Reflections by the Commander in Chief

AN EXAMPLE OF GOOD COMMUNIST BEHAVIOUR

I am referring to a Chilean woman, Elena Pedraza, a highly educated specialist in rehabilitation. More than 40 years ago she paid her first visit to Cuba. Allende, a medical doctor, was not yet the president of Chile. The Cuban Revolution was almost 8 years old and it was already training teachers, doctors, physical therapists and health specialists, full speed ahead.

I am writing this reflection partly as a summary of six pages printed in small letters that have landed in my hands. It is a bit longer than usual, but done with the thought that later the full version of the speech given by the Chilean specialist on the morning of March 15, 2002 at the Second International Congress of the Cuban Society for Physical Medicine and Rehabilitation taking place in the capital of Cuba will be published by the press somewhere or in some magazine.

Let us listen to her explain in her own words:

“I arrived in 1966 and Cuba was beginning an historic phase. Its beginnings were punctuated with great difficulties and shortages; they had to solve urgent problems, among which those dealing with health were considered to be a top priority…Personnel trained in this specialty were needed and so their education had to be addressed and time was of the essence; but it had to be done, despite all the limitations existing in the country.”

“Nevertheless, society acquires more and more awareness about the marginal world in which the disabled live. In Cuba, for example, there was only a small number of empirical therapists, some of whom had been trained in the United States during summer courses, and others had left the country.

“The Health Minister at that time, Dr. Machado Ventura, told me upon meeting me: ‘we must train physical therapists for the entire country, and we have to do it soon’. I answered in the affirmative and I asked him what such a mission would entail; he answered: ‘we need books’ and without hesitating he emphasized: 'We need books'. I never forgot that suggestion, for me it became a commitment that I have always tried to honour.

“My training in kinesiology began in 1930…”

“My work experiences during 30 years in my country, Chile, were difficult…”

“I completed by working years in Chile, but I had no hesitations about returning to take up this commitment in Cuba, in 1966.

“My first contacts took place in the Frank País Hospital. This centre was very well equipped for treating both child and adult patients in the specialty of traumatology and orthopaedics. It was explained to me that previously this centre had offered very selective care and a very tiny portion of the neediest population was able to have access to these services.”

As I was learning about the medium in which I was to be working, I could see the need for a very great undertaking that would also take a long time. At that time I was already able to see the State’s concern in taking on the population’s right to health throughout the entire country and in rehabilitation.

“We had to begin. I visited much of the country, getting to know some of its parts: I was in Santiago de Cuba, a very beautiful colonial city. There I made my first attempt to carry out an elementary training course, in a small centre for the treatment of patients suffering from various neuromotor disorders. It was headed by Dr. González Corona…”

“This doctor fabricated his own elements to treat his patients. He was telling me how he himself had built the devices from scrap aluminium sheeting so that children suffering from polio could walk; he also made parallel bars and built a rustic swimming pool for water exercises.”

In 1966, I officially begin to teach another more scheduled course on Kinesiology for the physiotherapy students at the Frank País Hospital…”

“At that opportunity I understood how relevant it was to bring the most important books in order to teach correctly. There were no study materials, we had to do it all with whatever means we had. But the students’ interest to learn was so intense, as was mine to teach, having no references and outside of my specialty, but rather involving my experiences acquired in my country and a sense of responsibility that I think I have had all my life in my work in hospital clinics."

“This was the beginning that became my model for future courses that were to be given and with the experience accumulated we adjusted each year’s programmes with great dedication. At the end of these, which ended up being three years, experience allowed us to go on to prepare comprehensive teaching material; in other words, the fundamental bases of a programme of this type for regular courses.”

In my stay at this hospital I was able to accumulate a lot of experience that would be very valuable to me during the years I was developing my work in Cuba.

“The path towards the development of what today is rehabilitation in Cuba was born in these episodes that I am telling you about, what this specialty was and how it grew year after year, throughout the entire island, until what we can appreciate today at this Congress.”

“…I made informational visits to hospitals and polyclinics located in peripheral areas, in all areas of the country, even in the most isolated of places. In some of them I discovered the existence of small modest physiotherapy departments which were being organized. Others which had already been installed were offering services to the people but to a large extent lacking trained staff able to provide care in this specialty.”

“…It was interesting to see everyone’s efforts to solve, step by step, this journey that we were all involved in. This experience was very important for me; I could see how from the Ministries of Health and Education, suitable departments were being created to offer more thorough training to future students; for example, raising the levels of instruction for enrolment in kinesiology courses, and also integrating courses in programmes related to the specialty.”

In 1979 I give my first lectures as a professor of kinesiology in the teaching programmes for residents in the specialty of physical medicine and rehabilitation…I taught them to always be in control of evaluation, avoid being imprecise and making unfavourable comments in order to correctly carry out their plan of action. I was able to recognize that this must always be an ethical norm, and thus would prevent the patient from feeling diminished at the beginning of a treatment.

“My years spent at Julio Díaz were very enriching and they allowed me to get to know all the situations experienced by a disabled person; the centre had hospital facilities, out-patient care and looked after a large population. As I am writing my memories, I return to that distant time. I must say that I was able to get to know a generous people who had a lot of solidarity. The hospital continued being better equipped with new elements that would offer more complete patient care; every year new specialties were being treated, and the building as well continued to grow until it reached the size it is today, that of a small fortress.”

“…I came to realize that a therapist does not forget the theoretical basis and the practices he was taught, nor can he forget to keep on studying and at the same time updating.

“I came to regard this centre with the affection one has for one’s home. I cannot help but remember so many things that I experienced, with so many colleagues, therapists, doctors, auxiliary staff, everyone always respecting me with great warmth…”

“I must also recall spending time in other hospitals where I taught, held conferences and training sessions, such as in the Hermanos Ameijeiras Hospital, and others. In the 1970’s, with the goal of contributing to the development of medicine in Cuba, we Chileans who were living in exile (even though I never felt like an exile in Cuba) decided to pitch in to acquire 23 volumes of books dealing with the specialty of kinesiology therapy. This happened as a response to the scant possibility of receiving foreign texts, which were so necessary to improve teaching and the training of professionals.”

“This Congress affords us a very complete view of what rehabilitation is doing throughout the country. This reflects the concern of the government and of the medical corps, and also the professional development desire’s of staff making up the rehabilitation teams who work in this specialty.”

The motto of this Congress ‘Disability, Rehabilitation, Humanity’, commits us to evaluate much more all that we are offering to the disabled. We make an effort to offer rehabilitation, but when this motto extends to the word ‘Humanity’, I realize that it is not just one simple word more, rather it is a very deep plea: humanity and dignity for human beings."

“In this international Congress, the great volume of work being done by Cuban doctors and the other members of rehabilitation teams is recognized; their experiences are demonstrated in all areas of the medical specialties and this reveals the constant dedication and sense of responsibility in the national and foreign papers presented at the Congress.”

“I should like to send an affectionate and friendly greeting to the young people who were my students, who are now professionals overflowing with experience and prestige; with them I took part in such gratifying tasks as voluntary work, which in Cuba has always been a complement to the work of each citizen."

“Havana, March, 2002.”

When the fascist coup takes place in Chile, funded by the government of the United States, and thousands of citizens are imprisoned, tortured, vanished or murdered, within or outside the borders of their country, Elena Pedraza moves to Cuba, and from here she moves to different countries, gathering world support for women. She continues to develop her research in our country as well as her training programme. Later, she returns to her native land, and from there she continues to collaborate with Cuba.

A few days ago I was able to leaf through an excellent book whose author Dr. Debra Rose is a citizen of the United States where rehabilitation is a very costly and elitist service, inaccessible to the poor. Cuba is forbidden access to this knowledge. Elena, who never tires of sending information that could raise the scientific levels of our specialists, sent that book, among other materials, which contains more than a hundred different simple and accessible exercises.

Nowadays rehabilitation acquires special and new meaning as it relates to life. Everyone is increasing their mental and physical potential up to the age of 35; some maintain that it is 30. From that age on, they can go on for two or three more decades enjoying good health and physical performance, holding on to them from the above mentioned age until advanced years at the end of which, life is extinguished. Human beings are content to look after themselves until the end.

The service is of benefit to all the inhabitants of the country, where today they are born having a life expectancy of 77 years and which continues to increase. Not only adults who are younger than 35 or 40, victims of all kinds of accidents, but also more and more children require the noble care provided by the rehabilitator.

In more than 600 centres, located in polyclinics and hospitals, or offering their services abroad, about ten thousand rehabilitators are at work, while a thousand more are being trained with increasing thoroughness and exigency.

Elena Pedraza is 97 years old and continues to offer her professional services as a consultant. She is a fine example of intellectual worker, womanhood and Communist. She was a member of the same party as Ricardo Fonseca, Luis Corvalán, Volodia Teitelboim and Gladys Marín, who recently passed away, and many others who dedicated their lives or died for their beliefs.

On behalf of the people who, challenging the empire, began the path of the Socialist Revolution more than half a century ago, I pay tribute to their work and to their example.

Fidel Castro Ruz

January 7, 2008.

5:12 p.m.