dimanche 28 juin 2009

Por que yo soy revolucionario/a?


Day 3 La Habana Diaries 23 June 2009

I will tell you why I am a revolutionary

I was sitting in a verandah of a colonial house lined with plants, with antique furniture and you knew you were in the house of someone with taste and class.

I was born into the middle class in Pinar del Rio, the lady with extremely fair skin and hair slicked on to her hair, continued. I am now 56 years old and I am grateful for my life.

Thanks to the revolution I was able to go medical school as I wanted to become a doctor and given the opportunity to work in the field of epidemiology and also in the small group of people trying create vaccines. Had I been in another country, perhaps I could have more money, but what the revolution has given me, perhaps they couldn’t have given me. I have travelled all over the world representing my country and I am grateful to have seen so much and having experienced so much. Both my children are doctors and live in Cuba.

I am grateful for my life and I am grateful for the revolution for having given me this life, of being to participate in education of other doctors, to participate in research leading to public health breakthroughs. I have this wonderful house and I am quite content with my life. Also I take pride in the advances in medicine in cuba especially in public health and also the help we have given to so many poor countries in this world. I had a project among the Ayamara in Bolivia for ten years.

I am stuck in the heady days of the 1980s which was the heyday for me, before the responsibilities and travel took away that freedom. Everytime someone wants to criticize the revolution, I remind them of their long history of association with the revolution.

I had lunch with her and my good friend ALP. The lunch was at La Roca, a restaurant in Vedado, where there is a pianist belting out nice tunes to accompany the dinner. The service was quick and efficient and the price extremely modest. I had pollo supreme which reminded me of what cubans in miami call pollo a la plancha with moros, with a nice glass of mango juice to start with and a nice chocolate icecream to finish.

We would have spent six hours in conversation by the time I said good bye to them after coffee and a most delicious home made fruit juice. Our conversation touched all aspects of our lives but mainly the spiritual aspect and how that affects our relationships and the priorities that we should make for ourselves.

Using her analogy, I must not forget what are my priorities and cannot let other things enter or destroy those priorities. Morgan and Paris are priorities, writing a book or compiling information on Medical Antrhopology to present to doctors is another one. The latter one would be a homage to my friend and mentor, Cecil Helman.

American Indians would retain their priority in my life without trouble or much discussion. As Rabbi Akiva once said.. the rest is all commentaries.

This woman, an example of cuban ness in its all flourishment, a well educated and well travelled and well connected woman holding no great dislikes in her life, not sprouting anti imperialistic slogans or cliches against any one person or country, was an inspiration indeed. I felt good listening to her since her ideas resonated with me well, especially with some those are fundamental to my belief system.

The conversation had been long and hard, one of the purposes had been to counsel our common friend ALP about the realities of this transition in Cuba. I told them that during liminal periods one tends to commit errors and one has to be especially careful.

Now back to La Roca Restaurant and the lunch. The pianist, an elderly gent with flowin gwhite hair, whose fingers emit those wonderfully romantic songs through the piano. The food is well prepared, adequate and the ambience good enough for a cuban lunch. I have noticed that the service in the public sector in cuba has improved dramatically as if some one had sent a circular to each of the heads of places of public interest, to sharpen their services. The icecream was just delicious.

Tired after so many hours of intense discourse and counselling, I was happy to get home and rest a little bit. An endocrinologist from Hospital Amjeiras came to visit and the conversation took us to a time when it was appropriate time to leave for La Torre restaurat for our dinner.

The endocrinologist had finished doing the field work for her research for doctoral degree (Ph.D), she had interviewed more than a thousand women regarding sexual dysfunction in this society. It is a very large number and the data voluminous, but it would be very interesting to see the results. The field work was done in Habana Vieja that would make it even more interesting!

Perhaps they are sexually very active, there is also great academic attention to the sexual dysfunction in this country. The Institute of Endocrinology has a separate Department of Psychology with some eminent psychologists who dedicate their research into the psychological aspects of sexual dysfunction. The lead researcher told me that about 40 per cent of her patients had diabetes and the other 60 per cent had other chronic problems, including Tobacco Use and Alcohol Use which are taken into account in the psychology fo sexual dysfunction.

As we were discussing this, I realized that we in the west generally do not pay much attention to the sexua l dysfunction of our patients. (we meaning the providers), is it due to the fact that an average provider has not ime to bring it up since that would invariably involve counselling and also would involve time, and unlike dietitian, diabetes educator and physical education teachers and other sundy professionals, we don’t have a proliferation of sex therapists to whom we can just refer any one patient who complaints about his inability to achieve an erection! More nutritionitsts have not reduced the rate of increase in obesity, more exercise people havenot made people healthier. Only in a system in which the profit motive is taken out such as the Indian Health Service and VA Health Service in the USA or the NHS or Health Services in France, that a patient could freely express and expect to receive more than just a few tablets after a consultation. Michael Moore’s Sicko may have been an exaggeration but certainly there is some truth to it. And you can see the struggle President Obama is having trying to reform the health care system, from drug manufacturers and insurance companies…