Global health care, Cuban-style

Movie REVIEW

Salud

Directed by Connie Field

New Paradigms, 2006

93 minutes

Against a backdrop of ratcheted-up Bush attacks on Cuba and the devastating contradictions afflicting U.S. health care, the documentary “Salud!” by Medical Education Cooperation with Cuba is timely, informative and inspiring.

The full story of 30,000 Cuban physicians carrying curative and preventive health care to 68 countries is largely unknown to the U.S. public. “Salud” fills that information gap with gusto and style. Arresting views of natural surroundings; wrenching vignettes into the beleaguered lives of poor, courageous people; and appealing original music by Arturo O’Farrill all point to high cinematic standards. That’s no surprise, given the film’s direction by award-winning Connie Field.

With brief portrayals of Cuba’s health system woven into the story of Cuban doctors overseas, the film takes viewers to Honduras, The Gambia, South Africa and Venezuela to look in on Cuban doctors at work, hear comments from colleagues and officials, and learn about the international thrust of medical education, Cuban-style.

The film provides an overview of the growing public health crisis afflicting the world’s poor, a situation compounded by the lack of health workers in poorer nations. “There is wide acknowledgement of the human resource crisis, but little action on the ground,” reads a recent report from Medicins Sins Frontieres. An MSF doctor working in South Africa says, “Clinics are absolutely saturated, waiting lists are growing, and it feels like we are losing the battle.”

“Salud” touches only lightly upon the effort, ideas and pragmatic spirit that have gone into shaping health care in today’s Cuba. What is so movingly displayed in this film would have remained a distant dream without a seemingly unprecedented national campaign for health care that began with the victory of the revolution. Cuba advanced from 3,000 physicians in 1960 to almost 70,000 now; from one medical school then to 24 now; and from 60 babies dying in their first year per 1,000 births to only 5.3 in 2006, the second lowest infant mortality rate (after Canada) in the Western Hemisphere.

Cuba’s health achievements are noted by several well-known, respected commentators, including President Jimmy Carter, professor and former public health official Fitzhugh Mullen, Mississippi Rep. Bennie Thompson and, tellingly, Dr. Paul Farmer.

Farmer, who teaches at Harvard Medical School, has provided care and consultation to people throughout the world, especially in Haiti. He says what matters most is the human right to health care. Without general acceptance of that right, Farmer suggests, the inspiring battle waged by Cuba and its heroic health workers may remain uphill and lonely.

Health care as a human right resonates with those who are marginalized and poor. For this reviewer, the reaction of a young, poor Venezuelan mother to the ministrations of Cuban doctors there, and to the realization that she, too, could be a doctor, was the high point of this wonderful film.

The notion of health care for all derives from “to each, according to his or her needs.” “Salud” conveys that message, which is the essence of socialism, from beginning to end. And the role in society of physicians is a subtheme.

German medical scientist and political revolutionary Rudolf Virchow, Karl Marx’s contemporary, was a model for Paul Farmer. “Politics,” he wrote, “is nothing but medicine on a large scale. The physicians are the natural attorneys for the poor, and the social problems should largely be solved by them.”

To order “Salud,” or for more information, go to www.saludthefilm.net, or call (800) 343-5540. The cost for group presentations is $60, for home viewing, $30.

W.T. Whitney Jr. (atwhit @megalink.net) is a retired pediatrician in rural Maine.