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3/1/1993 - Health Care in Child-care Centers in Santiago de Cuba, Part II by Bacete Othwonh Bwogo

NOT FOR PUBLICATION WITHOUTWRITER SCONSENT BOB Part II INSTITUTEOFCURRENTWORLDAFFAIRS Feb March Peter Bird Martin Institute Current World Affairs West Wheelock Street Hanover N H 03755 Dear Peter HEALTH CARE IN CHILD CARE CENTERS IN SANTIAGO DE CUBA The extensiveness primary health delivery network Cuba continue surprise Primary physicians known family doctors family nurses everywhere Caribbean Island The concept there should doctor wherever there citizen place neighborhood school child center hospital Although concept raise eyebrows elsewhere already there about trained doctors Cuba which trained family doctors fully involved primary health delivery parts country In letter I writing about visits child centers known circulos fantiles Santiago Cuba City But first circulos infantiles Who right Who responsible children there Until attend How And looks after health children In addition answering these questions short description about health Abel Santamaria urban community given Bacete Bwogo ICWA fellow studying primary health delivery Cuba Costa Rica Kerala State India USA Since Institute ofCurrentWorld Affairs theCrane RogersFoundation hasprovidedlong termfellowships enable outstandingyoungadultstoliveoutsidetheUnitedStatesandwriteaboutinternationalareasandissues Endowed bythelateCharlesR Crane theInstituteisalsosupportedbycontributionsfromlike mindedindividualsand foundations BOB PART II CIII O8 INlIkNIlI These centers where working mothers bring their children There taught painstakingly cared addition receive medical They permitted mothers enter country force provided their first opportunity further their education Day centers receive children years So there And although children under years centers everyday around children Some mothers benefit child centers although demand future enrollments satisfied Day centers under direction system school education The Federation Cuban women responsible circulos infantiles until Infancy Institute created which later became ministry education On education child centers offer special opportunity In these centers objective foundation integrated armonious development child personality through scientifically developed education integrates physical intellectual ethical aesthetic formation schoolers That carried people special training Different tasks activities provided according special requirement child first sixth Independent activity initiative child under guidance BOB PART II orientation educator special importance activities outings simple experience artistic cultural activity Pre school educational programme scribes single greatest importance through which children reflect their knowledge around imitate adults establish relationships develop power observation memory thought imagination creativity power considerably widen their sphere interest Children enter centers between AM leave between PM The children centers offered charge The public depends capita family income discount applied children enrolled The lowest pesos approximately U S dollars month although income family U S dollars monthly children The highest U S dollars Most pesos although annual child about This strong state subsidy activity whose global about million pesos HEALTH CARE In addition education programmes children centers health services present Ensuring child survival development principle areas intervention family doctor programme Thus health teams doctor nurse hygienist nutritionist centers address health needs school childre which include surveillance children growth BOB PART II development prevention accidents treatment outbreaks infectious childhood diseases actions aimed ensuring adequate nutrition hygiene cleanliness timely diagnosis mental hearing motor problems During Santiago I visited centers Capullito Almendros flores provincial school children Eduardo Mesa Llul Circulo infantil Capullito center ninos sanos healthy children I asked family doctor charge about other health workers center According health programme center operated through ordinated activities between health workers doctor nurse nutritionist hygienist educators instructors psychologist administration center The family doctor keeps clinical ecords children center She makes periodic evaluation nutritional status children keeps chart monitor their growth development There vaccination programme All children undergo physical examination determine their health status before enrolled If mental hearing motor disability detected early affected child referred special center where receive specialist attention appropriate programme education example Almendros flores children visual affections BOB PART II In circulo infantil Almendros flores I found children conditions myopia glaucoma aphakia One child artificial prostheses A technician trained ophthalmology looks after these children everyday their treatments An specialist visits center every check visual conditions children review their treatm After completing years sighted children normal primary schools while children blind special schools blind The education activities center interesting children They class There plenty playing Also there music piano children listen music They learn dance holding other orderly manner while their teacher watch Children sleeping They served three meals They bathed their teeth brushed older alone their clothes changed Little under cared separately those children years The Eduardo Mesa Llul school children province Santiago Cuba photos It enrolls boarding students girls They study primary through junior secondary technical school where learn special skill The students range years After every school students allowed spent their parents BOB PART II I visited students their class rooms Teaching student include observation visual alertness Modern hearing equipment computers teaching students increase their vocabulary Some equipment German others Cuba The school medical which consist nurses family doctor In addition usual primary special attention given affective problems children sometimes specialist attention hospital visited school Three children heart conditions receiving specialist attention Every Wednesday meeting Children parents review progress their children school They informed about special conditions their children Education given things should their children In manner school health workers parents finding promoting education child The slogan Eduardo Mesa school education child noble declaration The education children Eduardo Mesa entails enormous costs state since education According school director about pesos estimated average month student This include accommodation tuition recreation health which offered students school Although BOB PART II ensuring child survival development given priority Cuba This national policy percent Cuban population children under years protection health these children priority family doctor programme Since focus family doctor programme reduce mortality group considerable advances figures Peter I guess point I pause I intend write But I could resist telling about dedication health workers educators administrators Santiago Cuba young children centers handicapped specialized institution What I during short I stayed Santiago appears unusual experience developing country It surprising specially imagines primary delivery system Cuba One wishes children elsewhere reasonable health perhaps education This recall words Nobel prize winning Chile Gabriela Mistral years wrote We guilty errors faults worse crime abandoning children neglecting fountain Many things The child Right bones being formed blood being senses being developed BOB PART II TO answer Tomorrow His Today Can young children absolute priority All flowers future His Today The young child priority Hasta siempre muchas gracias Bacete Ot PoS Please order elongate letter further thought pictures photos Polyclinic Josue Pais Abel Santamaria urban neighborhood Santiago Cuba This I about going polyclinic facilities Footnote explanation accompany An image worth thousand words I pictures interesting Una gracias BOB PART II REFERENCES I G Mina An encounter Fidel Ocean Press Melbourne Australia Salud Para Todos Havana F Castro Pediatric Congresses Cuba Speech November Havana P P Brenner The Cuba Reader The making revolutionary society P Grove Press Publisher New York V Epsin Cuban women confront future Ocean Press Cuba family doctor programme UNICEF UNFPA OPS OMS MINSAP Ministerio Salud Publica MINSAP Programma trabajo Medico enfermera familia Ciudad Habana Marzo Report workshop sponsored Aga Khan Health Services Aga Khan Foundation Planning managing primary health programmes August Nairobi Kenya Received Hanover June ABEL SANTAMARIA SUB URBAN NEIGHBORHOOD BOB Polyclinic Josue Pals PART I I Santiago Cuba Visiting nursing mother Abel Santamaria Patients suffering bronchial asthma receive outpatient treatment Polyclinic Josue Pals BOB PART II Family doctor treat bronchial asthma sufferer using acupuncture As alternative means acupuncture treat other diseases While acupuncture treat overweight treat underweight improve appetite BOB PART II Nurse assistant acupunturist Polyclinic Josue Pais A health problems acupuncture techniques BOB PART II Doctors medicinal plants small gardens backyard Polyclinic Josue Pals needs caused shortages medicines The medicina verde green medicine increased during The Special Period CIRCULOS INFANTILES VISITED IN SANTIAGO DE CUBA BO B Capullito PART II Almendros flores Inside classroom Preschool children receive classes Circulo infantil Capullito child center Learning practical skills In picture children learn water plants BOB PART II Children problems attend school looked after special circulo antil center Almendros Flores With children suffer problems EDUARDO MESA LLUL SCHOOL FOR DEAF AND MUTE CHILDREN BOB PART I I Santiago Cuba Children hearing problems attend classes Eduardo Mesa LLuI special school The education child noble declaration Jose Marti STATISTICS BOB PART II LEVELS ATTAINED IN THE BASIC INDICATORS OF MOTHER INFANT HEALTH IN CUBA Infant mortality births Preschool mortahty inhabitants years Mortality under years birth Surviva years Maternal mortality birth Mortality acute diarrhea birhts School mortality nhabitants years CUBA INFANT MORTALITY RATE FOR THEST24 births Granma International Jan Bolivia Haiti INFANT Peru MORTALITY Honduras Dominican Republic RATE IN LATIN Ecuador Nicaragua AMERICA Brazil El Salvador Paraguay Venezuela births Mexico Note In Re Panama volution triumphed Infant Argentina mortality Uruguay btdhs Colombia Source National Statistics Di Chile rectorate MINSAP Costa Rtca Source State World Children published In UNICEF INFANT MORTALITY RATES OF LESS THAN Israel Portugal Greece United States SoUth Koree Ireland Singapore Belgium AuStralia Italy New Zealand Germany Denmark Austria Spain Canada Switzerland France England Norway Holland Rnland Japan Sweden Source State World Children published UNICEF BOB PART II Computers teaching teaching children impaired hearing A physical education class Eduardo Mesa LLul BOB PART II Cuba Principal causes dealh infants under number deaths births Causes dealh Perinatal factors Congenital factors Influenza pneumonia Gastroenteritis other diarrhoeal diseases Accidents Notaccounledamonglhe principal causes infant rnodality Cuba Principal causes death among children andfrom5to 14garsofage Causesofdeath 1o4yearsotage Accidents Congenital factors Malignant tumors Meningococcal inlecfions Influenza pneumonia 51o14yearsofage Accidents Malignant tumors Congenital factors Meningococcal infections Heart disease Dealhsper 000childrenin hisspecificogegroup Dealhsper childrenInthisspecificogegroup Source MINSAP Cuba family doctor programme BOB PART II Infant mortality provinces P DEL RIO HABANA CIUDADHAB MATANZAS VILLA CLARA ClENFUEGOS SANCTI SPIRITUS CIEGO DE AVILA CAMAGUEY LAS TUNAS HOLGUIN GRANMA STGO CUBA GUANTANAMO ISLA JUV to203040506070002030 IO20 Rate I000 births Source MINSAP Informe anual Cuba Mortality rates principal causes death Heart disease Malignant lumors Cerebral vascular disease Accidenls Influenza pneumonia Suicide inflicled wounds Diabeles mellilus Bronquitis emphysema asthma Perinalal factors Congenilal factors Source MINSAP Cuba family doctor programme BOB PART II Cuba Breakdown deaths morlaliiy rates infants underoneyarofage 7dcWs__ 27days 28days 11months NO deaths Rate NO deaths Rate NO deaths Rate NO dealhs Rale Raleofdealhspe births Source MINS P CUba family doctor programme Cuba Intanl morlalily Source MINSAP Cuba family doctor programme BOB PART II Morlalily acule hoeal diseases Source MINSAP Cuba family doctor programme Morlalily inteclions parasiles inhabilanls 19821983 19851986 Source MINSAP Cuba family doctor programme BOB PART II CUBA PREVENTION OF IMMUNO PREVENTABLE DISEASES Vaccinalioncoverages bytype vaccine groupand levelofschooling 1982and1989 Type vaccine Anli tuberculosis DPT PRS DPT Tetanus Toxoid TetanusToxoid DT Anti tuberculosis Anti typhoid Anti typhoid Tetanus Toxoid Anti lyphoid Share population fully inmunized Diphlheria Pedussis0 letanus vaccine Universe covered Coverage atlained Under Under ofage 65yrs First graders Fifth graders Fiflh graders Eighth graders Ninth graders Eleventh graders Parotidilis Rubeola Measles Diphlherla0 etanus CUBA INCIDENCE OF SELECTED DISEASES Typhoid level Tuberculosis Tube culin meningilis Diphlheria Perlussis Telanus Infanlile lelanus Measles Cases reporled inhabitants O Meningococcic meningilis Poliomyelilis Diaseases oulbreak which reported health aulhodlies Source MINSAP Cuba family doctor programme BOB PART DENCE OF SOME DISEASES OF OBLIGATORY DECLARATION Tuberculosis Diphtheria II J I I years years measIes Rubella L So years years Neonatal Tetanus D Tetanus Mumps years years years Source MINSAP Informe anual