Some day, therefore, medicine will have to convert itself into a science that serves to prevent disease and orient the public toward carrying out its medical duties. Medicine should only intervene in cases of extreme urgency, to perform surgery or something else which lies outside the skills of the people of the new society we are creating. And our task now is to orient the creative abilities of all medical professionals toward the tasks of social medicine.- Che Guevara in his speech to Cuban militia in 1960.
Today is Che Guevara’s birth anniversary and social media is replete with photos and quotes from Che. Che is remembered as a revolutionary and one of the heroes of the Cuban Revolution. In popular imagination, despite the Western propaganda, his iconic photo in military gear and beret is among the top 100 most famous photograph in the world.
Even among the left and progressive circles despite Che’s celebrity like status, much of his work after the Cuban revolution either remain unknown or is not considered glamorous for consumption. But I believe Che Guevara’s role after the revolution is equally and probably more significant and revolutionary than during the revolution. It put the foundation for a new Cuba with the socialist thought and people at its centre.
For more than a year, the world is struggling to contain a virus and keep its populations safe but failing at it. Barring a few, most countries saw a massive COVID positivity rate and high fatalities. What is obvious but some find is surprising that most developed countries, the so called beacons of human evolution and intelligence were the most affected. To these observers, one thing seem to the missing is the flawed idea of medical care in these countries.
The tiny virus has not only brought the world to a standstill but also exposed the completely privatised and for-profit healthcare model that is espoused by these countries. Words like Quality Universal Healthcare are making a comeback because if we are all equal then we should also have access to equal healthcare.
From one wave to another, we saw the run down govt hospitals as well as posh private hospitals crumble under huge patient load, shortage of doctors, nurses and caregivers. In many hospitals, nurses haven’t even been paid for months. In rural areas, the primary health centres are either non existent or bereft of any facilities or healthcare providers.
That is why, I am reminded of Che Guevara, the doctor and his vision of Social Medicine.
Medical Student to Revolutionary Soldier
In 1951, Che, a medical student took a road trip across Latin America in 1951 that changed his life. During the trip Ernesto and his friend worked as labourers and volunteered at the San Pablo leper colony in Peru on the banks of Amazon river.
The journey brought a fundamental change in him as he was deeply affected by intense poverty that he saw in every corner of the continent. These journeys brought him face to face with the economic hardships of the people of Latin America.
This is also where he recalled seeing the most impressive example of solidarity and loyalty among the men who had nothing materially. The solidarity that he sees among the lepers is how he thought all of society should operate.
Much after his death, Che’s diary was published in the 1990s as “Motorcycle Diaries” and became a New York Times best-seller and was adapted into a 2004 award-winning film of the same name.
Che’s vision of “New Man” and Revolutionary Medicine
Che’s travels across Latin America, his role as soldier and doctor during Cuban Revolution shaped his vision for the future.
After the January 1, 1959, victory that overthrew Fulgencio Batista, the new Cuban constitution included Che’s dream of free medical care for all as a human right. This gave Che a chance to combine his interest in socialist theory with his thoughts on social medicine into what he called “Revolutionary Medicine”. While in Cuba, Che used his near-celebrity status to lead the charge for revolutionizing medicine (Cueto & Palmer, 2015).
Che’s idea of social medicine went in parallel with the construction of a new Cuba and a “New Man”. Che hoped this “New Man” to be ultimately selfless and cooperative, hardworking, gender blind, non materialistic, incorruptible and anti imperialistic. His holistic approach to medicine was more focused on prevention than treatment and is beautifully illustrated in his speech-
“The principle upon which the fight against disease should be based is the creation of a robust body; but not the creation of a robust body by the artistic work of a doctor upon a weak organism; rather, the creation of a robust body with the work of the whole collectivity, upon the entire social collectivity.”
Che’s idea of social medicine is further emphasised when he talks about treatment of disease and how doctors should view interconnectedness of health, disease and society. Che says-
We shall see that diseases need not always be treated as they are in big-city hospitals. We shall see that the doctor has to be a farmer also and plant new foods and sow, by example, the desire to consume new foods, to diversify the Cuban nutritional structure, which is so limited, so poor, in one of the richest countries in the world, agriculturally and potentially.
A disconnected social system led to a disconnected health system. The Cuban revolutionary govt. connected the remote unreachable parts of the island with new hospitals and clinics. along with addressing crises of literacy, racism, poverty, and housing.
Within one year Cuban literacy campaign brought lilteracy from 60 to 97%.
Cuba has more than three times doctors per capita than the US. In 2020, eighty-nine thousand doctors, eighty-four thousand nurses, and nine thousand students graduated from medical studies.
Cuban medical internationalism
Fidel Castro had defined the medics of Cuba as Cuba’s “army of white coats”. For years now this army has been going across countries helping them through outbreaks of deadly viruses, be it SARS, Ebola, Cholera, or now Coronavirus.
During the COVID-19 pandemic, Cuba sent its first mission to Lombardy, Italy’s worst-hit region. Soon after Italy, it has sent its missions to over 20 countries. Cuban mission has been recommended for Nobel Peace Prize as part of worldwide humanitarian efforts during the pandemic.
Since 1963, Cuba has been training and sending medical personnels to several nations as part of its international solidarity and humanitarian ventures. Cuba provides more medical personnel to the developing world than all the G8 countries combined. It has 30,000 health personnel including 19,000 doctors in international collaborations in 103 different countries.
Cuba has also invested heavily in biotech sector to develop medicine and vaccines and support a prevention-oriented healthcare system. It developed the first vaccine to treat meningitis B and the only effective treatment for serious diabetic ulcers. Cuba is also known for exporting vaccines to treat Dengue fever to over 30 different nations.
Cuban pandemic control at home
As of today, Cuba has 1.58lakh cases of Covid 19 with 1.5lakh recovered and only 1,027 deaths.
Cuba started its lockdown a little before the first case was discovered. It took an ‘all-hands-on-board’ approach and responded swiftly to the threat. Cuba followed strict quarantine, contact tracing, massive testing and door to door frequent consultations.
Cuba is also the smallest country in the world to develop its own Covid-19 vaccine. Cuba has developed two of 23 vaccines worldwide that have entered phase III trials. The vaccines Soberana 2 is already being used for mass vaccination in the country.
Che’s vision of the New Cuba entailed the selfless, hardworking and non materialistic service to the nation and Cuba has been successful in revolutionising medicine and biotech sector with welfare of people at its core.