Embargo of Cuba Exacts a ‘Tragic Human Toll,’ Health Report Charges

The stringent U.S. embargo against Cuba that prohibits the sale of food and severely restricts the sale of medicine has significantly increased suffering and deaths in the Caribbean nation, according to a yearlong study by medical experts for the American Assn. for World Health.

Since the decades-old embargo was tightened by the 1992 Cuban Democracy Act, the health association reports, the number of unmet medical needs--patients going without essential drugs or doctors performing medical procedures without adequate equipment--has sharply accelerated.

“The declining availability of foodstuffs, medicines and such basic medical supplies as replacement parts for 30-year-old X-ray machines is taking a tragic human toll,” the medical experts report. “The embargo has closed so many windows that in some instances Cuban physicians have found it impossible to obtain lifesaving machines from any source, under any circumstances. Patients have died.”

The findings will be released today at a news conference by the association, which is a nongovernmental, educational arm of the World Health Organization. A copy of the document was obtained in advance by the Los Angeles Times.

The health situation in Cuba has been aggravated in recent months by Congress’ passage of the Helms-Burton Act, the association said. One provision of the 1996 law seeks to discourage investment in Cuba by permitting lawsuits to be filed in U.S. courts against foreign investors who use U.S. assets expropriated by Cuba after the revolution of 1959.

President Clinton initially opposed the Helms-Burton Act but embraced it during the national outcry last year that followed the shooting down by Cuban MIGs of two unarmed civilian aircraft piloted by four Cuban exiles. In January, he ordered a second six-month suspension of the law, but the health association report says the prospect of enforcement has had a “chilling effect” on health care providers who might contemplate trade with Cuba.

The law was strongly opposed by Mexico, Canada and U.S. allies in Europe, and those countries have retaliatory legislation in place in case Clinton implements the law.

Although the health association makes no specific policy proposals in its 300-page report, the group emphasizes that it would be “only reasonable” for the United States to exempt food and medicine from its embargo. International human rights conventions call for the free flow of food and medicine even during wartime.

The U.N. General Assembly, in four consecutive sessions, has adopted resolutions condemning the embargo and calling on the United States to rescind provisions that the assembly says violate the U.N. Charter and principles of international law.

Congress passed the Cuban Democracy Act after heavy lobbying by Cuban American groups. Underscoring the political impact of the law, then-President Bush, who was seeking reelection at the time, signed the law at a campaign appearance in Miami.

Ever since President Eisenhower banned exports to Cuba in 1960 and the following year added a ban on Cuban imports to this country, U.S. policy has been aimed at pressing the Cuban people to overthrow President Fidel Castro. Critics of the policy argue that while the embargo has caused widespread suffering in Cuba, it has failed to destabilize Castro’s Communist regime and may even have strengthened his grip on the country.

But Sen. Jesse Helms (R-N.C.), the chairman of the Senate Foreign Relations Committee, who has strongly supported the embargo, led efforts to tighten sanctions to make it clear that the United States “will do everything in its power to terminate his [Castro’s] brutal dictatorship.”

The health association, in its report, concluded that human effects of the U.S. embargo have been “dangerously exacerbated” by four factors stemming from the 1992 act:

* A ban on trade by foreign subsidiaries of U.S. firms, which has constrained Cuba’s ability to import medicines and medical supplies from third-country sources. Recent corporate buyouts and mergers between U.S. and European pharmaceutical companies further reduced the number of companies permitted to trade with Cuba.

* Provisions to license individual sales of medicines and medical supplies--ostensibly for humanitarian reasons to mitigate the embargo’s impact on health care delivery--that in practice are so restrictive they actively discourage any medical commerce. Numerous licenses for medicines and medical equipment have been denied on grounds these exports “would be detrimental to U.S. foreign policy interests.”

* A provision discouraging shippers from delivering medical supplies to Cuba by barring vessels from loading or unloading cargo in U.S. ports for 180 days after delivering cargo to Cuba.

* Long delays in licensing and other restrictions that have discouraged charitable contributions from the United States.

Cuba has managed to avert a “humanitarian catastrophe” only because Havana has maintained a high level of budgetary support for a system designed to deliver health care to all of its citizens, according to the report, which notes that Cuba still has an infant mortality rate half that of Washington, D.C.

Even so, the report continues, the embargo has created a health care crisis compounded by the country’s generally weak economic resources and by its loss of trade with the former Soviet Bloc.

The Cuban study team of nine medical experts, led by Dr. Peter G. Bourne, the health association’s board chairman and a former official in the Carter administration, evaluated research based on visits to 28 patient-care facilities and 15 nongovernmental and international organizations, as well as interviews with 160 professionals and “innumerable” patients and families.

They also found that Cuban patients are deprived of any drug internationally patented by a U.S. manufacturer since 1980. Since the United States boasts the world’s leading pharmaceutical research and production capability, the embargo effectively bans Cuba from purchasing nearly half the new world-class drugs on the market.

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The embargo also has contributed to serious cutbacks in supplies of safe drinking water by preventing the import of needed equipment and chemicals, and it has been a factor in the rising incidence in morbidity and mortality rates from water-borne diseases, such as typhoid fever, dysentery and viral hepatitis. For example, mortality rates from acute diarrheal disease increased from 2.7 cases per 100,000 people in 1989 to 6.7 per 100,000 in 1994.

Dirty water was blamed for 51 outbreaks of infections in hospitals involving 349 patients and 60 deaths in 1995 alone.

Screening and treatment for breast cancer have been severely compromised. Shutdowns in the entire screening program occurred in 1994 and 1995 for lack of X-ray film. During the 1980s, about 15 mastectomies were performed daily. Now, because of a lack of surgical supplies, the number has dropped to two or three a day, with as many as 100 women on a two-month waiting list.

Similarly, the number of surgeries dropped from 885,790 in 1990 to 536,547 in 1995, “a glaring indicator of the decline in hospital resources,” the report says. Surgical services face shortages of most modern anesthetics and related equipment, third-generation antibiotics and other key drugs, sutures and instruments.