Cuba Supports Health

People’s Democracy

Organ of the Communist Party of India (Marxist)


No. 20

May 16,

Supports Health And Literacy Programmes In Venezuela




is an abridged version of the original article published in the May 11th
issue of “The Militant”)


Adentro, which translates roughly as “Into the heart of the neighbourhood,”
is the name of a government-sponsored programme that has brought thousands of
volunteer Cuban doctors operating free neighbourhood clinics in working-class
districts and rural areas across the country where workers and farmers have had
little or no access to health care. This is one of the social programmes
launched last year, along with nationwide literacy campaigns now involving 4
million that have spread around the country with aid and volunteers from Cuba.


state government in Carabobo and the Valencia city administration have been in
the hands of the pro-imperialist opposition since Hugo Chávez was elected
president of Venezuela in 1998. The coalition of opposition forces, Coordinadora
Democrática, and the Venezuelan Medical Federation have waged a virulent
campaign against Barrio Adentro, charging that Cuban doctors are here as
“agents of Fidel Castro” who came not to save lives but “to indoctrinate
the poor with communism.”


the end of 2003, authorization by local governments was required to bring in
Cuban doctors. Now 1,200 Cuban doctors in Carabobo, about half of them in
Valencia’s working-class neighbourhoods. A total of 10,000 Cuban doctors are
now working in the country.


cut through the obstacles to Barrio Adentro in the eight states where the
government is controlled by forces allied with Coordinadora Democrática, the
national government declared all neighbourhood clinics operated by Cuban doctors
to be primary care centres under the jurisdiction of the national ministry of
health. As a result, approval by local authorities is no longer needed to bring
volunteer doctors from Cuba. So Barrio Adentro has now reached virtually every
corner of the country.



250 Cuban doctors, nurses, and technicians had served in Venezuela for about
five years, arriving soon after Chávez’s election. The ministry of health
first appealed to Venezuelan doctors who were willing to live in the
working-class areas and offer their services to residents for free, with a
salary of about $600 a month paid by the government. Very few came forward.


an agreement with Havana, large numbers of volunteer Cuban doctors, most of whom
have carried out internationalist volunteer missions in other countries, began
arriving in March 2003. The Cuban doctors receive a stipend of $250 a month to
cover living expenses. They live in workers’ homes in the areas where they
serve, operating clinics out of community centres and other facilities. They
provide much of the medicine, which is donated by Cuba, free of charge. After
receiving morning patients at the walk-in clinics, in the afternoons they visit
residents in the neighbourhoods assigned to them and practice preventive
medicine. Local residents were virtually unanimous in saying that the Cuban
doctors, unlike many Venezuelan doctors, treat them as human beings, answering
their calls after hours, even in the middle of the night.


the programme’s popularity began to spread last year, Barrio Adentro came
under fire from vested interests. The Venezuelan Medical Federation spread false
rumours accusing Cuban doctors of malpractice, and it asked the courts to bar
Cuban volunteers from practicing in the country. A lower court ruled in favour
of the Medical Federation but the government appealed against the decision.
While the legal challenge to the programme has not yet been completely resolved,
the exemplary conduct of the Cuban doctors has begun to defeat the
anti-communist propaganda campaign against the programme.


the same time, physical threats against the doctors have mounted and in some
cases have been carried out. One Cuban doctor was killed last year in Araguá
state, and a Venezuelan assistant to a Cuban doctor was killed in the Petare
neighbourhood of Caracas. Many working people said that a slogan promoted by
some supporters of Coordinadora Democrática during opposition rallies has been,
“Be a patriot, kill a Cuban doctor.”



class contradictions are evident, however, among those backing the Barrio
Adentro programme. Padrino, a Venezuelan co-ordinator of the programme said that
many Venezuelan doctors had come forward in Valencia since December. “But they
don’t have the kind of training Cuban doctors have,” he said, “especially
for servicing working-class neighbourhoods and living there.” A retraining
programme has been established for these doctors. He added, “They can sign up
to finish some additional medical and social relations courses in order to
enroll in Barrio Adentro.” Now radical Venezuelan doctors have developed
working relations with the Cuban doctors, and have helped out in a number of the
neighbourhood clinics that Cuban doctors operate.




these contradictions, Barrio Adentro is now expanding not just in numbers of
volunteer doctors and geographic area but in scope. Popular clinics, scheduled
to be built starting this year, will expand primary care offered through the
modules operated by the Cuban doctors. They will include modern equipment and a
larger number of doctors specializing in various medical skills so they can
offer minor surgery, dental care, and other such services. The popular clinics
will offer free medical care to all, regardless of income.


clinics are supposed to be staffed by a combination of Cuban volunteers and
Venezuelan doctors. About 500 Venezuelan youth are now studying in the Latin
American School of Medicine in Havana, The first contingent of them to graduate
will be among the first to staff the popular clinics.


skepticism about how this will all work, has now been replaced by hope. The
impact of the Barrio Adentro programme can now be felt across the country in
most urban centres. For the first time in decades, congestion and long lines
have begun to ease at emergency rooms in a number of major hospitals.


a result of the expanding and widespread activity of Cuban volunteers throughout
the country for two years, and the growing numbers of Venezuelan students going
to Cuba for three-month stints at Cuban schools, there is evidence that
anti-communism and prejudices against the Cuban Revolution are substantially
less now.




volunteers numbering about 15,000 throughout the country – include agricultural
specialists, physical education teachers, and trainers showing Venezuelans some
of the most effective methods to eliminate illiteracy.


Ribas is the second major literacy programme that has mushroomed across the
country. Its goal is to teach mathematics, geography, grammar, and English as a
second language to adults who have not graduated from high school. After a
preliminary course of six months, students who pass a basic test go on to the
programme’s last phase, which lasts two years. Classes are from 6:00 to 9:00
on weekday evenings. The aim is for everyone to get a high school diploma in
half the time it takes at public schools. According to government statistics,
nearly 1.4 million people are currently enrolled in the programme.


aim of Mission Robinson, which preceded Mission Ribas, is to teach reading,
writing, and arithmetic to 1.5 million people who are illiterate— about 12 per
cent of adults in this country of 24 million people. Literacy classes are taught
by some 100,000 volunteers, most of them university students. The Cuban
government donated more than a million TV sets, VCRs, reading glasses, and
literacy manuals used in these classes. In some cases — such as the indigenous
village of Mapiricure in Anzoátegui state, inhabited mostly by Cariña Indians,
Cuban volunteers are organizing the translation of literacy manuals into the
indigenous languages. The first phase of Mission Robinson lasts three months,
during which students learn the alphabet and basic arithmetic. Mission Robinson
II lasts six months.  Since the programme started last July with substantial aid
and volunteer trainers from Cuba, some 1 million people have graduated. A good
number of them are now moving on to Mission Ribas classes.


Sucre, which lasts for about a year, aims to prepare those with a high school
diploma for entry into universities and vocational schools. “I decided I could
do this now because the classes are right around the corner from where I
live,” said Naudy García, 51, an auto mechanic. “No other government in the
past has made it possible for us to do such a thing.” Most workers interviewed
said organizing the literacy classes within walking distance of their block has
made all the difference. Some have set their sights high, reflecting increased
self-confidence. “I will finish these courses and I will go on to Mission
Sucre, and I will get into medical school, and become a doctor,” said Elida
Liendo, the former garment worker.  “I
don’t care if I am 40; I don’t care what anybody says.”


who volunteered to teach Mission Robinson classes last year were promised a
stipend of about $80 per month from the get-go. As most did not get paid
regularly, however, thousands dropped out and did not volunteer for the second
phase of the programme that started last fall. The majority, however, more than
70,000, according to government statistics, did continue teaching classes on a
voluntary basis.


government has recently announced it will give a small stipend to the
facilitators of Mission Ribas classes. “I won’t turn it down, but that’s
not the reason I am doing this,” Peña – a volunteer teacher — said.
“It’s an honour for me to help my neighbours improve their skills.”


about 9:00 on weeknights, many of the households in workers districts are empty
or half empty. “There is a joke now that it’s almost impossible to organize
any neighbourhood meetings during the week because of the literacy classes,”
said Ibis Pino, a university student whose mother was attending another Mission
Ribas class that night. “Almost half of the country’s population is studying


4 million people are now involved in the country’s three main literacy
programmes. Combined with those attending public and other regular schools, the
number exceeds 10 million, we were told.


literacy classes and the Cuban doctors are not solving the basic economic
problems we face,” said José Landines, a truck driver who lives in the Sierra
Maestra section of the January 23 neighbourhood. “But we are in a better mood
and we have more confidence we can change the situation.”