Thursday, September 20, 2018

#NotesFromHavana: Healthcare in Cuba: Lessons for South Africa.

#NotesFromHavana: Healthcare in Cuba: Lessons for South Africa.

Floyd Shivambu

In a perspective titled On Revolutionary Medicine, Che Guevara, a Medical Doctor by profession and a revolutionary Internationalist par excellence, said in 1960 that “The work that today is entrusted to the Ministry of Health and similar organizations is to provide public health services for the greatest possible number of persons, institute a program of preventive medicine, and orient the public to the performance of hygienic practices”.

This principle, expressed more than 50 years ago came to underpin Cuba healthcare system. It is a globally accepted fact that one of Cuba’s greatest achievements since the victory of the Cuban revolutionary forces in 1959 is its public healthcare system. Cuba’s healthcare system is one of the best if not the best in the world.  This is reflected on the globally accepted indicators.

The World Health Organization gauges a country’s infant mortality and life expectancy rates as the most reliable indicators of a healthy nation. Of course, a country’s ability to preserve lives of newborn children and concurrent prevention of avoidable deaths are indicators that a nation state has working and impactful healthcare system.

The WHO’s latest report illustrates that Cuba’s infant mortality is 4.3 per 1000 births. This is far much better than the industrially and economically superior nations such as the US, Canada, and many Western Europe countries whose per capita income and GDP rates are miles ahead of Cuba’s meagre income and GDP per capita levels.

The other important indicator is life expectancy. The latest globally accepted reports illustrate that Cuba’s life expectancy is 79 for males and 80 for females. This is qualitatively and quantitatively higher than most developed nations in the world. When the Cuban revolutionary forces triumphed over the US controlled regime of Batista in 1959, Cuba’s life expectancy was just under 60 years. This means the socialist revolutionary healthcare reforms qualitatively and qualitatively expanded under the leadership of Fidel Castro.

Cuba expends more than 10% of its GDP on Healthcare, and about 20% of its annual budget is allocated to healthcare. It has 150 hospitals, 497 clinics, and 495 000 Health Practitioners, and of those, more than 90 000 of those are Medical Doctors. What this means is that in Cuba, there is 1 Medical Doctor for every 122 citizens. Cuba additionally has 12 Health Research and speciality institutions, whose main aim is to focus on the intricate details and specifics of each disease. These include specialized focus on Cancer, and other diseases.

Additional to this, Cuba’s 13 Medical Schools, which are evenly spread across its 15 provinces, produce 7000 Cuban doctors annually. As part of their curriculum and qualification sine qua non, Cuba Medical Trainees are obliged to provide family medical care for a minimum of 3 years before they can specialize, be sent on medical missions in any part of the country or abroad.

Cuba currently has more than 50 000 doctors practicing outside of Cuba, and in countries that understand and have internalized their modus operandi, these doctors focus on primary healthcare. Brazil has 8500 medical doctors from Cuba, and SA has 450. Cuba’s Medical Schools also train Doctors from 121 Countries including South Africa, China, US, and many African countries.

These statistics are however not the main reason why Cuba is the most healthy nation in the world. At the core of Cuba’s healthcare system is its focus on primary healthcare, which the ministry of health says is based on prevention, promotion of  and education on healthcare.

The global norm on healthcare is primarily focused on the philosophy of diagnosis, treatment and rehabilitation. Whilst Cuba excels on this front, it deliberately and emphatically focuses on the pillars of prevention, promotion of and education on healthcare. What this means is that Cuban Doctors and other health practitioners go to communities to consistently and reliably test its people, and prevent diseases before they escalate to the levels of hospitalisation.

Cuba’s focus on primary healthcare is what brings stability and excellence to its healthcare system. The essence of Cuba’s healthcare system is its emphasis on prevention of diseases, promotion and education on healthcare. Cuba’s Medical Practitioners philosophical approach to healthcare is humanist, and veritably not obsessed with profit maximisation like is the case with South Africa’a Healthcare system. This is evidenced on Doctors’ focus on family units and the medical history and complexities of each family in order to curb the root cause of the disease.

Despite its massive achievements and indicators that come as a result of maximum focus on primary healthcare, Cuba has developed excellent pharmaceutical capacity through the State Owned Centre for Genetic Engineering and Biotechnology or in Spanish, Centro de Ingeniería Genética y Biotecnología (CIGB), which the Parliamentary delegation visited and engaged with in Havana.

The CIGB works in more than 20 projects aimed at the obtainment and development of biomedical products for the prevention and treatment of infectious diseases, cardiovascular, neurodegenerative, cancer, inflammation, autoimmunity, healing and cytoprotection. It comprises the departments of Vaccines, Pharmaceuticals, Immuno-diagnosis and Genomics, Chemical Physics and System Biology, and Control of Scientific-Technical Activity and Administrative. It has 200 workers: 41% holding the degree of Doctor in Sciences and 37% Masters in Sciences.

As part of its programmes and promotion of South to South relations, CIGB has built and co-developed state of the art pharmaceutical factors in many parts of the world including in South Africa. The CIGB is part of an umbrella body called BioCubaFarma, which has 38 Enterprises and more than 22 000 qualified workers. BioCubaFarma manufactures generic drugs, therapeutic and prophylactic vaccines, biomedicines, diagostic systems, and high tech medical equipment. It also does researches in neuroscience and neuro-technology. As a matter of fact, BioCubaFarma domestically manufactures 583 of 881 generic drugs used in Cuba.

Cuba has also established an industrial Development zone which permits investors to play a role, with security of tenure and protection of investments in the pharmaceutical space. Furthermore, Cuba is willing to transfer skills and technology to the developing countries as evidenced by the partnership  with Biovac Institute South Africa. Biovac Institute  manufactures different vaccines and some of the vaccines being manufactured are awaiting approval after clinical tests and all the processes that have to be followed.

Added to these realities, access to healthcare in Cuba is free, and this right is enshrined in the constitution. In 1976, Cuba's healthcare program was enshrined in Article 50 of the revised Cuban Constitution  which states "Everyone has the right to health protection and care. The state guarantees this right by providing free medical and hospital care by means of the installations of the rural medical service network, polyclinics hospitals, preventative and specialized treatment centers; by providing free dental care; by promoting the health publicity campaigns, health education, regular medical examinations, general vaccinations and other measures to prevent the outbreak of disease. All the population cooperates in these activities and plans through the social and mass organizations."

In the dominant capitalist narratives, quality healthcare is a by product of an efficient free market and economic superiority. Cuba has illustrated without any sensible doubt that a quality healthcare system that takes care of its children and elderly can be built even without huge economic resources and certainly without capitalism.

South Africa.

South Africa has one of the most devastating health burdens in the world. This is reflected on the number of South Africans with HIV, at 7 million. Infant mortality rate in South Africa is at 32 per 1000 births, compared to Cuba’s 4.3 per 1000 births. South Africa’s life expectancy is about 64 years, and this is below the global average and far below Cuba’s average whose economy is not as big as that of South Africa.

The South African Medical Research Council’s National Disease Burden points to the fact that, “that non-communicable diseases have now become the leading group of causes resulting in death in South Africa accounting for almost 40% of total deaths and 1 in 3 deaths before the age of 60 years”. Furthermore the MRC says, “Our communities need to be empowered to adopt healthy lifestyles and our primary health care services need to better manage these conditions and their risk factors“.

Primary Healthcare is the future:

The World Health Organisation says Primary Healthcare, “is about caring for people, rather than simply treating specific diseases or conditions.

PHC is usually the first point of contact people have with the health care system. It provides comprehensive, accessible, community-based care that meets the health needs of individuals throughout their life.

This includes a spectrum of services from prevention (i.e. vaccinations and family planning) to management of chronic health conditions and palliative care”.

The emphasis is obviously on primary healthcare, and that is what South Africa should direct its focus to. The National Department of Health should set a target on Doctor to patient ratio and roll out a plan on training of those doctors. Furthermore, Medical training institutions should be empowered to produce as many health practitioners as possible and the entire healthcare system should shift into prioritizing primary healthcare.

The immediate focus should be on establishment of one clinic or polycyclic per Ward, and the focus will vary according to population size in each Ward. All Clinics should have permanent doctors and health practitioners such who will not just wait for patients to come to the clinic but should consistently visit households and individuals in their work places to develop a Ward based healthcare profile. In this way, the healthcare system will be able to detect the common diseases per Ward and thereafter develop mechanisms to prevent their spread before they reach crisis levels.

The overall target in South Africa should be that there should never be a citizen who finishes more than 3 months without undergoing medical checkup. Additional to this, health education and promotion should be encouraged through campaigns and different communications and mass media platforms. Citizens should be aware of basic healthcare practices and needs so that they get to the extent of self help and assistance when they detect early instances of diseases.

Currently, majority of South Africans have not had any form of interaction with formal medical checkup because medical checkup are a commodity. This therefore calls for the complete de commodification of healthcare, and it be Constitutionally declared an essential human right. This should be distinguished from the lax rights in the Constitution that come with a disclaimer that the State can guarantee access to healthcare only if it had available resources to do so.

South Africa should escalate its relationship with Cuba and establish a State Owned Pharmaceutical Company. This is certainly one of the component Cardinal pillars in the EFF Founding Manifesto, which states under building state capacity, that South Africa should establish a pharmaceutical company. The State Owned pharmaceutical Company should be competent and professionally run and produce generic drugs, vaccines and all the necessary medications needed for the phase of healthcare that deals with diagnosis, treatment and rehabilitation.

Due to massive South African intra-migration for economic and educational purposes, it is long overdue that the entire healthcare fraternity should establish an electronic healthcare data system which will keep the health history of each and every citizen. Once checked or diagnosed in one health facility, there should not be a need to repeat the same exercise if a patient migrates from one province/region to another. Of course this should be subjected to the standing quality controls and Doctor/Patient Laws that govern healthcare in South Africa.

It is reality that South Africa does not maximally utilize the spaces provided in Cuba’s civilian and military Medical Training institutions, whilst there are massive shortages of doctors in our rural communities. This should immediately change, and all the spaces that Cuba avails for the training of medical practitioners should be filled. A consideration should additionally be given to opening campuses of Cuba’s Medical Schools in South Africa, similar to the Escuela Latinoamericana de Medicina(ELAM), the Latin American School of Medicine. ELAM trains Medical Doctors from more than 100 countries and considered one do the best Medical Schools in the world whose philosophical approach is primary healthcare.

The reality is that at this stage, South Africa’s medical schools largely produce doctors who are ready for commercial healthcare, which is a preserve of the few. Additionally, South Africa’s medical schools tuition fees and admission criteria are prohibiteve to new black entrants, and those who get admitted struggle with finishing their medical degrees. South Africa needs to move to a new trajectory in terms of medical practice, medical doctors’ training and healthcare in general.

The essence of healthcare in South Africa has to be primary healthcare. The National Health Insurance should be located within the context of a comprehensive, implementable and cogent National Health System, whose philosophy should be prevention of diseases, promotion of and education in healthcare. The people of South Africa are dying due to preventable and curable diseases. The move towards primary healthcare is long overdue, and requires decisive and willing revolutionary political leadership which will define the philosophical approach and monitor its roll out.

As Che Guevara said, “Some day, therefore, medicine will have to convert itself into a science that serves to prevent disease and orients the public toward carrying out its medical duties. Medicine should only intervene in cases of extreme urgency, to perform surgery or something else which lies outside the skills of the people of the new society we are creating“. Salute•

Floyd Shivambu is EFF Deputy President. 

Tuesday, September 18, 2018

#NotesFromHavana: Reflections on Cuba’s Revolutionary History and Present.


Floyd Shivambu

From the 15th to the 22nd of September 2018, a Parliamentary delegation led by the Speaker of the National Assembly will be in Havana, Cuba to meet with the National Assembly of Cuba, the Ministry of Foreign Affairs, and the more than 700 Medical Students from South Afric who are being trained as Doctors in Cuba.

The visit to Cuba is possibly one of the most important Parliamentary visits undertaken by the 5th Democratic Parliament because it recognizes the role Cuba played in the anti-colonial struggles in Africa, which culminated in the liberation of South Africa. 

To the Economic Freedom Fighters (EFF), Cuba is a very important political territory, one which we draw inspirationand important lessons. It is also a political territory which we also learn from dedication, steadfastness and revolutionary internationalism. The EFF Founding Manifesto says, “The EFF is guided by revolutionary internationalism and solidarity that defined the politics of the July 26 Movement, which led the Cuban Revolutionary struggles. We will partake in international struggles that seek to emancipate the economically unliberated people of Africa and the world. We will form part of the progressive movements in the world that stand against continued imperialist domination “

It is perhaps important that we take this opportunity to remind the people of South Africa that despite the many textual messages of support from other quarters, Cuba played an active and decisive role in the political liberation of South Africa. Cuba should be the most important country to South Africa for historical and present reasons and these notes will illustrate how and why.

The battle of Cuito Cunavale

The battle of Cuito Cunavale refers to the military confrontation between then apartheid South African Defence Force (SADF) and the Cuban Military Forces in the village of Cuito Cunavale in Angola in 1987/88, (Adam, Heribert, and Kogila Moodley, 1993). While less spoken about in South Africa’s transitional politics, this battle played a decisive role in pushing the apartheid regime to the negotiation table because the battle made them realise that the apartheid military is not unconquerable as they thought. Addressing the 20th Anniversary to commemorate the battle of Cuito Cunavale, Ronnie Kasrils says, “[w]hilst the generals and pundits of the former South African Defence Force (SADF) are at pains to claim victory the acid test is to consider the outcome. The SADF which had carried out continuous invasions and incursions into Angola since that country’s hard-won independence in 1975 (which was the reason for the Cuban military presence in the first place) had been forced to totally withdraw; the independence of Namibia was soon to be agreed; the prospect for South African freedom had never been more promising” (Kasrils, 1998).

Discussing factors that precipitated negotiated transition, Van Zyl Slabbert acknowledges the role of the battle of Cuito Cunavale, which he generally refers to as the ‘war in Angola’. About this, he says “the South African regime engaged in this war (the war in Angola) with arrogant myopic vision and lack of insight. More than anything else it epitomised that which was part of the total strategy, name, the waste of lives, time, energy, and resources. The escalating costs of the war, the unanticipated resistance of the Cubans, as well as the increasing unpopularity of the war at home speeded up its end” (Lee & Schlemmer, 1991: 4). The Cubans formidable military confrontation, strategy and offensive against the SADF resulted on the independence of Namibia, (Gleijeses, 2007). 

It is important to note though that despite the intentions of the Cubans to sustain the military offensive until the liberation of South Africa, the ANC and its military wing, Umkhonto WeSizwe were not necessarily involved in the real battle. This is noted because if the ANC and MK were in pursuit of an alternative route to South Africa’s liberation, the route of intensified military offensive aided by a formidable army and armaments from Cuba could have been buttressed by intensified mass protests in South Africa until the total capitulation of the apartheid regime. Attempts to find the ANC or MK’s involvement in the planning, intensification of Cuito Cunavale at high level command return with nothing because they were not involved.   

What can be recognised from these observations is that faced with growing unpopularity amongst the white South Africans, in particular business that was bleeding billions and faced with formidable military challenge in the form of the Cubans, the apartheid regime realised in more practical terms that negotiation was the only way out of the political conundrum. Due to these factors without prioritizing one over the other, negotiations were inevitable, because that was also the original view of the liberation forces. Comandante Jorge Risquet who was the Commander of the Cuban African Missions in Cuito Cunavale attributes the concessions by the apartheid regime and granting of Namibian independence to the post Cuito Cunavale battle Quadripartite talks between Angola, Cuba, apartheid South Africa and the United States (Hedelberto Lopez Blanch, 2008: 78. He says these talks guaranteed the independence of Namibia and commitment by the apartheid regime to talk to the ANC for a negotiated settlement, (Hedelberto Lopez Blanch, 2008: 78).  

It is quite evident from these developments that the ANC-led liberation forces were not in pursuit of an alternate solution to political transition, because even with formidable military aid and commitment from the Cubans, the liberation forces did not escalate this to a people’s war to seize political and economic power. Military seizure of political power was going to have its own consequences yet was not attempted as a way to take political power in South Africa, because the liberation forces needed a negotiated settlement. 

There was obviously going to be tremendous difference between a transition that could have happened due to the military strength of the liberation movement, and a transition that happened though negotiations because the contending forces could not defeat each other. The ANC’s pursuit of negotiations even when there was possibility of military onslaught aided by the Cubans, led to the many capitulations that defined the negotiations and transition process.

One thing that should be categorically stated is that in 1988, Cuba, Angola and South Africa signed the New York Accords in terms of which Cuba withdrew its troops from Angola in exchange for South Africa granting independence to Namibia. What the accords do not say but are part of the classified information is that the South African apartheid government capitulated to a negotiated settlement as a basis of Cuba’s military withdrawal from Southern Africa. 

It should also be highlighted that the Cuban revolutionary forces under the leadership of Che Guevara and Fidel Castro had been in the African continent since the assassination of Patrice Lumumba by US Government’s sponsored violence and destabilization of the Congo. The Cuban forces were central to the defeat of colonial forces in Guinea Bissau of Amilcar Carbral, who was a protégé of el Comandante Fidel Castro, Angola, Namibia, Mozambique and certainly South Africa.  

It is also important to highlight that one of the outstanding soldiers and fighters in the quest for Africa’s decolonization is one Comandante Moya, who was deployed as a commander of the first battalion in the Congo. He’s a humble freedom fighter who, when we visited the site to commemorate African Freedom Fighters in Cuba, took us through the narrative. 

Cuba and South Africa post 1994: 

When he was released from Prison, the 1st democratically elected country president Nelson Mandela visit outside Africa was to Cuba, which was a way of showing gratitude towards the relentless and decisive work of Cubans in the liberation of South Africa and the continent as a whole. In that visit, El Comandante Fidel Castro committed to immediate bilateral assistance of the democratizing South Africa and committed to help South Africa with the training of medical doctors. 

The 1st intake of student doctors from South Africa was in 1998, and different government departments at national and provincial levels have been sending student doctors to be trained in Cuba. Cuba has mastered the science of healthcare and that is illustrated in its infant mortality rates and life expectancy. Cuba has infant mortality rates that are far below the rates of economically developed nations and life expectancy is far ahead of many countries. Cuba has the world’s highest doctor to population ratio. There is 1 doctor for every 175 people in Cuba, whilst in South Africa, it is 1 doctor for every 4000 people.

South Africa has been given the opportunity to send some average of 1000 medical students every year from poor and rural backgrounds. These are students who would not be accepted to South African Medical Schools because of the exclusionary nature and form of medical training including exorbitant cost in South Africa.  The Cuban medical trainingsphere produces the best holistic doctors, and yet in the recent past, South African medical fraternity and the Health Professionals Council of South Africa(HPCSA) have placed a mechanism that says all the Cuban trained doctors should finish their studies in a South African medical school, despite the fact that there are no spaces available and the manner in which the concluding curriculum is presented is different. 
More concerning is the fact that, the difference does not in any way suggest in any way that the South African medicalcurriculum is of superior quality, but because it’s based on different philosophical underpinnings. In fact, the corruption, maladministration and continued ignorance of the Minister of Health to deal with deteriorating state of affairs at HPCSA brings into questions such misguided decisions. 

With massive degeneration of South Africa’s healthcare, our country should and can massively derive maximum benefits from Cuba and should maximally use the opportunity granted. South Africa should use its strategic relationship with Cuba to invest in the training of medical practitioners in Cuba. Whilst quantitatively and qualitatively expanding South Africa’s capacity to train doctors, out Government should maximally support the training of doctors and health practitioners in Cuba.

The EFF Founding Manifesto says, “The South African government, at various levels, is already contributing to the education and training of medical doctors and other health professionals in Cuba. This should be radically expanded to a minimum of 10 000 students sent annually to various countries to attain skills, education and expertise on different, but critical, and fields. The number of students sent to the best universities around the world should be reflective of South Africa's demographics in terms of race, gender and class. Emphasis should be placed on the fact that the students sent to the best universities should have shown capacity to make progress because they should, indeed, make progress. These students will later contribute to the country's socioeconomic development, economy and knowledge development”.

At formative stage, the EFF had already recognized and appreciated the importance and vitality of leveraging on Cuba’s progressive internationalism. Training doctors is not just a numbers game, but a real act of humanity which changes the lives of all including the poorest

South Africa has since the Mandela/Castro accord on training of doctors sent more than 3000 students to different universities in Cuba to be trained as Medical Doctors from the length and breadth of South Africa. Currently, there are 1951 students in different Medical Schools. Cuba has produced 657 Doctors for South Africa and 712 Doctors are doing their final year in different Medical Schools in South Africa.

What this means is that within the next year, South Africa will have not less than 1500 Doctors produced in Cuba and when considering the number of Cuban Doctors in South Africa, the number is almost 2000. To be gifted with closer to 2000 Medical Doctors is one of the most decisive acts of revolutionary solidarity South Africa has ever gained from any of the countries all over the world. There’s not even a single country or nation state in the whole world which can claim to have made such a substantial contribution to the well-being of South Africa.

Despite their promises of economic prosperity, the Western Capitalist World has abused the gullibility of the post 1994 Governments and forced it to adopt Neo liberal policies, which resulted in capital flight due to liberal exchange controls and employment terminative tariff reduction in a manner that has trapped South Africa in perennial and crisis levels of unemployment. Without imposing its will on South Africa and without expecting anything in return, Cuba has been a true revolutionary friend of the people of South Africa in immeasurable ways.

The other strategic partnership between South Africa and Cuba has been the Defence partnership wherein South Africa is expected to send 120 Officers and Cadets for training in Cuba, more especially on areas of patriotism and work ethic. Additional to that, South Africans are given mechanical engineering training and the Cubans send some of their engineers to the South African National Defence Force(SANDF). The Defende attaché in Cuba illustrated during the briefing that part of the benefits for South Africa is that some of the Fighter vehicles which the army was about to disposedwith 30 000 kilometres on the clock were revived by the Cubans, who instructively indicated that these vehicles have a lifespan of up to 500 000 kilometresDespite the agreements, SANDF has not been sending the allocated number, and in many instances sent poorly prepared officers and cadets. 

Now, all of these positive developments from and courageous actions of the Cuban people happen against an economic blockage and sanctions from the United States and consequently most part of the economic world. The US, has since 1960 imposed sanctions against Cuba, restricting its trade and economic relations with many countries all over the world. The humanitarian impacts of the blockade have been documented, and it is on record that in 2017 only, Cuba lost US$4 billion (R60 billion) worth of trade due to US economic blockade and sanctions.

The basis of US’ sanctions and economic blockade on Cuba are senseless ideological constructs of successive neo-liberal governments in the US, whose nearest port for entry from Cuba is less than 400 kilometres away. Former President Obama attempted to lessen the trade embargo, and when madness assumed the office of president in the US through election of Donald Trump, the economic blockade, trade embargoes and sanctions were reinstated. 

The trade embargo, economic blockades and sanctions bring tremendous difficulty to Cuba’s economy, which lead to perennial shortage of machinery and other products that cannot be produced in Cuba. The economic blockade also causes strain to the country’s financial system, which cannot be seamlessly integrated into the otherwise complex global financial architecture, which relies on the US dollar for global monetary exchanges. 

Despite all these, the people of Cuba and its leadership are resilient and steadfast in maintaining a socialist path to human development because socialism represents the most superior manifestation of humanity. The progressive peoples of the world have recurrently called for an end to the trade embargo and the United Nations passed several resolutions calling for an end to the trade embargo and sanctions. The resistance always come from the US and Israel, who for senseless ideological reasons, continue to isolate Cuba. 

Cuba continues to be one of the most lucrative holiday destinations in the world with recorded 5 million visitors in the past year. Many governments visit Cuba to learn about its healthcare and education systems, which are universal and given for free to all its citizens. Cuba has one of the lowest infant mortality rates in the world and Cubans live longer due to its quality healthcare systems. Cuba has one of the lowest illiteracy rates because education is free and accessible to all, and this includes university education. 

Cuba is currently undergoing constitutional reforms which will allow for same sex marriages, institutionalize Presidential term limits, are decentralize political power to provinces, and extend be scope for ownership of personal non-exploitativeproperty. When we met with the Ministry of Foreign Affairs, they assured us and all the progressive forces of the world that the constitutional reforms underway will never sacrifice the socialist reconstruction of society that begun with the victory of the July 26 Movement. 

Amidst all of these, we as the people who gained independence from the racist colonial and apartheid oppression owe our revolutionary progressive internationalism and solidarity to the people of Cuba. Our solidarity with the people of Cuba therefore becomes a humanly and revolutionary obligation. The Cubans sacrificed their lives so that we can gain freedom from the nonsensical colonial, apartheid oppression and repression. 

Despite the rhetorical commitments to solidarity with the people of Cuba, there are practical interventions which the South African government, overseen by Parliament should engage in for the benefit of the people of Cuba and South Africa. 

The immediate intervention should be upgrading of the South African President embassy in Cuba to a Grade 5 embassy. Perhaps parliament should even pass a special resolution or motion to place Cuba in a special category of embassies, for historical and present reasons. There is no other country in the world that has committed to produce medical doctors for South Africa and transfer critical skills in the manner in which Cuba is doing despite trade and economic sanctions.

The South African government should scale up the many bilateral relationships established with Cuba since 1994 andshould dedicate resources to harnessing and enhancing such relationships. South Africa’s resource commitment to Cuba’s medical training fraternity and the pharmaceutical sphere will be one of the greatest contributions to humanity.

The Health and Defence attaches in Cuba should be appropriately resourced and capable and skilled guardians should be deployed to look after all the students and cadets in different Cuban training institutions on a ratio of 1 guardian per 10 students. Those deployed to Cuba should carry the necessary political consciousness that Cuba is a country under economic sanctions and will lack some of the luxuries associated with many meaningless foreign missions South Africa finances. 

Cuba’s dedication to saving lives deserves honour, not through rhetorical commitments, but through resource allocation and oversight on how such resources bring about maximum benefit to the people of Cuba and South Africa. When they conquered against Batista, the revolutionary July 26 Movement proclaimed “Hasta La Victoria Siempre”, May Cuba’s Victories Last Forever! Viva Cuba! Viva Socialist Reconstruction of society.