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Posted on: Thursday, April 28, 2005

Keywords: Women's Health, Combating Violence Against Women, Peace Building, Economic Justice, Environmental Justice, Cuba, Latin America and Caribbean

A MADRE Position Paper

Proponents of neoliberal economics routinely claim that the only way to improve healthcare in poor countries is through free trade, privatization, and corporate deregulation. Yet Cuba demonstrates that high standards of health and healthcare are attainable if governments meet their obligation to ensure health care for all. In Cuba, free, comprehensive, high-quality healthcare is guaranteed to everyone, as are education, food, and other resources needed to maintain good health. As a result, Cuba, a poor country by most standards, has a life expectancy of 77 years (the same as the US), and some of the highest global rates of child immunization (96 percent) and school enrollment (94 percent).

In fact, the biggest threat to public health in Cuba comes from the United States. Cuba is being subjected to the longest-running, most severe embargo in US history, which prevents Cuba from purchasing urgently needed food and medicine, with grave consequences for Cuban women and their families. Every year for the past 12 years, the UN General Assembly has formally condemned the embargo as a violation of international humanitarian law. Members of the US Congress have repeatedly introduced bills to end the policy, which was first imposed in 1961. Even amongst Cuban-Americans-commonly cited as the strongest proponents of the embargo-there is a growing call for ending the policy. But successive US Administrations have been obsessed with using the embargo to destabilize the Cuban government in order to dominate Cuba and the hemisphere at large.

A Model for Global Healthcare

In 1989, with the dismantling of the Soviet Union, Cuba lost 85 percent of its foreign trade. The US exploited the economic crisis by escalating the embargo and intensifying pressure on Cuba's healthcare system. Throughout the 1990s, medicines, supplies, and equipment-ranging from pens and paper to advanced technology-became even more scarce. Incidence of infectious disease and parasitic infection rose, as did death rates from tuberculosis, typhoid, and diarrheal diseases.

But even during the worst years of the crisis (1989-1993), the government guaranteed that vulnerable sectors of the society did not bear the brunt of the embargo. So while millions of Cubans have endured hunger as a result of food shortages, equitable food distribution policies have ensured that scarcity meant weight loss for most adults, not malnutrition for children or pregnant women. Similarly, while the 1990s saw a rise in low birth weights, Cuba's National Low Birth Weight Reduction Program prevented increased infant mortality. Indeed, despite the embargo, Cuban infant mortality rates are lower than those of Washington, D.C. Moreover, Cuba has maintained its commitment to a preventative healthcare system that is a model for most of the world. Its programs for treating and preventing HIV/AIDS have held Cuba's infection rate to 0.07 percent, one of the lowest in the world. And Cuba has been at the forefront of the global struggle to ensure access to effective antiretroviral medicines for anyone living with AIDS.

Cuba Policy Under Bush: From Bad to Worse

Instead of heeding the calls of public opinion and much of the US Congress, the Bush Administration has maintained the embargo and placed even tighter restrictions on travel to Cuba, as well as on money and other goods that can be sent by Cuban-Americans and Cubans in the US to family members on the island. Since 2004, family visits to Cuba by Cuban-Americans and Cuban nationals living in the US are allowed only once every three years (if the US Treasury Department grants the traveler a specific license), instead of every year on a general license. And the length of these visits has been reduced from 21 days to 14 days. The new restrictions thereby deny Cubans millions of dollars worth of financial and material support on which they depend because so many essential goods are unavailable or unaffordable, in large part because of the US embargo. Moreover, now visits and financial remittances can only be made to immediate, as opposed to extended, family members. Many Cubans, whose families extend beyond the US nuclear family model, find it particularly galling that George Bush claims the right to determine who is and who is not part of their family.

Bush has also allocated $90 million more to foment opposition to the Cuban government from within Cuba (a violation of international law) through propping up "dissident groups" and conducting propaganda operations that incite Cubans to overthrow their government. And Bush severely restricted the type of travel licenses that allowed MADRE and other organizations to bring educational delegations to Cuba. The travel ban, opposed by 80 percent of US citizens and the majority of Congress, violates the right of every US citizen to freedom of travel. Moreover, barring US citizens from meeting Cubans in their country, developing friendships, and witnessing firsthand the harmful impact of the embargo on ordinary Cuban families makes it easier for the Bush Administration to demonize the Cuban government and deny the human suffering caused by the embargo.

MADRE works to change US policy towards Cuba, calling for an end to the embargo, the travel ban, and Bush's latest restrictions, and for normalized relations that respect Cuban sovereignty and the human rights of women and families in Cuba. MADRE works in partnership with health professionals in Cuba to deliver life-saving medicines and medical supplies to combat AIDS, breast cancer, pediatric diseases, and other public health threats in Cuba that are exacerbated by the US embargo. In the international arena, MADRE works with the Federation of Cuban Women to call for an end to the US embargo.

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