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Context of 'August 23, 1960 and after: Federation of Cuban Women Works to Promote Women’s Health'

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The Federation of Cuban Women (Federacion de Mujeres Cubanas, FMC) is founded to promote gender equality and the full integration of women into the economic, political, social, and cultural life of Cuba. [Partido Comunista de Cuba, 7/29/2006; Cuban Education Tours, 7/29/2006] The FMC, a non-governmental organization, will liaison with the Cuban government through the People’s Health Commissions to promote women’s health. [Feinsilver, 1993, pp. 32] Some of the organization’s members will serve as brigadistas sanitarias (health brigade members), helping polyclinic (see 1964 and after) nurses provide women with first aid, injections, and general health information. They are also responsible for seeing that all women in their district regularly have pap smears, and that all pregnant women do not skip any of their prenatal exams or check-ups. When Cuba implements its Family Doctor Program (see 1984) many of the brigadistas sanitarias’ responsibilities will be taken over by the family physician-nurse teams. The role of the brigadistas sanitarias will focus mainly on health education. They will also occasionally assist family doctors and nurses. [Feinsilver, 1993, pp. 66]

Entity Tags: Cuba, Federacion de Mujeres Cubanas

Timeline Tags: Other Health Care Systems

1964 and after: Cuba Creates ‘Polyclinics’

Cuba transforms its health centers into “polyclinics.” Each of the polyclinics administers health services to a specific geographical region comprised of between 25,000 and 30,000 people and serves as the point-of-entry for most patients. [Feinsilver, 1993, pp. 35] In addition to treating patients, the clinics educate patients by holding daily lectures on health care in clinics’ waiting rooms. [Feinsilver, 1993, pp. 67] The region served by a polyclinic is further divided into health sectors. Within these sectors, all people are seen by the same medical teams, which after 1976 are mostly comprised of a physician and nurse trained in the same specialty. So for example, within a health sector, all children have the same pediatrician and all women have the same gynecologist. The polyclinic medical teams operate according to a paradigm known as “medicine in the community” which aims to treat patients as a biopsycho-social being in their respective unique environments. The medicine-in-the-community model is also designed to focus on disease prevention by identifying risks present in the environment before they become health problems. By the 1980s, it is apparent that something more needs to be done to achieve these objectives. The polyclinic medical teams fail to establish close relationships with their patients and have little time for prevention. This shortcoming leads to the creation of Cuba’s Family Doctor Program in 1984 (see 1984). [Feinsilver, 1993, pp. 35-40]

Entity Tags: Cuba

Timeline Tags: Other Health Care Systems

A bomb is detonated in the lavatory of Cubana de Aviacion Flight 455. The plane, on its way from Bridgetown, Barbados, to Havana, Cuba, plunges into the sea killing all 73 people aboard. A Cuban exile by the name of Orlando Bosch is accused of masterminding the bombing and spends 11 years in a Venezuelan prison. During Bosch’s time in prison, Otto Reich discusses the possibility of a visa for Bosch with the US State Department. After Bosch is acquitted, he heads to Miami, entering on February 16, 1988 without a visa. [Salon, 1/11/2002]

Entity Tags: Orlando Bosch, Otto Juan Reich

Timeline Tags: US-Cuba (1959-2005)

Cuba’s Ministry of Public Health establishes rules and standards on health care for women, infants, and young children. The rules make infant health and the reproductive health of women the country’s top health priorities. The ministry’s rules specify the minimum number of prenatal examinations and consultations for pregnant women and require that all pregnant women receive education on hygiene, health during pregnancy, childbirth, and child care. They are also to receive psychological counseling and instruction in birth exercises. When women miss appointments or educational lectures, doctors are instructed to go to their homes. Additionally, the ministry’s rules state that all childbirth must take place in hospitals, where women and their new babies will typically stay for four or five days. By the mid-1980s, prenatal care provided to Cuban women will far exceed the medical norms of most industrialized countries. [Feinsilver, 1993, pp. 48-49] The ministry also issues specifications for the care of infants and children, requiring that doctors conduct a certain number of check-ups every year. By 1989, the average number of well-baby visits per year will be 11. [Feinsilver, 1993, pp. 53] Author Julie Feinsilver notes that Cuba’s commitment to prenatal and infant care is cost-effective in the long-term. “These children experience less illness, require less curative medical care, and possess greater potential for development and educational achievement, which lead to greater work capacity and higher productivity.” [Feinsilver, 1993, pp. 51]

Entity Tags: Cuba

Timeline Tags: Other Health Care Systems

1984: Cuba Launches its Family Doctor Program

Cuba launches its Family Doctor Program. This new system is designed to make up for the shortcomings of the “medicine in the community” model (see 1964 and after) which did not create the intended close relationships between physicians and patients and which had failed in the area of preventative care. Under the new system, Cuba aims to put a physician and nurse team on every city block and in the remotest rural communities. The plan calls for the creation of 25,000 such teams by the year 2000, 5,000 of which would be assigned to factories, schools, ships, and homes for the elderly. The teams are charged with providing comprehensive medical attention to everyone in their districts, both healthy and sick. Each district consists of between 120 and 150 families. Special emphasis is placed on prevention and people are encouraged to exercise, eat well, and avoid unhealthy lifestyle habits such as smoking. [Feinsilver, 1993, pp. 35, 40-42] Implementing the system also requires corresponding changes in the country’s medical schools. All medical graduates except surgeons, nonclinical specialists, and future medical school professors are now required to complete a residency in family medicine before completing a second residency in a specialty area. [Feinsilver, 1993, pp. 30] After the Family Doctor Program is implemented, medical costs begin to drop. The reduced costs are attributed to decreased hospitalization and emergency room use, better health monitoring, improved patient fitness, and more effective prevention. [Feinsilver, 1993, pp. 35, 45]

Entity Tags: Cuba

Timeline Tags: Other Health Care Systems

By this date, Cuba has 6.0 medical assistance beds per 1,000 inhabitants and 1.3 social assistance beds per 1,000 people. The island boasts a total of 263 hospitals, 420 polyclinics (see 1964 and after), 163 dental clinics, 229 dispensaries, 3 medicinal spas, 148 maternity homes, 23 blood banks, 11 medical research institutes, 153 homes for the elderly, and 23 homes for the physically and mentally impaired. These facilities are distributed relatively evenly across Cuba, though there is a slightly higher concentration of beds in those provinces that serve as regional health centers. The Havana province also has a larger number of beds per capita because it is a national referral center. [Feinsilver, 1993, pp. 58-59]

Entity Tags: Cuba

Timeline Tags: Other Health Care Systems

In a speech, former National Security Adviser Zbigniew Brzezinski observes that in 1963, during the Cuban missile crisis between the US and the USSR, Secretary of State Dean Acheson offered to show French President Charles de Gaulle satellite photographs of Soviet missiles in Cuba to support President Kennedy’s request for French support in case the US needed to go to war with the US. De Gaulle replied that he did not need to see the photos, that Kennedy’s word was good enough for him. In April 2004, former ambassador Joseph Wilson, reflecting on Brzezinski’s words and the raft of lies and misinformation that led the US to invade and occupy Iraq, will write, “Who would now ever take an American president at his word, in the way that de Gaulle once did?” [Wilson, 2004, pp. 426]

Entity Tags: Dean Acheson, Charles de Gaulle, Zbigniew Brzezinski, John F. Kennedy, Joseph C. Wilson

Timeline Tags: US International Relations

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