Why Cuba is important.

post-peak oil transportation

The dialysis team at the hospital in Yaguajay, with Dr. Amaury Ung Salazar
Importation of modern dialysis machines?  -Forbidden by the US blockade.
Mailing a current copy of Handbook of Dialysis?  -Also blockaded.

Why is Cuba important?

11 million people in a little 3rd world nation with many problems... but with some startling 1st world statistics having to do with education (100% literacy; free education at all levels) and health care (infant mortality lower than that in the US.)

Because Cuba is not doing what the US and all the other countries in the global market dominated by the US are doing, which is maximizing corporate profits and earnings for the wealthy at the expense of everyone else and of the environment.  They have envisioned a more just society and are doing their best to carry this out, with  obvious imperfections and in spite of obstacles, by far the largest of which is the US economic blockade of the country.

Because in trying to create a society in which wealth and opportunity are more equally shared, and in resisting at any cost or sacrifice the coercion of the US, they are an example for Latin America and for the world.

Because the Cuban "better world" concept is internationalist.  They supply doctors to many countries, doctors who are trained to work in impoverished areas and in disaster conditions.  Cuba also educates doctors from  all over the world to return to their own countries and give care to poor communities.  The Latin American School of Medicine has 12,000 students, including some from the US.  This education is free.

Because the whole world owes a debt to Africa and only Cuba has really tried to pay back.

Because Cuba is "post peak oil" and has worked out transportation and agriculture alternative methods which can be used in other countries that need to or wish to reduce their petroleum consumption.  Cuba is sustainable. 

Because there are no homeless people.

Because Cuba has shown that the population won't explode if you reduce infant mortality and prevent disease, even without any coercive population control measures.  All that is needed is to educate and empower women.

Because the Cubans make mistakes and admit them and correct them.  The Cuban revolution was initially hostile to religion and to homosexuality, for example and both these attitudes have been reversed.

Because Cuba is a great place to have your revolution AND dance.

Because the Cubans exemplify Winston Churchill's famous words, "Never give up.  Never, never, never, never, never give up. Never give up.  Never give up."  

ELAM graduation

The first time I saw an ELAM graduation, or more exactly ELAM graduates, I cried.  This had something to do with the fact that I'd had just 2 or 3 hours of sleep the night before but much more because this was the medical education of my dreams and I had missed it.  I'm not complaining about my medical education which was excellent and occurred back when University of California medical schools didn't cost much to attend.  Medical school is a process more than a place and many who start are starry-eyed idealists who want to serve and help people.  By graduation, and certainly by the end of internship, the bloom is off the grape.  The eyes are set in strained hyper-alertness, trying to stay awake, feeling deeply fatigued, exploited, entitled...  Payback time.  The education has focused on fact, which is necessary and may not be sufficient.  Idealism is not nourished although it would be tolerated if a student or house officer managed to maintain it.

         But everyone sounds enthusiastic at graduation, so how can one know that these ELAM students have really been trained to "serve the people?" (that phrase which still has meaning for me even after decades of  Maoist use and abuse) 

Because they do.  ELAM is free: room board, books, lab, tuition.  What is asked in return is that students return to their countries and practice medicine serving a poor and under-served group of patients.  There is no enforcement mechanism; none is even possible.  Yet over 90% of the students do this.  They go to poor and rural areas and care for patients who would not otherwise have a doctor and who cannot pay much.  They have learned to do this in medical school.  They have given up a lot for the opportunity to serve - a six year program spent in a dorm situation far from friends and family and familiar surroundings and comfort.  Certainly there is support, some of it institutional, much of it mutual and cooperative aid among students.  For many students it is in a new language too, which doesn't make reading and comprehension any easier.

After graduation, when the new ELAM trained doctors return home, instead of joining the elite which is where most doctors are located in most societies they dedicate, not just a few years, but their careers to poor people's medicine.  It doesn't just happen.  This is exactly what they learned in school.