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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

The World Health Organization’s (WHO) representative in Cuba states that “there is no question that Cuba has the best health statistics in Latin America.” [South End Press, 1993, pp. 151]

Timeline Tags: US-Cuba (1959-2005)

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

Under political pressure, the Justice Department allows Orlando Bosch, the alleged mastermind of the bombing of Cubana de Aviacion Flight 455 (see October 6, 1976), to remain in the US. Bosch has been in US custody since he entered the US illegally in 1988 (see October 6, 1976). The Justice Department’s decision releases Bosch from custody and puts him under house arrest. It also reverses an earlier ruling that Bosch be deported and it ignores Cuba’s request that he be extradited to Cuba to stand trial for the downing of Flight 455. Later, in 2001, he will be accused of supplying the explosives used in more than a dozen 1997 bombings in Havana. Despite his alleged connection to the bombings, he is permitted to stay in the US. [Salon, 1/11/2002]

Entity Tags: Orlando Bosch

Timeline Tags: US-Cuba (1959-2005)

In a national referendum, 72 percent of Venezuelan voters approve a new constitution that significantly increases the state’s role in the economy and society. The constitution—Venezuela’s 26th since winning independence from Spain in 1821—codifies into law Chavez’s progressive agenda. It requires the state to promote sustainable agriculture, protect the environment, guarantee the rights of indigenous peoples, take affirmative action against the effects of institutionalized discrimination, and guarantee every Venezuelan the right to a fair wage, health care, and a secure food supply. The victory seems to have been a result of Chavez’s immense popularity and not necessarily the constitution itself, which, according to one poll cited by the Washington Post, was read by only about two percent of the population. [Washington Post, 12/16/1999; Washington Post, 12/17/1999]
Selection of Constitutional Provisions -
bullet The constitution changes the country’s name from “Republic of Venezuela” to “Bolivarian Republic of Venezuela” [Constitution of the Bolivarian Republic of Venezuela. Title IX, 1999] in honor of Simon Bolivar, the South American liberator who fought for the independence of Venezuela, Colombia, Ecuador, Peru, and Bolivia. [Venezuela Analysis, 8/27/2003] The constitution bases “its moral property and values of freedom, equality, justice and international peace on the doctrine of Simon Bolivar, the Liberator,” Article 1 says. [Constitution of the Bolivarian Republic of Venezuela. Title I, 1999] The new name reflects Chavez’s desire for a more integrated Latin American, which he hopes will be achieved through a federation of “Bolivarian Republics.” [Venezuela Analysis, 8/27/2003]
bullet The new constitution implies a distinction between the concepts of “law” and “justice.” [Venezuela Analysis, 8/27/2003] Article 2 of the constitution says that “Venezuela constitutes itself as a Democratic and Social State of Law and Justice… .” [Constitution of the Bolivarian Republic of Venezuela. Title I, 1999] Gregory Wilpert, a supporter of the Chavez government, notes: “This stands in contrast to many other country’s constitutions [such as Germany’s], which simply say that its state is a state of law. In other words, the Venezuelan constitution highlights the possible differences between law and justice, implying that justice is just as important as the law, which might not always bring about justice.” The term “justice” is not defined anywhere in the document; however, Wilpert suggests that the constitution’s “declaration of motives,” (the section that precedes the official text of the document) provides an indication of what the constitutional assembly understands justice to be. It states: “The state promotes the well-being of Venezuelans, creating the necessary conditions for their social and spiritual development, and striving for equality of opportunity so that all citizens may freely develop their personality, direct their destiny, enjoy human rights and search for their happiness.” Others warn that the constitution’s failure to explicitly define the meaning of the term creates the possibility that the government could use its own understanding of justice to subvert the law. [Venezuela Analysis, 8/27/2003]
bullet Article 13, in designating the country as an “area of peace,” prohibits the establishment of foreign military bases or facilities in Venezuela “by any power or coalition of powers.” [Constitution of the Bolivarian Republic of Venezuela. Title II, 1999]
bullet The constitution requires the state to respect and guarantee any and all rights declared in international human rights treaties that are signed and ratified by Venezuela. [Constitution of the Bolivarian Republic of Venezuela. Title II, 1999]
bullet The constitution adopts a broad definition of discrimination and makes it the responsibility of the state to correct any inequalities resulting from discrimination. Article 21 thus states: “[A]ll persons are equal before the law and consequently: No discrimination based on race, sex, creed or social standing shall be permitted, nor, in general, any discrimination with the intent or effect of nullifying or impairing upon the recognition, enjoyment or exercise, on equal terms, of the rights and liberties of every individual. The law shall guarantee legal and administrative conditions such as to make equality before the law real and effective manner; [and] shall adopt affirmative measures for the benefit of any group that is discriminated against, marginalized or vulnerable… .” [Constitution of the Bolivarian Republic of Venezuela. Title III, 1999]
bullet Article 58 guarantees the right to information that is “timely, true, and impartial” and adds that such information must be disseminated “without censorship, in accordance with the principles of this constitution.” [Constitution of the Bolivarian Republic of Venezuela. Title III, 1999] Critics argue that what constitutes truth and impartiality is subjective and therefore this article could provide the government with a pretext for censoring the media. [Washington Post, 12/16/1999, pp. A30; Venezuela Analysis, 8/27/2003]
bullet The constitution eliminates state financing of political parties. [Venezuela Analysis, 8/27/2003]
bullet Articles 71 through 74 gives the national assembly, the president, and registered voters (when a petition is signed by 10 to 20 percent of the registered voters) the power to initiate a public referendum. A referendum can be one of four types: consultative, recall, approving, and rescinding. A consultative referendum asks the population to give its opinion on a non-binding question that is of a “national transcendent” nature. [Constitution of the Bolivarian Republic of Venezuela. Title III, 1999] For example, a referendum might ask whether the country should sign a free trade agreement. [Venezuela Analysis, 8/27/2003] A recall referendum is a binding referendum that can be used to recall any elected official after the official has served half of his or her term in office. In an approving referendum, also binding, the public would be called upon to approve a constitutional amendment or an important law or treaty that would infringe on national sovereignty. The rescinding referendum would allow citizens to rescind existing laws. [Constitution of the Bolivarian Republic of Venezuela. Title III, 1999; Venezuela Analysis, 8/27/2003]
bullet The constitution guarantees the freedoms of expression, assembly, political participation, as well as the right to employment, housing, family planning, and health care. [Constitution of the Bolivarian Republic of Venezuela. Title III, 1999] For example, with regard to health care, Article 83 states: “Health is a fundamental social right and the responsibility of the State, which shall guarantee it as part of the right to life. The State shall promote and develop policies oriented toward improving the quality of life, common welfare and access to services.” [Constitution of the Bolivarian Republic of Venezuela. Title III, 1999] Concerning employment, Article 91 states, “Every worker has the right to a sufficient salary that allows a life with dignity and covers his own and his family’s basic material, social, and intellectual necessities.” The constitution also requires that the state promote and protect economic democracy. [Constitution of the Bolivarian Republic of Venezuela. Title III, 1999]
bullet Article 84 charges the state with administering a national public health system that is “governed by the principles of gratuity, universality, completeness, fairness, social integration and solidarity.” The article also outlaws the privatization of health care. [Constitution of the Bolivarian Republic of Venezuela. Title III, 1999]
bullet Article 87 states that all Venezuelans are entitled to the benefits of the social security system, including those who are unable to contribute. [Constitution of the Bolivarian Republic of Venezuela. Title III, 1999]
bullet Article 88 recognizes the contribution of women homemakers and accordingly guarantees them the right to receive social security benefits. “The State guarantees the equality and equitable treatment of men and women in the exercise of the right to work. The state recognizes work at home as an economic activity that creates added value and produces social welfare and wealth. Homemakers are entitled to Social Security in accordance with law.” [Constitution of the Bolivarian Republic of Venezuela. Title III, 1999]
bullet Article 91 states that the minimum wage is to be computed on an annual basis and that its value will be based, in part, on the cost of the basic consumer goods basket. [Constitution of the Bolivarian Republic of Venezuela. Title III, 1999]
bullet Article 103 guarantees every Venezuelan free education up to the undergraduate university level. [Constitution of the Bolivarian Republic of Venezuela. Title III, 1999]
bullet Article 115 states: “The right of property is guaranteed. Every person has the right to the use, enjoyment, usufruct and disposal of his or her goods. Property shall be subject to such contributions, restrictions and obligations as may be established by law in the service of the public or general interest. Only for reasons of public benefit or social interest by final judgment, with timely payment of fair compensation, the expropriation of any kind of property may be declared.” [Constitution of the Bolivarian Republic of Venezuela. Title III, 1999]
bullet Articles 119-126 of the constitution recognizes, for the first time in the country’s history, the indigenous population’s right to exist, to its languages, cultures, and to hold its lands in collective ownership. It also requires the state to help indigenous groups demarcate their lands and guarantees that state-led exploitation of natural resources in their lands “shall be carried out without harming the cultural, social, and economic integrity of such habitats, and likewise subject to prior information and consultation with the native communities concerned.” Under the new constitution, the state is also required to promote indigenous cultures and languages and protect their intellectual property. It prohibits outsiders from registering patents derived from indigenous knowledge. [Constitution of the Bolivarian Republic of Venezuela. Title III, 1999; Venezuela Analysis, 8/27/2003] Article 186 guarantees the political rights of Venezuela’s indigenous population—estimated at 316,000—mandating that they be allocated three of the 130 seats in the National Assembly. [Constitution of the Bolivarian Republic of Venezuela. Title III, 1999]
bullet Articles 127-129 charges the state with protecting biological diversity, genetic resources, ecological processes, and national parks. It requires that environmental and socio-cultural impact reports be prepared in advance of any activities that could potentially cause environmental damage. [Constitution of the Bolivarian Republic of Venezuela. Title III, 1999]
bullet The constitution specifies that the national government will consist of five powers: the legislative, executive, judicial, electoral, and public. The public, or citizen, power would provide oversight to the four other powers to ensure that they adhere to their constitutionally determined functions. Public power is thus charged with “preventing, investigating and punishing actions that undermine public ethics and administrative morals; to see to sound management and legality in the use of public property, and fulfillment and application of the principle of legality in all of the State’s administrative activities, as well as to promote education as a process that helps create citizenship, together with solidarity, freedom, democracy, social responsibility and work.” The responsibility of the electoral power is to oversee state elections, and in certain cases, the elections of civil society organizations, such as unions. [Constitution of the Bolivarian Republic of Venezuela. Title V, 1999; Venezuela Analysis, 8/27/2003]
bullet The new constitution replaces the former bi-cameral system with a unicameral one. The stated reason for this change is that it will enable the quick passage of legislation. Critics argue that this centralizes state power. [Constitution of the Bolivarian Republic of Venezuela. Title V, 1999; Venezuela Analysis, 8/27/2003]
bullet At the insistence of President Chavez, the constitutional assembly extended the presidential term from five to six years and eliminated the provision that previously barred presidents from serving two consecutive terms. Chavez argued that a single five-year term would not be sufficient to fully implement the revolution’s policies. [Constitution of the Bolivarian Republic of Venezuela. Title V, 1999; Venezuela Analysis, 8/27/2003]
bullet Title VI of the constitution charges the state with promoting industry, agriculture, and various other smaller branches, such as fishing, cooperatives, tourism, small businesses, and crafts. [Constitution of the Bolivarian Republic of Venezuela. Title VI, 1999]
bullet Article 301 grants the state the right to use “trade policy to protect the economic activities of public and private Venezuelan enterprises” and charges the state with ensuring that foreign-owned enterprises are not afforded preferential terms that could put Venezuelan enterprises at a disadvantage. [Constitution of the Bolivarian Republic of Venezuela. Title VI, 1999]
bullet Article 302 enshrines continued state control of the petroleum industry and states that all industries of a strategic nature are subject to state control. Article 303 gives the state complete ownership of Petroleos de Venezuela, S.A. [Constitution of the Bolivarian Republic of Venezuela. Title VI, 1999]
bullet Article 304, acknowledging that water “is essential to life and development,” specifies that it belongs in the public domain. [Constitution of the Bolivarian Republic of Venezuela. Title VI, 1999]
bullet Articles 305 and 306 require that the state pursue a food production strategy aimed at self-sufficiency. The approach would entail promoting “sustainable agriculture as the strategic basis for overall rural development”; promulgating any necessary “financial, commercial, technological transfer, land tenancy, infrastructure, manpower training and other measures”; and compensating agricultural producers “for the disadvantages inherent to agricultural activity.” Article 307 states emphatically that the “predominance of large land estates is contrary to the interests of society” and that “farmers and other agricultural producers are entitled to own land.” It thus authorizes the state to implement taxes on landholdings that are left in fallow, to establish the necessary measures to convert fallow lands into productive economic units, and to protect and promote associative and private forms of property. [Constitution of the Bolivarian Republic of Venezuela. Title VI, 1999]
bullet Article 311 requires that “any revenues generated by exploiting underground wealth and minerals, in general, shall be used to finance real productive investment, education and health.” [Constitution of the Bolivarian Republic of Venezuela. Title VI, 1999]
bullet Article 236 gives the president the exclusive authority to promote high-ranking military officers. This authority previously laid with the legislature. Critics of the constitution argue that these provisions effectively consolidate Chavez’s control over the military by providing him with a means to pack its leadership with political supporters. [Constitution of the Bolivarian Republic of Venezuela. Title V, 1999; Venezuela Analysis, 8/27/2003]
bullet Article 330 gives members of the military the right to vote, a right they were denied under the previous constitution. [Constitution of the Bolivarian Republic of Venezuela. Title VI, 1999; Venezuela Analysis, 8/27/2003]

Entity Tags: Hugo Chavez Frias

Timeline Tags: US-Venezuela (1948-2005)

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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