Embargo's ill effects

While failing to destabilize the Castro regime, the U.S. squeeze on Cuba has had a baleful impact on the health of the island nation's people.

August 01, 1999|By Lauren Goodsmith

FOUR A.M. at Miami International Airport. I'm surrounded by people with enormous black duffel bags stuffed with clothing, gifts and medicines. Their carry-ons are filled with over-the-counter supplies: aspirin, Tylenol, Imodium and Citrucel.

I'm on my way to Havana to take part in a public-health study tour organized by the Center for Cuban Studies in New York. Most of the other people on my flight are going to visit family members in "extreme humanitarian need," one of the few circumstances under which the U.S. government allows its citizens to travel to Cuba.

A few minutes before boarding begins, a flight attendant requests the attention of the crowd, and a hush falls over the waiting area. She reads a statement in Spanish detailing the conditions governing visits to Cuba by U.S. citizens, the limitations on the amount of U.S. currency that can be carried and spent there, and the general restrictions of the embargo.

Now in its 38th year, the U.S. embargo on Cuba has apparently done little to destabilize Castro's rule. But it has succeeded in seriously harming the health of countless Cubans.

In its 1997 report, "Denial of Food and Medicine: The Impact of the U.S. Embargo on Health and Nutrition in Cuba," the American Association for World Health stated that "the U.S. embargo has caused a significant rise in suffering -- and even deaths -- in Cuba."

The report also said, "A humanitarian catastrophe has been averted only because the Cuban government has maintained a high level of budgetary support for a health care system designed to deliver primary and preventive health care to all of its citizens."

Professional groups come from all over the world to study Cuba's health care system, long considered a model for developing nations. It is a model from which even "developed" countries such as the United States could learn a thing or two.

I went to Cuba legally, as part of a professional group whose members received licenses from the U.S. government. My companions on the tour in mid-April included dentists, physical therapists, a prosthodontist and a psychiatrist. They traveled to Cuba from Jamaica, the Bahamas and Mexico.

Health care -- like education -- is considered a fundamental right of all Cubans. Health services, with the exception of prescriptions, are free. Cuban physicians work closely with communities, emphasizing preventive and primary care.

During the first years under the revolutionary government, the island's dismal infant-mortality rate was drastically reduced. Cuba's rate is now the lowest in its region, identical with that of the United States, and its childhood immunization rate surpasses ours, according to the United Nations Children's Fund.

Our visits to numerous family doctors' offices, clinics and hospitals, and discussions with medical professionals in each of these facilities, left my colleagues and me deeply impressed by the efforts to sustain health standards despite the embargo, which has caused shortages of basic drugs and supplies.

The trip also left us profoundly troubled by the U.S. government's role in inflicting suffering upon a people indiscriminately.

The effects of the embargo, which began in 1961, are insidious and far-reaching. In 1992, the embargo tightened when Congress passed the Cuban Democracy Act, which bars foreign-based subsidies of U.S. companies from doing business in Cuba. The act allows private groups to deliver food and medicine to Cuba, but it is a process filled with red tape.

Since 1992, replacement components for the majority of Cuba's water chlorination plants have been unavailable from the U.S. firm that produces the parts. As a result, drinking water supplies for more than 4 million Cubans are in poor condition. Water-borne diseases such as dysentery, typhoid fever and viral hepatitis have been on the rise this decade.

Many important new drugs, especially immunosuppressants, are produced only in the United States and are difficult or impossible to obtain in Cuba. The limited availability of treatments for Cuban HIV/AIDS patients is considered by the the American Association for World Health to be the embargo's single most serious consequence.

Even the island's efforts to produce drugs and vaccines have been seriously hindered by provisions of the Cuban Democracy Act that impede export sales of Cuban biotech products. In the 1980s, Cuban researchers developed a meningococcus vaccine, which they hailed as the first of its kind. They are seeking to produce a combined vaccine for Hepatitis B, dengue fever and meningitis. They are also carrying out advanced research on an AIDS vaccine. At least part of this work is funded by foreign sales of vaccines developed in Cuba.

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