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What's With All the Cuban Doctors?How Castro built a nation of physicians.

By Christopher Beam
Posted Thursday, Feb. 1, 2007, at 7:04 PM ET

Cuba has announced it will send a group of doctors to help Castro's old ally President Daniel Ortega bolster the health system in Nicaragua. Castro also sent about 1,700 physicians to Bolivia in 2006 to lend aid to the government of Evo Morales. Why does Cuba have so many doctors to spare?

Well, because Castro said so. The Cuban constitution guarantees every inhabitant the "right to health protection and care." After the revolution in 1959, half of the country's 6,000 doctors fled the island. The new government promoted medical education as part of a national project to revamp the health-care system, and by 1984, Cuba had enough doctors to put a physician and a nurse in every neighborhood. Some will tell you Cubans become doctors because they believe in universal health care; others emphasize the social and economic rewards. (Doctor aren't paid much, though—some make less than $40 a month.) Whatever their motivations, Cuba has more doctors per capita than any other country: 70,000 for a population of 11 million.

As a result, Cuba's national health-care system—there is no private care in Cuba—is widely praised, and the Latin American School of Medical Science in Havana attracts students from around the world. But some say the system has been crippled by a lack of supplies. The combination of the U.S. embargo and the collapse of the Soviet Union, Cuba's primary financier and supplier, have hurt Cuba's access to medical equipment. Some critics of Castro cite his own dire medical condition—and the decision to bring in a Spanish doctor to treat him—as evidence of a failed system. But the numbers suggest Cubans lead healthy lives. Life expectancy in Cuba is the same as that of the United States, and its rate of HIV/AIDS is one of the world's lowest.

In fact, Cuba's medical prowess may be its ticket out of poverty. In the 1990s, Cuba was the first country to develop a meningitis B vaccine. In 2005, Cuba provided cancer treatment technology for a new biotech company in China. Then last year Washington agreed to make an exception to the trade embargo to allow a California firm to test a Cuban cancer treatment. Thanks to an increase in biotech exports, Cuba raised its health budget a couple of years ago to $300 million.

So, if having all these doctors has helped Cuba, why does Castro send so many of them abroad? Part of it is Cuba's commitment to internationalism, another ideal of the revolution. (Political opponents say the government is showcasing one success of an otherwise botched revolution.) "Medical diplomacy" is also a way to win and keep friends, and to trade services for goods that Cuba wouldn't have otherwise. For example, about 15,000 Cuban doctors and dentists currently work in Venezuela, while President Hugo Chavez supplies Cuba with oil. Castro even offered to send a group of 1,600 doctors to the Gulf Coast after Katrina, but he said the United States didn't respond.

Got a question about today's news? Ask the Explainer.

The Explainer thanks Ellen Bernstein of the Interreligious Foundation for Community Organization and Felix Martin of Florida International University.

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Christopher Beam is a Slate political reporter.
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