NEWTON'S OPTIC: As Cuba considers the death of its president-for-life, Newton Emerson reflects on the healthcare revolution that made it all worthwhile
No article on the remarkable life of Fidel Castro - which may now be nearing its end - can neglect to mention the Cuban healthcare system, which has always impressed anyone prepared to ignore everything else. This article will certainly be no exception. Shortly after becoming prime minister in 1959, Castro realised that free healthcare would be hard to deliver in a multi-party democracy.
"By then, experience in Britain had already shown that a change of government could confuse hospital managers," Castro explained in a six-hour state television interview recorded in 1971 and still repeated nightly at 8pm. "That left me with no choice but to ban all other political parties and throw their leaders into the same prison where the last regime kept me."
Unfortunately, even this was not enough to ensure a fully nationalised medical system.
"It also became necessary to execute several thousand political opponents," Castro explained. "A state-controlled pharmacy just can't compete with over-the-counter revolutionaries."
As Cuba's healthcare revolution took hold, medical supplies were threatened by an American trade embargo.
"How are we supposed to run a communist system without free trade?" Castro's health minister asked shortly before his unexplained disappearance. The answer to that question was trade with the Soviet Union, which sent Cuba all the medical supplies it needed in exchange for almost starting World War III.
"That would certainly have pushed up hospital waiting lists," Castro recently joked at a conference for Iranian physicists.
In 1964 Castro's new health minister, Che Guevara, left the country due to an argument over the effectiveness of Chinese medicine. He died two years later in a Bolivian high-velocity acupuncture accident. Despite this setback, Castro continued exporting his healthcare revolution across Latin America by forcing 10 per cent of the Cuban population to study medicine then exchanging surplus doctors for oil. This policy continues today with Venezuela, although not everyone is convinced of its worth.
"I'd sooner have the oil than the Cuban doctors," admitted one Caracas resident. "It takes four of them to push your car."
Other revolutionary Castro health care initiatives included the abolition of Christmas between 1969 and 1998, primarily to prevent indigestion, and the Mariel Boatlift of 1965, when 25,000 psychiatric patients were passed off as fleeing dissidents and shipped to Miami.
"That freed up space in our mental hospitals for the actual dissidents," explained a Cuban doctor. "Fidel gave them political asylum."
Following the collapse of the Soviet Union in 1991, Cuban health care entered the so-called "Special Period" of minor economic adjustment.
Fortunately, at exactly the same time, Cuban medical researchers discovered that malnutrition increases life expectancy.
"Perhaps this is why Fidel is now so ill," one researcher speculated. "Throughout the Special Period, he bravely risked his health by eating while we starved."
As Castro slowly succumbs to the effects of his normal diet, ordinary Cubans are already reflecting on the man who gave them so much.
"It is true that we were beaten, tortured, imprisoned, impoverished, censored, patronised, shot at, lied to, denied the vote, denied our religion and prevented from leaving for 50 years," explained one Havana resident. "But whenever it made us sick, there was always a doctor."