Reflections by Comrade Fidel

WITH A CLEAR CONSCIENCE

I would not have wished to utter any harsh criticism against any of the companies that manufacture medical equipment, whose profits do not derive from the production of weapons to kill, but from the combat of diseases, suffering and death. That is why I have always treated all of them with respect, and I liked to exchange with them about their scientific advances.

Something quite different is thinking bitterly about those countries which do not have these equipment; sadder still is the fact that a country from the Third World realizes that all its efforts are hindered because of a stupid measure imposed by a rich and powerful country on those who manufacture those equipment: to discontinue the supply of spare parts required for their use.

Cuban cardiology specialists both in Venezuela and in Cuba operate 28 Philips echocardiographs, without which an accurate and completely safe diagnosis would be impossible. For every one of them that goes out of order, five hundred patients will stop receiving that vital service every month.

In our country, cardiopathies account for the first cause of death; in Venezuela the situation is more or less the same. Defibrillators are the instruments par excellence that allow patients to recover from a cardiac arrest, from which they could die if they don’t receive urgent assistance. Of the 3 553 equipment bought from Philips, 2 000 were of this type, and were being used in the Cuban Polyclinics as well as in the Venezuelan ‘Barrio Adentro’ Diagnostic Centers.

The 12 different Philips equipment which were bought at a price of 72 762 694 dollars, were all indispensable to offer high-quality services in Cuba and in the ‘Barrio Adentro’ No.1 and No. 2 programs in Venezuela, which were being implemented with the participation of Cuban doctors and specialists. Those equipment were bought and paid for by our country, as had been previously agreed.

The Siemens equipment, with the exception of some that were sent to Bolivia, were operating in Cuba and in the two Venezuelan programs. The total cost of the equipment bought from that firm amounted to 85 430 000 dollars. In addition to the two aforementioned companies, others from Europe and Japan supplied important additional equipment for the 27 High-Tech Diagnostic Centers of ‘Barrio Adentro’ No. 2.

Philips does not question the data published. The complete discontinuation in the supply of spare parts started as from the end of the year 2006; almost three years have elapsed ever since.

That firm recognizes that the demands of the US government had been the reason behind the discontinuation of supplies until recently, when it paid a fine of 100 000 Euros, a ludicrous figure as compared to the 72 millions that were paid to that company for those equipment.

As far as we understood, there was no violation whatsoever of any of the rules imposed on the world by the empire. We were dealing with medical equipment, destined to save lives; those are not weapons.

In January, 2007, the Bush administration appointed John Negroponte –the scourge of the Nicaraguan people during the dirty war that was waged against that country, which began in 1981 from the Yankee base of Palmerola in Honduras- as Under-secretary of State. He had accumulated a sinister record during the wars of aggression against Vietnam and Iraq. He was the Director of the powerful National Intelligence Agency. He accompanied the US President at the White House Conference held by mid 2007, where so much was talked about education and health. They were both aware that our specialists offered their medical services using Philips equipment in Cuba and in Venezuela. They had exerted some pressures on the Dutch firm and managed to prevent this from supplying spare parts for those equipment.

Social programs in Venezuela emerged as a result of the Bolivarian Revolution. I do not need to praise the close historical links and the friendship ties that unite both peoples.

I already explained the decision taken by President Hugo Chávez which gave rise to our cooperation programs. Likewise, on the early days of 2007, he came across the idea of adding the ‘Barrio Adentro’ No. 3 program to the already existing ‘Barrio Adentro’ No. 1 and No. 2 programs. This new program would be carried out by Venezuelan doctors and the cost of the equipment would be covered by Venezuela.

Chávez, who knew very well about our experience in negotiating with the medical equipment manufacturing firms, and the excellent prices that we got, given the volume of the operations, asked our country to buy medical equipment, instruments and inputs hundreds of millions of dollars worth. The aim of such an investment was to incorporate a significant number of hospitals to the services that were being offered to the Venezuelan people through ‘Barrio Adentro’ No. 1 and No. 2 programs; all of these were in addition to the program in Cuba to train thousands of Venezuelan youths for them to become doctors ready to offer their services anywhere, both inside or outside the country. The graduates from the Latin American School of Medicine are an encouraging proof of their spirit of sacrifice. Even in Venezuela we were helping to train more than

20 000 students of Medicine.

Our staff made contact again with the best firms that supplied medical equipment, components and furniture, with the exception –of course- of the US companies, which were completely banned from sending even the tiniest supply to Cuba.

Although the medical equipment manufactured by that country are of quality, their prices are quite often abusively high. In the international market there are specialized firms whose equipment are considered to be the world’s best. It is perfectly possible to dispense with the US equipment if you want to avoid the risks of a criminal blockade like the one that has been imposed on Cuba for 50 years. In the hospitals of Japan, a country whose population records the highest average life rates, the overwhelming majority of the medical equipment is Japanese; the rest are imported from Europe or the United States.

In the most industrialized countries of the old Europe, where the health rates are also higher than those in the United States, hardly 30 per cent of the equipment come from Japan or the United States. They rather use European equipment. In Japan as well as in Europe, quality standards are much stricter that in the United States.

I am pleased to see that the strategy followed by the Cuban enterprise specialized in the purchase of medical equipment has strictly observed the principles established in previous purchases.

More than 50 well known firms were considered. I will just mention the ones that competed in quality and price. The biggest volume was negotiated with the German firm Siemens -73 910 000 dollars; Drager, 37 277 000 dollars; Toshiba, 36 123 000 dollars; Nihon Kohden, 30 516 000 dollars. We also signed contracts with Olympus, Karl Storz, Aloka, Carl Zeiss, Pressure, and others well known to our specialists. All of them are representative of the revolutionary progress that has taken place in the field of medical technology in the last 20 years.

Considering the standards of quality and price, we would have bought from the Dutch company Philips, which was considered and included among the most important firms, a total value of

63 065 000 dollars. But that moment coincided with the discontinuation of the supplies of spare parts for the equipment already bought from that firm which were operating in Cuba and in Venezuela. We had no other choice but to suspend the drafting of the contract.

Not all of the equipment of the total amount agreed have been received in Venezuela, but the number of equipment, instruments and components received are worth 271 million dollars. This situation forced Venezuelans and Cubans to make a special effort to fully develop the important ‘Barrio Adentro’ No. 3 program, which complements and articulates one of the most important social and human programs of the Bolivarian Revolution. Both countries are aware of that obligation.

In addition to that, we intend to make the necessary effort to take ‘Barrio Adentro’ No. 1 and No. 2 programs to unheard-of levels by incorporating more than 2 500 advanced students of Medicine who are being trained in Cuba, so that they, together with the General Comprehensive Medicine specialists who teach them classes, can join the ‘Barrio Adentro’ project.

Optimal medical assistance to patients was always the raison d’être of the doctors’ offices, the Diagnostic Centers and other services in which Cuba participates. The response given by the Cuban health collaborators to my former Reflection has been excellent. No wonder they reaffirm that the imperialism will not win this battle against Barrio Adentro.

No one can compete today with the United States in the manufacturing and trade of weapons destined to war and destruction. They control two thirds of the world’s arms trade; those are the fruits of the Industrial Military Complex. Today, that imperial power, with less than 5 per cent of the world’s population, not only consumes 25 per cent of the fossil energy; it pollutes the atmosphere, destroys the environment, threatens the world with its extermination weapons and is the biggest arms trader and manufacturer. However, it can not guarantee health to almost 25 per cent of its people.

We will not refuse to deal with any company willing to manufacture or trade in medical technologies. We will gladly accept any rectification. Humanity has to cope with very difficult problems. I wish our species is not faced with disaster, and many of us could have a clear conscience for having done our best to prevent it.

Fidel Castro Ruz

September 10, 2009

3:11 p.m.