Wyatt Egger, Melinda Nevarez, Gjermayne Wilson Chapter 5: The Irony of Success Social Accomplishments and Their Unintended Consequences Wyatt Egger, Melinda Nevarez, Gjermayne Wilson

Health Welfare Medical system and health welfare became Castro’s obsession Castro identified health welfare as a basic human right Castro saw the medical system as a basis for the island’s global empowerment In 1980s, Castro spoke out on developing Cuba into a world medical power

Health Welfare: The Medical System Castro’s government invested in expanding and democratizing access to Cuba changing under Castro= Cuba committed to health care Medical training was designed to produce a “new professional man” Castro encouraged low-cost public health campaigns In 1980s, Castro continues to encourage innovations in the the medical system Family Doctor Program= better relationship between the doctor and patient The Family Doctor Program= the first international effort to provide family medicine universally without charge as part of an integrated national health system

cont. The medical care system was designed to reach large numbers of people with some possible sacrifice to costly, specialized health needs Why they sought to “fix things” = Hospitals offered more specialized treatment than polyclinics and family doctors Cubans were happy with their medical care In the 1900s, too many people wanted to become a doctor The increase in demand of medicine= high cost Raised the cost of healthcare Castro’s social project was hurt and collapsed Cuban gov. Assigned higher priority to the production of pharmaceuticals for export, harming the needs of the Cubans Answer to problem= advocated traditional herbal medical cures to Cubans

Nutrition Health welfare depends not only on the size and scope of a medical delivery system but also on nutrition. Because the government regulates the production and distribution of food, its policies directly influenced dietary patterns Poor people often consumed insufficient calories Data on per capita protein and caloric consumption suggests that Cuban nutritional standards deteriorated during the 1960s and then improved In the mid-1950s daily per capita intake was higher than the estimated requirement but the diet was not well balanced since rich and poor alike sought high in carbohydrates.

Cont. The deterioration in nutritional standards in the 1960s came first with the restructuring of agriculture The “push for communism” Nutritional standards improved once government reemphasized production for domestic consumption after the crisis of 1970 The country's regional ranking on caloric intake improved by two by 1970 while its regional ranking on protein intake deteriorated under Castro until the mid- 1980s With food scarce the government became a de facto administrative weight watcher

Cont. Government efforts to guarantee everyone adequate food at affordable prices failed for several reasons Heavy rains and import cutbacks such as the blockade of trade from soviet union's Producers and distributors siphoned foods off to the lucrative black market The March “storm of the century” Nutritional deficiencies with the crisis of the 1990s new health problems arose Between the mid-1970s and mid-1980s official policy was most tolerant of dietary needs Near total food rationed during the 1990s special period that officially equalized dietary consumption

Life Expectancy and Infant Mortality Life expectancy arose from fifty-nine years before the revolution to seventy-six years in 1992 Cuba's regional ranking improved under Castro which the county came to have the highest life expectancy up from the third highest under the old regime Government social policy contributed to market decline in the infant mortality rate Health care may have decorated under Castro until a new generation of medical cadre were trained to replace the physicians who left The government made a concerned effort to improve children's life expectancy upon birth

Fertility Decline The drop in the fertility rate as of the 1970s was especially dramatic among women over twenty-four Women in conjugal relationships expected on average to have no more than two children Changes in the health care delivery system made it possible for women's ideal family size to become reality Once medical care became a basic right of all Cubans and medical facilities were extended, Cuba came to have the fifth highest known abortion rate in the world surpassed in the 1970s

Social and Fiscal Ramifications Life expectancy up; fertility rate down Population stopped reproducing itself Government had to pay for all the old people Medical carefree

Women in Labor Force Began in 1970s Most women in government Work up, causing fertility to go down