnoses or incorrect treatment.

In many hospitals, either with the indulgence (or ignorance) of hospital authorities, the following kinds of incidents often occur:

Hospital workers demand extra payments from patients in exchange for better service.

III. My Experiences with Cuba's Health Care System

Inspired by developments in the new scientific field of neurological restoration, in 1987 I led a small group of specialists in the neurosciences in creating the first Cuban research hospital dedicated to work in this area. After much negotiation and extensive efforts, our plan was approved. We were given a semi-destroyed house on Avenida 25 for experimental laboratories, the nineteenth floor of the Hospital "Hermanos Ameijeiras" for consulting facilities, and a budget of $3 00,000 (US) to construct and maintain our Center. With a small group of workers we trained an inefficient construction brigade, readied the facilities and acquired a minimal amount of equipment. Our work was initially limited to Cuban patients. The institution applied research and intensive, personalized neurorestorative treatment to patients affected by Parkinson's disease, cerebrovascular illnesses, lesions of the spinal medulla, relative alterations to cerebral aging, cerebral tumors, and craneocephalic trauma.

Hospital "Hermanos Ameijeiras"
This Center is comparable to any low quality private Latin American clinic. Although its facilities have been extraordinarily expensive to install and maintain, services have deteriorated rapidly due to a poor record of maintenance and a lack of government funding.

The Hospital Board, particularly its director, Dr. Raul Gómez Cabrera, systematically hides or minimizes the institution's deficiencies. This irresponsible approach, dangerous in any healthcare facility, has led to a general deterioration in plant and equipment, and to the collapse of any sense of ethical obligation on the part of the staff.

The enormous negligence found in the intensive care unit is worthy of mention. [While it was directed by Dr. Negrín various patients died there, personnel of the hospital assured me]. The energetic arguments I had, and the efforts I made to rectify negative situations were not adequately addressed by the authorities. Rather, I found them impervious to the problem, firmly supportive of Dr. Gómez Cabrera and his subordinates, and inclined to criticize me for raising the issue at all.

These new therapeutic methods employed state-of-the-art neuropharmaceutics, neurorestorative surgical techniques, integral and intensive neurorehabilitation, and biophysical stimulation. The Center could also perform brain transplants, first of the medulla suprarenal; later, the tejido nervioso embrionario in patients with Parkinson's disease.

The Center developed rapidly, generating increased support from foreign researchers and increased demand for services among foreign patients. As a result, we were assigned a larger facility, completing construction of the new hospital within a year.

Fidel Castro seemed fascinated by the Center's results and, particularly, by its international prestige. He visited numerous times, showing that he was personally assigning a high priority to our Center and goading other institutions to achieve similar progress.

Center of Medical-Surgical Research (CIMEQ)
This institution provides services only for Cuba's elites, diplomats and leaders of international governments friendly to the Cuban authorities, leaders of international revolutionary movements in other countries supported by Cuba, fugitives from justice in their own countries and international figures who have been granted asylum here. This Center has been placed in a separate area and enjoys resources and luxuries rarely found in Cuba.

The Center recently decided to broaden its activities to provide services to foreign patients willing to pay in US dollars. However, this hospital is incapable of offering services different from, or better than, treatment people could receive in their own countries. Foreign patients are obliged to share their facilities with military personnel, since the hospital functions in many ways as a military installation. Hospital authorities work closely with unscrupulous recruiters abroad who funnel patients to it via misleading information. The services offered to foreign patients are inefficient. This is particularly the case in the intensive care unit.

Although this hospital always enjoyed the support of the late Interior Minister, General José Abrahantes, there have been incidents of corruption and illicit diversion of funds. There also is evidence that Abrahantes used it to cover up his own trafficking in narcotics.

However, differences and confrontations between the directorate of the Center (which I headed), and the Provincial Communist Party, the Ministry of Public Health, and other government authorities soon emerged. I never attempted to forge special friendships with political leaders nor did I allow them privileged access to the services of the Center. I did not participate in their parties and attended only those required by protocol, remaining the minimum time possible. I did not ask for, or receive, benefits of any other kind from the Cuban government.

Ignoring Cuban government restrictions, we established direct relationships with the international scientific community to encourage the rigor and responsibility of our work and to enrich our medical knowledge. This put the Center's staff in a different situation than most Cuban biomedical researchers who remain in scientific isolation with the international community, avoiding the rigorous demands and accountability. Cuban authorities were not in favor of the Center's approach because it demonstrated to the international community that the US economic embargo did not have to affect scientific work. It also revealed the superficiality, irresponsibility, and even scientific cowardice of other Cuban institutions. I was considered a threat because I regularly obtained visas to enter the United States while other Cuban scientists were denied them.

THE INTERNATIONAL CENTER FOR NEUROLOGICAL RESTORATION IS NOW LIMITED TO FOREIGN PATIENTS WHO CAN PAY IN US DOLLARS.

I also refused to engage in political propaganda during my scientific visits abroad and refused to participate in the Cuban government's efforts to recruit foreign scientists for nonmedical tasks. Despite government opposition, the Center managed to maintain contact with the world's most prestigious neurological restoration specialists.

Central Clinic "Cira García,"
This clinic was the first Cuban institution established to provide medical services to foreign patients capable of paying in US dollars. I do not possess much in-depth information about its current operations, but I do know that the problems plaguing the aforementioned institutions also exist here. A succession of directors has come and gone for various reasons: inefficiency, misuse of funds and financial deals with patients or their families. This institution is equivalent to any other private hospital in Latin America where standards are either mediocre or of low quality. The international patients who come here for treatment could receive the same services in their own countries: there is no benefit to spending additional money to travel to Cuba.

The propaganda being broadcast abroad, advertising the Clinic's services, is full of misrepresentations and false promises. For example, the Clinic claims to have a "very effective" treatment for multiple sclerosis that has generated enormous hope to thousands of MS patients and their families. However, the centerpiece of this treatment is a Cuban drug called Timocina, and many patients travel internationally to this clinic without ever obtaining Timocina or other forms of treatment that might improve their condition.

The Clinic's doctors are poorly prepared professionally, so the majority of services rendered are actually carried out by specialists from other hospitals who work on an ad-hoc basis as outside consultants. As a consequence, the patients in residence receive only sporadic attention from qualified professionals.

The Center selected personnel based on merit, contracting employees only after a trial period during which they had to demonstrate their scientific and moral qualifications as a capable healthcare worker. Those who failed to do so were promptly dismissed. We firmly refused to rehire such people, despite the Provincial Communist Party's pressure on us to take back even people found guilty of serious crimes.

I was also prohibited from and criticized for attempting to create a chapel at the Center for those patients who wanted to worship.

Another area of confrontation with the government was the Center's determination to provide the same services to both Cuban and foreign patients, contrary to official instructions. Although I accepted requests to increase the number of foreign patients, we attempted to eliminate the role of Servimed and its foreign representatives, establishing direct links to the foreign patients instead. This enabled us to provide the patients with more rapid and efficient service, and relieved them of the fees to Servimed and its correspondents. Hospital workers used the gratuities they were sometimes given by foreign patients to purchase basic necessities such as soap and milk, rather than sending it to the Provincial party officials as was required.

Rehabilitation Hospital "Julio Diaz, "Pediatric Hospitals "William Soler" and "Juan Manuel Márquez"
These institutions do not possess the resources required to guarantee even minimally adequate treatment. They are comparable to private clinics of low quality in any Latin American country, and despite misleading advertising, do not offer services that are different or superior in any way. The "Julio Díaz" Hospital advertises services in other countries that it is in no position to offer. The Hospital promotes a therapeutic procedure which it claims "cures paraplegics": the application of peripheral electro-stimulation, with devices manufactured in Cuba. The advertising for this therapy is full of misrepresentations, and the claims lack any scientific basis.

The nursing staff is deficient at all three centers, as are hygienic conditions. The doctors and technicians at "Julio Diaz" are especially incompetent. The specialists and technicians charged with rehabilitation possess limited qualifications, and many also have deficient medical and personal ethics.

As in the other hospitals I have mentioned, there is a significant difference in the quality of medical attention offered to Cuban and foreign patients. Even Cuban children are treated as second-class citizens.

I refused to prescribe unnecessary treatment to patients, although on many occasions I was pressured unsuccessfully to perform more operations to increase our income. I persuaded various international firms to donate drugs to be given free of charge to thousands of Cubans suffering from Parkinson's disease.

Although some of my fellow directors have (since my departure) surrendered to the pressures of the government either out of fear, opportunism, or some other cause, while I was in charge, they fully supported me in my confrontations with government authorities.

The International Center for the Treatment of Retinitis Pigmentosa "Camilo Cienfuegos"
This Center is only open to foreign patients and specializes in retinitis pigmentosa, an incurable disease whose cause is perceived to be hereditary. The symptoms are serious, progressive alterations in vision and shrinkage of the visual field. The institution's director, Dr. Orfilio Pelaez, created a surgical treatment for this disease, but it has only caused improvement in very few cases, and to a very modest degree. Furthermore, it is impossible to buttress his results with solid scientific arguments. It is not surprising, therefore, that he has refused to discuss his work at any length with the international scientific community or to publish his findings on the grounds that he does not wish to have his techniques "stolen" from him. The Cuban government has repeatedly supported and defended these absurd ideas and practices.

To offer false hope to victims of this ailment is to dangle illusions before desperate people. Nonetheless, this is precisely what is occurring through the institution's massive propaganda campaign designed to attract thousands of international patients suffering from various kinds of optical defects.

A great number of patients who are suffering from other eye diseases (not retinitis pigmentosa) have been subject to this operation, following false diagnoses. Once this treatment begins, patients are pushed into two or three operations, followed by therapeutic treatments that include drugs, all of which increases the total cost to them and ensures larger returns for the Cuban government.

The Center has also dreamed up other methods to generate more foreign currency, including the hiring of health professionals and technicians for outpatient care. In spite of these profit-seeking measures, the Center has not managed to cover its costs. Ironically, Dr. Pelaez took his wife and son for costly medical treatment in the United States at a private clinic.

Embryonic Transplants:

The government was determined to demonstrate that Cuba was actually more advanced in performing embryonic transplants than the United States and Sweden, and sought to prove this point by performing this technique on a massive scale, often overlooking internationally accepted procedures.

Government authorities expected me to comply with their plans to perform numerous embryonic transplants on foreign patients to make the procedure a major source of foreign income. However, I categorically refused to do the operation unless it was needed. The Center made a careful selection of cases which were subject to the strictest observation, as prescribed by international protocols. We welcomed prestigious international specialists and commissions to periodically evaluate our work. Cuban authorities criticized these elaborate measures, suggesting that we should "lighten up increase the number of operations, shorten hospital stays, and reduce overhead costs.

I also opposed efforts to carry out transplants through a highly risky surgical procedure that required a wide opening in the skull. I opposed the efforts of Dr. José Angel Obeso to perform functional surgery in cases of Parkinson's disease, judging them as too risky for patients and insufficiently studied. In other words, I opposed the use of Cuban patients as laboratory animals.

Instead, I pressured the government to purchase the necessary equipment to perform a noninvasive, low-risk procedure, with the same outcome. Only after my extensive efforts, and after the Center produced much more foreign income than was required to pay for the equipment, did the government approve the purchase so the transplants could safely proceed.

The procedure was limited to a handful of foreign patients: one Soviet, one Uruguayan, one Dominican and one Puerto Rican. In all cases no other options existed; in the first two cases, the operations were performed free of charge, although I have no way of knowing if Cubanacán imposed additional charges without telling us.

Fetal Tissue:

I opposed the efforts of Dr. Obeso to export fetal tissue for experimental use. In order to get fetal tissue, unwitting donors were deceived into having a Cesarean section, and then their embryos' destiny was hidden

From them, It was argued that a Cesarean facilitated easier access to the fetal tissue. I opposed this, and to ensure donor's safety, we bought a sophisticated ultrasound device and other equipment, which allowed us to abort through low-pressure transvaginal vacuuming, a relatively non-traumatic method. I also demanded that the donor be told the truth about the outcome of their fetus. However, when my son visited the Maternity Hospital in November and December 1993, we learned that the doctors had lied to us: Women continued to be deceived and subjected to unnecessary psychological pressures, while all the equipment we had donated was underutilized

IV. The Cuban Government and the Center

A permanent conflict between the Cuban leadership and our staff developed. The authorities used subtle methods of repression to bend our will, adopting measures intended to put us out of business. While they pretended to be cooperative, they withdrew all the financial contributions our Center warranted, so that we were forced to become self-financing within the country's tight Communist restrictions. They tried to reroute foreign patients to other institutions. They excluded me from everything they could and forbade me from accepting invitations to travel abroad. They repeatedly and randomly I inspected the Center. They unsuccessfully tried to organize whispering campaigns against the Center and against They introduced persons into the Center whose purpose was to sow dissent between management and staff. They promoted and supported protests among workers whom we had dismissed for immoral actions.

This led me to understand that the problems which, in my naiveté, I had attributed for years to individual errors, were part of a larger system; one with neither scruples nor any sense of ethics. I shared these judgments with other senior staff members. In retrospect, I believe one or more of them were in contact with State Security and passed on our ideas and purposes. We nonetheless decided to remain in Cuba in hope that we would be in a better position to carry out useful work.

In spite of our precautions, in December 1993, the Provincial party launched a campaign against me and attempted to politicize the Center. Our staff was forced to attend innumerable party organized meetings, interfering with patient care and operation schedules. The message from these meetings was clear: I was required to follow all the party's instructions. I was forced to rehire a group of rehabilitation specialists who Were members of the Communist Youth, despite the fact that they had been discharged for engaging in a range of illegal activities including robbery, sexual abuse, prostitution and extortion. I also was prohibited from giving resources to the Center's staff who were in deficit from government allotments and who were required to donate their tip money to the Provincial party.

In February 1994, 1 had a meet into discuss my leadership status with Dr. Julio Teja, the Minister of Public Health, and with Dr. Julión Alvarez, the Vice Minister of Science and Technology, whose agency had direct responsibility for our Center. Because of my scientific qualifications and international prestige, I could continue as the Center's director, but would be required to have a "political commissariat" functioning alongside me to ensure that the Center operated along government- prescribed lines.

Refusing to accept these conditions, I was relieved of my position. I subsequently resigned from the Center, the Communist Party, the Cuban Federation of Women and the National Assembly. My unexpected departure forced the government to ask Vice Minister Alvarez to keep his bureaucratic position and take over direction of the Center. (That's why Dr. Alvarez, a gastroenterologist now directs a hospital dedicated to the neurosciences.)

After my resignation, the authorities harassed me and attempted to discredit me both personally and professionally. They followed all my movements for at least two months, and during this entire period, an occupied automobile was always parked outside my house. They tapped my telephone (I also received various anonymous phone threats) and they intercepted and opened all my personal correspondence. My staff was intimidated and prohibited from speaking with me, and all areas of my work were scrutinized in an unsuccessful attempt to find some pretext for censuring my qualifications.

Their campaign against me was also aimed outside Cuba. All my communication with colleagues abroad was blocked. The authorities discredited my scientific reputation and tried to send other specialists in my place to the medical congresses to which I was invited, though foreign scientists refused to accept the replacements. The government went so far as to try to "expropriate" my foreign professional friendships. They tried to "buy" many of the specialists with whom I had established professional relations. This tactic met with limited success.

IN HOSPITALS THAT TREAT BOTH CUBANS AND FOREIGNERS, THERE IS AN ENORMOUS DISPARITY IN THE QUALITY OF HEALTHCARE SERVICES.

My family was also affected, When my son and his wife prepared to visit Japan, both were detained at the airport and were subject to a brutal assault and incredible harassment. They had obtained all the necessary travel documentation, but it appeared that they would be forbidden to travel. Though they managed to leave two hours later, I sent an energetic letter of protest to the authorities, demanding an explanation. Their reply referred to my scientific and professional merits, and begged apologies, alleging that "there had been a regrettable confusion in the course of a sweep intended to capture someone who was traveling on a false passport."

Since I was removed as Director of the Center, Cuban patients have been given treatment inferior to that given to foreign patients. The hospital facility is now limited to foreign patients who can pay in US dollars, leaders and bureaucrats of the regime and their friends and family. Everyone else is required to be treated in an annex that lacks many basic facilities. The Cuban victims of Parkinson's disease are not guaranteed the scarce and expensive drugs they need, and the practice of prescribing unnecessary Cuban drugs continues.

The quality of the Center's staff has diminished. There has been a proliferation of acts of robbery, corruption and illegal diversion of funds. Hospital workers are clandestinely promoting and selling medicine to patients. (The drugs in question could be adulterated or fake.) Continuing scientific and professional staff education has been replaced by unproductive, demagogic political assemblies, since far greater emphasis is now placed on the Center's role in propagandizing the supposed virtues of the regime. The Center has lost complete contact with the international scientific community, largely because specialists in other countries refuse to work with an institution so heavily politicized and so sloppy in its professional discipline.

The Center advertises and performs restoration surgery, yet the specialist assigned to this work is a generalist and possesses neither the proper qualifications nor the necessary training. Soon the Center will carry out functional surgery on patients suffering from Parkinson's disease, a form of treatment which has not been adequately studied. These operations will also be carried out by young, unqualified physicians. Many of the professionals charged with rehabilitating patients have been trained in education or sports and thus lack the proper background to deal with neurological patients. The wavering attention to hygiene in the preparation of food in the hospital has frequently resulted in cases of gastroenteritis and enterocolitis. Obscure practices have invaded the institution --even in the presence of patients, procedures of santería and witchcraft are practiced.

Since February of 1994, the negative practices I outlined earlier have become standard in all Cuban hospitals that sell medical services to foreign patients. The main objective of many Cuban hospitals is generating foreign cur currency, by any means necessary. International relationships are driven by business logic and the need to make a profit. Acting as intermediaries, unscrupulous foreigners promote Cuba's services and recruit patients, many of whom are subject to deception or fraud. For example, through an association with the Italian businessman Guiseppe Dell'Osso, drugs past their expiration dates are promoted and sold at excessively high prices. Quite frequently, unnecessary surgical procedures are recommended just to generate more income. The operations are carried out by young physicians who lack the necessary experience or knowledge to perform them successfully.

Why have I taken the trouble to write down all these terrible situations? Because I hope it will convey the unscrupulous nature of the Cuban authorities regarding the provision of medical services as an income source. I hope that it illustrates how those same authorities are capable of destroying work that benefited thousands of sick people, and attacking individuals who have committed no crime, save to defend ethical and moral values and to refuse to bend to government pressure. I am not moved by any personal interest, much less by a desire for revenge. But I do consider it my obligation as a physician to defend both ethics and truth. Let those who read these pages do with the information what they consider best.

Dr. Hilda Molina, a former member the Cuban National Assembly, is one of Cuba's most distinguished scientists. She broke with the government on the issue of medical apartheid, the denial of medical care or medicine to Cubans while the same services are provided to dollar-paying foreign patients. In this report, smuggled out of the island, she says that she "opposed the use of Cuban patients as laboratory animals." Dr. Molina is founder of Havana's International Center for Neurological Restoration. She is a virtual hostage on the island, and despite repeated requests, she and her elderly mother have not been permitted to travel abroad.

Cuban Medicine and Foreign Patients

Mark Falcoff

Few political myths in the contemporary world have proven more durable than the notion that medicine in Communist countries is somehow superior in quality and service to that offered in the West, particularly the United States. For some inexplicable reason, the collapse of the Soviet Empire and the embarrassing revelations in its wake have done little to diminish the notion as far as it applies to one of the world's few remaining Communist states: Fidel Castro's Cuba. Establishment figures such as former Defense Secretary and World Bank President Robert McNamara, though gingerly critical of Cuba's political system, go out of their way to praise the island's medical "achievements," and the American press periodically regales its audience with reports on the thousands of foreigners who flock to Cuba for excellent medical treatment, at a fraction of its cost, we are continually reminded, in the United States.

Even now, nearly seven years after the collapse of its Soviet patron and financier, Cuba harbors pretensions of being a "medical superpower." As the author of this document makes clear, this is no accident: rather, it is the product of a conscious political and ideological campaign with important economic implications. Today, Cuban medicine and, particularly, its surgical branches are wholly oriented toward the generation of foreign currency. As a result, ordinary Cubans are shunted aside or made to wait indefinitely while foreigners occupy hospital beds, surgical wards, recovery rooms and rehabilitation facilities.

But this is not all. Even in the privileged precincts where only foreigners are treated, medical care is often substandard or flatly fraudulent. Foreign patients are lured to Cuba with promises of nonexistent treatments or cures for diseases where none exist. The treatment they receive is in no way superior to what they would obtain in their own countries, and, in some cases, it is inferior. Once in Cuba, the foreign patients are subject to robbery, sexual harassment, and extortion by hospital and nursing staff. They are prescribed Cuban drugs they do not need, merely to increase the size of their bill. Most important, many patients do not improve after treatment. Some succumb to opportunistic infections due to unsanitary conditions in kitchens and even operating rooms.

Some of the incidents described here are horrifying: Women seeking abortions are forced to have Cesarean sections when an ordinary vaginal procedure would suffice; fetal tissue is sold outside Cuba; patients are urged to submit to unnecessary surgery so hospitals can fulfill their "quotas;" qualified doctors and staff are often replaced by party hacks and bureaucrats; hospitals are used in narcotics trafficking. All this and more is detailed in the pages that follow. It does not make for appetizing reading. But it provides a devastating corrective to notions all too prevalent in the Western media and in many political and cultural circles in the United States and Western Europe. Perhaps surprisingly, although Cuban hospitals are being pressured to become financially self-sufficient by giving exclusive priority to foreign patients who can pay in US dollars, our author tells us that most medical institutions on the island are starved for resources: What they earn from their foreign patients must be forwarded to a central fund from which they cannot draw at their own discretion. Rather, the state decides funding levels, which, according to the author, almost always fall short of the hospitals' actual needs. She also suggests the possibility that the central fund is used for decidedly nonmedical purposes, namely, to pay for trips abroad for the Cuban chief and his cohorts.

FOREIGN PATIENTS ARE LURED TO CUBA WITH PROMISES OF NONEXISTENT TREATMENTS OR CURES FOR DISEASES WHERE NONE EXIST... THEY ARE PRESCRIBED CUBAN DRUGS THEY DO NOT NEED, MERELY TO INCREASE THE SIZE OF THEIR BILL.

The author of this document is no run-of-the-mill Cuban physician. A distinguished neurosurgeon of international reputation, she is the founder of Cuba's International Center for Neurological Reconstruction and a pioneer in the treatment of Parkinson's disease. Until recently, she was a member in good standing of the Communist Party and the Cuban Federation of Women. Her relatively high standing in the medical establishment is attested to by the fact that she occupied a seat in the National Assembly, Castro's puppet parliament. Her difficulties with the regime began in 1989, after the Soviet subsidy ended and Cuban hospitals were pressured to follow the regime's new economic logic. But there were other problems as well. She refused to engage in political propaganda on her foreign trips, which she regarded as wholly of a scientific nature. She refused to participate in Cuban efforts to recruit foreign scientists for tasks of an (undisclosed) "nonmedical nature." She resisted attempts to divert her staff from their duties to attend sessions in political indoctrination. Her efforts to enforce high ethical and professional standards among subordinates backfired politically, causing her serious problems with the provincial authorities of the Communist Party.

But her chief difficulty with the authorities was her refusal to convert her Center into a cash cow for Castro's regime: She would not prescribe therapy or drugs that her patients did not need. In retaliation, the authorities forbade her from traveling abroad. They organized a whispering campaign against her and her Center. They even introduced political provocateurs to sow dissent between the hospital management and its workers. Eventually, the Cuban government and the Communist Party demanded that she share administrative authority in the hospital with a "political commissariat." Instead, she resigned. At that moment she also rescinded her party membership and her seat in the National Assembly.

Thereafter, the Cuban regime blocked all her communications with professional colleagues abroad, intercepted and read all her personal correspondence, tapped her telephone and put her under surveillance. She even received anonymous phone threats. The regime attempted to undermine her reputation in Cuba and "to create confusion and disinformation abroad about [her] work,'' happily without much success. Most recently, she was refused an exit permit to visit her son, also a physician, who lives in Buenos Aires with his Argentine wife. From a woman deeply involved in the revolutionary process, she has suddenly become a non-person.

Since her departure, the International Center for Neurological Reconstruction has completely lost contact with the international scientific community. The foreign contacts it maintains are driven strictly by the need to generate money from abroad. Servimed, the Cuban government agency in charge of recruiting foreign patients, now works hand in glove with unscrupulous tour operators and foreign physicians (many trained in Cuba) to funnel unsuspecting patients to the island. Close by are a gaggle of foreign politicians, businessmen and diplomats who skim off resources in their role as Servimed's advance men and propagandists. Let those who contemplate medical treatment in Cuba, the author seems to say, beware.

The document which follows begins with a general survey of medical conditions in Cuba since the Soviet Union's collapse. From there, it turns to an extensive discussion of the conditions in the author's hospital and the difficulties that eventually led to her resignation. Finally, it concludes with a brief survey of other Cuban hospitals, about which the author has some professional knowledge, presumably through her still wide network of professional contacts in Cuba .

This testimony does not make for light reading. More than just a report on a medical crisis, this is a remarkable exercise in self-revelation. A woman fully committed to Communist ideals came to see over time that "the problems which, in [her] naiveté, [she] had attributed for years to individual errors, were part and parcel of a larger system, one with neither scruples nor any sense of ethics." She continues, "Let those who read these pages do with the information what they consider best. I am not moved by any personal interest, much less desire for revenge. But I do consider it my obligation as a physician to defend both ethics and truth." Both are well-served by this timely, courageous and revealing document.

Mark Falcoff is Resident Scholar in Foreign Policy at the American Enterprise Institute in Washington, DC. He was a professional staff member with responsibility for Latin America of the Senate Foreign Relations Committee in the Ninety-ninth congress, and has taught at the universities of Illinois, Oregon, and California (Los Angeles). He is the author of Small Countries, Large Issues, A Tale of Two Policies, and Modern Chile: A Critical History.

Cuban Doctors Imprisoned for
Warning of a Dengue Fever Outbreak

Anita Manning

A Cuban physician has been in prison for more than a year after being arrested for criticizing his country's handling of an epidemic of dengue fever.

Public health experts fear his conviction for spreading "enemy propaganda" will stifle reports of disease outbreaks that could have international significance.

The arrest of Dessy Mendoza Rivero, they say, comes at a time when world health leaders have called for better communication and surveillance to spot emerging diseases that could race around the globe at the speed of a jetliner.

"It is notable that countries are becoming more open about reporting outbreaks, in the interest of global public health," Says Jack Woodall, director of ProMED-mail, an electronic disease surveillance network.

"Nowhere, with the single exception of Cuba, have we heard of anyone being imprisoned for carrying out their duty as a physician to report publicly matters affecting the public health."

Mendoza 43, was arrested June 25, 1997, in Santiago de Cuba. He was brought to trial on Nov. 18 and now is serving eight years in Boniato Prison. He is permitted visits only every other month.

His wife, Caridad del Carmen Pinon Rodriguez, also is a physician, and they have three sons, ages 13, 7 and 1. The baby was born just 20 days before his father's arrest.

Pinon spoke by telephone recently with Sarah DeCosse of Human Rights Watch, describing events that led to her husband's arrest.

"In early 1997, Dr. Mendoza had become aware there were a lot of cases of dengue in Santiago," DeCosse says.

He visited hospitals, clinics and family members of victims. Dengue causes painful fever and in its hemorrhagic form, internal bleeding.

Mendoza estimated that 20 to 40 people had died and 3,000 had been hospitalized; 30,000 had fallen ill, but not seriously.

"He was concerned because none of the official media was reporting the outbreak. So he went to the international media," DeCosse says.

He gave interviews, to Radio Marti, the U.S.-sponsored radio network, along with a Spanish news service, and Netherlands radio.

"What likely propelled this case was that soon after Dr. Mendoza made his statements, the Spanish and Portuguese press did coverage that warned tourists to be careful," DeCosse says. "It seems likely the Cuban government would be sensitive to that, in that they have invested so much in tourism."

Cuban authorities ultimately acknowledged the epidemic, claiming eight deaths and 2,058 hospitalized, and took steps to eradicate it, she says. But Mendoza remains imprisoned, suffering from high blood pressure and cardiac arrhythmia, DeCosse says.

Human Rights Watch and Amnesty International have protested Mendoza's imprisonment. Barbara E. Joe, Amnesty coordinator for Cuba and the Dominican Republic, says Mendoza is "a prisoner of conscience and deserves to be released. He's never advocated or engaged in violence. He's being imprisoned for engaging in free speech toward a benign end -- public health."

But spokesmen for the Cuban government disagree and, while refusing to discuss the case, they question the interest of human rights groups.

"He was sentenced for activities against the country," says Luis Mariano of the Cuban Intersection, the Cuban representative in Washington, DC He d no further comment and said he did not have a contact in Cuba who could comment.

David P. Fidler, who teaches law at Indiana University, specializing in international law and public health, says he hopes the World Health Organization and and International Commission on Human Rights will challenge Cuban president Fidel Castro on Mendoza's behalf.

But no such action has been taken, he notes and, in fact, WHO recently awarded Castro a "Health for All" gold medal "in recognition of outstanding contributions to the attainment of health for all."

WHO spokesman Gregory Hartl said it's not WHO policy to comment on the citations it wards to individuals.

But, says Fidler, "One of the key elements of the new WHO strategy for emerging disease is global surveillance.... If we don't know what's going on out there, were not going to be able to develop intervention strategies."

Reprinted from USA TODAY, July 16, 1998

Healthcare in Cuba is free, and worth every penny.

Being sick (or well) in Cuba is bad for your health!

BUMP for the excellent information!!

Socialized Medicine in Cuba 2002, Part II –
Other Hidden Faces of Cuban Medicine
Miguel A. Faria Jr., M.D.
Monday, Aug. 26, 2002

In Part I of this essay, we discussed the secret epidemic of dengue fever, the Cuban gulag and other aspects of Cuban medicine leading to a poor state of health in that Caribbean island, based on Dr. Dessy Mendoza Rivero's book "¡Dengue! – La Epidemia Secreta de Fidel Castro" (in Spanish only).

Cuba's health care system is a disaster for both patients and physicians. Because of the meager salaries paid Cuban physicians, on the average 400 pesos per month (equivalent to $20 U.S.!), many doctors quit the profession and seek jobs in the only industry that offers any chance for economic opportunity and access to dollars – the Cuban tourism industry. Doctors can be found driving dilapidated taxis, acting as tour guides, or even working in the paladares (family inns) as meseros (waiters) or cooks.

Those who choose to remain in the medical profession suffer long hours of work and lamentable working conditions. This is particularly true for female physicians who, despite the "liberation" of the Revolution, are not only working mothers but also the spouse who shoulders the lion's share of domestic chores in a persistently machismo-oriented society.

Dr. Dessy Mendoza writes, "When a woman physician, one of the thousands in the island, ends her 24-hour duty in the hospital where she is assigned, she must get home and then as if by magic find food [if she can find any available] to feed her family."

Dr. Mendoza's revelations are in accord with my own research in this area. In "Cuba in Revolution," I commented:

"Fidel, in fact, proudly counts the number of physicians and professors in Cuba as another great achievement of the Revolution. But of what good are these highly educated and trained professionals to the nation when the country remains drawn into a perpetual economic black hole? There are no incentives for these professionals to work hard and be productive because individual initiative is not rewarded. Citizens are not entitled to the fruits of their labors because communism does not take into account enlightened self-interest. Neither professionals nor workers are allowed to accumulate wealth or to own private property for the betterment of self and family. Consequently, the Cubans on the island do not strive to succeed or even to be productive. They play the game, but do not produce. Marxist theoreticians do not understand that when individuals are materially rewarded for their work in a free market society, the community and society also benefit, because there is a beneficial exchange of goods and services guided by Adam Smith's classical concept of the invisible hand of supply and demand of the free market and laissez-faire economics."

In Cuba, science and medicine remain subordinated to the state and political considerations – that is, the whims of Fidel Castro. Even the doctors serving in the government health agencies or ministering to patients in clinics and hospitals are not informed about new technology or medical breakthroughs, except for the privileged few – the Communist Party members, the privileged mayimbe class, who are allowed to travel abroad or are employed in the clinics serving the tourist industry – "sociolismo," the Cubans call it.

Moreover, specialized diagnostic studies (e.g., CT scans, endoscopies, ultrasound, etc.) and treatments (e.g., chemotherapy, radiation therapy, surgery, etc.) must be approved by medical bureaucrats with political connections, another example of "sociolismo."

Castro's 'Doctor Diplomacy'

Cuba's young physicians must serve in international missions to assist Third World nations for propaganda purposes. Presently, Dr. Mendoza estimates that close to 1,500 Cuban physicians are employed in what many of us in the U.S. have characterized as Castro's "Doctor Diplomacy."

A Cuban physician in one such "humanitarian mission" found to his dismay that in Guatemala, where he had been sent, common laborers and unskilled workers were paid between $100-$300 monthly. Guatemalan physicians earned well over $1,000 monthly, while he, a Cuban surgeon, was paid less than $25! While in Guatemala, the Cuban surgeon found himself relying on the good will and the financial aid of his humble Guatemalan patients.

Cuban physicians in Nicaragua are paid the equivalent of $50 per month by the Cuban government. The Nicaraguan government has been forced to supplement the income of their intended benefactors with a subsidy of $40 to $70 per month, depending on the specialty, just to make ends meet for the Cuban physicians!

It is no wonder that many physicians in such missions defect to freedom. The reader may remember the saga of two Cuban physicians, Drs. Leonel Córdova and Noris Peña, who defected two years ago in Zimbabwe. They were imprisoned for two months in that African country, ruled by dictator Robert Mugabe. After finally reaching freedom, the two Cuban physicians reported that during their mission they did not render medical care to the people as propagandized. According to Dr. Córdova, they "did not even touch a single patient." Their purpose in that mission was solely to support the embattled regime of the Marxist dictator, on behalf of Fidel Castro.

The vast majority of physicians, though, submit to the Cuban government because their families are held as hostages in the communist (fascist) island, at the mercy and reprisals of Fidel Castro. So the doctors comply with their internationalist mission and return to Cuba to continue their professional enslavement and to submit to the will of Fidel Castro.

Tourism and Medical Apartheid

According to dissident physician Dr. Hilda Molina Morejón, a Havana neurosurgeon and founder of the Colegio Medico Independiente de Cuba (Independent Medical Association of Cuba), "the main purpose of many hospitals in Cuba is to generate foreign capital, one way or the other … the government assigns special budgets to those hospitals that serve foreign patients."

So in contrast to the deplorable state of medical services provided to ordinary Cubans, there exists in Cuba special hospitals and clinics with the latest medical technology that cater to two types of patients – foreign tourists with hard cash and the privileged mayimbe class of the communist (fascist) hierarchy.

In "Cuba in Revolution," I mentioned the documented case of an ordinary Cuban citizen who was denied medical care at the Cira García clinic for foreign tourists. We learn from Dr. Dessy Mendoza that such cases are the rule rather than the exception. Furthermore, Dr. Mendoza recounts the difficulties of obtaining even those medications and treatments prescribed for ordinary Cubans.

He cites cases of patients with cancer who cannot get treatment because the medications have to be bought with dollars and not Cuban pesos! Yes, some pharmacies, like the specialized clinics, are authorized by the government to accept only dollars and are almost exclusively patronized by foreign tourists and the mayimbe class with access to dollars. So much for Cuba's revolutionary ideals of social justice and egalitarianism!

Cuban communism looks more like fascism as the years pass, but what is the difference between the two iniquities? They are kindred spirits of the same evil totalitarianism/collectivism!

Foreign tourism has brought much needed hard currency to the dictatorship of Fidel Castro, but it has increasingly alienated the Cuban people, who continue to suffer in silence. Cuba has more problems. Another problem is one of the highest suicide rates in the world, much higher than that of other Latin American nations or the U.S. That, notwithstanding, the government agency SERVIMED, founded in 1989, is in charge of promoting tourism and medical apartheid. Cuban physicians are paid in pesos while Castro's government keeps the dollars. Be that as it may, doctors employed in these facilities are the privileged few, part of the "sociolismo" network.

Slogans used to attract foreign tourists include "Cuba: An Ideal Destination for Your Health" and "Cuba: Tourism and Health." The most deceiving slogan, according to Dr. Mendoza, is "Cuba: The Most Salutary Health." While SERVIMED does provide high technological medicine in modern centers throughout the island, it is patently false when it claims in the advertisement underneath the aforementioned slogan: "Health can be recuperated in Cuba because the island is free of contagious diseases."

Deceitful ads such as this can be promulgated with some success not only because of the state-controlled press as well as the complicity of the U.S. media but also because "access to medical statistics and scientific information is restricted to the high-ranking public health, bureaucratic hierarchy," which, of course, is only possible in a totalitarian, fascist state.

In addition to such diseases as dengue fever, typhoid fever, leptospirosis and hepatitis that we discussed in Part I of this report, other diseases have become resurgent in the island because of increased sexual promiscuity, prostitution and, increasingly, tourism. (Tourism in Cuba, though, has taken a dive since the 9-11 tragedy, severely hurting Cuba's flow of hard cash.)

Tourists are not being informed about these diseases in tourist pamphlets or promotional material. For example, they are not told that AIDS increased 150 percent between 1990 and 1995. Moreover, gynecological infectious diseases are rampant, particularly in the young jineteras (prostitutes), including vaginal monilia (yeast), trichomoniasis, bacterial leukorrheas and other sexually transmitted diseases. Syphilis and gonorrhea, in fact, have increased dramatically in direct correlation with the tourism industry. Dr. Mendoza relates that in the native female population these types of infections are widespread, in part due to the lack of antibiotics and medications necessary for treatment.

Perhaps the most choking admission for Dr. Mendoza was not what he experienced in communist Cuba – after all, he was born in 1954 and thus grew up with the Revolution – but what he experienced when he reached freedom: "What I could never imagine from my neighborhood in Santiago is that I would come abroad and have to educate and inform first the Europeans and then the Americans, still fascinated with the Revolution and Castro, about the horrors of Cuban socialism."

Amen!

Miguel A. Faria Jr., M.D., is Editor-in-Chief of the Medical Sentinel (www.haciendapub.com) and author of "Vandals at the Gates of Medicine" (1995); "Medical Warrior: Fighting Corporate Socialized Medicine" (1997); and "Cuba in Revolution: Escape From a Lost Paradise" (2002). All three books are available from www.haciendapub.com.

"Cuba in Revolution" is also available from the NewsMax.com store.

Read more on this subject in related Hot Topics:
Castro/Cuba
Health Issues

THEY WILL BE ABLE TO WITNESS THE ADVANCES IN ELECTROSHOCK THERAPY FOR DISSIDENTS WHO ARE NOT ABLE TO APPRECIATE cASTRO'S GOODNESS.

ACCUSED CUBAN TORTURER, 79, DIES MEDEROS DIDN'T GO TO JAIL AFTER TRIAL

By Charles Rabin
The Miami Herald
La Nueva Cuba
Agosto 25, 2002

Accused Cuban torturer Eriberto Mederos died of prostate cancer Friday morning in a Catholic hospice as a court hearing was underway to determine when the former psychiatric nurse was to report to prison.

Earlier this month, he was found guilty by a federal jury in Miami of lying about torturing Cuban dissidents on his application to become a U.S. citizen. The 79-year-old never spent a day behind bars after his conviction.

Five minutes into the 10:30 a.m. hearing, Mederos' attorney, David Rothman, approached the bench and informed U.S. District Judge Alan S. Gold that Mederos had died.
''We realized there was no point in going forward. So we recessed,'' said Assistant U.S. Attorney Frank Tamen, who successfully prosecuted Mederos earlier this month.

Experts hailed Mederos' Aug. 1 conviction as a historic decision, saying it was the first time an accused torturer had been convicted on criminal charges in the United States. After World War II, Nazi war criminals had been held accountable, but only in civil proceedings here.

The jury found Mederos obtained his U.S. citizenship in 1993 by illegally concealing his membership in the Communist Party in Cuba and his role in electroshocking political prisoners at the Mazorra psychiatric hospital in Havana.

Gold's courtroom deputy Jacob Hasbun said the government filed a written motion in court Aug. 14 to revoke Mederos' citizenship. That motion is still pending since Mederos' attorney Rothman has yet to file a response.

But the prosecution is unlikely to follow through with the motion. Tamen called it a moot point.

Rothman did not return several phone calls. Several calls to Mederos' family members were also not returned. It is unclear where he will be buried, or when a funeral will be held.

The relatives of one of Mederos' victims, Regina de Sosa Fonts and her husband, Carlos Fonts, say they still want Mederos to lose his citizenship, even after death.

Regina de Sosa Fonts' father Eugenio de Sosa Chabau -- a one-time prep school classmate of President John F. Kennedy -- is largely credited with launching the case after a chance meeting with Mederos at a Hialeah nursing center in the early 1990s.

De Sosa Chabau said he was a victim of Mederos in Mazorra in the late 1960s. He died of cancer in January at age 85, unable to witness Mederos' conviction.

Regina, 60, and her husband were at the hearing Friday when the judge told the courtroom of Mederos' death.

''It's hard to describe the feeling,'' Regina said. ``To me, Mederos died the other day when he was convicted. Justice was done. This is not a matter of vengeance.''
Belkis Ferro, 47, of Perrine, is another victim who testified she was tortured by Mederos after destroying government tobacco plants at a government farm in Mazorra when she was 16. She said she never believed Mederos was sick.

''I didn't expect this,'' she said. ``But he will have to answer to God now.''

Mederos admitted during the trial that he administered electroshock treatment to patients, but only under doctor's orders.

The claim contrasted sharply testimony from seven former political prisoners who said at the trial that Mederos shocked their temples and testicles while they were held down on concrete floors filled with feces and urine.

During the trial, Tamen called Mederos an evil servant of communist tyranny who terrified inmates from 1968 to 1978. Mederos began working at Mazorra hospital in the 1940s.
Rothman conceded the conditions at the hospital were horrifying.

But he claimed Mederos was merely following medical orders.
After his conviction, Gold ordered Mederos to report to jail the next day. But the judge, aware of Mederos' illness, extended that deadline at least three times. He was to be sentenced Oct. 16.

A Black Journalist Goes to Havana
Myles B. Kantor
NewsMax.com, July 11, 2002

I respect Justice Clarence Thomas a great deal, so George Curry isn't someone I'm inclined to praise.

While editor in chief of Emerge magazine, Curry mocked Justice Thomas as a marionette of white conservatives. A 1993 cover depicted Thomas with a handkerchief around his head à la Aunt Jemima and as a lawn jockey on the November 1996 cover.

Curry got Justice Thomas obscenely wrong, but at least he gets Cuba right.
Curry and other black journalists recently went to Havana – capital of America's closest sponsor of terrorism – for a colloquy with Cuban "journalists." Curry knew that journalism means something different in Cuba than in America, but he hoped he and his peers would have some commonality with their hosts.

His hope wasn't fulfilled. "If any of us were momentarily lulled into believing that these were our counterparts," Curry writes in "Reporting on Cuba's 'Reporters' " (http://www.blackpressusa.com/op-ed/Speaker.asp?NewsID=2371), "that impression was quickly shattered when several declared that they had supported the Castro revolution in 1959 and view their job today as helping those in power.

I cringed. These are not journalists, I thought, these are government public relations agents. Actually, I was more derisive – I called them “flacks."

To be a journalist in Cuba, one must belong to the Union of Cuban Journalists (UPEC, or Unión de Periodistas de Cuba). This corresponds to Article 53 of Cuba's "constitution": "… press, radio, television, movies, and other mass media are state-owned or socially owned, and can in no event be privately owned." Flacks indeed.

Witnessing Cuba's totalitarianism made Curry think of his rights as an American: "At home, we can openly question George W. Bush's intelligence [or deride Justice Thomas], but here it is unlawful to be disrespectful of Castro."

Curry isn't being figurative; "disrespect," or desacato, is a crime in Cuba, applicable to Castro and all of his functionaries. (Disrespecting Castro and senior functionaries carriers a harsher penalty, though) "Disrespect" is the instrument of repression often used against Cuba's bona fide journalists, those who don't work for the regime and report its reality.

One of these crushed voices belongs to Bernardo Arévalo Padrón, sentenced to six years in November 1997 for disrespecting Castro and "Vice President" Carlos Lage during an interview. Forced labor and beatings have been perpetrated against Padrón in prison.

This man should be a professor, not a prisoner.

Neither did the regime's denial of race consciousness in Cuba – where people of color are a majority – persuade Curry. He reports, "[S]peak to any dark-skinned person on the streets of Havana and once they're convinced that you are not a government official, they will admit that both color and class remain staples of Cuban society."

As a black prisoner of conscience, Dr. Oscar Elias Biscet wrote to Coretta Scott King in January 1999, "They [black Cubans] have a very low political, economic, and judicial representation in contrast to the numerous prevailing black penal population. This situation is never publicly manifested by the government but is a component of communism's subtle politics of segregation." Heroic black Cubans like Dr. Biscet and Jorge Luis Garcia Perez have been ripped from their families for criticizing Cuba's white autocrat.

Unlike black Fidelistas such as Al Sharpton, Randall Robinson and Alice Walker, Curry doesn't glorify this autocrat.

He doesn't boast about having lunch with Castro, as Sharpton did on "The Chris Rock Show" in 2000.

He doesn't write about how Castro's "eyes shone with intelligent intensity," as Robinson does in "The Debt: What America Owes to Blacks."

He doesn't compare Castro to the Dalai Lama and rhapsodize over embracing him, as Walker does in "Anything We Love Can Be Saved." (See "Hugging Fidel.")

Curry appreciates what the black abolitionist and journalist Frederick Douglass said in 1860:

Liberty is meaningless where the right to utter one's thoughts and opinions has ceased to exist. That, of all rights, is the dread of tyrants. It is the right which they first of all strike down. They know its power. Thrones, dominions, principalities, and powers, founded in injustice and wrong, are sure to tremble, if men are allowed to reason of righteousness, temperance, and of a judgment to come in their presence. Slavery cannot tolerate free speech.

CASTRO'S DOCTOR DIPLOMACY

Virgilio Beato-Núñez,
MD, Enrique Cantón,
MD, Gladys Cárdenas,
DO, José Carro,
MD, et al
The Medical Sentinel

Feature Article

Castro's "Doctor Diplomacy"

Cuba's health services have come under attention recently.(1,2) Since 1963, Fidel Castro has been exporting health care personnel including physicians to countries in Africa, Latin America, and Asia. It is estimated that approximately 5 percent of the Cuban physicians working for Castro's MINSAP (Cuban Public Health Service) are involved in service abroad.(3) The so-called "doctor diplomacy" may have begun in the manner of an assistance program for guerrilla movements, but it soon turned into big business for Havana. In this article, we analyze briefly the current events that led to two physicians serving in Castro's "doctor diplomacy" in Africa to desert in a maneuver that turned dangerous for them and for innocent bystanders.(4) Furthermore, we analyze the recent offer from Fidel Castro to train low-income Americans in medical sciences in order to remedy the health statistics of the United States in the context of the "doctor diplomacy" --- one of Castro's ways to influence public opinion abroad.

The Breadth and Scope of "Doctor Diplomacy"

The story of two Cuban physicians who were serving in Castro's elite "doctor diplomacy" service in Zimbabwe became front page material when they dangerously escaped from being kidnapped and returned to Cuba under the "long arms of the revolution."(2) The doctors who managed to escape, Drs. Leonel Cordova and Mirta Peña, were two of the thousands of physicians and health care personnel who are currently stationed in carefully crafted, thoroughly supervised and managed units in many countries of the so-called Third World. The income to Castro's purse from this "doctor diplomacy" in Zimbabwe alone is estimated at $1.2 million (U.S.) per month.(4) A very small fraction of this goes to pay the physicians themselves and their families in the island.

Contrasting with the saga of the doctors serving in Zimbabwe, two weeks ago, Castro offered free medical instruction to recruit and register Americans to join his "doctor diplomacy."(5) Castro's offer was made to "low income Americans" who were invited to study medicine in Cuba for free and then return to the United States to provide treatment for the poor and underserved in what may turn into the latest twist of the "doctor diplomacy" schemes. These events seem to be temporally intertwined making it possible to look at them chronologically. Let us retrace them together from the various press releases that have appeared later. On May 26, the first signs of defection of Drs. Cordova and Peña were noted in Havana. During the weekend of June 3-4, Castro offered free medical training for low income Americans to a congressional delegation of African-American lawmakers that were touring Cuba. At that time, the communist leader was already attempting to divert the defection by kidnapping the Cuban doctors, ordering them to return to Havana via Paris.4 Later, when the logistics in Zimbabwe and South Africa became known through a note written by the defecting doctors and the press coverage, perhaps Castro attempted to divert negative public opinion on his "doctor diplomacy" by offering free medical training to Americans.

Castro made the free training offer without consulting the proper authorities in his own MINSAP. He just commented to the press on this "offer that could not be refused" after Democrat Rep. Bennie Thompson told him that his Mississippi Delta congressional district has an infant mortality rate much higher than that of Cuba. According to the Associated Press, Castro stated: "It would be hard for your government to oppose such a program. It would be a trial for them. Morally, how could they refuse?"(5)

We feel compelled to reject the offer made by FIdel Castro. His is an offer of malicious distraction, and a propagandistic attempt to improve on the perception of the health standards and achievement claims of his Revolution.(6) Castro has used these claims to justify all aspects of his 41 year rule by a single party and a single individual --- himself.

Our conclusion is based on facts that can be described and analyzed. The first consideration in assessing the offer by Fidel Castro for free medical training is that medicine is in reality a social science that uses the methods of the natural sciences to attain four goals: to promote health, to restore health, to prevent disease, and to rehabilitate the patient.(7) The practice of medicine is therefore carried out in a social order that cannot be improvised, invented or assumed to be totally controlled or controllable --- unless, of course, one practices medicine in a totalitarian society. While it is no secret that Castro's Cuba is a totalitarian society ruled by a tyrannical leader for the past 41 years, the people of the United States and of Mississippi in particular must not be intimidated into accepting an "offer that could not be refused." Castro's offer can and must be refused on further grounds. While Castro pointed out that Cuba has an infant mortality rate of 7.3 deaths per 1000 live births,* he did not disclose that the mortality of children in Cuba in the age group from 1 to 4 years is 11.8. This latter figure is 34 percent higher than the equivalent health statistic for the United States, despite the fact that Cuba has the most comprehensively organized health service in the Americas. These official data from the Pan American Health Organization (8) and our analysis suggest that Castro has organized the MINSAP services with one goal in mind: to lower the infant mortality rate without effective consideration to other important health parameters.

The importance of infant mortality is that it correlates with the overall health, education, nutrition, standard of living and well-being of the population. In Cuba's case, this is not true. Cuban health services are organized and structured so that the resources, support, and services are directed to reach the facilities that must maintain a lower infant mortality (death from the time of birth to 12.0 months). Therefore, in Castro's Cuba, life support may be artificially instituted and continued on an individual infant or a community to achieve a numerical goal in the infant mortality of a particular health sector or region. This is done without consideration to other health services that are rationed, denied, simply ignored, or blamed on the CIA, obscure reasons or the improperly called American embargo. While these excuses are made part of the propaganda, fundamental health issues such as the provision of the elements for public hygiene are not prioritized. Instead, priorities are given to the desired goals of the MINSAP, a lower infant mortality with bonuses and favors for those physicians and units that reach their goals. Therefore, infant mortality data in Cuba since the 1970s reflect the organization of the health services and the compliance of the health care personnel in terms of the promulgated and designated goals promulgated by the totalitarian State. Infant mortality in Cuba cannot be a measure of the well-being and the standard of living of the population under these circumstances.

The issues on infant mortality must be developed further. The following brief analysis will demonstrate the lack of seriousness in Castro's infant mortality propaganda. Consider, for example, a health parameter linked to infant mortality, maternal mortality. The maternal mortality of Cuba in the last three years has been 26 to 33 deaths per 100,000 live births. This health statistic is not low despite the fact that Cuba has the lowest birth rate in Latin America (12.5 births per 1000 population). Cuba's maternal mortality figure is in fact 4 to 5 times greater than the equivalent parameter for the United States (8.4). Furthermore, Castro's comments to the African-American lawmakers alluded to the health status of Mississippi, a State with an infant mortality of 10.2 but a maternal mortality of 9.3.(9) It is well recognized that mortality statistics do not depend solely on medical care. Issues such as nutrition, education and communication are considered important in achieving truly significant health statistics. Therefore, unless Castro is planning to take over the economy, the schools, the agriculture, and the communications of Mississippi, how can he offer to lower this important health statistic through his "doctor diplomacy?"

Physicians who take their undergraduate training in a foreign country outside the regulations of the American Association of Medical Colleges are required to apply to the Educational Commission for Foreign Medical Graduates (ECFMG). This is a regulation that applies to all individuals, foreign born or nationals, who have completed a course equivalent to that of an American medical school. The ECFMG has supervised and controlled the influx of foreign medical graduates (FMG) since its inception in the late 1950s. At this point in time, FMG's sit for the same exams offered to American medical students and graduates but the passing scores are not identical for each of these groups. The passing score of FMG's is set, among several considerations, on the number of physicians that may be desired in the U.S. for immigration purposes. Where will the graduates of this new posture of Castro's "doctor diplomacy" fit in any of these regulatory measures? It is true that Cuban FMG's have in general passed the required examinations in about 25 percent of the cases in their first attempt.(10) But even if the graduates from Castro's "doctor diplomacy" do go through the arduous passages reserved for FMG's, how are the imprints of communist social indoctrination going to fit into the training programs offered in the U.S.? Or how are the working habits, values, and merits for promotion free of political alignment or ideology going to adapt to American institutions? Some have argued that medicine under Castro in Cuba has been inappropriately contaminated with militarism, politics, specific guidelines and schemes for the management and treatment of all commonly seen illnesses, and directives on what can and cannot be written into a death certificate.

Finally, medical education is known to be easily adapted to fit one or another system of indoctrination using biological or social principles.(11) Therefore, during the so-called free medical education offered by Castro, one could easily expect that students will be subjected to the systematic indoctrination that goes on in Cuban medical education under Castro. Cuban medical indoctrination has been applied to Cubans and Latin Americans enrolled in medical schools in the island since the early 1960s.(12)

The indoctrination begins with the premise that the physician owes to society and the Castro regime their medical education. It continues in terms that the physician must become a communist and he or she must pledge to improve his or her skills as a communist in parallel to his or her skills as a physician. Finally, the graduate swears to be like Che Guevara.(12) Although this last goal of Castro's medical education may provide a new fashion to European designers, the fact remains that violent revolution, destruction, and death were all part and parcel of the preachings and deeds of the communist martyr of Cochabamba.

While Castro told the black lawmakers that he supports their efforts to issue him credits despite the dismal status of his bankrupt economy; the bearded, legendary communist leader failed to discuss with the African-American lawmakers the current issues dealing with physicians in the island. Castro did not address anything regarding the situation of Dr. Oscar Elias Biscet, prisoner of conscience. Castro never mentioned his handling of the Colegio Médico Independiente during the destruction of Concilio Cubano in 1996.(13)

Moreover, since 1999, Cuban physicians have not been able to leave Cuba with proper documentation and permits according to the MINSAP regulation Number 54.14 According to this regulation, medical doctors and dentists must serve 3 to 5 years in designated areas in the island of Cuba before they are considered for a permission to leave the island. In this manner, Cuban physicians are blatantly discriminated and made to suffer higher penalties than the rest of the professionals.

Castro also failed to recall the stories of Dr. Desy Rivero(15) and Omar del Pozo Marrero,(16) both physicians who were unjustly jailed and later forcefully exiled from Cuba for reasons that perhaps Castro alone would have been able to explain to the press and the American lawmakers. And, it goes without saying that Castro failed to disclose to the lawmakers and the press those sensitive negotiations that he was carrying out with Zimbabwe's dictator-president, Robert Mugabe. The nature of those negotiations on the defection and fate of the Cuban physicians may have enlightened the lawmakers from their financial, human rights, and political perspectives.

Conclusions and Summary

In summary, Castro's "doctor diplomacy" involves utilizing Cuban physicians to serve in areas where the Cuban regime has entered into contractual relationships with the expressed intention of providing health care aid and establishing or nourishing diplomatic relations with the host community. The physicians serving in these units are essentially under surveillance all the time and any change in their plans not consistent with the orders given from Havana invariably lead to the involvement of police or paramilitary security forces. In the recent desertion of Dr. Cordova and Dr. Peña from southern Africa, the news media got involved in the saga about one week after its onset. This led to massive media attention and the eventual agreement between Castro and Mugabe to "let the doctors go." The terms or consequences have not been disclosed. Financially, "doctor diplomacy" is an outstanding source of income for Castro's economy since his MINSAP pays doctors and other personnel only a small fraction of the millions of dollars that are received by Cuba. Regarding the alluded health statistics for Mississippi, the offer of Castro to train for free low-income Americans must be refused because his "claims on health achievements" are based on propaganda that are not indicative of health, well-being, or adequate standards of living in Cuba. We must reject the fact that these young American students will undergo an aggressive brainwashing and indoctrinating process through which they will become Castro's pawns. They will inevitably take to Castro the much desired influx of dollars that he needs to remain in power. Finally, the specific claim of Castro that he can lower the infant mortality rate in Mississippi implies a future control by Castro of health care, finances, education, nutrition, and communications in that State. Obviously, such claims must be denounced as delusional and their malicious implications rejected.

Castro's offer of free medical training to serve the poor and underserved can and must be refused. First and foremost, it must be refused because there is no need to turn Mississippi or any State or region of the United States into another Cuba. Second, there is no need for hundreds of young Americans to turn into Che Guevaras, who will then come into the United States to preach and practice death, hate, and oppression of individual and collective rights and liberties. Furthermore, there is no need to adopt the propaganda in "Castro's revolution health achievements" without recognizing their hidden liabilities: widespread alcoholism, sociopathic behavior, low birth weights, endemic giardiasis, growing incidence of hepatitis E infection, widespread venereal diseases, very high abortion rates, high maternal mortality, double to triple the deaths from unintentional injuries and accidents. Finally, there is no need to guide the wholesome medical vocations of young people in the United States from any race, creed, nationality or income bracket to become physicians in Cuba. Castro's is a society that will likely turn them into revolutionaries looking for some "Mission Impossible" scheme in order to establish an elusive, egalitarian, socialist worker's paradise that has never existed. Instead, it has forged chains on the people and a Hell on Earth wherever it has been established.

Footnote

* This figure is highly open to question and does not agree with U.S. government figures as published elsewhere. For example, I suspect "live" is subject to Fidel Castro's interpretation. See Tom Carter, "Cuba was 'advanced' before Castro took over, report says." The Washington Times, March 29, 1998, p. 23. It cited an infant mortality figure of 12 per 1000 live births, according to Cuban government figures.

References

1. Cuba sells snake oil to visiting congressmen. Miami Herald, June 6, 2000, p. 6B.
2. Gaither C, Marques-García S. Castro maneuvers to bar doctors' defection to U.S. Miami Herald, June 11, 2000.
3. Miranda OC. Recursos humanos en salud de Cuba. Educ. Med. Salud. 1986;20(3):375-381.
4. Gaither C. Diserción en Zimbabwe empaña la "diplomacia médica" de Castro. El Nuevo Herald, June, 12, 2000.
5. Shepard P. Castro to offer medical training. Associated Press, June 4, 2000.
6. Breo D. In socialist Cuba, primary care now reaches rural areas. American Medical News, July 25, 1977, pp. 11-13.
7. Martí-Ibañez F. To be a doctor. Miami Medicine, November 1987, pp. 27-29.
8. Health situation in the Americas. Pan American Health Organization. Basic Health Indicators 1999. PAHO/99.01, Washington, DC.
9. Personal communication with Dr. Thompson, Head of the Mississippi Health Department contacted by telephone.
10. Seywell RM, Studnick J, Bean JA, Ludke R. A performance comparison: USMG-FMG house staff physicians. Amer. Journal Public Health 1980;70(1):23-28.
11. Stetten D. The medical school curriculum: the indoctrination of the medical student. Bull. New York Acad. Med. 1973;49(4):285-288.
12. Gordon AM. Medicine in Cuba. Lancet 1983, October 29; 2 (8357):1026.
13. Amnesty International. Cuba: government crackdown on dissent. April 1996. AI Index: AMR 25/14/96.
14. El gobierno Cubano pone trabas a los viajes de médicos y dentistas. El Nuevo Herald, September 13, 1999.|
15. Cuba: doctors imprisoned. Lancet 1998;351:439-440.
16. Gordon AM. Omar del Pozo Marrero, physician prisoner of conscience. Lancet 1995. August 19; 346 (8973):509.

The collaborators for this paper were: Virgilio Beato-Núñez, M.D.; Enrique Cantón, M.D.; Gladys Cárdenas, D.O.; José Carro, M.D.; Alberto Fibla, M.D.; Sergio González-Arias, M.D.; Antonio Gordon, M.D., Ph.D.; Eduardo Martínez, M.D.; Manuel Peñalver, M.D.; Juan C. Pérez-Espinosa, D.O.; E. Ricardo Puig, M.D.; Joel Silverman, D.O. Finlay Medical Society, P.O. Box 523096, Miami, FL 33152, http://www.finlay-online.com.

Originally published in the Medical Sentinel 2000;5(5):163-166. Copyright ©2000 Association of American Physicians and Surgeons.

WORDS AND ACTIONS DIFFER WHEN IT COMES TO CUBA --- RCB

Excerpts from UN and OCHA pages: http://www.reliefweb.int/ocha_ol/civilians/the_media/index.html

"As human beings, we cannot be neutral, or at least have no right to be, when other human beings are suffering. Each of us...must do what he or she can to help those in need, even though it would be much safer and more comfortable to do nothing."
- Kofi Annan
UN Secretary-General

THE MEDIA
The misuse of information can have deadly consequences in armed conflicts, just as information correctly employed can save lives.
If the first casualty of war is the truth, the next victims are those who are unable to draw attention to their need for protection. They are all too often rendered speechless and faceless by war, reduced to crude statistics in the news. Giving these victims a voice can be vital for mobilizing the support necessary to protect human life. Informed public opinion can act as a brake on human rights abuses, by countering the culture of impunity and urging respect for international law.

Informed public opinion can act as a brake on human rights abuses, by countering the culture of impunity and urging respect for international law.

October 7, 2002

UNITED NATIONS

Office of the Spokesman for the Secretary-General

inquiries@un.org

http://www.un.org/News/dh/latest/contactuspage.shtml

http://www.unhchr.ch/html/hchr.htm

http://www.un.org/english/

Dear Sir or Madam:

SUBJECT: BEATINGS, MUTILATIONS, PERSECUTION * IS THIS ADMISABLE?

It is with utmost regard for your work that I place emphasis on several issues that urgently need a prompt resolution.

Information Missing from ALL MUZZLED MEDIA.

Misleading information is blocking Cubans for their many attempts for liberalization. -- Obstruction of justice ---

CNN Lucila Newman and others in Havana are chumming with Castro and do not report incidents and important meetings involving the many dissidents and actual Opposition in Cuba. By concealing the facts they are empowering the oppressor.

It is alarming that readers of influential journals would fall so easily for the savage PR campaign against people who are passionate about freedom. Cubans have a great love for democracy and a deep dislike for abusive totalitarian regimes.

Human Rights Violations in Cuba for over 43 years.

Some political prisoners awaiting trial for over two years are mutilating themselves in despair because of brutal treatment. Direct contacts inform us that hunger is a daily reality. Citizens are persecuted for expressing their ideas; either they are thrown in jail, or if lucky, just beaten.

Will the United Nations ever stand up to condemn these acts in a public forum for the rest of the world to understand the affliction of the Cuban people in the island and abroad?

Some Cuban Americans in United States are ex-patriots who escaped Castro’s bloody hand. Almost all have relatives who were either jailed, tortured or killed by Fidel Castro in order to keep his miserable vision of Socialism alive. America offered a safe haven to preserve their culture, waiting for the chance to return to a free homeland.

We thank you for your last private and sympathetic response, but public acknowledgement is what the writer in distress needs.

There is a massacre going on and you are turning the other way. This deplorable attitude must stop.

Cuba needs someone in the UN to come out in defense of the oppressed people of Cuba, and for this official to take a vigorous and drastic stand against the Dictator Castro, violator of human rights.

Thank you for your consideration.

Respectfully,

Rosa C. Bengochea

Fort Lauderdale, Florida, U.S.

FOR FREEDOM & JUSTICE GROUP
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