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The emergence of Covid-19 as a pandemic shows, paradoxically, two weaknesses of the Cuban regime. On one hand its emphatic narcissism and on the other, the disconnect between its health system and its capacity to respond to emergencies.
In itself, the quality of Cuban medicine is remarkable. It is part of Cuba’s commitment to excellence in which it has always excelled in diverse fields, from architecture to teaching. In the field of medicine, it produced some world renown references, such as Carlos J. Finlay and Tomás, before 1959.
In the Amazon, one can acquire a text: Personalities in the History of Cuban Medicine, 1760-1959, by Dr. Federico R. Justiniano, which documents well our place in the medical firmament ever since we have tried to be a nation.
What distinguishes the Cuban health system after 1959 is not its epistemological rupture with the previous one – between them there is no hiatus – but rather an ideological rupture marked by a social vocation and, mainly, its inclusion into state propaganda facilitated by the revolutionary myth of the early era of globalisation. Cuba as a planetary account was born in 1959, and this account include the juicy chapter of public health.
The work of Cuban doctors as a state mission is thus better understood both from the ideological department of the Communist Party’s Central Committee and from the Ministry of Foreign Affairs, as opposed to the Ministry of Public Health.
The agility with which Cuba has mobilised Cuban doctors in more than 20 countries in the face of this pandemic responds to the vision initially partitioned between ideology and diplomacy, to which a new aspect is needed: that of money.
A three-layer armour increasingly necessary for the government, but which now does not achieve three essential things to the regime: sustain the perception of equivalence between public health and Cuban medicine (public and free health which exists all over the world is an old reality updated by Covid-19), monopolise the diplomacy of solidarity (this is practiced by all kinds of states) and distinguish itself by its trademark competence (here Cubans act more as flag-lined paramedic brigades than as specialised personnel).
The level of global exposure to which this pandemic is subjecting all health systems in the world may inadvertently put an end to the myth of Cuban revolutionary medicine. Cuba is far from the revolutionary impact that technology is having on health and its management methodology and here we wonder why Cuban biotechnology does not participate in the joint research work presided over by the Bill and Melinda Gates foundations and Wellcome Trust to find a multinational response to Covod-19. On the other hand, robust health systems demand a solvent economy. Finally, their modern conceptions begin in the anterooms of polyclinics, medical offices and hospitals. In the food security of a country (capacity plus reserves) and in the depth and quality of its health system. Everything that Cuba lacks.
In the exact sense of the Narcissus myth, the Cuban state may drown in the attempt to kiss the constructed and projected image of itself in an era previous to instant and globalised information. In the post-Covid-19 world, states need more than mirrors. They need effiicency.
Manuel Cuesta Morúa is a historian and author of the book “Ensayos progresistas desde Cuba” (Progressive Essays from Cuba) (CADAL, 2014).