CubaBrief: How communists exploit doctors, manipulate health statistics and cover up epidemics

Two articles in The Wall Street Journal and an article in the Foundation for Economic Education drive home that communist regimes are a threat to public health. Daniel Henninger’s January 29th piece in The Wall Street Journal, “A Communist Coronavirus” describes “who calls the shots” on what is to be made public in the midst of a viral outbreak in China.

 If ever an epitaph is written for the People’s Republic of China, it may be Wuhan Mayor Zhou Xianwang, trying to apologize for delays in informing the public about the coronavirus: “If in the end you say someone has to be held accountable, you say the masses have opinions, then we’re willing to appease the world by resigning.” But the Chinese people know they are not allowed to hold anyone in Beijing accountable for this virus, or for the sickening pollution of their air and water. Mr. Zhou made clear who calls the shots: “As a local government official, after I get this kind of information I still have to wait for authorization before I can release it.”

This is reminiscent of how public health has been repeatedly handled in Cuba. 

In 1997 when dengue broke out in Cuba, the Castro dictatorship tried to cover it up. When a doctor spoke out, he was locked up, sentenced to 8 years in prison. Amnesty International recognized Dr. Desi Mendoza as a prisoner of conscience, and he was released from prison in 1998 under condition he leave Cuba. The dictatorship eventually recognized that there had been a dengue epidemic.

A 2012 cholera outbreak demonstrated how the Cuban public health system operates. News of the outbreak in Manzanillo, in the east of the island, broke in El Nuevo Herald on June 29, 2012 thanks to reporting by the outlawed independent press in the island. Official media did not confirm the outbreak until days later on July 3, 2012. BBC News reported on July 7, 2012 that a patient had been diagnosed with Cholera in Havana. The dictatorship stated that it had it under control. Independent journalist Calixto Martínez was arrested on September 16, 2012 for reporting on the Cholera outbreak, and declared an Amnesty International prisoner of conscience.

Thousands of Zika virus cases went unreported in 2017, according to an analysis of data on travelers to Cuba, which said “veiling them may have led to many other cases that year.” On January 8, 2019 New Scientist reported: “Cuba failed to report thousands of Zika virus cases in 2017.” Tourists with Zika, which can be both sexually transmitted and transmitted by mosquito, would return home infected and spread the contagion without having known that they were at risk.

According to the Centers for Disease Control, “Zika virus infection during pregnancy is a cause of microcephaly. During pregnancy, a baby’s head grows because the baby’s brain grows. Microcephaly can occur because a baby’s brain has not developed properly during pregnancy or has stopped growing after birth.”

Baby with microcephaly due to Zika. Castro dictatorship placed thousands at risk.

Baby with microcephaly due to Zika. Castro dictatorship placed thousands at risk.

The statistics and numbers that the international community has access to with relation to the Cuban healthcare system have been manipulated by the Castro regime. Katherine Hirschfeld, an anthropologist, in Health, Politics, and Revolution in Cuba Since 1898 described how her idealistic preconceptions were dashed by ‘discrepancies between rhetoric and reality.’ She observed a repressive, bureaucratized and secretive system, long on ‘militarization’ and short on patients’ rights. 

In the case of the Castro dictatorship what is disturbing is that it has penetrated the international health community. Mary O’Grady in her January 26 article in The Wall Street Journal, “The U.N. and Human Trafficking” exposes a troubling relationship between PAHO and the Castro dictatorship.

“In a 2018 class-action lawsuit filed in federal court in Miami, Dr. Matos Rodriguez and three other Cuban doctors claim that 85% of the money went to Havana via the Pan American Health Organization, or PAHO, which acted as the go-between. By gaining PAHO’s cooperation, Brazil’s then-President Dilma Rousseff was able to conceal the illegal arrangement from the Brazilian Congress, other federal institutions and the international community, the suit alleges.PAHO is a United Nations outfit, and member countries pay its annual budget, with the U.S. providing more than half. But the lawsuit claims that in its secret agreement with Cuba, the organization was also taking a 5% cut of the doctors’ salaries as they passed through Washington.”

This relationship between PAHO, the World Health Organization, and the Castro dictatorship may explain the following claims:

The 2016 claim of the World Health Organization Bulletin that “last year Cuba became the first country in the world to eliminate mother-to-child transmission of HIV and syphilis as public health problems.” Meanwhile, according to Avert, an NGO that provides information on HIV worldwide, “nearly 90 percent of new infections in the Caribbean in 2017 occurred in four countries — Cuba, Dominican Republic, Haiti and Jamaica.”

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Nicholas Kristof’s January 18, 2019 OpEd in The New York Times, “Why Infants May Be More Likely to Die in America Than Cuba” cites the questions about Cuban government statistics and dismisses them by citing that the World Health Organization and the United Nations have praised the Cuban health care system, but failed to mention that a subsidiary of the WHO was getting a 5% cut from collaborating with the Castro dictatorship in human trafficking. 

Luis Pablo de la Horra in an article published by the Foundation for Economic Education titled “Why Cuba’s Infant Mortality Rate Is So Low” answers the question in the subtitle that “Cuba’s impressive infant mortality rate has a simple explanation: data manipulation” and provides a more detailed explanation that is reproduced below.

“In a 2015 paper, economist Roberto M. Gonzalez concluded that Cuba’s actual IMR is substantially higher than reported by authorities. In order to understand how Cuban authorities distort IMR data, we need to understand two concepts: early neonatal deaths and late fetal deaths.
The former is defined as the number of children dying during the first week after birth, whereas the latter is calculated as the number of fetal deaths between the 22nd week of gestation and birth. As a result, early neonatal deaths are included in the IMR, but late fetal deaths are not. For the sample of countries analyzed by Gonzalez, the ratio of late fetal deaths to early neonatal deaths ranges between 1-to-1 and 3-to-1.
However, this ratio is surprisingly high in Cuba: the number of late fetal deaths is six times as high as that of early neonatal deaths. This number suggests that many early neonatal deaths are systematically reported as late fetal deaths in order to artificially reduce the IMR. Gonzalez estimates that Cuba’s true IMR in 2004, the year analyzed in the paper, was between 7.45 and 11.46, substantially higher than the 5.8 reported by Cuban authorities, and far worse than the rates of developed countries.”

The failure of Western intellectuals to recognize the public health disaster in communist regimes, and how they cover up endangering not only their own citizens but foreign visitors, is a scandal that should be made better know before the consequences prove disastrous.  

The Wall Street Journal, January 29, 2020

A Communist Coronavirus

China’s political system is eventually going to damage the world, by accident or by intent.

By Daniel Henninger        
Jan. 29, 2020  WALL STREET JOURNAL

Wonder Land: The coronavirus is a metaphor for two political ideas that are incompatible with the realities of the modern world: China’s Communist Party and isolationism. Image: Noel Celis/AFP via Getty Images

The Wuhan coronavirus is a metaphor for two political ideas that are incompatible with the realities of the modern world: The Communist Party of China and American isolationism.

We now live in a world in which everything travels everywhere all the time. People, products, ideas and data have become uncontainable. Centuries-long attempts by authorities to control their populations are ending.

The internet phrase “going viral” implies minimal controls over flows of information and a phenomenon that is by no means benign. Malicious software code that spreads quickly and is difficult to treat is called a computer virus. The coronavirus itself jumped from a “wet” meat market in Wuhan to other countries. All these modern viruses inevitably migrate to the U.S.

The most familiar photograph in the news this week is of crowds of Chinese people in antibacterial face masks. Is this the way we want to live?

Those masks and the mass lockdowns of Chinese cities are themselves striking metaphors of the attempt by the Communist Party, since 1949, to control what the people of China can say and do. But the party’s tools of information control, notably its divisions of internet monitors, are collapsing beneath the coronavirus, even as President Xi Jinping told his censors this week to “strengthen the guidance of public opinions.”

If ever an epitaph is written for the People’s Republic of China, it may be Wuhan Mayor Zhou Xianwang, trying to apologize for delays in informing the public about the coronavirus: “If in the end you say someone has to be held accountable, you say the masses have opinions, then we’re willing to appease the world by resigning.”

But the Chinese people know they are not allowed to hold anyone in Beijing accountable for this virus, or for the sickening pollution of their air and water. Mr. Zhou made clear who calls the shots: “As a local government official, after I get this kind of information I still have to wait for authorization before I can release it.”

This Communist control model in recent years arrived at its beyond-Orwellian endpoint in the Chinese region of Xinjiang with the creation of a high-tech, always-on surveillance state put in place to contain the area’s Uighurs.

The political and personal reality of life inside such a grand-scale authoritarian system is the reason citizens of Hong Kong have been massed in the city’s streets the past year. It is the reason the people of Taiwan last month voted overwhelmingly to re-elect President Tsai Ing-wen, who promised continued independence from mainland China.

They don’t want to live like that. They already knew what this crisis is making clear everywhere else: China has become too complex and too unavoidably open to the world for its people to survive—perhaps literally—under the closed and obviously unhealthy ideology of communism.

The coronavirus has also exposed the fallacy beneath an idea promoted in some corners of the American right and intermittently by the rhetoric of President Trump—isolationism.

Isolationism is the political belief that bad problems elsewhere in the world are their problem. But the coronavirus obviously is our problem.

The stories of attempts at global containment of the virus are astonishing. Planes are evacuating foreign citizens out of China, and business travel into China is virtually at a halt. Facebook has reportedly asked U.S. employees recently returned from China to work at home for now. The Centers for Disease Control are testing travelers from China at 20 U.S. airports. British Airways has canceled flights to China.

Reacting like this to an infectious virus may seem obvious, but why should the U.S. think it can isolate itself—politically or physically—from the challenges of a modern world that is constantly pushing past previous boundaries?

Huawei’s threat sits unsolved—an important 5G technology and a clear danger to U.S. and international cybersecurity. China’s military penetrations into the South China Sea are a form of man-made political virus designed to weaken the orientation of the Pacific region toward the U.S. China’s Belt and Road initiative is in more countries than the coronavirus.

The spectacle and symbolism of planes evacuating foreign nationals fleeing a Chinese bat-borne virus represent an unappealing future. China has to change, but how? The U.S. president’s opposition won’t want to hear it, but Mr. Trump’s trade negotiations with China may offer a rough model.

Despite global agreement that China was cheating, it was also clear that dealing with it inside the framework of traditional, 20th-century diplomacy was simply too slow, archaic and out of sync with the tempo of the modern world. The alternative Trump model was to lean in and not let up.

The real China problem is bigger than one trade deal or this virus, but the coronavirus has focused minds. This looks like a moment for the U.S. to enlist its allies to lean in again and not let up. Publicly support Hong Kong, a model for what China indeed should be.

On current course, China is liable to do significant damage to the rest of the world, by accident or intent.

https://www.wsj.com/articles/a-communist-coronavirus-11580341911  

The Wall Street Journal, January 26, 2020

The U.N. and Human Trafficking

Four victims of Cuba’s medical missions sue the Pan American Health Organization.

By Mary Anastasia O’Grady

Cuban doctor Ramona Matos Rodriguez in Brasilia, Feb. 10, 2014. PHOTO: BETO BARATA/AFP VIA GETTY IMAGES

Cuban doctor Ramona Matos Rodriguez in Brasilia, Feb. 10, 2014. PHOTO: BETO BARATA/AFP VIA GETTY IMAGES

Cuba’s military dictatorship sent Ramona Matos Rodriguez to Brazil in September 2013 as part of its foreign “medical missions.” Posted to the Amazonian state of Pará, Dr. Matos Rodriguez was to be paid by Brazil for her services. But she says she received only about 10% of the salary Brazil allocated.

In a 2018 class-action lawsuit filed in federal court in Miami, Dr. Matos Rodriguez and three other Cuban doctors claim that 85% of the money went to Havana via the Pan American Health Organization, or PAHO, which acted as the go-between. By gaining PAHO’s cooperation, Brazil’s then-President Dilma Rousseff was able to conceal the illegal arrangement from the Brazilian Congress, other federal institutions and the international community, the suit alleges.

PAHO is a United Nations outfit, and member countries pay its annual budget, with the U.S. providing more than half. But the lawsuit claims that in its secret agreement with Cuba, the organization was also taking a 5% cut of the doctors’ salaries as they passed through Washington.

Dr. Matos Rodriguez lived a life of poverty in Brazil, and she couldn’t leave. She had effectively been sold into slavery by her own government. She had a 6 p.m. curfew and a “minder.” She was forbidden to move about socially in her free time. Her family in Cuba wasn’t allowed to visit, and she could go home only once a year.

The story of how Brazil, Cuba and PAHO allegedly conspired to traffic Cuban medical professionals may never have come to light if Dr. Matos Rodriguez hadn’t made a dramatic escape to Brasília in January 2014. There she asked the Brazilian Congress for protection and spilled the truth about the plight of the Cuban doctors in the country.

Cuba has been trafficking people for decades, and thousands of Cubans have told similar stories after fleeing their captors and making it to freedom. According to the World Trade Organization, in 2018 Cuba generated $10.7 billion from “exports of commercial services.” The bulk of this income came from its foreign servitude scheme.

The difference in this case is the charge in federal court that a U.N. agency played a pivotal role. In their lawsuit the Cuban doctors allege that PAHO “has collected over $75 million since 2013 by enabling, managing and enforcing illegal human trafficking of Cuban medical professionals in Brazil.”

[More]

Foundation for Economic Education, January 25, 2020

Why Cuba’s Infant Mortality Rate Is So Low

Cuba’s impressive infant mortality rate has a simple explanation: data manipulation.
Saturday, January 25, 2020

By Luis Pablo de la Horra

Fidel Castro, the dictator who ruled Cuba with an iron fist for almost six decades, has been dead for more than three years now.

Unfortunately, his regime didn’t die alongside him. The Caribbean’s largest island is still under the burdensome yoke of communism.

Since Castro took over in 1959, Castroism has been characterized by the brutal repression of political and civil rights, as well as low economic growth. Real GDP growth averaged a meager one percent from 1959 to 2015.Cuba’s “Low” Infant Mortality Rate

Despite the lack of freedom and the poor economic track record, Cuba is often praised for its social achievements in health care and education, some of which rival developed countries. A good example of this is the Infant Mortality Rate (IMR), which is defined as the share of children dying before their first birthday. The graph below plots Cuba’s IMR against four developed countries:

Surprisingly, Cuba’s IMR in 2017 was lower than that of both the U.S. and Canada: 4.1 deaths per 1,000 live births as opposed to 5.7 in the United States and 4.5 in Canada.

This seems counterintuitive. How could a poor country like Cuba, whose income per capita is a fraction of those of developed countries, outperform two of the world’s wealthiest nations?

There are a few possibilities, both of which involve health care spending. Are these stellar numbers the result of Cuba spending more than the U.S.?

Not according to the data. As the following chart shows, Cuba’s health care spending per capita is substantially lower than that of the United States.

But higher spending doesn’t ensure better results. According to the Bloomberg Health Care Index, which measures cost efficiency in health care, the U.S. spends four times as much as Singapore in per capita terms, yet life expectancy is four years higher in the Asian country. Therefore it could be that, despite spending less, Cuba achieves better results.

Unfortunately, Cuba’s planned economy is far from what anyone would call efficient. This means that there has to be another explanation.

Data Manipulation

In fact, Cuba’s impressive IMR has a simple explanation: data manipulation.

In a 2015 paper, economist Roberto M. Gonzalez concluded that Cuba’s actual IMR is substantially higher than reported by authorities. In order to understand how Cuban authorities distort IMR data, we need to understand two concepts: early neonatal deaths and late fetal deaths.

The former is defined as the number of children dying during the first week after birth, whereas the latter is calculated as the number of fetal deaths between the 22nd week of gestation and birth. As a result, early neonatal deaths are included in the IMR, but late fetal deaths are not.

For the sample of countries analyzed by Gonzalez, the ratio of late fetal deaths to early neonatal deaths ranges between 1-to-1 and 3-to-1. However, this ratio is surprisingly high in Cuba: the number of late fetal deaths is six times as high as that of early neonatal deaths.

This number suggests that many early neonatal deaths are systematically reported as late fetal deaths in order to artificially reduce the IMR. Gonzalez estimates that Cuba’s true IMR in 2004, the year analyzed in the paper, was between 7.45 and 11.46, substantially higher than the 5.8 reported by Cuban authorities, and far worse than the rates of developed countries.

That Cuba’s dictatorship manipulates self-reported statistics shouldn’t come as a surprise. After all, the Castros have been trying for years to prove that, despite the lack of freedom in their country, their regime has built a welfare state where high-quality public services are guaranteed for all citizens.

Nothing could be further from the truth. The only achievement of the 1959 Revolution was to turn Cuba into a huge prison where misery and repression dominate the lives of millions of Cubans that haven’t had the opportunity to flee the country in search of a better life.

Dictatorships have always resorted to data manipulation for political purposes. This isn’t new. What is really disturbing is that Western intellectuals continue to buy the propaganda of the oldest tyranny in the Americas.

https://fee.org/articles/why-cubas-infant-mortality-rate-is-so-low/