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Tens of Thousands Protest the G8 in Genoa

Updated 10:00 GMT July 21: 

Yesterday an estimated 100,000
people were in the streets of Genoa,
Italy, to express dissent against the closed meetings of the
Group of 8. The 'G8' - the leaders of the world's most
economically powerful countries, meets yearly to discuss general
international policy direction. Demonstrators from all over Europe
have converged on Genoa to present alternative visions of the way
the world's population could organize to undo poverty, inequality
and environmental disintegration. The Genoa Social Forum has
hosted groups from around the world, which have spoken of
alternatives to the current destructive economic policies pursued
by Western governments. 

Yesterday's demonstrations included a mass action of organized
civil disobedience headed by the Italian Ya Basta! movement,
attempting to break through the sealed off 'Red Zone' security
barriers dividing the militarized town of Genoa. There has been
one confirmed death in Genoa yesterday of a young Genovese
man. The man was shot by Italian police and then run over by a
police vehicle. There are still unconfirmed reports of another death
of a woman. At least two other men received serious hits in the
face by the 40mm tear gas canisters being shot at the protesters,
and many other people were injured.IMC-Italy has a picture
sequence of the protester at the time of his death. 

On Thursday over 50,000 were in the streets to protest and offer
alternatives to worldwide immigration policy (see feature on
"border camps" below). Protests at the G8 meeting mark a
climax of the European Summer of Reistance which has included
festivals and demonstrations accross Europe in places including
Goteborg, Sweden, Barcelona, Salzburg, Austria and Bonn,
Germany, (see climate conference feature below), to express
dissent against the current form of 'globalization' and to move
towards different forms of global unity. 

Emergency solidarity demonstrations are being organized
worldwide against the G8 and the police violence: Buenos Aires,
Stockholm, San Francisco/Berkeley, New York City, Vancouver,
Germany, Nelson, BC, Canada. 

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http://www.latimes.com/features/health/la-000056343jul09.story

Los Angeles Times

July 9, 2001

Old-Fashioned Doctoring Keeps Cubans Healthy

By Sarah Lunday <slunday@star-telegram.com>, 
Special to The Times

HAVANA -- In the office of Dr. Alex Carreras near downtown
Havana, water drips from a patched ceiling, a window is
missing glass and a broken machine for sterilizing
instruments lies idle. The phone rings constantly as
Carreras explains that his only nurse is out for the week.

Carreras and the nurse care for 120 families in the
neighborhood.

Living and working in the community is essential to
understanding patients' needs, he said. Recently, after a
patient said he had stopped smoking, Carreras was suspicious
and went to the patient's house.

"I could see the cigarettes on the table," he said with a
shrug.

Carreras keeps track of the community's health with
handwritten charts, noting basic indicators such as who has
high cholesterol, who has diabetes and who has a drinking
problem. "You know everything," he says.

While Cuban doctors might not actually know everything about
their patients, they come closer than their counterparts in
many areas of the world, including the United States. Their
ability to track patients' histories, ensuring that children
get their immunizations and that older patients stay active
in the community, has made this country a model for primary
medical care for other impoverished countries and even areas
of the United States.

The Cuban system involves an extensive network of family
doctors scattered throughout its countryside and cities.
Primary care doctors become very familiar with the
neighborhoods they live in and generally have no more than
500 patients. (By comparison, some U.S. doctors might have
several times that number of patients in their care.) If
patients need more than basic care, the doctors refer them
to rural and neighborhood hospitals.

To be sure, the system has its drawbacks: frequent shortages
of medical supplies and long waits for complicated
procedures that require hospitalization. Yet basic health
care for all of Cuba's 11.2 million residents is provided,
unlike in the United States, where an estimated 40 million
Americans lack health insurance.

"Everybody is in the system. They do a lot better in
teaching preventive care than most countries," said Dr.
Stephen A. Schendel, chief of plastic and reconstructive
surgery at Stanford University Medical Center.

Schendel has made many trips to Cuba in the last five years
to perform reconstructive plastic surgery on children and to
train Cuban physicians in advanced techniques.

Cuban physicians, such as Carreras, say what the country
lacks in up-to-date technology and journals, it makes up for
through its extensive network of family doctors. The country
has 58.2 doctors for every 10,000 people, as contrasted with
27.9 doctors per 10,000 in the United States, according to
the Pan American Health Organization.

Cuban doctors' closer relationships with their patients also
allow them to diagnose diseases early, decrease smoking and
deliver healthier babies, according to Bob Schwartz,
executive director of Disarm Education Fund, a nonprofit
medical assistance program based in New York. The country
may be one of the poorest nations in the world, but its
inhabitants report health indicators that rival those of
rich countries, such as the United States. For example, the
average American's life expectancy is 77 years, while in
Cuba it is 76. Cuba reports infant mortality rates of 6.4
deaths per 1,000 births, compared with a U.S. rate of 7.3
deaths per 1,000 in 1999. Immunization rates for children
older than 1 are roughly equal in the two countries, at
about 95%.

Cuba's system is the product of significant investment in
national health reform that Fidel Castro began after taking
power in 1959.

Today, the Cuban health system serves as an international
model for rural health care. Poor communities throughout
Latin America and Africa have been influenced by Cuba's
health system, according to the Center for Cuban Studies in
New York.

The country has sent thousands of physicians abroad to live
and work, providing free medical care in countries including
Nicaragua, El Salvador, Honduras and South Africa.

In the early 1980s, Cuba's health-care system influenced the
development of rural health-care programs for Native
Americans in California, said Mario Gutierrez, who was
executive director of the California Rural Health Board for
five years. Under his term, health clinics in rural areas
became more like community centers than outpatient
facilities.

The centers established community health representatives who
are still a feature of the programs today. The
representatives know every family in the area near the
clinic. They drive people to and from doctors' offices, make
home visits after surgeries and ensure that children receive
all immunizations, said Gutierrez, who is now director of
strategic programs at the California Endowment in
Sacramento.

Dr. Debra Johnson, a plastic and reconstructive surgeon in
Sacramento, has visited Cuba three times and says she learns
something during every visit.

"It's sort of a duct tape and bailing wire kind of
medicine," said Johnson, who is married to Gutierrez.

"The Cubans are the absolute best at doing something with
nothing."

Dr. Henry Vazquez cares for about 480 people in and around
the mountain village of Boquerones. He has no computer or
X-ray machine. He sometimes fashions home remedies from an
herb garden when medicines are unavailable. Once, when no
car or truck was available, he rode a village mule to
transport a sick patient to the nearby rural hospital four
miles away.

When the 27-year-old family doctor walks through this tiny
village of tin-roofed row homes, mango trees and chickens
pecking the dirt, young men stop to greet him and women wave
from their doorways. He fondly pats them on the back and
talks about their past illnesses.

Vazquez can rattle off statistics about this community
without hesitation: There are 45 patients older than 60.
Eight patients are younger than 1. About 20 babies are born
annually. There are no cases of HIV or AIDS.

The doctor says he likes primary care and believes he is
prepared to take care of any emergency health problems at
his small office in the village. However, in a few years, he
may ask the government to move him to a more exciting post.
Maybe even emergency medicine in the city.

"If I choose to move," he said, "I'll feel like I've left my
mark."

--

Sarah Lunday is a freelance writer in Atlanta who recently
traveled to Cuba as part of the Kaiser Media Fellowship
program.

Copyright (c) 2001 Los Angeles Times. All Rights Reserved.

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