I promised to say a few words following Comrade Miret’s intervention to explain my absence from this forum.
Actually, a great number of activities accumulated in the last few days. There were visiting heads of government that we should receive and converse with as well as other personalities, not all of them reported by the press. Many of said personalities are of great importance for a number of activities taking place in our country at this moment, therefore, it was necessary to take some time to attend to them.
There are times when all things come together, and before we realized it the forum was already upon us, at a time of year when a lot of activities simply do not allow us the time, and there are still quite a few of them pending. Time flies and in a few days there will be the Young Communist League's Congress and a series of other events and meetings such as the National Assembly and others.
Despite all these obligations, I would have found time to be here with you for a few hours and take part in the debates during some sessions. I have always been much interested in listening to all the opinions and proposals expressed in these forum. I like to be well informed and involved so, when my turn comes to speak, I can be well aware of the characteristics, the content and the relevance of the presentations and debates.
I have not missed a single forum since 1990. They used to be held annually. I remember when this event which began modestly as a meeting on spare parts --a primary need then-- became what it is today, an extraordinary science and technology movement. I liked the annual meetings but such efforts were required that we felt it would be more rational to hold them every two years, so they are biennial now. However, this first biennial forum I was unable to attend and take part in the debates for the reasons I have explained.
The most important reason that prevented me from been here is not related to my other obligations, those that are planned and those that come up throughout the year since you can plan 50, 100, 200 activities and by the end of the year you have had 400. Sometimes you need to sacrifice sleeping time or the time usually taken to rest and to study; because we also need to study like you do, we have to read and analyze information. Perhaps, we could have managed a few hours to participate in the forum had it not been for the hurricanes that have been following one another.
First, it was the notorious hurricane George which swept across the Dominican Republic and Haiti. It also caused damage here, quite a lot, because it followed an intense drought so aid had to be sent to many places, as it is usually the case. Still, we gave a priority to the Dominican Republic and Haiti that were badly stricken. They lack the experience we now have; they have not reached our degree of organization to protect the population and the facilities.
Special attention was paid to obtaining assistance for these countries, basically through diplomatic work. In this effort, we were strengthened by the moral value of our stated position, in the sense that we preferred the Dominican Republic and Haiti be given a priority because they were enduring more suffering, they had sustained a harder blow.
We truly are better organized today, better than ever before. It would be difficult to find another country as prepared as we are to face all sorts of difficulties, and you are morally stronger when you solicit help for others and work for others. We could never have imagined that just a few weeks later another hurricane of exceptional characteristics would come along. Hurricane Mitch, which has been considered one of the four most formidable in the century, posed a threat to us. It was in the south of Cuba and almost every hurricane entering that zone at this time of year turns north and comes through our country.
That monster of a hurricane had sustained winds of over 250 kilometers an hour and gusts over 300. Meteorologists now classify hurricanes in the categories of 1, 2, 3, 4 and 5, and some might be confused by these categories. A category 1 hurricane has sustained winds over 100 kilometers an hour. When the winds are stronger than 250 kilometers an hour, it is a category 5 hurricane. Anyone might think that a category 5 hurricane causes five times more damage than a category 1 hurricane; it is a simple calculation, we are used to multiplying and dividing and anyone could be misled. But the fact is that a category 5 hurricane --and this I learned quite recently-- is 25 times more destructive than a category 1 hurricane. It is 25 times more destructive!
This hurricane was coming our way and it looked poised to hit the country right in the middle. It seemed like it was going to pass west of Jamaica, through Camagüey; it was heading that way but then it turned west. It was moving very slowly but it advanced with the winds gathering force because hurricanes draw their strength mostly from the heat in the sea. Over the land they lose strength, worn down by the friction and the irregular terrain. When they encounter high mountains they break up quite a bit until they reorganize again but at sea they gather strength immediately. This hurricane was coming along the Gulf Stream, which carries its energy from the equatorial seas to Norway, and so you can imagine the kind of energy that stream provided for this hurricane to grow stronger.
It was being carefully monitored. Even though some people were getting tired because they had been mobilized for several days, Rubiera [the head of the Meteorological Institute Forecast Department] insisted on it because the only thing you can do in such situations is to adopt measures in advance; it cannot be left to chance in the belief that it might not come near because no one can be certain. The residents in the Pinar del Rio province were mobilized in case it hit there but it went off west. There was even a moment when it began moving southwest.
The fact is that this highly unusual hurricane remained stationary for a long time off the coast of Honduras and for as long as it remained there, the risk existed that it would head north and assault Pinar del Rio. I do not know what would have been left of the tobacco plantations and the tobacco drying sheds in Pinar del Rio; and tobacco is one of the country's fastest growing export items.
I have asked one of the experts here if we could grow quality tobacco throughout the island and he has said yes. The country is working towards a future production of 400 million cigars annually for export; they are in high demand. Some of our cigars are sold to tourists in other Caribbean islands for 40 or 50 dollars each while we receive a dollar fifty or two dollars; still, it is a source of revenue. Here, we do not sell them at such high prices although they are also sold to tourists.
There is a huge demand and it is a growing sector so, if that hurricane had hit Pinar del Rio it would have caused tremendous damage. Most of the raw material from the first quarter of the year, 15,000 tons of tobacco, are in the drying process. The tobacco harvested in the first quarter of the year is being processed there.
Well, an amazing thing happened: that hurricane remained stationary off the coast of Honduras for 58 hours. The little islands in the vicinity were completely wiped out. But, the hurricane gradually lost energy because using up the enormous energy needed to reach over 300 kilometers gusts it gets spent and weakens --as an airplane flying at 1000, 1500, 2000 kilometers an hour which uses much more energy than at 500-- and at such high speeds a certain amount of energy is lost. But, the fact is that it remained for 58 hours off the coast of Honduras, and not far from Nicaragua.
There were very heavy rains so the damage was not so much caused by the winds --although the winds were strong enough to knock down banana trees, houses and many other things but these were not winds of 200 or 150 kilometers an hour, there were times when the sustained winds were less than 100 kilometers an hour-- the damage was caused by the rain. It rained throughout all these hours, and then it moved inland, losing force, until entering Guatemala.
Then, it disappeared in the mountains of Guatemala, the hurricane was said to have disappeared. Some 48 hours passed, and there was Rubiera announcing that the hurricane was back, this time in the Gulf of Campeche.
The famous hurricane reappeared and I clearly remember it was a beautiful day when the news was released that the hurricane was gaining back its strength. It was heading northeast and no one knew how far away from us it would pass or how much rain would fall, and this at a time when we were already feeling far from any danger. Imagine that!
It passed about 170 kilometers from the coast of Pinar del Rio so the rainfall was not very heavy and it did not cause any considerable damage. But, I remember that when the Meteorological Institute was reporting it 300 kilometers away from Cuba there were gusts of wind of up to 100 kilometers an hour here, and 105 or 110 kilometers at the site of the weather bureau in Havana.
It is worse when they are disorganized as was the case with hurricane George which had three eyes when it left Haiti before it reorganized again but with gusts of wind that could be felt 300 kilometers away. Hurricane Mitch caused a real disaster; it is considered the worst natural disaster in Central America in the last 200 years. Only watching the pictures of the destruction it brought to these countries can anyone have an idea of what this means. Also because these are poor countries. Honduras and Nicaragua, for example, are two of the poorest countries in the Americas. Haiti may be number one in poverty, not only in this hemisphere but in the world --not number one but it is among the poorest in the world-- but Honduras and Nicaragua, the hardest hit, are among the poorest countries in Latin America and the Caribbean, except for Haiti.
The rest are very poor, not as poor, but very poor: Guatemala is a poor country, El Salvador is a poor country. They are also threatened with another hurricane: the deportation of a large number of the so-called undocumented Central American immigrants who live in the United States and send money home to their families in Central America; they are being expelled.
There was this terrible destruction. Everything was swept away in Honduras, not a single banana tree remained standing, not a single crop left, nothing, and vast areas flooded. An average size river runs through the capital, somewhat like Havana's Almendares River --and the Almendares used to give us headaches with floods every year around the Rancho Boyeros highway before the Mamposton dam was built-- and there, in Tegucigalpa, the amount of rain that fell was unimaginable. Added to this is the fact that Central America has been heavily deforested, tens of thousands of hectares of forests have been lost every year. Forests retain water but when there are no forests the water runs to the rivers and so the flooding in the capital was sudden and dreadful.
There are two major factors about floods: the amount of rainfall and the time period in which it falls. Look what happened with hurricane George in the town of Mayari where people had to be evacuated --when the hurricane was practically gone-- from places where there had never been any flooding so they were not usually evacuated. At Mayari, a large town located on the highest bank of a river that sometimes rises considerably, the people had to be evacuated under the rain. A dam there had not been completed due to the special period but we plan to work on it little by little until it is finished. The problem was that 300 millimeters of rain fell in four hours, and 300 millimeters in four hours is quite different from 700 millimeters in 24 hours.
The same thing happened in the area of San Nicolas, at the Havana province, a town that had never seen floods before. Some 300 millimeters of rain fell in just a few hours nearby, at the source of a stream, and the same thing happened as in Mayari.
Nobody knows how much rain fell in Central America. Watching the films makes you think it was not as much as during hurricane Flora but, again, it does not have to be that much.
It is not known yet for certain how much rain fell during hurricane Flora. The estimate is 1600 millimeters; there were not many check points then but there were a few and they registered 1500 and 2000 millimeters. The width of the flooding and the current in the center of the Oriente province --and I was an eyewitness-- was the same as the width at the mouth of the Amazon River, I mean, at the point where the water from all the rivers converged. Today all those rivers have dams. Before hurricane Flora they used to partly flood the Cauto Valley every year.
Today, dams have been built in all those rivers. Even in the Cauto river before it reaches the Central Highway. There is a dam near Miranda and the Contramaestre river is dammed too. All the rivers that spilled over during hurricane Flora, including those in Manzanillo and Granma provinces, now have dams. But all that water --it was raining for 36 hours-- was flowing down the river which grew like a sea wave, like a moving wall, in the early hours of morning and everyone was taken by surprise. Some farmers thought it was the sea invading from the north of the Oriente province.
Around 1200 people died at the time of hurricane Flora. Today, they would not have died because every time a hurricane poses risks, despite the dams that have been built, all the people living in the area are evacuated. There is a high degree of organization, with everybody involved, together like at this forum with discipline and all guaranteed, as Miret has said: 700,000 people were evacuated during hurricane George, and that as a preventive measure.
Now, hurricane Mitch was highly unusual. None of the countries affected can be criticized because the effects went beyond all calculations. I was telling you about a river that flows through the capital of Honduras; the rain caused the river to overflow and the flooding and mud-slides almost covered the city, entire neighborhoods were completely wiped out.
I was saying that deforestation contributed to the damage caused by the hurricane. Various factors combined, really: the unusual nature of the hurricane, the number of hours of rainfall and the deforested mountains, since forests retain water. Thus, it is not just the amount of rainfall but the time in which it falls, plus the capacity of these rivers’ sources to retain the water. If the water can be retained for several hours, the flooding is not as destructive.
On the other hand, El Niño is having an impact. There are already climate changes and not only that but also deforestation. This is the price that mankind is beginning to pay for its assault on nature as well as the reason for the growing emphasis on environmental issues and the need to attach ever greater importance to this problem.
There had never been a drought in Cuba like the one preceding hurricane George. It is true that it did not strike the whole island the same way but in large areas of Holguin, Las Tunas and part of Guantanamo, it was extremely severe. The drought disturbed some areas more than others but the island in general had never suffered a drought like this before. In some areas there was absolutely no rain all spring.
On the other hand, hurricanes like these are more frequent now. El Niño is producing major floods in some places and major droughts in others. For these countries it was a catastrophe. It is said that this will cause a 50 years relapse.
There has been a high number of victims. The figures vary and no one will ever know the exact number because there are the dead and the missing people. The bodies of many victims of hurricane Flora that hit Cuba in 1963 were never found. Nobody should think that after such a flood the bodies start to show when the rain stops. Actually, many bodies are washed away by the current never to be found.
In Central America, between 10,000 and 12,000 bodies have been recovered, different figures have been reported. The initial reports were about 30,000 people either dead or missing. As a rule, 95% of the missing people turn out dead. Hundreds and perhaps thousands of people are still buried under the mountain mud. I know that in Nicaragua several thousand people lived in five villages at the foot of a volcano --I read these data-- and only 180 had been found; the others remain buried there and are counted as missing.
We considered it our primary duty to effectively support Central America according to some considerations made after the passage of hurricane George in view of the ravages sustained by Haiti and the Dominican Republic. We sent a medical brigade to the Dominican Republic as soon as there was a landing strip available in the capital. I hear that one of the doctors in the brigade spoke here this afternoon.
I keep fresh in my mind many interesting and moving stories about what they did in Barahona. There were two towns there: one on the left bank of a river, the other on the right. The one on the right was much more seriously affected, the mud reaching almost to the house rooftops. In the town on the left, there was not as much mud, as it is on higher grounds. Two different municipalities, with an old hospital in the one on the left and a new one in the one on the right, recently completed but buried under the mud. They cleaned the mud off the equipment. Can you image anesthesia equipment, respirators and others covered by the mud?
Only a few pieces of equipment could not be recovered, that is, they were beyond repair but most were recovered. Hardly 48 hours later the equipment rescued from the mud was being used in surgeries. They performed over 100 deliveries and operations, notwithstanding the thousands of people who came to see them from up to 50 kilometers away. The authorities had to step in with armed personnel and forces to preserve order. People began lining up at 3:00 a.m. to see a doctor.
It had a great impact. The government was very appreciative, all the authorities and organizations were grateful for the work done by these 13 health-care workers; that is what we should call them because among those 13 people was the electric generator technician and a few nurses. It was all very moving because there was nothing they would not do to honor these workers and express their appreciation for what they did and the example they set, for the way they had restlessly labored. They were taken to other places later. The Dominican authorities are very interested in our experience. What happened in the Dominican Republic gave us valuable ideas about possible forms of cooperation in this field.
Before that, when the same devastating hurricane passed over Haiti, we were wondering what would happen to that country. It was then, on September 28, that we advanced the idea of a comprehensive health-care program for Haiti. Between 200 and 250 people were reported dead and a number of people missing. They did not know the exact figure but it could be estimated in 500 altogether. Well, it hurt badly to hear about those 500 victims and we thought about the poverty in Haiti where many houses are made of palm-tree leaves and other fragile materials. Fortunately, the mountain range between Haiti and the Dominican Republic acted as a windbreak. There are mountains over 3000 meters high which worked as a windbreak, so the damage was not caused so much by the strong winds as by the rains that flowed down the mountains. That was what happened in Haiti.
We thought about this because there has been so much talk about Haiti for so long but nothing has ever been resolved. Despite the fact that we were also affected, we felt that the international community should give a priority to those countries. But, we still wondered, what could we do for Haiti? The experience accumulated over these 40 years of Revolution has taught us how an effective health-care program can be developed, how much it costs and what is essential for such a program.
At the triumph of the Revolution the infant mortality rate here was, in the first year of life, 60 per 1000 live-births and it is 7.2 now. What was the death rate for children from 0 to four or five years old per 1000 live-births? It could not have been less than 75, and it is 9.3 today.
When the hurricane battered Haiti, we proposed a health-care program based on the following idea: there are 135 deaths between the ages of 0 and 4 per 1000 live-births in Haiti every year. That is what the statistics report, but let us say between the ages of 0 and 5, since the statistics for Central America are always given for the ages of 0 to 5. Based on the experience accumulated by our country, the possibility of reducing that figure from 135 to 35 is not only feasible but easily attainable, I would say, if the adequate personnel and necessary medicines are provided.
It was then that we announced that if one or several developed countries --we mentioned some-- would contribute the medicines, we would be willing to provide the doctors needed. The matter remained pending.
In fact, there were not even communications with Haiti at the time but as a result of that proposal Rene Preval, President of Haiti, visited Cuba a short time ago accompanied by his minister of health and other ministers. He arrived in our country right after the disaster that impacted on Central America which created new moral obligations for us but by then we already had the essential ideas worked out. We thought about what could be done. The news from Central America were not about 250 deaths and a similar number of missing people; Central America was reporting 30,000 victims.
We know that the potential number of lives to save per million inhabitants in Central America is lower than in Haiti where an infant mortality rate of 135 per 1000 live-births, from 0 to 5 years of age, creates an enormous potential for life saving. On that occasion we discussed the possibility of saving about 25,000 lives in Haiti, 15,000 of them children -- a conservative estimate because there really would be more but it is always better to make conservative estimates-- and some 10,000 adults, again a conservative estimate.
Actually, with a program like I have described, between 20 and 22 thousand children could be saved in Haiti. Every year, between 200 and 220 thousand children are born in Haiti whose population is 7.5 million. Two fundamental figures should be kept in mind: the total number of births and those who die in the above-mentioned age groups.
We immediately analyzed all those figures on Central America to determine the potential to save lives. Something else was involved here that did not apply in the case of Haiti: the situation in these countries with large areas flooded, including the capital of Honduras and a huge number of victims was reported by television networks throughout the world. CNN and every other TV network were shooting film footage of the catastrophe and broadcasting it to the world. The images and reports of what happened in Central America shocked the world. The world did not see these images of Haiti or the Dominican Republic.
At the same time, everyone is aware that Central America is the poorest region in the continent, although there are other poor countries in Latin America: Bolivia is a poor country, and so is Paraguay, to a certain extent. The mortality rates in these countries are still rather high.
We then thought it best to work with a figure that would eloquently exemplify what could be done for the countries so dramatically affected. Since 30,000 victims are reported, we wanted to know if it would be possible to save as many lives every year as had been lost to the hurricane based on the premise that if the world was shocked by the tragedy of 30,000 people killed and the enormous material damage caused, then it was time to do something for these long-suffering peoples.
The need to condone debts was raised. Nicaragua’s debt was about six billion dollars. Among others, it had an outstanding debt with Cuba, therefore, the first thing we immediately did was to condone that debt. This action had a moral value, a symbolic value. Ours is not a rich country so, most of their six billion dollars debt they have with international institutions and wealthy developed countries with lots of money and resources.
The request to write off their debts was officially put forward by the Central American countries themselves. At an emergency meeting held in El Salvador, they advanced seven points which you know about through the press and television coverage. They requested a moratorium on the expulsion of the so-called Central American aliens from the United States; condoning the debts to the two most seriously affected countries, that is, Honduras and Nicaragua; and a regional development program, among other requests.
All the calculations made, we realized that even if the number of deaths were 30,000 --assuming the number was 30,000 although I hope that when more precise calculations are made the number will drop to 25,000 or lower-- that it would be possible to undertake a comprehensive health program to save as many lives every year as were lost in the hurricane.
The argument we put forward to the international community was this: it is very important that international financial institutions like the International Monetary Fund, the World Bank, the Inter-American Development Bank, and countries like France, Spain, Austria and others in the European Union, the United States, Canada, and institutions like the European Parliament and many others are shocked and beginning to talk about writing off or cutting down debts that total 10 billion dollars; that is very good, really important.
I think that if this battle continues, the debts will eventually be condoned; many have already begun proposing to condone these debts. They could write off 80% or even 100% of Nicaragua's and Honduras' debts. They also could, and should, relieve the debts of the other countries affected. A large part of these countries' annual budgets is used to pay the interest on these debts or to amortize them.
Nicaragua's outstanding debt with Cuba was not building up interest because we had canceled the interest. Initially it was larger but we had made reductions and cancellations. Some amounts had been repaid but we had called off the interest on that debt. At one point, it had reached 90 million dollars but by now it was reduced to 50.1 million, without the interest.
These countries sometimes must spend 30% or 40% of their annual budgets on servicing their foreign debts and so they are left with practically nothing for social spending, very little for education and health-care, therefore, having these debts condoned would bring a major relief to them although it would still be far from enough. Let the debts be condoned but still the countries need to be rebuilt and that requires billions of dollars; the countries need to develop and that requires billions more.
As for the requests put forth by the Central American governments, we immediately supported the seven points, just hours after the agreement was published. We supported it immediately! The first two countries to cancel their foreign debts were Cuba and France. The decision had been made here in the early morning hours of the day it was announced but due to some details and calculations, some precision or other that we needed to have, it was announced in the afternoon. But the decision had been made 14 hours earlier.
France is in a different time zone. When we were meeting during the small hours of morning, it was already daytime there. At that same meeting, we drafted the note that would be published; later in the morning it had to be typed, figures had to be checked, it had to be translated into different languages and the Foreign Ministry also had to attend to an important visitor that morning, so we decided to make the decision public in the afternoon.
We are not rivaling the French on this. Chronologically, they announced before Cuba the canceling of Nicaragua’s 70 million dollars debt. We could not condone any other debt with Central America because there were not any. We did not condone debts with Guatemala, Honduras or El Salvador because there were no debts. Nicaragua’s was the only debt we could cancel because it was the only country that had one with us.
We are not competing with the French, I am simply explaining a historical fact. The decision had been made at the time I said, upon receiving news of the agreements adopted at the meeting in El Salvador. We take pleasure in conceding to the French the honor of being the first because it was more significant that France did it.
Unquestionably, Cuba’s gesture is of great moral value since we are a Third World country, undergoing a special situation, blockaded and subjected to an economic war. What France did is particularly significant because it is a European country with lots of resources and a major influence in the European Union. We attach great importance to France’s decision and we are very pleased that, along with France, Cuba was one of the first two countries to condone a foreign debt. Later, other countries did likewise. I think Austria was the third country to announce.
The Spanish did not talk about canceling the debt, however, they offered a great deal of aid and suspended the servicing of the debt for a period of time. The Spanish are really taking substantially major steps in providing aid to Central America. I also think that at least 80% of Honduras' and Nicaragua's foreign debts might eventually be condoned.
Presently, large amounts of funds are needed for two things: rebuilding and development. Mankind cannot go on accepting the drama and terrible poverty in which so many people live. A world where we hear talk of so many millions and trillions, where there is so much waste, it is no longer acceptable that when faced with tragedies like this we limit ourselves to providing first aid, some help for reconstruction and nothing else, end of story.
Our proposal for Haiti had already been conceived. As you know, on September 28 we raised two fundamental ideas: that Haiti did not need a soldiers’ invasion but rather a physicians’ invasion, an invasion of teachers ---who would have to speak either French or Creole-- and an invasion of many million dollars for the country's development because what is happening there is a source of shame for this hemisphere, for all the West and for the world today. Haiti was the first nation in the Caribbean and Latin America to attain independence almost 200 years ago through the triumphant slave revolt that defeated the most powerful army in Europe at the time, Napoleon Bonaparte’s; the first social revolution on the continent, while in the United States, slavery continued for almost a century after the famous declaration that considered it a self-evident truth that all men were born "free and equal."
We stated that it is time to end the policy of invasions, interventions and similar strategies that have historically been used against Haiti. Everyone knows the cause of poverty in that country. There was not a single school that taught reading and writing to those slaves who, on the other hand, were capable of wining their independence. It is time for Mankind, that talks so much about globalization and humanism, to solve these problems and provide definitive solutions for cases like Haiti’s. There is more than enough money for that.
When one tragedy followed another --Central America’s immediately after the Dominican Republic and Haiti’s-- we said it was time for the problems of Central America, the poorest area in the hemisphere, home to the poorest countries in the region except for Haiti, to be solved once and for all instead of simply making much noise and visits and tours and then forget about it.
We looked at the seven points set forth by the Central American governments, the essential matters put forward by them. First, we fully supported the seven points, and then we added our willingness to send, for the time required, all the doctors needed to back up the program for reconstruction, economic and social development in the countries affected.
First, we made some calculations. Infant mortality between the ages of 0 and 5 years in each of these countries, according to United Nations figures is as follows: Guatemala, 63 per 1000 live births --I read in one of the front page articles of Granma today the figure of 58, and the difference is not great but we worked with the figure of 63, I do not know if there is a more recent figure-- Nicaragua, 57; Honduras, 48; El Salvador, 47. These are the figures we worked with.
Last night we were discussing whether 48 applied to El Salvador and 47 to Honduras, based on two different sources. Anyway, the minimum average infant mortality rate for this age group in the four countries affected by the hurricane is 54. We also calculated the number of births, which is around 900,000 a year, based on an approximate average birth rate of 3.4%. By rigorously comparing the figures with the most recent information available and analyzing it country by country, you can obtain almost exact figures that would barely differ from those we used.
We calculated what would be needed and the possibility to undertake a comprehensive program for reducing infant mortality which might be brought down to 20 if the program were properly implemented. Based on our own experience, we know how this goal can be achieved and even what the cost might be.
While in Haiti we proposed reducing it to 35, we believed that the conditions existed in Central America to reduce it to 20. That is more than twice the rate in Cuba now and ours is a blockaded country, subjected to an economic war and enduring great needs, where there has even been a major reduction of calories and proteins intake since the beginning of the special period. Nevertheless, infant mortality has continued to decrease to 9.3 between the ages of 0 to 5 and only 7.2 in the first year of life.
Therefore, what we are advancing for Central America is still more than twice the infant mortality rate in Cuba today --and there are new techniques, new medicines and new vaccines that would make this task easier-- and 50% higher than the rate in Costa Rica. There, we have the example of a Central American country [Costa Rica] that worked at developing health-care programs over the course of many years, even before the triumph of the Cuban Revolution. They have worked hard and with international support they have reduced the rate to 14 between the ages of 0 to 5 per 1000 live-births a year, according to United Nations figures. That is to say, if a country in Central America has a rate of 14, it is perfectly possible to reduce the index to an average of 20 in the other countries of the region. Today, that goal could be reached in a very short period of time.
Moreover, if it were not reduced to 20 but to 25, it would still be possible to save 25,000 children between the ages of 0 to 5 in Central America, 25,000 children a year. To tell the truth, with the program we are advancing, 30,000 could be saved. If you add the rest of the population over five years of age, a very conservative calculation would tell you that 20,000 lives might be saved in Central America.
But it is not just a matter of the lives that could be saved. After talking with the doctors who have been to the Dominican Republic --and I spent five hours talking with them the day after they got back, listening to all the details of their experiences during the 40 days they were there-- we realized that extending the services to the whole population could prevent many people from being disable. Many do not die but can lose, for example, their sight, hearing or normal movement capacity and be left disabled or partially disabled, walking with a limp, or unable to use a hand or an arm. Some are left disabled and others suffer dozens of years from curable diseases.
A comprehensive health program cannot be measured only by the number of lives saved but rather for the millions of people who begin to feel safer, and that comes first in health care. That sense of security is offered to millions of parents, aunts and uncles, grandparents, children, because a child has a parent of a certain age who might suffer from one thing or another, or might die from a preventable or curable disease.
You also need to consider how such a program would raise life expectancy and bring from eight to ten additional years of life to many million people. Also, that life would not only be longer and safer but also more humane because a countless number of people would be spared from disabilities and suffering. I do not want to mention specific cases because some are terrible.
There are many minor disabilities involving arms or legs that could be remedied and backbone deformities that treated in time can spare a human being 30 or 40 years of suffering. I have given you only three or four examples but 50 could be given. For a comprehensive health program we tend to use a very illustrative figure and that is the number of lives that can be saved. It is still clearer if the lives saved are associated with those that were lost in a natural disaster which shocked the world because the world saw corpses floating in the water or buried in the mud, as described in the Cuban statement. This had an impact on billions of people.
Now, the thousands dying silently whose names are not printed by any newspaper, whose corpses are not captured in any picture or television shot, who are known only to the parents who bury them --I am talking about children in this case-- like those who filled the south coast of the Sierra Maestra with crosses because no boats happened to pass by to take them to a doctor in Santiago de Cuba. Now, these cannot continue to be forgotten.
Human loss is always the most shocking although material losses should also move us because those crops provide for all those human beings. But the biggest impact comes from knowing that there are thousands of people buried in a mountainside and others whose bodies were swept out to sea, others who are still buried in mud or at the bottom of a river or a lake and who now constitute a serious problem because this is a source of all kinds of diseases, and there is no clean drinking water.
In Honduras there was no clean drinking water anywhere. A few days ago I read the story of a girl who was killed for a pitcher of drinking water she was carrying on top of her head; because all the water is contaminated, all of it. The aqueducts are not operational and the rivers are full of corpses, from both people and animals. There is no water to drink.
Of course, the material damage must be repaired. What I am telling you about the water is not something you can see, someone has to talk about it. On appealing to the international community we said: a hurricane worse than Mitch is causing terrible human damage, it is a hurricane that kills more people every year than this one, some of its victims you saw on television and were moved by them. Twenty years can pass without a Mitch and a million people will silently die in Central America without anyone taking notice.
Shall we have to wait for still worse hurricanes, given the climatic changes and the ever more frequent El Niño phenomenon? Shall we have to wait for more hurricanes, earthquakes and other disasters, or droughts that cause considerable damage although they do not kill people directly like a hurricane? When are we going to pay attention? In substance, this is what we are putting forward. They are basically ideas relevant not only for Central America but also for the rest of the world. This is the message that must be spread throughout the world, this global world, with so much technology, so much waste and so much inequality in the distribution of wealth.
But there is more: these health care goals we are fostering for Central America can be achieved without a change in the social system. It would not make any sense to say that this could only be achieved by first carrying out a political and social revolution, in other words, a revolution like in Cuba. It would not be necessary and no one would have the right to wait for such changes to save hundreds of thousands of lives that can be saved with a bit of rationality and common sense. It is possible to do it with this same social system, the existing ownership system, even with a modest support from the international community. That is because this task is relatively easy, it is both, possible and easy.
A task that is possible and easy no government in any country would turn down, no government! On the contrary, what we have perceived through the delegation that visited Honduras and Guatemala is a great interest on the part of both governments in implementing such a plan and a great enthusiasm over the possibility of doing it.
It must be done. Of course, it is essential to know how to do it. What do I mean by this? That it must be done very tactfully. First of all, it is important that nobody feels wronged by this, that no doctor feels wronged or in any way affected by such a program. This program does not intend to take the place of a single doctor in any country of Central America. On the contrary, we can modestly cooperate with them in those health matters where our experience may be useful.
There is leptospirosis, for example. We have developed a vaccine against it and a million people in our country have been vaccinated because it has proven to be effective. It is a new vaccine produced here. We are not exporting it yet, we have applied for registration, but it is being widely used already. I have been told that close to a million people have been vaccinated in our country.
In addition, we have developed a very effective biological product, a lethal enemy of rats, which sells at 8,000 US dollars a ton; it is called BIORAT. We have already sent some to the region. First, Nicaragua requested five tons and we immediately sent them by plane. Then they requested 15 more tons, and we sent them. We produce it here and there are costs involved, but production is growing considerably.
We sent the BIORAT, and we have the vaccine. One of the most seriously affected countries has solicited 40,000 doses of the vaccine. When they learned about the vaccine, and that we were using it, they asked us for 40,000 doses. They made the request yesterday, or the day before yesterday, and tomorrow or the day after they will be using it to help contain the leptospirosis epidemic.
Well, I have been sharing with you some of the principles supporting the comprehensive health-care program we are advancing as a model for cooperation programs in the poorest Third World countries. Take notice that this proposal originates in Cuba, a country that is far from wealthy, a blockaded country enduring a special period. If we can do this, a world with a gross product that is about 30 trillion dollars can also do it. The United States alone is producing about eight trillion and Japan four trillion, to cite two examples. Europe must be producing about the same as the United States.
We would have to work out the numbers, of course, but I would dare say that the industrial nations with one-sixth of the world's population account for over 80% of the gross product. They have so many resources that I believe a program like this --and I have not finished explaining the details which I want to do today-- could be implemented with a minimum effort.
They are constantly joining forces, entire armies join forces to wage wars, invade countries, intervene here and there. Based on their concept of civilization, enriched with certain hegemonic interests for world domination plus the need to preserve order --their order-- they try to prevent local or internal wars where unfortunately 1000, 10,000, or even tens of thousands are killed with weapons supplied by the large producers, who are all too well-known, thus providing the ideal pretext to the most wealthy and powerful for waging their "humanitarian wars."
I have been making the estimates of what a health program in Central America would require and the enormous benefits it would bring. If applied to the rest of Latin America, Africa and the countries of Asia you can imagine how much good it would bring humanity. You can work out the costs yourselves and see that it would be ridiculously low. Ten different arguments can be used to demonstrate how ridiculously little it would cost to apply such a program that could save the lives of tens of millions people every year, as many people as those who died in World War I.
The war against underdevelopment, poverty, hunger and disease would be the only truly humanitarian war.
Cuba wants to prove that if a country with such limited material and economic resources can do something like this in our region, the industrial world can do infinitely more. I am not saying that we are poor in human resources because in that sense we are really wealthy, like Olympic champions, and I am not simply boasting or being vain about it.
I wonder, really, if the United States could send 2000 physicians to work in the conditions our doctors are willing to in solidarity with Central America. We are not contemplating that they go to the capital cities, to the big cities, to live in hotels or residences; they will be living in tents, or huts, or wherever they need to live, as was the case during the literacy campaign in our country.
The 100,000 students who volunteered to end illiteracy in Cuba, where did they stay? And these were young people 13, 14, 15, 16, 17 years old, 100,000 of them! They stayed in the farmers’ hovels, anywhere they could. That is part of many of our best doctors’ background. Many of these doctors took part in the literacy campaign thus educating their hard-working spirit, their fraternal sentiments. They began the tradition. That is why, when it comes to resources, I say we are wealthy in human resources.
Shall we be able to send 2000 doctors? In August, 2500 more will graduate. In South Africa, there are 402 of our doctors working in the remotest townships. They have even learned the language of the townships. They had studied English but they have learned the languages of the townships where English is not spoken.
We were really pleased when a minister from a very important country in this hemisphere, the Health Minister of Canada who recently visited our country and talked about these issues, told me at the end of our conversation that he had met with the South African Health Minister a short while ago and the South African minister had widely praised the work of the Cuban doctors in the South African townships.
This was a timely comment that we received at the exact moment when we needed to have such news, and no less than from this major, outstanding political personality: the Health Minister of Canada. I had discussed with him some of these issues, these countries’ needs and the possibility of doing much with very little. I was trying to persuade him and he was actually very receptive to our views. At the end, he told me he was very highly impressed by what the South African Health Minister had told him.
Thus, our doctors working in South Africa have become an example. They are contributing with their work to the effort of building an awareness about what can, and should, be done.
There were times when 6000 students enrolled at the medical school in a single year. Today, 3000 to 4000 new doctors graduate every year. By August, we will have 66,000 doctors. Of course, from that figure we should deduct the 400 who are presently in South Africa and other places, a 1000 doctors deduction.
We have offered Haiti 200 doctors. Well, that was a working figure but we have not set any limits. We have been discussing the issue and four Cuban health-care experts have gone to study the situation in situ. They have clinics there --donated by foreign institutions or countries-- fully equipped and modern but with no personnel.
The work we are discussing now is really direct, like a community doctor’s. But then, of course, cases immediately start to appear that require surgery and these people have to be hospitalized. All this will have to be studied. We also plan to continue lobbying the international community so that there are not only doctors in remote places where they are needed but also certain networks of primary care clinics with a few beds and facilities for surgery.
As for now, our doctors will have to work there without laboratories, determining whether it is a parasite, amoeba or something else, causing the problem, make a diagnosis based on the symptoms and decide on the medication. Our community doctors know quite a lot about this because they have worked in the countryside. Our specialists in general integral medicine have a three years minimum of community work experience.
The medical teams have been formed. A major effort should be done now to study the situation, not at some unknown point in the future but immediately. The four experts will be returning from Haiti today or tomorrow. They met with the President and they also bring ideas resulting from their fact-finding mission. They have said that conditions in some areas are truly rough. The population is large and there is a lot of eroded and deforested land.
No time has been lost. Four experts left for Haiti with the President and we have been making arrangements here, working and soliciting support for the program in Haiti. It is not for us that we are asking, it is for others and that is always easier than asking for oneself. If, in addition, you are contributing an essential element like the people needed there, people ready and willing to go to any mountain, any valley or rural area, that gives you a certain authority, a certain moral stance for making proposals.
This is how two hurricanes brought two programs together. Both programs are feasible and require few resources. We will provide the human resources. We will send as many people as required and replace them when necessary. There are 21 medical schools in this country, they are located in every province. At the moment, two ideas born from two hurricanes are underway and we can calculate the figures mathematically. The number of lives that can be saved in 10 years and in 20 years with the two programs. Someone once said --I think it is a line from a tango-- that 20 years are nothing. Well, I assure you that over a million lives might be saved in 20 years.
The annual figures are very illustrative. In Haiti, 25,000 lives can be saved. That means 50 times more lives than were lost in the hurricane, assuming 500 were lost, that is, dead and missing people. But, because the victims and the destruction in Central America were so dramatic and so deeply shocking to the world, this has led us to consider the saving as many lives --and there were a great many-- as were lost in the hurricane.
At the same time, we continue promoting internationally the other two ideas: reconstruction and economic and social development programs. When I speak of social development I am also thinking of education, housing, employment and other needs. I am talking of an extremely important aspect of social development, that is, human health. We can make a considerable contribution, both in Haiti and in Central America.
What can we offer? Let us put it in figures because if you say, for example, all the doctors needed, no one knows how many are but when you say 2000 doctors for Central America, that is clearer and more concrete. Being conservatives, and to avoid an overstatement, we said 2000 which is a remarkable number and has made an impact in the world.
Our announcement received the least publicity with our neighbors in the north. I do not know how many people in the United States are aware that Cuba has proposed such a program and is willing to immediately send the doctors it has offered. Of course, we will have to wait a short time before sending them all because we need to study where they will go and draw up the program in detail, but our willingness to send 2000 doctors immediately has been expressed. We will have to feed the full text of our statements to Internet --since they have more computers than anyone else in the world-- for the people in the United States to know about the first and second statements. They have already been translated, well translated.
The Cuban Government Statement read by Robertico [Foreign Minister Roberto Robaina] at the United Nations, was distributed to all delegations there as soon as he finished reading it. The 180 delegations received it translated into English and French, as well as the original Spanish; there was not enough time to translate it into other languages. Then, as soon as it was confirmed that he had finished it was released. We did not want to take any chances in case Robertico might get sick, or anything that might come up, and then we would have published a statement that had not been made, or publish it before he had read it out because of a delay. Anyway, as soon as it was confirmed, the head of the Cuban Mission was notified. The statement had already been printed and the copies sent to all the diplomatic missions in the countries with which we have relations, as well as at the Cuban Interest Section in Washington, from where it could be sent to many people in the United States.
There is no doubt that we will have to feed them to Internet and recommend... (HE IS TOLD THAT THE DECLARATIONS HAVE ALREADY BEEN FED TO INTERNET). Both of them? Remember the first one, supporting the Central American governments’ proposal after the meeting in El Salvador.
There are three important documents: first, the message to the Nicaraguan people; second, the statement announcing the cancellation of Nicaragua's foreign debt, the support for the points adopted at the meeting in El Salvador, and the medical offer; and third, very concretely, the Cuban Government Statement that Robertico read at the press conference in the capital of Honduras, Tegucigalpa. Rosa Elena [Simeon, Minister of Science, Technology and the Environment], make sure that the three are on the Internet, well translated.
We must reach the American people with them, it is important. I do not know why and I do not want to blame anyone for this --perhaps there are other important news or issues-- but we have asked the Foreign Ministry and the head of our Interest Section in Washington whether it has been published in the United States and they have said no. It has been published in Europe and in many other countries, but not there.
This blockaded country enduring a special period is willing to send a minimum of 2000 doctors immediately. Would it not be great if the United States tried to compete with us in this area! They are helping, we must say they are helping; their military helicopters have rescued people in isolated, endangered areas and they have carried food and medicine to places where they could not be delivered any other way. They are not sending doctors, they are sending soldiers. Of course, they are not there to kill people. They have done it before but not this time. Now it seems that these soldiers have been given a really constructive, positive and useful mission.
In fact, they lack the civilian organization needed for this. The army is perhaps the only institution with all the means and the organization required to build highways and bridges at full speed in any emergency situation. They plan to send 4000 soldiers to work basically in the infrastructure and help with other important works; it must be recognized that these are important tasks. They have said that they will provide some medical services, I do not know what they will be like. They must have very good doctors in the army, I can imagine they are experts, mainly in war medicine.
Thinking about what I was told by the doctors who went with the brigade to the Dominican Republic, like the story of an excellent obstetrician who assisted in a complicated delivery performed under the difficult conditions of a makeshift hospital and who saved the lives of both the baby and the mother, I cannot imagine a member of the U.S. army medical corps, in a Central American village, assisting with a breech birth, in the conditions our doctor was working, or providing care in English, or working without a laboratory or an X-ray equipment, treating a child suffering from any of the various diseases so common in a tropical Third World country.
Anyway, this I want to say: they are helping in Central America with reconstruction work but they have to do it with soldiers who are part of an organized and disciplined institution with all the engineering equipment, transportation, material resources and money needed to do it at the necessary speed. Other countries have also sent soldiers and we are happy that they are providing these services to the countries of Central America.
That is exactly what we are preaching, that those countries need help. Thus, it would be good if the American people could know how much can be done with very few resources in other fields essential to the well-being of Central American peoples. I hope the U.S. press will also publicize what others are doing.
I will tell you the truth: we are giving some publicity to our cooperation but not to boost Cuba's prestige because we do not go around publicizing and exalting what we do. How many Cuban doctors have rendered their services in the Third World? Twenty-six thousand doctors. I said it in South Africa but here we never talk about that. The countless services this country has provided to other peoples and to many individuals from other countries have received a minimum of publicity or no publicity at all.
In this case we are publicizing it, first because it is necessary to build an awareness in the international community and the wealthy countries about issues and problems crucial to the world; second, because an effort of the nature and magnitude we are proposing must be explained to our country, what it consists of and how we are going to carry it out. We need all the support of our doctors, nurses and health technicians. We need the support of all the people. We need our people to enthusiastically and proudly understand and cooperate as they have always done with such noble and worthy efforts.
Now we are asking for 2000 voluntary doctors. We know that many are coming forward and applying to participate. Everywhere in Cuba, in every province and municipality doctors, nurses and health technicians are applying to take part. If they do not receive all the necessary information they cannot be properly mobilized. Medical personnel also have families, patients, obligations, plans for further studies. Nonetheless, I have no doubt of their response.
I was talking with Juventino, the doctor who spoke about natural medicine and I told him: Juventino, we may need your help in the Central American program. He was talking to me very enthusiastically about natural medicine, saying that it was the medicine of choice for poor countries.
I used the figure of 2000 volunteers. I know they can be mobilized with practically no publicity but this is a great effort, one that demands great sacrifices. We are asking for a little more than that: we are asking for 2200, because we need 200 for Haiti, and still more, all the available volunteers because if 500 more are needed in Central America we must send them; and if 200 or 400 more are needed in Haiti we must send them.
That is why we are giving the people vast information. If it were not for that reason you can be sure that we would not be saying a single word about this or that medical brigade, we would do it discreetly and quietly as on many other previous occasions.
Our honorable tradition of providing medical assistance to other peoples in the world is not new. I recall when the first brigade arrived in Algeria in 1962 or 1963, when that country had just gained its independence. It was then that the history of our doctors' missions abroad began. I recall the medical assistance sent to Nicaragua when the earthquake destroyed the city and our planes took in medications. I recall the medical brigade sent to Guatemala, a long time ago, because on these matters we do not mind ideological issues or political differences, not at all. It is a matter of solidarity, of our duty to other peoples, our duty to humanity and we simply do it.
At the time of the earthquake in Peru, we did not have diplomatic relations with any South American country. There were 70,000 deaths due to that earthquake. In 10 days, our people made 10,000 blood donations to the Peruvian people and Cuba not only sent medical brigades but also construction brigades to build hospitals in the most damaged areas.
It is an honorable and glorious tradition in our country which in a spirit of solidarity has never excluded any country for no reason whatsoever. It is not a new idea. No one can think that we want to use the Central American countries' tragedy to improve our image or win political advantages. It is a great tradition. Even when very hostile men ruled in those countries and there were absolutely no relations we sent medical aid every time there was a catastrophe. Today, our capacity in this field is incomparably greater.
There is something else. When there was a major earthquake in California we sent a message to the governor of that state expressing our willingness to send at least a few doctors or do anything within our power, even if symbolic, as an expression of our wishes to help; and that was California, a very rich state of the United States of America, the country blockading us.
Since we have relations with some black friends and legislators, and we know that there are neighborhoods in the United States that lack adequate medical services, on occasions we have said that the day they need Cuban doctors in one of those neighborhoods, they can have them. Of course, our doctors would never be allowed into that country, that is certain, but we have been willing to send them to the United States free of charge. It is a tradition with us and this would be much in line with that tradition, but still more in line with today's world and with Cuba’s statements with regard to the present world situation, with our preaching.
To these elements I will only add something else which I feel is very important: the cost. How much would it cost to save perhaps 30,000 lives? We have told you the estimates and that this program would intend to save 50,000 lives. However, we have not talked about 50,000 in Central America. We have talked about saving the same number of lives that the hurricane took, assuming there were 30,000 deaths. We have talked about 30,000 and we have talked about no less than 25,000 children among those 30,000. I am basically talking here on behalf of the 25,000 children who can be saved each year.
How much could that cost? There is one thing about medications. Medicines are usually very expensive if you buy the finished product from commercial companies, and one product can come under 15 or 20 different brand names. We produce ourselves many of our medicines and vaccines. We also import the raw material to produce 90% of our medications here. We only import 10% that we cannot produce.
We are even working on cancer and AIDS vaccines. The hepatitis B vaccine, the first one produced in the world and the only one in the world today obtained through genetic engineering is a Cuban vaccine. Interferon and many other drugs are produced in our country. We often lack medicines. We have shortages for different reasons which are sometimes administrative or due to some people’s hoarding; there are also those who steal medicines. Those things are known and we are tenaciously working to establish controls over all that. Quite often, though, the shortages are due to delayed arrivals of raw materials from distant places.
Just think that in better times, although there were some drugs we bought from the socialist countries, we spent approximately from 100 to 110 million US dollars --and look that we are talking hard currency-- on a population that was then over 10 million people fully covering medical services, mostly by producing medications here at considerably lower costs.
I have been recommending to representatives of countries from whom we have been asking cooperation for the health programs in Haiti and Central America that, if they decided to participate, considering the profoundly humanitarian nature of the programs, they could ask the laboratories in their countries to cut down prices or set them at cost plus a moderate profit.
We know what can be done in our country with a million dollars in raw materials for medicines. The cost of medicines for the comprehensive health program in Central America to save the lives of no less than 25,000 children and 5000 adults --in other words, no less than 30,000 lives-- must be very carefully studied but possibly the need for medications and vitamins could be covered with no more than 200 million dollars. It could be a little more or a little less, depending on the way they are purchased or produced with the assistance of the World Health Organization and the Pan-American Health Organization, which have experience and sometimes obtain very low prices. That is, 200 million dollars, and this is an approximate mathematical calculation, it could be a little more or a little less; it could even be lower depending on various circumstances and possibilities.
What does 200 million dollars amount to? I am thinking about the United States' war budget, 260 billion dollars, plus other programs for the development of ever more deadly, sophisticated and expensive weapons, when the cold war is supposed to be over. One dollar out of every 1250 dollars spent in military activities --if used in a rational and cooperative health plan like we are suggesting for Central America-- could save 50,000 lives and 100 dollars out of every 1250 could save 5 million lives.
How much is a human life worth? What is the sense of the world spending 800 billion dollars in military budgets every year? What could it not be achieved in health care, education, drinking water, housing, irrigation systems, food production, scientific research and environmental protection with half of that money? Where is the rationality and what hope is there for humanity with the world order imposed?
Everyday currency speculation activities involve one trillion dollars. If those operations were taxed at the rate of 1%, enough money would be collected for the Third World's economic and social development and to save millions of people dying every year of curable diseases. A Nobel laureate in Economics raised this 1% tax idea very seriously a few years ago when this new and colossal phenomenon was just beginning, and it would be easy to do it with the computers available. There is already the example of countries such as Brazil, which charges a 1% tax on every check issued.
As for the comprehensive development plan, I dare say that it would be possible to carry out this health care plan in Central America which has been the focal point in my words. I dare say that, among so many huge amounts of misspent and mismanaged money in senseless and dishonorable speculative operations, an annual investment of 200 million dollars in a noble and humanitarian way would be about enough.
Cuba provides the medical personnel to work, first of all, in the most remote and difficult places where no one else would go and, secondly, in clinics which can become a supportive network where specialists are needed; even in a national hospital if there is a shortage of personnel in a given specialty. They would not take the place of a single local doctor in those countries. On the contrary, they would work with them, transferring any experience they can and asking them for their valuable and indispensable help. It is not hard to find Central American doctors who studied in our country.
Oh! Here is another very interesting subject. Who accompanied Robertico on the visit to the medical brigade in the Honduran capital? The archbishop of Tegucigalpa, Monsignor Oscar Rodriguez Maradiaga, who is the very well known chairman of the Latin American Bishops' Council (CELAM) of which all the Latin American bishops are members. We know that he is a man deeply concerned about social problems. We are aware of the excellent speech he gave in Rome last year at the synod and his efforts to help the poor. He was very interested in the Cuban program, so together the Honduran and the Cuban foreign ministers and the archbishop of Tegucigalpa went to visit a medical brigade serving a very poor community of 80,000 residents that was virtually wiped out by the hurricane.
The next day we received another interesting piece of news. I had asked Robertico to visit the archbishop as soon as possible, to explain the program and ask for his cooperation. Later on, Robertico sent his report of the visit to La Mosquitia. Let me tell you that to speak of La Mosquitia is to speak of our Cienaga de Zapata, that swampland multiplied I do not know how many times, and the doctors move through that area for hours in boats. The first brigade to arrive, where was it given shelter? Part of it in the church. A very dedicated Catalonian priest let them stay there and offered his full support. Robertico offered a very good description of this priest in his report.
The groups working on a plan like this need everyone's cooperation. These doctors are not involved, nor will they ever be involved, in political issues. They will work with everyone and cooperate with everyone, first of all with the local authorities, with the different local institutions and with the religious organizations.
There are in Central America Catholic churches and other denominations and for this humanitarian mission we are asking for the cooperation of all religious organizations. We are asking for cooperation from every Catholic parish, priest or a pastor of a Christian church. They live there, they know the families and the social problems thus their support for the health programs is indispensable. We must conciliate and respect ideas and criteria. We should work on this endeavor together with all the civic institutions of any social, ideological and political stance.
Cooperation with everyone is basic to the success of this medical program. I am saying this here because I want to make it clear right from the beginning: our doctors will definitely not meddle in internal politics. They will absolutely abide by the laws, traditions and customs of the countries where they work. The dissemination of ideologies is not their mission. They will scrupulously respect the ideologies of peoples and patients as well as their religious beliefs, thus earning respect for their own patriotic feelings, political ideas, philosophical or religious beliefs which they will not preach or try to advance to others. They are going to Central America as doctors, selflessly promoting human health, working in the most difficult places and under the most difficult conditions to save lives, to preserve or reestablish good health and well-being, and to exalt and increase the prestige of the noble medical profession. Nothing else.
These are, in substance, our ideas. There is just one more thing: we will not limit ourselves to sending 2000, 2500 or 3000 doctors. There is something more important. Along with the offer to send doctors we have offered to train Central American doctors in Cuba.
Our doctors have great prestige everywhere. They study six years and then they spend three other years working and continuing to study in the community --that is what the most recent graduates have done-- plus two, three or four years specializing, depending on the specific requirements. Our doctors are actually very well prepared. We can have full confidence in our doctors who become still better, and we know it, when they are assigned an important and difficult mission. That is a characteristic of our people.
We will take especial care in training those future Central American doctors. We already know that the school year there ends around this time. I think their vacations begin in December so their academic calendar is the reverse of ours. Our university courses start in September but we can use that time difference. I think they should come a few months before the beginning of the courses for a general review, an evaluation and intensive preparation for entering the first year of medical school because the first two years are quite difficult in the basic sciences. As I said, we will take especial care in training those future Central American doctors.
We have offered 500 scholarships every year to study medicine. Some press dispatches have reported 500 every year but, in general, they are reporting 500 scholarships: Cuba has offered 500 scholarships, they say. Well, I want to explain the idea properly.
We are offering 500 scholarships a year for a period of 10 years. Initially we did not mention this detail but our idea is to grant 500 medical school scholarships a year for a period of 10 years to young people from Central America who are already high school graduates. In other words, Cuba is really offering 5000 scholarships, not 500. Five thousand! That is what Cuba is offering, 500 a year for a period of 10 years. Five thousand scholarships altogether!
We were very pleased by the conversation our Foreign Minister had yesterday with the President of Guatemala where the latter expressed great interest in those scholarships and raised this idea: he wants half of those scholarships to be granted to young indigenous students. What an excellent idea! Over 50% of the population in that country is indigenous, and in many villages the whole population is indigenous, so it seemed a great idea to me.
At the moment, we are concentrated on the selection for the scholarships. That work must be done as quickly as possible.
Now, let me tell you that the impact of the news of Cuba's 500 scholarships offer per year has been incredible --really incredible!-- in the two Central American countries Robaina has visited.
I should also say that yesterday and the day before, that is, in the two days since the announcement of this program Wednesday at 2:00 in the afternoon, it has been widely reported by radio, television and the written press throughout Central America, and the telephones in our Embassies in Nicaragua and Guatemala, and our Interest Section in Honduras have been ringing constantly.
Last night we wanted to know and they said that the phone calls do not stop. We asked our chargé d'affaires in Nicaragua, for instance, how many people enrolled at the universities every year and the figure he gave us, pending confirmation, was about 5000 students all in all. I asked how many graduate from high school every year and he said, "20,000 to 25,000." There is an enormous youth potential in that country from which to select those who will study medicine.
Presently, we have to discuss the selection criteria with each country. I have already said that the President of Guatemala expressed special interest in at least half of those selected being from the indigenous communities. We are of the view that professionals should be train who are willing to work in the remotest and most difficult places. The larger the number of people meeting the requirement, the greater the possibilities to make a good selection. We must analyze the criteria and methods of selection with the health ministers and authorities of every country.
I imagine it is the same all over Central America. We should take advantage of the five or six months before September to provide intensive courses in preparation for their first year of medical studies.
We are looking at our capacities in basic sciences at Giron [Medical School] and other facilities, what needs to be done to receive them as soon as possible, starting in January, so that we will not lose several months that could be used in their preparation.
Right now the demand is such that we are even thinking that within the 10 year program we might enroll 1000 the first year instead of 500. At the two countries visited we have seen an enormous interest in the scholarships, both on the part of authorities and the youth. We are making a full evaluation and we believe we will be able to receive 1000 in the first year, and later it can be 500, 500 and 500 every successive year.
While they are training, their countries can have our doctors’ services, and not just Cuban doctors; we do not want to be there alone. We have proposed that this be a Latin American program with the participation of Latin American doctors. We are even proposing that it be an Ibero-American program, including Spain and Portugal. It could even become a Euro-Ibero-American program because I think there are possibilities and some Western European countries might want to contribute with such a program economically and also with skilled personnel.
Thus, in 10 years there would be 5500 medical students on scholarships. We are going to wait awhile but we have already shared with some governments in the area the idea of raising the number of scholarships this first year because there is going to be great pressure.
We have the capacity to do it and so we are training doctors from the Caribbean. All the Caribbean countries want to train doctors. We are also training doctors from South Africa and other countries. You can see that we really do not make any propaganda about the cooperation we give to a number of Third World countries.
A while ago, Paraguay requested scholarships and there are now 120 Paraguayan medical students on scholarship here. Not a word had ever been said about that. There are others who help pay the costs of their studies, who pay a certain fee. During the special period that was a formula applied to some cases. But to our Caribbean neighbors we have offered all those scholarships free of charge. When I say scholarships they are free of charge. Paraguay, for example, received 120 scholarships free of charge; these young Paraguayans studying medicine were mostly selected from outside the capital. I understand that there are also about 80 who are paying to study medicine in our country, although most of the Paraguayans are on scholarships.
How many paying medical students do we have, Dotres? (DR. DOTRES, MINISTER OF PUBLIC HEALTH, RESPONDS THAT THERE ARE 500 PAYING MEDICAL STUDENTS AND 800 STUDENTS ON SCHOLARSHIPS) Right. Those who are not on scholarships pay 5000 US dollars a year for their stay here and their studies, that is the cost. Those figures are far below the fees in the United States, for example. Some universities charge 15,000, 20,000, 30,000 a year.
How many South African medical students are there? (DOTRES RESPONDS THAT THERE ARE 60 OR 70 SOUTH AFRICANS) The South Africans are paying, that is, the South African Health Ministry is paying their expenses. It is a country with considerable resources but given the social problem in South Africa, where all the villages are asking for Cuban doctors, we have actually proposed to them that we send them medical professors so that they can train doctors there as massively as possible. It should be taken into account that the black population in South Africa had very few possibilities to study in the universities. It was a privilege for the wealthy class which supported apartheid. We told them that we were really embarrassed having a few dozen African students paying for their studies.
Given the budget available to the South African Public Health Ministry, headed by a woman who was a great fighter against apartheid and who while visiting Canada explained there what I just told you, the number of medical students it can send to Cuba is limited. We said to them that we were really embarrassed receiving payment for those 60 students so we were renouncing such payment. Also, that they had to send more students and taking into account the travel expenses, they should promote massive medical studies in South Africa with Cuban professors. Otherwise they will never meet the true need for doctors in that country, doctors who are willing to work in the townships.
Do you know what the capacity of our 21 medical schools is? Thirty thousand. There are about 15,000 medicine students now including, of course, some foreigners. We had been progressively reducing the number of Cuban students from 6000 new enrollments annually to approximately 2500. We had essentially met our needs of medical personnel for our ambitious health programs. Then, we only had to train the replacements and keep a reserve.
For our program designed in the '80s the idea was to have 10,000 doctors ready to help in the Third World. It was at that time, long before the special period, that all the medical schools we now have were established. Then came the special period, the limitation of resources and other difficulties which to a certain extent changed the programs. Part of the capacity designed for medical students was used for university degree programs in nursing and other health technicians. But we have a reserve capacity.
The English-speaking Caribbean countries, our closest friends, who were at the forefront in the fight against our isolation in this hemisphere, who have courageously supported Cuba at the United Nations, in the Lomé negotiations and in every international forum; these small countries have a combined quota of no less than 1000 scholarships for various specialties, and if they need more, they will have all they need.
In Namibia I had the pleasure of meeting some people who came to Cuba as children, at the ages of 10 or 12, survivors of the Cassinga massacre in southern Angola, one of the great crimes the fascists of apartheid committed there. We established a school for them in the Isle of Youth. On my recent visit to that country, I had the satisfaction of meeting some of those children that I had visited so many times at the school and who are today doctors and professionals --from a moral and humane point of view the significance of what we did is immeasurable-- and some have risen to the level of government ministers. The head of one of Namibia's most important ministries given its bountiful seas, the Ministry of the Fisheries, is a young doctor trained in Cuba, who came here when he was 12, a survivor of the Cassinga massacre. It is impossible to measure the value of sowing those seeds throughout the world.
At a given time we had in our country 22,000 foreign students on scholarships. No other country in the world ever had as many scholarship students per capita as Cuba, and they are now all over the world, in Africa and other regions of the world. That partly explains the Third World's solidarity with Cuba and the 157 to 2 votes in favor of our UN General Assembly resolution condemning the blockade, although that is not why we did it. We did it for our ideals and our feelings of solidarity and internationalism. (APPLAUSE)
That is our ideology and that is what we preach, not with words but by example. We enjoy the freedom of being, perhaps, the only country in the world --mark my words-- I am not saying the only free country in the world but rather the only country in the world that can speak with absolute freedom, with 100% freedom. Take off 0.5% if you want, because there are times when --without lying, because we never lie-- strictly out of diplomatic courtesy, we must be careful in what we say on some issues. (LAUGHTER)
But we are a country that can go to the United Nations, to any forum, anywhere and say what even some good and honest friends cannot say for one or another important reason for their countries, such as a credit from the International Monetary Fund or the World Bank, or such-and-such a regional bank, or the United States ExImbank. Our country does not depend on any of those institutions. It learned to survive under extremely difficult conditions and for 40 years it has defended that independence we hope to preserve forever, with or without a blockade.
If one day the blockade were removed and relations were normal --and we already know what normal relations with the United States are-- we would still be living in a world where the truth is necessary so, we shall never renounce our right and our freedom to tell the truth.
Our international relations are extensive. We have diplomatic relations with a large and increasing number of countries. But the basic, fundamental, essential ideas of Cuba's international policy and our Revolution's ideology we discuss everywhere. I assure you that there is nothing as productive as that freedom and that possibility of telling the truth. Under the most improbable and incredible circumstances we are preaching with words and deeds, and that brings great results.
We are not thinking of results for ourselves. We will continue fighting very hard for ourselves, to provide the best for our people's well-being. We have something that can be very helpful to the world. We are an example and examples can be helpful. We have ideas that can help the world very much, a world where within 50 years there will be 10 billion people who must survive, who will need solutions and who will not survive without an example, without ideas, without truth.
These are elements of judgment I wanted to give you. Later on I will see if I have overlooked something.
Of course there is still one more thing and that is thanking this forum. (APPLAUSE) It is thanks to you, and to millions of men and women that our country can write this page of glory, honor and humanity. Thanks to millions of men and women like you our country has resisted, and not only does it resist but it moves forward; and not only does it move forward --I am not going to measure it with material production data which are still modest but heroically achieved-- but it is significantly contributing to progress in the world.
We must get used to the idea that in this world where we must live no country can solve its problems all by itself. In today's world, solutions to the world problems need to be found before any particular country’s problems can be solved. A very eloquent example are the Asian tigers, which grew and grew and grew. They had dazzling economies, tens of billions of dollars’ reserves but neo-liberal globalization, that system imposed on the world, drove them to bankruptcy in a matter of days. No country on earth is secure.
Europe is uniting because a European country alone cannot survive economically. Great Britain cannot survive on its own; the U.S. speculators devalued its currency and put it on the verge of ruin. France cannot survive on its own, nor Spain, nor Italy. Germany cannot survive alone, even though it is one of the world's greatest industrial and economic powers. It cannot! They must unite to survive total domination in the economic, political, military and cultural field, which is becoming U.S. imperialism's number one weapon. We could perceive that in our Congress of Writers and Artists, that is, the attempt to impose a cultural empire, its fundamental weapon today. Someone well versed in these matters called it the 21st century nuclear weapon.
Economically, no country in the world can be safe, nor will it ever be. They are the only ones relatively safe. Actually, it is just a certain degree of safety because they are the ones who print the world's money, they have appropriated that privilege for themselves. They have all the money they want at everyone else's expense. They are the largest investors in the world; they invest other people's money, the bills other people received and deposited in their central banks or in the U.S. banks, and they use them to buy companies anywhere in the world, to build factories but there is a limit to that. The past few months have seen the world close to that limit, on the brink of an economic catastrophe although, as we have said, they still have the possibilities and the resources to delay the crisis, to postpone it which is what they are doing.
The system cannot be saved. The established domination cannot be maintained. That is the reason we have told many people that no country can solve its problems alone.
Now, this very Revolution, if it had triumphed at this moment in 1998, if they had let it triumph, if they had not tried to crush it almost before we returned to Cuba on the Granma, or left Mexico, I tell you this Revolution today would be only a revolutionary power that could not exist. We can exist because we were born at a specific moment and historical conjunction. We managed to gather together all the strength that comes from consciousness and human values, this which Cuba is today despite all problems.
Look that I have not talked to you about problems. What for? We have been talking about them all these days and we know them by heart. I am aware of them all, as I am aware of the everyday struggle we must wage. On the other hand, I do not fail to see what we are and what we have created. It can be seen at a time like this, when practically a whole hemisphere would have to get involved to bring together the doctors with the true spirit of health missionaries that we can provide.
Actually, we could simultaneously carry out four or five other programs like this that we are proposing. Cuba has the resources to organize a health program --note this carefully-- not only in Central America, that is, human resources which is where I say we have unlimited resources but also to support a health care program like this for all the isolated places in Latin America where there is no medical care.
I say this only to give you an idea of the strength we have created in terms of human resources. We have created it in many other sectors. Look that 600,000 professionals have graduated in this country since the triumph of the Revolution.
Of course, in Latin America there are countries with more economic and social development than others, such as Chile. I think there are very few rural residents in Chile who do not have access to health care. Once, under Allende's presidency, we sent doctors to some areas where they lacked certain medical services. I am also thinking of Uruguay and Costa Rica. There are countries in Latin America, not very many but a few, that do not need such a program. But we also know of many places in Latin America whose population, mainly the rural, does not have access to any health services.
I could complete this idea by stating that we have enough personnel to carry such a program to all the rural areas in this hemisphere. I will say only this and avoid figures. Why? If I say it at this moment, if I say this and bring up this subject, it is because I mentioned the values and human resources this country has created, the Revolution has created, with which we have defended ourselves, resisted and struggled for the Revolution, which will soon be 40 years old.
We have been blockaded almost the whole time. Some say it has been 37 years and others say 36, but that is not true. As soon as the Revolution triumphed they suspended all our credits in the United States. On January 1st, 1959, there was not a penny left in the state reserves, still they took away our commercial, bank and all kinds of credits from the very first day. Later they took things away from us bit by bit, and the sugar quota piece by piece. That is the truth and we have resisted. The socialist bloc collapsed and we have resisted. We were left on our own and we have resisted. Today, we have more relations and international support than ever, more friends than ever, even within the United States.
Also, we have all the patience in the world needed to fight and resist because if we had every reason to struggle on January 1, 1959 when the Revolution triumphed, today we have 40 times more reasons. We are almost the only banner left for the most fair causes, with an advantage: because it is not enough with having just, noble and good ideas, it is necessary for those just, noble and good ideas to coincide with the moment when humanity cannot be saved unless such noble, just and good ideas are applied.
Thank you very much.
(HE IS HANDED A LETTER FROM A RECENTLY GRADUATED MEDICAL STUDENT)
"I would like you to communicate to our commander-in-chief the recent medical school graduates’ willingness to participate in the solidarity efforts in Latin America."
Dr. Pedro Luis Alonso, recent graduate, Commission 09.
Commission 09 is the students commission [at the forum]. (SOMEONE SAYS SOMETHING TO HIM.) (APPLAUSE)
Look, this is great. We are not planning to use recently graduated personnel initially but rather those who have spent at least one year working in the community where they gain a lot of experience. From the new graduates we need to ask them to take great care, to make great efforts and learn because later we will have to send replacements.
I think that after graduation --although we know they graduate with much knowledge and hospital experience-- they should have at least a year of professional work with the people. We will see how many specialists in general integral medicine we need in the first contingents.
Anyway, you know that where there are three doctors working in an urban community one can be taken out, not in the mountains where they are spread far apart. In the clinics, of every three we can take out one who has graduated in general integral medicine or is quite advanced in that specialty. Just among those working in general integral medicine, the potential for mobilization is almost 10,000. Those who have acquired experience in rural areas are particularly important. Once we have a more precise and detailed idea of what their missions will be, the places where they will be working and the characteristics of each place we will able to consider including recently graduated personnel in teams of very experienced doctors.
Aside from specialists in general integral medicine, various other specialties will unquestionably be required but for that we have a rich source and potential. I do not recall if we have 2500 or 3000 surgeons. We have thousands of pediatricians and thousands of obstetricians. We have thousands of specialists in the fields most in demand now. I can assure you that if we take 10,000 doctors from this country to carry out an honorable and humane mission abroad that will not affect our health programs, simply because of the numbers we have working mostly at the basis, in the community, one of the most important places where there are tens of thousands of professionals.
We have also discovered that the doctor in general integral medicine is almost the perfect doctor for this endeavor. Specialists in general integral medicine are in very high demand and every place in the city where there are three --the famous trios-- you take out one and the other two can do the work.
We just took out 2000 and in a few months we shall be replacing them, 2500 will graduate in August. Our medical schools can go up to 3000 or 4000 new enrollments per year without failing to fulfill the plans I have mentioned for the scholarships to the Central American students, in case of a pressing and visible need in the future.
We have a great school of basic sciences in Havana. Aside from that, just today some comrades who are here with us went to visit an excellent naval officers' school, an excellent facility which the MINFAR [Ministry of the Revolutionary Armed Forces] as a result of its downsizing can release, and wants to do so for the program to train Central American doctors. We are thinking of using it as a school of basic sciences for the first two years of medical school. Now, the Central American students are going to have it but later it can remain as a Latin American school of basic sciences for the study of medicine.
We have to work on the issue of unity between Latin American and Caribbean countries which I assure you is moving forward. Look that, on June, there will be a meeting of all Latin Americans: Mexico, Central and South America, and all the Caribbean countries with the 15 European Union nations, in Rio de Janeiro. It will be a summit conference.
We must become more and more united. I have explained to you about Europe where if they do not unite they are lost. We are working very, very, very hard on the issue of rapprochement and unity among the Latin American countries avoiding ideological problems, just analyzing the situations occurring in the world today which are catastrophic for the Third World, a terrible plunder, not only taking into account the environmental problems but also demonstrating that this situation is untenable and warning about all the risks to life. We have to work for unity. That is why I think that that school will remain at the service of Latin American medicine.
Why do we want to train Central American doctors? Because what is important is that, in the future, the doctors from those countries will provide the services. I think of the day when a Nicaraguan will work in Honduras and a Honduran in El Salvador. Those countries were united, they were born to independence together and now they are separated.
The South Americans will also have to unite because they cannot survive if they do not unite. They must unite to survive and still then the world economy's essential and profound problems will be very far from resolved, and they will go from crisis to crisis. No one can turn back globalization, nor is it necessary. Just that it is a humane globalization that we need, something that simply does not exist today.
How can it be that in Haiti 135 children from 0 to 4 years of age are dying for every 1000 live-births? All the European countries put together have a rate of, perhaps, 10 deaths per 1000 live births. Well, Cuba which is right here has a 9.3/1000 live-births rate, just to give you an example, we are very close to the best rates, are we not? But some countries, like Finland, Sweden and others are most likely below 9.3/1000. The fact that some have infant mortality rates of 7 or 8, while another has 135, and others 60 or 70 is not moral or humanly acceptable
Throughout South America, except for Chile and perhaps Uruguay and Argentina, the infant mortality rates are very high. Is Chomi somewhere here? Chomi, what was the infant mortality rate we saw yesterday for ages 0 to 5 in Latin America, except for Costa Rica which has 14 and possibly Chile? What is Chile's figure, does anyone know? (CHOMI RESPONDS THAT THE CONTINENT'S AVERAGE IS OVER 40.) Chomi, I think it was about 45. (CHOMI ADDS THAT IT WAS BETWEEN 43 AND 45.) Well, yes, over 40 is awful.
For example, what is Bolivia’s rate? It is an example of a country that might well need cooperation in this field. You forgot? (LAUGHTER) I think I recall the figure of 83 (CHOMI SAYS THAT IN 1996 BOLIVIA HAD 102 IN THE GROUP UNDER FIVE YEARS AND 71 UNDER ONE YEAR) It seems to me that the difference between the group under five and under one year of age is too high. Anyway, taking the lowest figures, it is incredible that so many children die at those ages. Bolivia would be second after Haiti.
Something else, Chomi. What is Paraguay’s rate? (HE RESPONDS THAT PARAGUAY HAS 47 FOR THE GROUP UNDER FIVE AND 39 UNDER ONE YEAR) They are much better off than Bolivia but, honestly, that is still really high.
What about the giant, our friend Brazil? (CHOMI SAYS THAT BRAZIL HAD 52 IN THE GROUP UNDER FIVE AND 44 UNDER ONE YEAR, ACCORDING TO 1996 DATA) They told me a short while ago that it was high.
Actually, it can be said that for every child under five years of age who dies in Europe, five die in Latin America, and I am not talking of Africa or Haiti. The Europeans invented modern slavery by forcibly bringing men and women from Africa as slaves but then those slaves were the heroes who liberated that republic. For every child who dies in Europe, 14 die in Haiti, and everything else is the same. This is just an indication of all the calamities our peoples must endure.
Now, with globalization ideas spread throughout the world more rapidly and I see advances, there really are advances. However, I really think that the objective situation in the world today is way ahead of the peoples' consciousness although the consciousness of the world population about many problems is growing.
In fact, not only the objective conditions characterizing our planet today are important but also humanity's consciousness. I do not think these problems will be solved through war. It will not be that way, although at the pace we are moving there could be all kinds of social upheavals and unprecedented explosions. That is mathematically true, exact science, I could say.
So today, Mainegra, we can include politics in the Science and Technology Forum, (LAUGHTER AND APPLAUSE) if so, I have kept to the subject. (LAUGHTER AND APPLAUSE)