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

2. 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

3. 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

4. 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

5. 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.

6. 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 s
With food scarce the government became a de facto administrative weight watcher

7. 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

8. 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

9. 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

11. 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

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