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Proletarian issue 58 (February 2014)
Cuban life indicators continue to rise
Another vindication of a society that puts people first.
In December, at the memorial service for Nelson Mandela, Cuban President Raul Castro and US leader Barack Obama shared a handshake – the first between their nations' leaders in well over a decade. It may very well have been impromptu, but it nevertheless prompted a flurry of speculation across international media. The handshake, it was suggested, is symbolic of thawing Cuban-American relations.

The following month, the BBC quoted Edward Alex Lee, deputy assistant secretary of the US State Department, as saying the United States is “very open” to building new relations with Cuba. In fact, he said, both countries had shared “very productive” talks and made “substantial progress” on bilateral issues such as migration, aviation safety, counter-narcotics operations, and resuming postal services. The United States is keen to continue these “rare negotiations”, the article stated. . (‘ Cuba - US very open to new relationship’, BBC News Online, 11 January 2014)

Ileana Ros-Lehtinen, Republican congresswoman in Florida and virulent anti-communist, condemned the exchange and the perceived easing of tensions, labelling Cuba as “cruel, ruthless and [tyrannical]”. Mr Lee was then quick to reaffirm the United States’ concerns over its neighbour’s ‘human-rights record’ and stated that any improved relations must be accompanied by a “fundamental change” in the attitude of the Cuban government towards its own people. (‘White House says Obama-Castro handshake not planned ’, BBC News Online, 10 December 2013)

Infant mortality falling

So what exactly is the Cuban government’s attitude towards its people? In fact, there was a clear demonstration of this in December as the public health ministry released data showing that the infant mortality rate in Cuba continues to decline, and is now just 4.2 deaths per 1,000 births – the lowest in the island’s history.

Infant mortality is a key indicator to “measure the health and well-being of a nation, because factors affecting the health of entire populations can also impact the mortality rate of infants”. (Centre for Disease Control and Prevention, 2012)

It is often difficult to compare statistics between socialist and leading capitalist countries, because the latter have enjoyed centuries of economic development; development that has rested upon the exploitation of their workers and the plunder of vast colonies abroad. Socialist countries, by contrast, are relatively young, and are subject to intense economic restrictions imposed by stronger capitalist states that want to see them fail.

Cuba is a perfect example of this: the tiny island has faced a brutal economic blockade enforced by the mighty US for more than five decades. In practice, this deprives the Cuban economy of billions of dollars each year, as well as holding back its technological development.

Yet, despite this handicap, and comparing 2013 statistics from the US Central Intelligence Agency (CIA), Cuba’s infant mortality rate compares favourably to the European Union average (4.43 per thousand), the United Kingdom (4.5 per thousand), and the United States (5.9 per thousand).

This is truly extraordinary. How can it be that a small, poor and economically-blockaded country is able to ensure safer delivery of its children than the wealthiest nations on earth?

The contrast is even sharper when we compare Cuba’s infant mortality rate with its close Caribbean and Central American neighbours – countries that also share ‘developing nation’ status: these are Jamaica (13.98 per thousand), Mexico (16.26), the Dominican Republic (20.44) and Haiti (50.92). ( The World Factbook , Central Intelligence Agency, 2013)

Roberto Alvarez, head of the maternal and child department in Cuba’s public health ministry, has stated that the latest achievement is “an expression of a just society”. Alvarez explained that this is not an isolated example, but part of the government’s commitment to the continuous improvement of the population’s health. (‘Low infant mortality rate in Cuba expression of a just society’, Escambray, 3 January 2014)

Life expectancy rising

As well as having a greater chance of surviving past infancy, Cuba’s people also live longer and healthier lives. Cuba has a life expectancy of 79 years old – greater than the United States (78); and, only slightly lower than the UK (80). (‘ US life expectancy ranks 26th in the world OECD report shows’, Huffington Post, November 2013)

With all these figures, it must also be remembered that an overall average may hide a very wide range. While the US and Britain are riven with inequalities, Cuban society is infinitely more egalitarian. This means that although infant mortality and life expectancy figures in Cuba and Britain may appear to be broadly similar, the deviation from these rates according to geographical location and income bracket that is commonplace in imperialist countries means that there is actually a huge difference in the lives of ordinary workers.

To give just one example, in a WHO study in 2008, men living in two neighbourhoods in Glasgow were found to have a difference in life expectancy of 28 years. The male inhabitants of wealthy Lenzie could expect to live to age 82, on average, while their counterparts in the poor working-class district of Calton, just a few miles away, were only living on average to 54 – and even this low figure dropped to 53 in the poorest streets. (‘GP explains life expectancy gap’, BBC News Online, 28 August 2008)

Such massive discrepancies are unknown in Cuba, where all the basic requirements for a decent life are met for everyone – a guaranteed roof and job, free education at all levels, free health care and access to culture and a vibrant community support network. The depression and anxiety that go with isolation, uncertainty over jobs and housing, inability to pay bills etc, which are a common feature of working-class life in Britain – and a major contributor to chronic health problems – are unknown in Cuba.

Meanwhile, the island has also achieved the lowest prevalence of HIV in Latin America and the Caribbean. (See , 16 May 2013)

And there is a ratio of one doctor for every 220 people – one of the highest in the world, compared with one for every 370 in England. (‘ Cuban medics in Haiti put the world to shame, Independent, 26 December 2010)

Cuba’s doctors care for the people of the world

The fact that Cuba has such a high proportion of doctors inside the country is even more remarkable considering its historical commitment to providing health care – both emergency relief and long-term development work – throughout Latin America, Africa, Asia and elsewhere.

Tens of thousands of Cuban doctors are working across the world’s poorest regions. In Venezuela alone, there are more than 30,000 Cuban doctors and dentists. The Brazilian government signed an agreement late last year whereby some 4,000 Cuban doctors will work in some of the country’s poorest regions.

Also last year, the governments of Cuba and South Africa signed an agreement that nearly doubles the number of Cuban doctors helping to alleviate a post-apartheid ‘flight’ of white doctors. This policy of internationalism is enshrined in Cuba’s constitution.

The Cuban healthcare system is also cheaper than others; costing only $400 (£260) per person in 2009 compared with $3,000 (£1,950) in the UK and $7,500 (£4,900) in the US, according to the Organisation for Economic Cooperation and Development (OECD).

Advancing under socialism

It is claimed that the key to Cuba’s success is free, universal health care that promotes early prevention and an array of public-health programmes with wide coverage. This is only half-true. Britain still has near universal health care and a welfare system built upon the financial benefits of colonialism, yet impoverished Cuba out-performs Britain on many key indicators.

The most important difference is that Cuba has a socialist system – one that prioritises the health and well-being of its people above the wealth of a relative few, above vast profits for multinational pharmaceutical companies or for those participating in PFI (private finance initiative) scams.

Every Cuban adult, for example, receives a monthly ration of 283g of fish, 226g of chicken, 500g of meat products, 3.8kg of rice, 283g of dried beans, crackers, 2.3kg of sugar, 113g ounces of coffee, around two cups of cooking oil, 10 eggs, a bag of salt, a bar of soap, a tube of toothpaste, 226g of dried pasta, 226g of sweetened cocoa, 1.8kg of potatoes, 30 bread rolls and a bottle of dishwashing liquid – all free of charge. This supplements the food that they buy at subsidised prices with their own money. (‘ Healthcare in Cuba’, Guardian, 17 July 2007)

It would be impossible to evaluate the achievements of the Cuban revolution in all other fields in the space of a short article, but great advances have also been made in education, housing, gender and even LGBT (lesbian, gay, bisexual and transgender) rights, of which latedly US imperialism has been keen to appoint itself a ‘champion’.

Cuba’s literacy rates, for example, are among the highest in the world at 99.98 percent – greater than both that of the United States (officially stated as being 99 percent, although the US Census Bureau has reported a rather more believable figure of 86 percent) and Britain (95 percent). Education is free from kindergarten to university level, including the provision of meals, uniforms and materials.

Housing is heavily subsidised and homes are affordable for workers and their families. There is also a strong sense of community, in which individual problems are solved collectively. In this environment, there is virtually no homelessness. As a concept, it simply does not exist in Cuba. (See ‘Homeless in Cuba? Not likely’, , 13 September 2011)

This is in stark contrast to the housing crisis in Britain, where millions of families struggle to pay their rents or mortgages every month. Here, unemployed and temporary contract workers, in particular, face destitution and 80,000 children are homeless, living in poor temporary accommodation. (‘80000 children facing homelessness this Christmas’, Shelter, 4 November 2013)

Cuba has also made great advances in gender equality, as reflected by the high numbers of women in parliament (48.9 percent, the third highest in the world) and at university (64 percent of places), as well as in its generous maternity leave and its system of affordable child care.

The Cuban revolution of 1959 inherited a traditional culture intolerant of homosexuality and transgender issues, and initially mistreated LGBT citizens. This, of course, was not uncommon. Homosexuality was a criminal offence in Britain until 1967 and was not decriminalised throughout the US until 2003. In Cuba, as elsewhere, the government has in recent decades been correcting this anachronism – in a region where conservative values still predominate.

Indeed, in January 2014, the Cuban police arrested Maxim Martsinkevich, the notorious leader of a far-right vigilante group in Russia, who terrorised LGBT teens and posted video recordings on social media. (See , 18 January 2014)

Much as US imperialism would love to castigate Cuba for committing the sins that only yesterday it itself was committing with great gusto (in the same way that it is constantly harping on about the lack of gay rights in any muslim countries that take an anti-imperialist stand as though it is a great support to gays to be subjected to imperialist bombing and imperialist-inspired internal armed conflict), even on this aspect of human rights Cuba cannot be criticised.

The absurdity of Edward Alex Lee’s statement – that the US demands Cuba makes a “fundamental change” in its attitude towards its people – is therefore clear. Cuba is able to provide its people accessible, quality health care, education, housing, food and culture. There is a thriving local democracy in which citizens can recall their community and regional representatives. So what is it that needs to change?

Mr Lee’s words are disingenuous. The United States is calling for a fundamental change of political and economic relations in Cuba – one which would operate in the service of US imperialism and against the interests of the Cuban masses.

In 2013, 188 countries voted at the UN to condemn the United States’ economic embargo of Cuba, with just the US and Israel voting against the motion, in a demonstration that the vast majority of humanity recognises the injustice of the blockade. (‘ UN urges end of US embargo on Cuba’,, 29 October 2013)

It’s clear that the real demand for ‘fundamental change’ should be levied at the US government – to invest more in its own people and to let Cuba develop her economy without interference.

It is ironic, of course, that the recent criticism of Cuba by the United States was prompted by a meeting at Nelson Mandela’s memorial service. After all, the US CIA provided crucial information to the South African apartheid regime leading to Mandela’s arrest in 1962 and the US kept Mandela on its ‘terrorist watch list’ until 2008. (See ‘One of our greatest coups: the CIA and the capture of Nelson Mandela’,, 13 December 2013)

Meanwhile, the great South African leader himself once remarked:

“We [recognise] our great debt to the Cuban people. What other country has such a history of selfless behaviour as Cuba has shown for the people of Africa? How many countries benefit from Cuban healthcare professionals and educators? How many of these volunteers are now in Africa?

“What country has ever needed help from Cuba and has not received it? How many countries threatened by imperialism or fighting for their freedom have been able to count on the support of Cuba? ... It is in this context that we value our friendship with Cuba very, very much.” (See ‘Nelson Mandela on how Cuba destroyed the myth of the invincibility of the white oppressor ’,, 11 December 2013)
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