AAOS Bulletin - June, 2006

Letters from our readers

Cuban visit

I write to echo and expand upon the recent comments by Manual J. Coto, MD (Bulletin, April 2006) regarding the trip to Cuba by William B. Stetson, MD (Bulletin, December 2005). There is no freedom in Cuba, and if Americans—physicians and patients alike—do not understand that, then they need to research the issue much more. But more relevant to our profession is the grand myth surrounding Cuban medicine.

I witnessed the facade created by the Cuban government regarding the state of health care there when I attended the SICOT World Congress in Havana two years ago. I had the chance to speak to the public, including my relatives there, and to orthopaedic surgeons in active practice. They took me on an unheralded tour of Frank Pais, the “great” Cuban orthopaedic hospital.

Fortunately I was under the radar, unlike the big American medical groups for which they amply prepare. I expected to be impressed but instead was appalled. The primitive facilities appeared 40 years behind the times, and there was minimal clinical activity. The irony is that people from countries [with] better equipped [health care systems] frequently travel as health care tourists to Cuba. They would be much better off seeking the best care in their own lands. I really expected that Castro’s flagship hospital would at least have the basics. I can only imagine what community hospitals caring for “the people of the revolution” are like.

The world community has this romantic notion that Cuban medicine is at an excellent level despite some hardship. Nothing could be further from the truth.

Alejandro Badia, MD

Miami, Fla.

When I read the letter by Manuel J. Coto, MD, in the April 2006 issue of the Bulletin, I was stimulated to go back and read Dr. Stetson’s article. It frankly disheartened me. I am surprised that astute Americans in this day and age—when Castro’s virulent form of Communism is spreading throughout South America, and when Communist governments are nationalizing business and confiscating private property as Castro did 40 years ago—would, in any way, allow themselves to be used as part of Castro’s propaganda industry. I can imagine that Dr. Coto and other Cuban exiles feel as I would have if Dr. Stetson and his comrades had visited Hitler in Nazi Germany and returned and said how wonderful Germany and its people were.

To imply that the U.S. trade embargo with Cuba is somehow responsible for the poor conditions in Cuban hospitals, the shortages, the people’s suffering and other shortcomings of the Cuban industry and economy is simply beyond explanation. Cuba now has the opportunity to trade with virtually every country in the world except the United States. Cuba is surrounded by the Caribbean, which has some of the greatest fishing waters in the world, and yet has shortages of seafood. The U.S. trade embargo is not the cause of the problems in Cuba; Communism is the cause. The solution is not supplying small amounts of equipment through humanitarian junkets, but freedom for the Cuban people. Cuba would be a diamond of the Caribbean if Castro would remove the yoke of Communism.

It is not surprising that Dr. Stetson’s group encountered “nothing but smiles, friendship and open arms,” because any Cuban who was unhappy with the government is either silenced by fear, in a jail, six feet under or has self-exiled to the United States.

There are many countries in Central and South America that could use our humanitarian help. I certainly hope that the Academy’s leadership does not condone trips to countries that are our sworn enemies.

Jonathan L. Kates, MD

Somerset, Pa.

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