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A time-honored axiom among clinical psychologists notes that every crisis has two pathways-- one of danger and one of opportunity. The art and skill of the psychotherapist is then to help the patient better understand the crisis so that the danger is minimized and eliminated and the opportunity is recognized and seized. The case of Elian Gonzalez is one in point.
The danger remains that Elián is not yet at home in Cuba with his loving family where he belongs.
Stay tuned for that one. The opportunity is that the hullabaloo over his presence in the US surfaced for many the realities of what it is like for a little boy in socialist Cuba, even in the throes of the US blockade that has put Cuba in a state of war for almost 40 years. President Fidel Castro has reminded the world many times over that despite the hardships of a 3rd World embargoed life style that has denied the Cuban people of many of the consumer niceties of life, education and health care in Cuba have never been compromised.
By every standard and statistic by every world health organization, this has been confirmed. The Under Five Mortality Rate (U5MR) that determines the general health of a nation by the UN has Cuba ranked with the very best developed countries.
I recall my own experience a few years back in Habana when I was being introduced to the then newly- appointed Minister of Health. Before he explained, he startled me by shaking my hand in comradeship and then saying, "I am not the Minister of Health. Fidel is the real Minister of Health," he went on. "He calls me daily to be assured of the progress of my work and the ministry. That is how important health care is to a country and to a revolution." I understood.
The turn around in Cuba's health care delivery system these past four decades is the marvel of the world. Every world authority, including many of our own, has taken note. In 1959, as the embryonic revolutionary government started its rebuilding processes, there were three medical schools in Cuba, six blood banks, and an expected dearth of all other vital medical services. They obviously served the wealthy. Of the 9,000 physicians, nearly 6,000 fled for points north, and Fidel had to stop the medical hemorrhage. He applied a Band-Aid by making a "deal" with the archdiocese that ran the medical schools in Habana and then started major healing and rehab.
The original polyclinic system that opened up satellite health stations on all parts of the island, some that had never seen a single medical officer, was gutted in the 1980s in favor of the now established Family Health Care System. The island today has 39 medical training centers, 75 blood banks and full services that reach the most remote parts of the country. Mountain top villages, reachable only by horse and wagon or chain-driven vehicles, have doctors and nurses in attendance at all times.
The most remote areas have full service hospitals and clinics, with transportation available to the tertiary medical centers in Habana or other urban centers.
There are now 60,000 medical doctors in Cuba of all major specialties, giving them the world's best patient: doctor ratio.
Last year, every Cuban neonate was born in an hospital unit under the care of a certified obstetrician; every adult woman had a PAP smear, and every child in need had the availability of a full pediatric clinical facility. An annual fall in the U5MR is reflective. It was near amusing for the Cuban exile community in Miami these past few months to recount the charm, stamina and energy of little Elián for his survival in the Florida Straits and the enormity of his tribulations during the circus that surrounded his political situation. This can only be attributed, of course, to his healthy upbringing with a loving family and an education and health care delivery system that are second to none in the 3rd World and comparable to the developed nations.
As Cuba continues its struggle to survive in a hostile capitalist world and build its socialist society, it has put education and health as its priorities. This is the advice Fidel Castro has given to other nations of the world that have been able to make some headway in their fight for social overhauls. A revolution can survive, he has stated over again, only if the people are literate and healthy.
Sadly, the US remains the world's only developed nation without a universal health care plan for its people. We are the only industrialized nation without a subsidized prescription drug plan for all. These are the issues that must be used to judge our candidates this election year. We are a secure nation, and from that strength, we must not be too proud to ignore the paradigm that is Cuba.
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