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By John M. Kirk; H. Michael Erisman

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Additional resources for Cuban Medical Internationalism: Origins, Evolution, and Goals

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Significantly, they were to be paid a salary deemed appropriate by the government and were no longer able to charge patients what the market would bear. In addition, private clinics were no longer morally acceptable, since they implied privileged treatment for those with resources to pay for such specialized care—unacceptable in a revolutionary socialist system. The doctors would now be trained for free but had to work for a two-year period wherever they were needed in the country, and not where they would necessarily prefer to live or could pursue a lucrative career.

Many doctors and nurses (with roots in the urban middle class) preferred not to live in rural areas, as they were comparatively underdeveloped; in addition, the population was widely dispersed, and, of course, most peasants were poor. In 1953, for example, fully 1,779,236 Cubans were unemployed. 15 Many doctors trained in the prerevolutionary system were thus opposed to leaving the comforts of Havana (where they could charge their patients for medical services provided) and moving to rural areas, where they feared that their earning potential would be far less.

12 In sum, those analysts who claim that prerevolutionary public health care in Cuba was the best in Latin America are indeed correct. T H E C U B A N H E A LT H C A R E S Y S T E M 29 But they fail to see the contrast between the presence of good quality medical care and facilities in the cities (where 64 percent of available beds were located to serve 20 percent of the population) and the glaring lack thereof in rural areas. In 1961, the revolutionary government began construction on 156 rural hospitals to remedy this situation.

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