Reality Check



Ask any admirer of Cuba to justify the existence of such a ‘brutal regime’ [1] and before long you will inevitably be referred to the socialist republic’s apparently glowing healthcare record. There are approximately six physicians for every 1,000 people [2] and an infant mortality rate of just under five deaths per 1,000 live births. The Cuban government has been praised for sending their $20-a-month medical personnel overseas (although they do sometimes defect [3]) to provide treatment for disaster victims e.g. during the aftermath of the 2010 Haiti earthquake. But perhaps the most loudly trumpeted statistic is Cuba’s average life expectancy of 79 years, according to the World Bank (2010). Whilst admirable in isolation, Cuba’s superior healthcare statistics sit alongside a decidedly inferior human rights record. Indeed, Dr. Katherine Hirschfeld has previously highlighted that ‘the Cuban government continues to respond to international criticism of its human rights record by citing…praise for its achievements in health and medicine’ [4]. So what are the top three things that a citizen can look forward to during their 79 years in Cuba?

1. Forced abortions.

Dr. Hirschfeld explains that ‘the Cuban Ministry of Health [MINSAP] expects physicians to structure their clinical interventions to achieve the Ministry’s annual health goals. As with other sectors of the economy, MINSAP sets statistical targets that are viewed as the equivalent of production quotas. The most carefully guarded of these health targets is the infant mortality rate. Any doctor who had an unusually high rate of infant deaths in his or her jurisdiction would be viewed as having failed in a number of critical respects. One of the family doctors I worked with in Havana was quite politically militant and took these health goals very seriously. One day during my clinic observations I observed her scheduling an ultrasound for a pregnant woman.

“What happens if an ultrasound shows some fetal abnormalities?” I asked.

“The mother would have an abortion,” the doctor replied casually.

“Why?” I queried.

“Otherwise it might raise the infant mortality rate.” [4]

2. Totalitarian repression of basic freedoms.

Amnesty International has not been allowed into Cuba for over twenty years. In the words of the Human Rights Watch, ‘Cuba remains the only country in Latin America that represses virtually all forms of political dissent. The government enforces political conformity using harassment, invasive surveillance, threats of imprisonment, and travel restrictions’. Using the internet through state-monitored access points costs ‘about half the average monthly wage’, and writing articles of ‘counter-revolutionary’ sentiment is punishable by a ’20-year prison sentence’ [5].

The constitution of Cuba does in fact guarantee freedom of speech and a free press. That is, freedom of speech and press ‘in keeping with the goals of the socialist society’ [6]. It also condemns those who ‘insult or with other acts show disrespect to the Flag, the [National] Anthem, or the National Seal’ to a maximum of ‘one year of imprisonment’ [6]. A thorough and deeply disturbing account of the denial of basic civil rights in the Cuban constitution can be found here.

3. Cuba…for life.

Excluding top government officials, athletes and academics, the route out of Cuba is desperately tough. Citizens travelling temporarily cannot take their children. Before they have the chance to even get to a foreign country, they must ‘be specifically authorized by the Ministry of the Interior and by the institution where that person last worked’ [7]. Total exit fees can exceed $500 (over two years worth of wages). Unbelievably, they must then pay anything from $40 to $150 a month to the Cuban embassy whilst abroad.

The other option is permanent emigration from Cuba. If a citizen somehow manages to save enough money to afford this, they lose all property and rights in Cuba upon departure.  If they ever want to see their family again, they must be ‘specifically authorized by the government through a stamp that is placed in their passport and authorizes them to stay for 21 days’ [7].

Moving Forward

In some areas, Raul Castro and the Cuban government are beginning to make some progress towards a decent, civilised society. Following the announcement of sweeping economic reforms earlier this year, ‘Cuban officials expect roughly half of the economy will be reborn in the private sector over the next five years’ [8]. But to defend Cuba as a legitimate example of socialist success shows naivety and a delusional grasp of morality.


1 Statement by Governor Mitt Romney on Cuba

2 CIA World Factbook

3 Castro’s program to aid Chavez opens way for ‘desertions’

4 Re-examining the Cuban Health Care System: Towards a Qualitative Critique

5 Going online in Cuba: Internet under surveillance

6 Direct quotations from the Cuban constitution

7 The (Non) Right of Cubans to Travel

8 Cuba’s Economic Desperation



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