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Cuba’s socialist regime continues to engage in widespread
manipulation of its health care statistics to enhance its legitimacy
abroad, experts say.
The issue of Cuba’s health care record came up again recently after Sen. Tom Harkin (D., Iowa) visited
the island in January, telling reporters afterward that Cuba is a “poor
country” but “their public health system is quite remarkable.” He said
Cuba has a lower child mortality rate than the United States and a
higher life expectancy.
Sen. Marco Rubio (R., Fla.) contested Harkin’s claims in an impassioned floor speech last week.
“I wonder if the government officials who hosted him, informed him
that in Cuba there are instances reported, including by defectors, that
if a child only lives a few hours after birth, they’re not counted as a
person who ever lived, and, therefore, don’t count against the mortality
rate,” he said.
Dr. Rodolfo Stusser, former adviser to the Cuban Ministry of Public
Health, said in an email that the ministry has contrived its health data
since Fidel Castro’s 1959 revolution.
Stusser conducted his own personal research on Cuba’s health care
system since 1800, but has been unable to review more data in recent
years. Officials at Cuba’s Health Statistics Bureau told him in 2009
that old archives had been lost in a fire.
Stusser presented research
last year to the Association for the Study of the Cuban Economy (ASCE)
showing that declining infant and gross mortality rates predated
Castro’s takeover. However, health care successes in Cuba’s colonial and
republican eras “have been systematically erased or distorted,” he said
in the report.
Cuba had the 14th lowest infant mortality rate in the world in 1958,
lower than France, Germany, Italy, and Japan. Cuba has the 42nd lowest
rate today, according to 2013 estimates in the CIA’s World Factbook.
While Cuba’s infant mortality rate is lower than the United States,
Stusser said Cuban authorities use heavy-handed methods to keep it that
way.
Doctors in Cuba’s public health system are pressured to induce
abortions for potentially problematic pregnancies in order to
artificially lower the infant mortality rate. Stusser estimated
that if the deaths of living fetuses older than 21 weeks had been
reported, Cuba’s infant mortality rate would be at least 50 percent
higher.
Katherine Hirschfeld, chairwoman of the anthropology department at
the University of Oklahoma, said in an email that she observed similar
practices in Cuba in the 1990s.
One doctor told Hirschfeld that not encouraging abortions for fetuses
with abnormalities “might raise the infant mortality rate.” She said
Cuba lacks neonatal intensive care wards that would prevent the deaths
of infants with genetic defects, creating additional pressure to abort
them and keep mortality rates low.
“The Cuban government’s approach to health and health care seems to
prioritize the health of ‘the revolution’ above the health of individual
patients,” she said. “This means doctors must hit specific statistical
targets for their communities.”
Cuba’s life expectancy statistics are also disputed.
The United States has a life expectancy of 78.62 years compared to 78.05 in Cuba, according to CIA estimates. Data from the Pan American Health Organization (PAHO), by contrast, gives Cuba a slightly higher life expectancy.
Hirschfeld said there is reason to be “skeptical” of PAHO’s data
because it relies on self-reported health statistics that are not
independently verified.
Cuban officials have been reluctant to acknowledge disease outbreaks
in the last couple decades despite multiple reports. A cholera outbreak beginning in July 2012 sickened hundreds and killed at least three people.
Hirschfeld said she contracted dengue fever while in eastern Cuba and
was placed in a crowded hospital, where no medications were offered and
medical assistance was limited. Patients who could walk helped the more
severely ill, and all of them were expected to have their own dishes
and utensils.
Cuba actually eradicated
diseases such as smallpox and yellow fever in the early 1900s—before
the United States did, Stusser said. However, Castro’s nationalization
of the health system banned private initiatives and public-private
partnerships, hampering Cuba’s biotechnology industry and drug
development.
Cuba now has a glut of poorly trained family doctors, and many of the
best health care facilities are reserved for elites and foreigners,
Stusser said. Thousands of doctors have defected.
A spokesperson for Harkin did not respond to a request for comment on this article.
Humberto Fontova, columnist and critic of the Castro regime, said in
an interview that Cuba’s health care system tends to receive favorable
coverage from the media despite mounting evidence that it is not as
excellent as the Cuban government claims it to be.
A 2009 CNN report
noted decrepit and unsanitary hospitals and emergency rooms in Cuba but
quoted health officials who said “no one falls through the cracks.”
“This stuff has been known and written about and shouted from the
rooftops for the last half-century,” Fontova said. “The problem is that
much of it didn’t make it past the mainstream media filter.”
Castro called propaganda “vital” and “the heart of all struggles” in a 1954 letter to a revolutionary colleague, Fontova noted.
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