September 29, 2022

A Second Look at Cuba’s Educational and Health Care “Miracle”

revolucion-cubana-fidel-castro-imagenes_975513036_117864884_667x375With the death of Fidel Castro this month, his supporters in the Establishment media and large swathes of the Left recycled the hoary old myth that Cuban Communism brought massive advances in health care and education. The purpose of this paper is to demonstrate that the successes of Cuban health care and educational system was disinformation aimed at the American Left and population. Like their ideological counterparts in the communist world (and fascist countries), the Cuban intelligence services and foreign policy apparatus staged elaborate Potemkin village tours to demonstrate how Cuban Communism supposedly benefited average citizens. The purpose of this disinformation program is to discredit America’s Cuban policy and to shore up the credibility of the Castro dictatorship. One high level Cuban intelligence defector Juan Menier Rodriguez noted that “visiting foreigners, always under the eye of the DGICI,[1] would be shown the new schools and hospitals and go away impressed. Bu they did not understand that many teachers were semi-literate and that even simple medicines were unattainable.”[2] Such guided tours were also not unprecedented in the history of Cuba’s dictatorships. General Machado, who ruled Cuba until the early 1930s, also utilized foreign journalists to project a positive image of his regime’s alleged achievements. According to an article in The New York Times (October 21, 1930), General Machado’s dictatorship would deflect the issues of political oppression and pointed to state-funded economic achievements. This practice mirror imaged the deflection techniques later utilized by the American Left when confronted by Castro’s human rights violations. The article noted: “thus the answer to the charge that General Machado’s friends had abused the Constitution to continue him in office for another six years was to point to a gleaming new hospital; the answer to the charge that opponents of the government had been denied opportunity to organize a party was an immaculate new high school; the answer to the charge that the President has burdened the country with heavy taxation to carry out his ambitious program was a model industrial city where the workers live in better homes than they enjoy in the United States.”

Defectors from the Cuban health system confirmed how Castro’s medical “miracle” was a nightmare for the average citizen. These revelations occurred even before the massive scaling back of direct Soviet subsidies for Cuba. Dr. Maria Isabel Gonzalez Betancourt, the former chief of the Cuban national hospital system, defected to Mexico in September 1990. According to an article in Commentary Magazine, Dr. Gonzalez reported that in “Cuban hospitals many patients perish needlessly from post-operative infections because surgeons are unable to wash their hands with antiseptic soap or distilled water—both articles being virtually nonexistent; and that kidney patients are expiring because of a shortage of spare parts for dialysis machines.” She was quoted as stating: “It is not true that, as in Mexico, government hospitals provide their patients with medicine free of charge; in Cuba one receives prescriptions at the doctor’s office, and the patient then has to go out and try to buy his medicine in the street. This is so because the public pharmacies are lacking about 320 basic drugs, including penicillin, which we in the hospital system had to do without for various weeks at a time.”[3] Other witnesses reported serious issues associated with the Cuban government medical system. One Cuban exile in Venezuela Pedro Alvarez visited Cuba in 1988 with private businessmen from his adopted country. Alvarez tagged along with them to visit Cuba and witness the alleged positive changes under communism. Alvarez reported that “free medical services are generally available, but pharmaceutical products are expensive and scarce. Education at lower levels is widespread, but so is Marxist indoctrination.”[4]

Image result for hospitals in cubaThe reports of Cuba’s collapsing medical system became more prevalent after 1991. The founder of Havana’s International Center for Neurological Restoration, Dr. Hilda Molina, resigned in 1994 in protest against the priority treatment given to foreigners. She also resigned her seat in the National Assembly of People’s Power and returned the medals bestowed to her by Fidel Castro. [5] Dr. Molina reported that “the main purpose of many hospitals in Cuba is to generate foreign capital, one way or the other the government assigns special budgets to those hospitals that serve foreign patients.”[6]

According to Dr. Faria, another government doctor who defected, Dr. Dessy Mendoza, told of rampant diseases plaguing average Cubans. He told of needy Cuba patients being turned away from the elite Ciro Garcia Clinic for foreigners; denial of cancer medications; a 150% increase in AIDS between 1990 and 1995; and the spread of venereal diseases on the account of the proliferation of jineteras (prostitutes) in resort areas reserved for foreigners.

A group of Cuban doctors who defected to the United States reportedly were “mystified” by claims in a report of the American Association for World Health (AAWH) that the United States embargo was to blame for the poor medical system in Castro’s dungeon.  According to these doctors, “we…can categorically and authoritatively state that our people’s poor health care situation results from a dysfunctional and inhumane economic and political system, exacerbated by the regime to divert scarce resources to meet the needs of the regime’s elite and foreign patients who bring hard currency.” In reference to the inequality of medical apartheid in Cuba, the doctors indicated their “wish that any one of us could provide tours to foreign visitors of the hospitals Cira Garcia, Frank Pais, CIMEQ, and Hermanos Ameijeiras, in order to point out the medicines and equipment, even the bed sheets and blankets, reserved for regime elites or dollar-bearing foreigners, to the detriment of our people, who must bring their own bed sheets, to say nothing of the availability of medicines.”[7]

Image result for hospitals in cubaWhile the number of physicians and life expectancy increased in Cuba from the 1960s to the 1980s, severe public health problems remained. Mosquito control and garbage collection were woefully inadequate in Cuba. By the late 1980s, outbreaks of dengue, intestinal disorders, malaria, blennorrhagia, and syphilis were common in Cuba. Some of these diseases were brought to Cuba by returning soldiers from Africa and then spread throughout the island due to poor medical treatment, poor nutrition, dirty water, and cramped living quarters.[8]

The breakdown of the Cuban health system started shortly after the communists took power in January 1959. Cement that would be normally used for construction of health related infrastructure was diverted for military use. By 1963, water trucks and fire hydrants spewed out streams of contaminated water, which was caught in unsanitary buckets by Cuban citizens. Average Cubans experienced shortages of basic toiletries, including soap. Sewage systems broke down as a result of neglect. Defecting Cuban Supreme Court Justice Julio Garceran forwarded a complaint to the OAS which charged that over 169,000 Cubans contracted gastroenteritis, of which over 3,000 died. Hospitals fared no better. Former Cuban government doctor Jose Delgado reported that “we cannot prescribe drugs for our patients because the simplest medicines-iodine, laxatives, even aspirin-are not to be found…sheets are only changed only once a week in the hospitals, despite the amount of blood, vomit, and excrement on them…the number of premature births is beyond count, due to the weakness of mothers who do not have proper food and must work for the Communist regime to within a months of birth.” The former consulting physician at the Los Angeles Polyclinic in Pinar del Rio Province until his defection in 1963 confirmed that Cuba’s hospital patients suffered malnutrition and shortages of anesthetics. Even Castro officials admitted to the breakdown of elements of the health care system. Vilma Espin admitted at the 1963 Infants Week meeting that “cases of gastroenteritis have increased…we must carry out a successful campaign…you know that notices are being published in the newspapers explaining the measures to be taken.”[9]

It appeared that the Castro dictatorship channeled the bulk of its medical resources towards superior treatment of the Party elite, internationalist allies, and medical tourists from the capitalist world. American dollars garnered from Western medical tourists were diverted to purchase essential goods from the capitalist world. These medical treatments were disbursed at the Ciro Garcia Clinic in Havana and payable in hard currency only. Doctors there provided high quality physical exams, kidney stone removal with laser beams, and open heart surgery.[10] The Cuban Communists then received the added benefit of a propaganda victory derived from foreigners satisfied with their experience in Castro’s medical apartheid. In fact, The New York Times noted in 1988 that “for Cuba, health tourism is not only a source of income; like sports and education, it is a tool for promoting Cuba’s Communist system.”[11]

The Party and top governmental elite, generals, and officers of the Ministry of the Interior received the finest treatment money could buy in Cuba. In fact, Castro and his top cronies received quality medical treatment in the capitalist world. One diplomatic cable made available by Wikileaks reported that “Even the Cuban ruling elite sometimes goes outside of Cuba for the best medical care. Fidel Castro, in July, 2006 brought in a Spanish doctor (Jose Luis Garcia Sabrido) during his health crisis. Vice Minister of Health Abelardo Ramirez went to France for gastric cancer surgery. The neurosurgeon who is Chief of CIMEQ Hospital (reportedly one of the best in Cuba) went to England for eye surgery and returns periodically for checkups.”[12] The cable also reported that “As described in reftel, the best medical institutions in Cuba are reserved for foreigners with hard currency, members of the ruling elite and high-ranking military personnel. These institutions, with their intended patient clientele in parentheses, include: Clinica Central Cira Garcia (diplomats & tourists), Centro Internacional de Investigaciones Restauracion Neurologica (foreigners & military elite), Centro de Investigaciones Medico Quirurgicas (military & regime elite), Clinica de Kohly (Primer Buro Politico & Generals of the Ministry of Interior), and the top floors of the Hermanos Ameijeiras Hospital (foreigners) and Frank Pais Hospital (foreigners). These institutions are hygienically qualified, and have a wide array of diagnostic equipment with a full complement of laboratories, well-stocked pharmacies, and private patient suites with cable television and bathrooms.”[13]

The same cable reported that a Cuban Foreign Health Service nurse provided the details of the A. Hermanos Ameijeiras Hospital in Havana. She reported how average Cubans were turned away from this elite hospital which catered to foreigners. The cable reported that the A. Hermanos Ameijeiras Hospital was “built in 1982, this newly renovated 600 bed, 24 story hospital is depicted in Michael Moore’s film ‘Sicko,’ where some 60 surgeries are performed daily including heart, kidney, and cornea transplants, mostly to patients who receive free treatment as part of Operation Milagro (mostly from Venezuela, but also from the rest of Latin America). The two top floors (shown in the movie) are the most modern and are reserved for medical tourists and foreign diplomats who pay in hard currency. The hospital has three intensive care units and all medical specialties except Pediatrics and Obstetrics/Gynecology and has no emergency room. The facility has a CT scanner (often said to be out-of-service), MRI and hyperbaric chamber capabilities. Upon entering the building the FSHP was struck by the grand and impressive lobby with a four-story ceiling, polished terrazzo floors and an elegant center reception booth. No one was in the reception booth, which displayed a digital streaming ticker-tape announcing an outdated hospital event; 30 or 40 people were sparsely scattered in the leather-like chairs throughout the lobby. There were no wheel chairs or other obvious signs this was a hospital. She was told the majority of patients came from Venezuela and each received weekly one bar of Palmolive bath soap, Palmolive shampoo, and a tube of Colgate toothpaste. She was also told the Venezuelan patients frequently take these items outside to the front parking lot and sell them to local Cubans. Cuban in-patients receive one tube of Colgate toothpaste and no other toiletries. Due to the high volume of foreigners receiving treatments and surgeries, most Cubans do not have access – the only chance might be a through a family member or connection working there and a gift or 20 CUCS (USD 21.60) to the Hospital Administrator. Cubans are reportedly very resentful that the best hospital in Havana is ‘off-limits’ to them.”[14]

In 1996, more than 7,000 “health tourists” paid Cuba $25 million for medical services. In 1997, the Cuban Medical Technology Fair displayed foreign and Cuban-manufactured medicines and high-tech medical equipment and services items not available to most Cubans. The fair showcased Cuban elite hospitals promoted by “health tourism” enterprises such as SERVIMED (formed as a state corporation in 1989) and MEDICUBA. In 1994, Cuba exported $110 million worth of medical supplies. In 1995, this figure rose to $125 million. The funds garnered by these exports were spent on biomedical research (and quote possibly the country’s alleged biological warfare program).[15]

Reportedly, average Cuban citizens were apparently dissatisfied with Cuba’s health care system. During the second half of the year 1987, the Revolutionary Orientation Department’s People’s Opinion Section collected polled user satisfaction on Cuba’s health care facilities from residents in the eastern portion of Holguin Province. Being the boyhood home of the Castro brothers, Holguin Province received additional social welfare and health infrastructure from the communist dictatorship. Despite such attention, the results of the survey were quite dismal: 87.6% of the residents were dissatisfied with the government health care facilities. The survey reported instances of abuse of hospital property by staff (using ambulances for joyrides); urban areas receiving more medical resources than the rural areas, relative satisfaction with the family health centers; deficiencies in the consultation centers; hospital emergency room doctors being either absent or inexperienced; deaths of patients due to incompetence by surgeons; lack of staff and appointment availability; corruption and favoritism; drunkenness by medical staff; deaths of pregnant women; and mistreatment of elderly patients.[16]

A leaked diplomatic cable confirmed that conditions have not changed since 1987. This cable contained anecdotal accounts of the disaster called the Cuban health system. This information was compiled by a Cuban Foreign Service Health Practitioner (FSHP) nurse. I quote it at length to illustrate my point:

“A Cuban woman in her thirties confides, ‘It’s all about who you know. I’m okay because I am healthy and I have ‘friends’ in the medical field. If I didn’t have my connections, and most Cubans do not, it would be horrible.’ She relates that Cubans are increasingly dissatisfied with their medical care. In addition to the general lack of supplies and medicines, and because so many doctors have been sent abroad, the neighborhood family physicians now care for 300-400 families and are overwhelmed by the workload. (Note: Neighborhood doctors are supposed to provide care for only 120 families. End Note.) In the absence of the physicians, patients go to their municipality’s ‘polyclinic,’ but long lines before dawn are common, with an all too common 30-second diagnosis of ‘it’s a virus.’”

“A 40-year old pregnant Cuban woman had a miscarriage. At the OB-Gyn hospital they used a primitive manual vacuum to aspirate the contents of her womb, without any anesthesia or pain medicine. She was offered no emotional support for her ‘loss’ and no pain medication or follow up appointments.”

“A 6-year old Cuban boy with osterosarcoma (bone cancer) is admitted to the oncology hospital. Only his parents are permitted to visit, and then only for limited hours. He does not have a television nor any games or toys. The hospital offers no social support services. The parents do not seem informed as to their son’s case. When asked by the FSHP what they know about the management of the disease, they shrug their shoulders. According to the FSHP, cancer patients do not receive on-going basic care utilizing testing procedures common in much of the world to monitor cancer care-such as blood chemistries and tumor markers, sonograms, x-rays, CT and bone scans, MRIs, PET scans, etc. Patients are generally informed of the type of cancer they have, but know little of its staging, tumor size, metastasis, or prognosis. They may be offered surgery followed by chemotherapy and/or radiation but are not given choices to decide an aggressive versus less aggressive approach, nor are they allowed internet access to learn more of their disease.”

“Many young cancer patients reportedly have become infected with Hepatitis C after their surgeries. Contracting Hepatitis C after surgery indicates a lack of proper blood screening prior to administering transfusions. All blood should be screened for Hepatitis B, C, HIV and Syphilis prior to use. Patients have no recourse and are not fully informed of the seriousness of such an inadvertent infection.”

“During chemotherapy and radiation treatments, patients receive little in the way of symptom or side-effects care (i.e., severe nausea, vomiting, low blood counts, fever, diarrhea, radiation burns, mouth sores, peripheral neuropathies, etc.) that is critically important in being able to continue treatments, let alone provide comfort to an already emotionally distraught victim. Cancer patients are not provided with, nor can they find locally, simple medications such as Aspirin, Tylenol, skin lotions, vitamins, etc. Most Cuban patients are not offered Hospice Care or any social support programs for children, adults, or their care providers.”[17]

The most vulnerable patients (e.g. ones infected with AIDs and political prisoners incarcerated in mental hospitals) were also the subject of abuses. Former Cuban Air Force General Rafael del Pino reported that AIDs patients were quarantined in veritable prisons. Escaped patients were hunted down like wild animals and apprehended by the army and police. According to General del Pino, those (including returning army soldiers) “infected with AIDS are interned on an estate called Los Cocos. They say that it is a sanatorium, or a completely isolated hospital, but in actuality it is a jail. What has awakened most displeasure in the military is the fact of the isolation, because, in the final analysis, it’s a sick person, not a convict. In a few cases, family members have been allowed to visit the building. They’re taken there in a military vehicle with a guard escort. There was even a case where a patient, because of carelessness by the guards, had gone down to the corner to use the public telephone, and the guards, when they realized where he was, sent out large detachments with rifles to apprehend him, as if he were one of the most dangerous of criminals.”[18] According to other refugees, AIDs patients were detained at a “secret hospital” which appeared to be more of a detention center as opposed to an institution of healing and convalescence. This “hospital” was guarded by soldiers and personnel from the Ministry of the Interior, which controls the State Security police.[19]

Modern medicine was also misused in the name of persecuting and torturing political dissidents in Cuba. Political prisoners were taken by State Security officers to the Havana Psychiatric Hospital. They were specifically interned in the Salas Carbo-Servia and Castellanos wards, which were administered by State Security. According to the research of Charles J. Brown and Armando Lago, political prisoners were forced to ingest large amounts of psychotropic drugs (including Thorazine and other phenothiazines) and undergo electroconvulsive therapy (ECT), usually without anesthesia or muscle relaxants. This “treatment” was administered by a brutal orderly named Heriberto Mederos, who was actually a State Security agent nicknamed “El Enfermero” and his assistants. Chemical lobotomies were often administered to mentally challenged patients. These patients were then reduced to human “vegetables” as a result of such a barbaric “treatment.”[20] Even some of Castro’s most ardent leftist supporters in the United States privately lauded such practices. As Suzanne Ross, a future founder of the communist front Committee in Solidarity with the People of El Salvador put it during a tour of the Havana Psychiatric Hospital: “We have to understand there are differences between capitalist lobotomies and socialist lobotomies.”[21]

Cuban education was a tool for the indoctrination of the youth in the ideals of communism. Communist culture also precluded intellectual freedom and curiosity in favor of maintaining Marxist orthodoxy. The communization of Cuban education commenced early in the revolutionary transition. By 1961, all private schools were closed. Students performed farm labor free, while teens were sent to state boarding schools to ensure their ideological loyalty to Marxism. Alternative youth lifestyles were punished. Elite schools such as the Centro Vocacional de Lenin, on the outskirts of Havana, catered to the children of the Party elite and military. Technical education and engineering were stressed by the new educational authorities in an effort to pursue increased industrial development of Cuba.[22]

Image result for cuban schools indoctrination

Indoctrination of school children in the use of arms to defend the revolution.

One Cuban refugee Luis Garcia recalled that when he was a child, students had to “We learn to recite the alphabet where the F is for Fidel, the R is for rifle and the Y for Yankees… Learning about Fidel and rifles and why we should hate the Americans can sometimes take up a fair amount of the school day, even in primary school.” Another refugee confirmed that “even our children were subjected to daily indoctrination.” Teachers were forced to teach revolutionary Marxism. One former government teacher commented that “the history text for secondary schools…omitted or maligned Cuban patriots. Carlos Manuel de Céspedes, hero of the War of Independence, was presented as a large landowner who went to war only to protect his own interests. Even the Spanish grammar book was full of propaganda.” Children were taught to fight for Cuba: “If you died while fighting it meant you were a good revolutionary.” Children as young as three years of age were taught to recognize pictures of Fidel Castro and other “good” revolutionaries, like Ernesto Che Guevara, and were told to want to grow up to be “just like Che.” Children were also indoctrinated in atheism; one Cuban refugee’s recollection of his primary schools years documented the rampant atheist propaganda exercises. The teacher told the children to shut their eyes, hold out their hands, and ask God for candy. When they opened their eyes there would be no candy. Then they were told to shut their eyes again and ask Papa Fidel (Fidel Castro) for candy. When they opened their eyes, they were holding candy. The teacher would then ask, “Who is more powerful, God or Papa Fidel?” [23]

In December 1960, the government decreed the establishment of the Accumulative Student Index, which tracked everything about the students and their families. According to the regime’s newspaper Revolucion, the Index was tasked to collect such data in order for educators to “understand the child’s problems and difficulties as well as learn of its interests and aptitudes, by observing and registering all activities inside and outside school.” Many parents were rightfully concerned that such a measure was yet another totalitarian control imposed by the Castro regime.[24]

Meanwhile, many teachers were poorly qualified, with some only have completed sixth grade. Other professional teachers fled abroad, while others were imprisoned for opposing efforts to indoctrinate students in Marxism. Shortages of qualified teachers increased.[25] While the literacy rate increased, Cuba remained a center for stifling intellectual controls. As the leftist Argentine writer Jacobo Timmerman concluded “if it is true that (today) every Cuban knows how to read and write, it is likewise true that every Cuban has nothing to read and must be very cautious about what he writes.” Timmerman also added that no Cuban author wrote anything “that goes beyond pamphleteering stupidity.” Not a single major Cuban novelist continues to live on the island.[26]

In conclusion, when one has the misfortune to listen to the propaganda on Cuba’s alleged achievements in health care and education, they should remember that such nonsense is repeated by the American enablers of leftist tyranny. Documentary filmmaker Michael Moore and a myriad of other extreme leftists are hypocrites who simultaneously benefit from the political and economic freedom that our Constitutional system, while supporting the enemies of the United States. As I listen to the panegyrics of Cuba’s health care and education systems, I am reminded of a statement made by the defecting Cuban government doctor Dr. Dessy Mendoza: “What I could never imagine from my neighborhood in Santiago is that I would come abroad and have to educate and inform first the Europeans and then the Americans, still fascinated with the Revolution and Castro, about the horrors of Cuban socialism.”[27]

  1. The DGCI is the General Directorate for Counterintelligence.
  2. Barron, John. “Castro, Cocaine, and the A-Bomb Connection” Reader’s Digest March 1990 page 68.
  3. Falcoff, Mark. “The Last Communist” Commentary Magazine June 1, 1991 Accessed From:
  4. Carbonell, Nestor T. And the Russians Stayed (William Morrow and Company New York 1989) pages 288-289.
  5. “Health Care in Cuba: Medical Apartheid and ‘Health Tourism’” El Blog Medicina Cubana November 15, 2005 Accessed From:
  6. Dr. Miguel A. Faria “Socialized Medicine in Cuba 2002 (Part I): A Poor State of Health!” August 20, 2002 Accessed From:
  7. “Health Care in Cuba: Medical Apartheid and ‘Health Tourism’” El Blog Medicina Cubana November 15, 2005 Accessed From:
  8. Ibid, page 300.
  9. Bethel, Paul D. The Losers (Arlington House New Rochelle 1970) pages 409-411.
  10. Ibid, pages 300-301.
  11. Treaster, Joseph B. “Room With a Nurse: Cuba’s ‘Health Tourism’” The New York Times May 29, 1988 Accessed From:
  12. “Cuban Health Care: Here Nothing is Easy” Diplomatic Cable Confidential Thursday January 31, 2008 19:52 Courtesy Wikileaks Accessed From:
  13. Ibid.
  14. “Cuban Health Care: Here Nothing is Easy” Diplomatic Cable Confidential Thursday January 31, 2008 19:52 Courtesy Wikileaks Accessed From:
  15. “Health Care in Cuba: Medical Apartheid and ‘Health Tourism’” El Blog Medicina Cubana November 15, 2005 Accessed From:
  16. Steven Ullmann, Mary Helen Spooner. Cuban Health Care: Utopian Dreams, Fragile Future (Lexington Books 2014) pages 18-19.
  17. “Cuban Health Care: Here Nothing is Easy” Diplomatic Cable Confidential Thursday January 31, 2008 19:52 Courtesy Wikileaks Accessed From:
  18. General Del Pino Speaks (Cuban-American National Foundation 1987) Accessed From:
  19. Nicholas Eberstadt. The Poverty of Communism (Transaction Publishers 1988) page 9.
  20. Charles J. Brown and Armando Lago. The Politics of Psychiatry in Revolutionary Cuba (New Brunswick, N.J., and London: Transaction Publishers, 1991)
  21. Radosh, Ronald. Commies (Encounter Books 2010) page 127.
  22. Hare, Paul Webster and Gomez, Andy S. “How Education Shaped Communist Cuba” The Atlantic February 26, 2015 Accessed From:
  23. Nailer, Lindsay. “Education Under Castro” Dickson College 2009 Accessed From:
  24. Yvonne Conde. Operation Pedro Pan: The Untold Exodus of 14,048 Cuban Children () pages
  25. Nailer, Lindsay. “Education Under Castro” Dickson College 2009 Accessed From:
  26. Falcoff, Mark. “The Last Communist” Commentary Magazine June 1, 1991 Accessed From:
  27. “Health Care in Cuba: Medical Apartheid and ‘Health Tourism’” El Blog Medicina Cubana November 15, 2005 Accessed From: