Speech given by Dr. Fidel Castro Ruz, President of the Republic of Cuba, at the first graduation of students from the Latin American School of Medicine. Karl Marx Theatre, August 20, 2005

Excellencies and dear friends who, in representation of the countries that are home to the doctors who graduate here today, honor us with your presence;

Tenacious and dedicated young people who graduate today as a new class doctor, and their families;

Professors and workers of the Latin American School of Medicine;

Dear compatriots from Cuba, the Caribbean and Latin America;

Distinguished guests:

Almost seven years ago this graduation ceremony was merely a dream. Today, it is a confirmation of the power of human beings to reach the loftiest of goals, and it is truly a prize for those of us who believe that a better world lies within our grasp.

The idea was born when the news services began to report that Hurricane Mitch had taken the lives of more than 40 000 people in Central America. We proposed to send a medical corps that would save, on a yearly basis, as many lives as those which had been taken by the hurricane. We did not hesitate to do this, even though we were still enduring the worst of the Special Period. It was made possible because, even in the midst of those terrible tribulations that followed the collapse of the socialist block and the USSR, which deprived us from all outside cooperation, and at a time when the world had given up our cause for lost, the Revolution never ceased, for one moment, creating human capital.

Together with the idea of helping Central America by sending over thousands of doctors, the Latin American School of Medicine sprang into being, with the aim of progressively replacing the Cuban medical personnel with local doctors, as the former completed their missions. Today this school, with its ever-expanding development, helps to train doctors not only in Central America, but also in other parts of the world.

Looking back in retrospect, we remember that before January 1, 1959, a bloody and repressive regime closed down hundreds of our institutions of higher education, including the only Medical School at the University of Havana.

Most of the graduates came from economically secure families. Half of the doctors, lured by the United States, abandoned their threatened and assaulted Homeland. Only three thousand doctors and a reduced number of Professors of Medicine stayed. Alongside them we began to build what we have today.

Because of this, only a handful of students graduated as doctors during the first years following the triumph of the Revolution. The first graduation of young doctors who had begun their studies after January 1, 1959 took place on November 14, 1965.

Our armed struggle in the eastern range of the Sierra Maestra had ended hardly six years earlier. With memories of that conflict fresh in my mind, I invited that group of 400 young people who were completing their medical studies to hold the graduation ceremony on the highest peak in that range and in Cuba, at an altitude of two thousand meters, that is, at the Turquino Peak.

Today, as I stand before you in this theatre, the words that I spoke to those graduating doctors on the summit of that steep mountain seem unreal.

After underlining some paragraphs from that speech, I cannot resist the temptation to repeat some of the things that I said then tonight, when a group of 1,610 doctors are graduating from the Latin American School of Medicine, including graduates from the Caribbean who studied in other Cuban universities.

At that time, we were also victims of constant pirate attacks and acts of terrorism directed against our country, which were organized by the government of the United States.

This is what I said to those young people at the time: ´In this journey, many of you had the opportunity to understand many things, things unspoken, without indoctrination, without speeches, transmitted in this soundless but highly eloquent language that speaks of social and human realities. I am sure that rather than abstract ideas, inclinations, vocation, and the natural condition of each and every one of you -which are unquestionably good – the factor that will make you live up to your duties and always act the best way possible, will be the attitude of the peasants of these mountains, the type of men and women that you have seen here; the goodness, friendliness, generosity, solidarity, appreciation, and gratitude of men, women, children and elderly people who have worked, grown and lived under such difficult conditions in these mountains; their truly spontaneous gestures, the flowers with which they welcomed you, the fruits of their harvests, the coffee, the water, their willingness to help you, their cooperation in all types of organization, their high regard for doctors."

"The oath taken by these graduating students, its internationalist and revolutionary spirit...all of this must be very painful to the enemy.

"Perhaps they tried to minimize this in some way, so last night, according to the news we received this morning at approximately 12:45 a.m., a pirate boat opened fire on the coast, in the area of Lagunas Street in Havana. Three or four minutes later, another pirate boat, apparently searching for the President’s residence, opened fire and caused great damage with machine gun fire on the National Aquarium building. This happened just today.¨

I will try to make a brief summary of the results of our efforts with regard to the training of personnel and the development of medical sciences all along these years for the distinguished guests who honor us with their presence as well as for all those who are also present here at this graduation ceremony.

Medical doctors who graduated in our country following the triumph of the Revolution:

• During the decade 1960-1969: 4,907.
• During the second decade, 1970-1979: 9,410
• During the third decade, 1980-1989: 22,490.
• During the fourth decade, 1990-1999: 37,841.
• During the fifth decade, 2000-2004: 9,334

The total reaches 83,982. Three thousand six hundred and twelve out of this big total have come from other countries. We must also add the 1 905 Cuban doctors graduating this year, which means that the total actually reaches 85,887.

Nowadays the methods used to train doctors is radically different. Before the Revolution, the size of school classes was huge, practical lessons were minimal, and the fundamentals of basic sciences were virtually non-existent. Students were able to graduate without having ever directly examined a patient or assisted a childbirth. The curriculum was mainly aimed at curing patients and the private practice of the profession. These features were far removed from the health problems, thus affecting the country. The word ‘prevention’ was hardly ever used. On average, 300 doctors and 30 stomatologists graduated each year.

Today the number of youth from Cuba and from other countries around the world, who are ever more united in the struggle for a more just and humane future, is rising considerably in the different areas required by a logical and efficient public health system.

During the academic year 2004-2005, the students' breakdown was as follows:

· Medicine: 28.071

· Stomatology: 2.758

· Nursing: 19.530

· Health Technology: 28.400

Current students' sum total: 78.759.

Currently, more than 12 000 medical students from 83 different countries are studying for their degree in our country:

· 5.500 come from South American countries

· 3.244 come from Central American countries

· 489 come from Mexico and North America, including 65 young people coming from the United States and two from Puerto Rico.

· 1,039 come from the Caribbean

· 777 come from Sub-Saharan Africa

· 42 come from 6 countries in Northern Africa and the Middle East

· 61 come from Asia

· 2 come from Europe

The Latin American countries with the largest numbers of students in Cuba are:

1. Venezuela 889

2. Honduras 711

3. Guatemala 701

4. Paraguay 641

5. Brazil 629

6. Bolivia 567

7. Nicaragua 560

8. Ecuador 551

9. Colombia 545

10. Peru 532

From the Caribbean:

11. Haiti 676

12. The Dominican Republic 403

13. Jamaica 134

14. Guyana 117

15. Belize 79

16. Saint Lucia 69

Today we have the enormous satisfaction of seeing you, 1 610 new doctors, graduate:

· 495 from South America

· 771 from Central America

· 343 from the Caribbean

· 1 from the U.S.A.

Over the past seven years our battle for solidarity and for the training of doctors from Cuba and from other sister nations has been intense and ever-increasing.

The means and the methodology have been incredibly revolutionized, and theoretical and practical training has considerably surpassed that which had traditionally prevailed throughout history. It would be more accurate to say that the traditional form of training has been improved several times over.

While in the past there was only one university hospital, now all hospitals fall into the honorable category of university hospitals.

What is more: today, any of the 444 polyclinics which offer primary medical care can also serve as medical training centers. With the support of audio visual aids and interactive computer softwares, plus the assistance of dozens of specialists, Master degree and even Ph.D's holders, our results can compare and are even superior to those achieved by past methods used to train those who must ensure the health and well-being of the people.

Seven months ago I had the great satisfaction of meeting with 300 young people from Haiti, Guatemala and Honduras, who were in the midst of their last semester of studies and were about to return to their respective countries to work alongside brigades of Cubans specialized in General Comprehensive Medicine, who were working in the most far-flung corners of this region. They were accompanied by 50 young Cubans from the same level of studies. The results have been impressive. I promised them that I would attend their graduation ceremony, and here they are, as part of this very crowd, standing shoulder to shoulder like Spartan soldiers of Medicine, brandishing their victorious shields.

Glory be to these young people! Glory be to these new saviors of lives who are taking this noble medical profession to new heights of dedication and ethics, never before seen in this world! They embody the kind of doctors claimed for with desperate urgency by billions of people .

However, everything that I have said so far pales in comparison to the colossal movement that is being promoted by Venezuela and Cuba to train doctors ready to march in the vanguard of the Bolivarian dawn. Thanks to this, and as part of the ¨Barrio Adentro¨ Mission developed by President Hugo Chavez, 22,043 Venezuelan under-graduates have now embarked on their pre-med studies in the 7,898 Barrio Adentro surgeries, in close cooperation with the Venezuelan Ministries of Higher Education and Public Health.

On October 3, they will begin their first-year studies in Medicine. In only ten years time, 40 thousand will be graduating.

Likewise, in Cuba we are developing a program to educate, in an equal length of time, 20 thousand Venezuelan doctors from the Ribas Mission and from high-schools, as well as 30 thousand doctors from Latin American and Caribbean countries. These programs are available to young people from Latin American and the Caribbean who have not been able to study in the best high schools or been able to secure entry into medical schools due to their humble backgrounds.

Training a medical doctor in the United States will cost the family no less than 300 000 dollars. Cuba, however, is presently training more than

12 000 doctors for the Third World, thus contributing to the well-being of these countries, to a value of more than three billion US dollars. If we train or help to train 100 000 doctors from other countries in a period of ten years, we will be contributing the equivalent of 30 billion U.S. dollars, despite the fact that Cuba is a small, Third World nation suffering from an economic blockade imposed by the United States.

What is the secret? It lies in the solid fact that the human capital is worth far more than the financial capital. Human capital involves not only knowledge, but also – and this is essential – conscience, ethics, solidarity, truly humane feelings, spirit of sacrifice, heroism, and the ability to make a little go a long way.

Rich countries do just what Cuba does, only the other way around. They don’t train doctors for the Third World, they snatch the ones that are trained by these countries.

A report issued by the University of Harvard and the World Health Organization denounces the scandalous plundering of doctors from poor countries by rich nations. A list was published with the total percentage of doctors from different countries who are Third World immigrants:

Austria 5 per cent

France 6 per cent

Germany 7 per cent

Denmark 7 per cent

Norway 15 per cent

Australia 22 per cent

United States 24 per cent

Canada 26 per cent

United Kingdom 32 per cent

New Zealand 35 per cent

The fact that these professionals leave their countries of origin means that, as the report points out, poor countries subsidise rich nations in this way with 500 million dollars every year.

These vast figures of which I speak are real and have their price in the capitalist market, but they do not require extensive material resources and can be, in fact, within the grasp of any country.

Venezuela and Cuba are cooperating together in one of the most exciting programs ever implemented: to return or preserve the sight of more than six million people in Latin America and the Caribbean.

Conditions have been created in Cuba, and are being developed in Venezuela, to diagnose, operate on or cure 25 000 people from the Caribbean, 100 000 from Cuba, 100 000 from Venezuela and 120 000 from South and Central America each year.

As a matter of fact, this program is already underway in 14 of the 24 ophthalmologic institutions that will become operational in our country by the end of this year. They have been equipped with the most advanced world-class technology available. Our country is now performing 1,500 eye surgeries per day.

This year we have reached the figure of 50 000 Venezuelans from the Barrio Adentro Mission who have undergone eye surgery as from the middle of January up until today, August 20. In less than a month 1 093 people from the Caribbean have received the same treatment, by virtue of the Agreements signed at the Venezuelan state of Anzoátegui, on June 30 last.

It is important to note that every year, more than four and a half million people from Latin America and the Caribbean require this service, but do not receive it due to conditions of poverty, and more than half a million each year loose their sight, often without ever having been examined by a doctor.

Just as I did 40 years ago, please allow me to dream. The only difference being that now, after half a century of struggle, I am absolutely sure that no-one can say of our dreams what Calderon de la Barca once said: ¨...all life is a dream, and dreams themselves are only dreams. ¨

Let us march forward! Forward, all of you invincible standard-bearers of such a noble profession, in demonstration of the fact that all the gold in the world cannot subdue the conscience of a true guardian of health and life, who is ready to go to any country where its services are required, convinced that a better world is possible!

EVER ONWARDS TO VICTORY!