The Scientific Research Project of Commander Fidel Castro Ruz
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The great work developed by the Commander and from which he is, above all, the author and fundamental actor, is that transcendental investigation that could be entitled: "Strategy for the implementation of a Social Revolution in Cuba," from which innumerable theoretical and practical contributions have emanated. After years of study, review and direct immersion in the field of action, the written document that supported this investigation and constituted his most finished research project, saw its first version in what we all know as his self-defence plea: "History Will Absolve Me," delivered on October 16, 1953 in the nursing school of the Civil Hospital of Santiago de Cuba.
In that document, Fidel, as a good scientist, described the context in which Cuba was developing in those years and defined the problem situation that led him to reason what would be the best (scientific, from the present perspective) hypothesis for the Cuban people to overthrow the dictatorship, take power and achieve the social gains yearned for, for years. From that analysis, the armed struggle was defined as the principal method for realizing the main actions, objectives and strategic tasks that were projected in that statement, among which was the problem of health for the majority of the population.
It should be noted that the historical leader of the Cuban Revolution always assumed the strategic task of developing, improving and perfecting the Cuban health system, not as someone external to it, but as one more member of the contingent in white coats. He, without any academic training in the field of health sciences, always demonstrated his direct link with that branch of science, like when he stated in his speech to the third graduating class of Havana's Institute of Medical Sciences on August 27, 1990, "This year the largest graduation in the history of our country has taken place: more than 4,000 doctors. Look at what a tremendous and impressive force we doctors are with around 40,000 of us in this country. And I include myself on the list, because I have worked on this as well. I am not a doctor, but I am a promoter of the health program. Sometimes I have used other words when I have been asked, "Are you a doctor?" And I, with great immodesty, have replied, "I am not a doctor, but I am a health strategist."
The adaptation of Fidel's thought to the scientific development of Medical Sciences can be analyzed from the epistemological evolution of the definition of health, in its different stages:
1st -- Absence of disease
2nd -- Complete state of physical, mental and social well-being
3rd -- Health-disease process
4th -- Health as a social product, in which the preventive approach prevails over the curative.
In the middle of the 19th century, medicine was considered a social science, however this trend was still underdeveloped at the end of the 50s of the 20th century; nevertheless, during his stay in the Sierra Maestra, Fidel not only had definite ideas to improve the structure of the Cuban health system, as he explained in "History Will Absolve Me," but he began to define changes that should occur in the health process that would allow improving the integration of the components of that system and, therefore, improve medical attention to the population groups who had been most unprotected throughout the Cuban colonial and republican history.
In this sense, Fidel stated, "It is not
possible for this peasant population, the pure
soul of our land, to continue abandoned, hungry,
without medical assistance, without education,
their organisms destroyed by parasites or
malaria. We must bring health to the
countryside. These mountains, like all rural
areas, must be cleaned up (...) We must not wait
for diseases to arrive with their grim threat,
we must prevent them, we must avoid them. From
now on it is necessary to develop health plans,
just like economic, social and educational plans
and coordinate them all with urgent, functional
efficiency."
About this preventive approach, he would say a
few years later, "... we will fight, disease by
disease, and in that way decrease the number of
epidemics, the number of deaths, the number of
victims. And so that great purpose will be
fulfilled: go from therapeutic to preventive
medicine, that is, prevent citizens from getting
sick."
With the revolutionary triumph, on January 1, 1959, another stage of the research project developed by Fidel was completed. After that stage, the scientist Fidel developed, as a good strategist, the aspects that would define his vision of future scenarios to which the Cuban government and people should aspire and have to work for.
It was from that moment that a process of transformations began in the field of revolutionary Cuban Public Health, which had as fundamental aspects:
- The development of human capital.
- Coverage of the population with services equipped with the most modern technologies.
- Solidarity as an ethical principle in health services.
- Scientific research as the basis of health actions.
- Internationalism practiced without political conditions.
Regarding human capital in the scientific field, Fidel expressed as early as January 15, 1960: "Today, in the new homeland... scientists, researchers... have the satisfaction of knowing that there is a revolutionary government that seeks truth, it needs scientists ... thus, the scientist ... today has the ideal scenario where his intelligence and talent can find full development in search of truth and good, because the Homeland has taken the path where intelligence is not persecuted but rather is stimulated and rewarded: the Homeland has taken the path in which it is necessary for all of us to study and investigate ... The future of our Homeland must necessarily be a future of men of science, it must be a future of men of thought, because it is precisely what we are cultivating the most; what we are cultivating the most are opportunities for intelligence ...."
Fidel, in his concept of human capital outlines its socialist dimension: "Human capital implies not only knowledge, but also -- and very essentially -- conscience, ethics, solidarity, truly human feelings, a spirit of sacrifice, heroism, and the ability to do a lot with very little."
In this sense, and defining the characteristics of human capital, specifically in the health sector, on October 17, 1962, the Commander-in-Chief explained at the opening of the Victoria de Girón Institute of Basic and Pre-clinical Sciences, "... we are going to create, to train doctors, in massive quantities, and much better - much better! And we understand that this is a duty that the Revolution has toward the people. Looking to the future, the only, the true, the definitive solution is the massive training of doctors. And the Revolution today has strength and resources and organization and has men -- men! which is the most important thing -- to begin a plan to train doctors in the numbers that are necessary. And not only many, but above all good doctors; and not only good as doctors, but good as men and as women, as patriots and as revolutionaries!"
Together with its human resources, the Cuban Revolution, as a great strategic project, has allowed the development of a health infrastructure that provides universal and free medical coverage to the entire Cuban population, directing its actions to the reorganization of the system and the training of the human resource in health through:
- The introduction of the family doctor and nurse program.
- Full coverage with the family doctor and nurse in the urban and rural community, as well as in schools, day care centres and work centres.
- The design and development of the comprehensive family care program.
- The achievement of organizational and conceptual changes.
- The consolidation of institutional and home care.
-Attention to the hospital network.
- Community and intersectoral participation in the comprehensive health care model, developed jointly with political and mass, governmental and social organizations.
- Empowering individuals and families to become agents of their own health and that of the community.
When evaluating the results of a scientific investigation, they must meet, among other things, the criterion of being reproducible. In accordance with that criterion, Fidel conceived of solidarity among the pillars of the health system, not with the objective of reproducing ideological aspects of the Cuban Socialist Revolution in other countries, but with the objective of sharing the effectiveness of the training of professionals with high levels of humanism, solidarity, academic training and with a profound social orientation.
In this regard, he stated in the Constitution of the 1st Class of the Carlos J. Finlay Medical Sciences Detachment, on January 6, 1982: "... we must defend the principle of having a doctor with solid basic knowledge and a doctor who does not have a profile so narrow, that afterwards he cannot face many problems that he has to face in life, especially when he travels abroad and has to go to a country like Angola, Nicaragua, Iraq, Libya and many others."
That idea materialized to a superlative degree in the act of constituting the "Henry Reeve" Brigade, on September 19, 2005, where he expressed, "... this glorious organization, the first of its kind in the history of a humanity that more and more requires cooperation and solidarity [...] We will show that there is an answer to many of the planet's tragedies. We show that human beings can and must be better. We demonstrate the value of conscience and ethics. We offer lives. [...] We must train the doctors required in the fields, the villages, the marginalized and poor neighbourhoods of the third world cities... We offer to train professionals willing to fight against death."
September 19, 2005. Fidel Castro speaks before the first 1,586 doctors of the Henry Reeve Brigade.
Fidel, as a man of thought and action, in his conception of how the Cuban doctor's training model should be, stated that "at no time should theory be contrasted with practice," that the doctor "should have a solid training in theory and a solid training in practice too:" elements that identify not only the doctor, but all health workers in Cuba and that constitute one of the main foundations of the educational system in Medical Sciences.
Greater access to (medical) universities and the strengthening of the teaching and learning process in those institutions after the revolutionary triumph was an element that comrade Fidel always considered essential in the development of the country, giving priority to the need to incorporate, generate and generalize knowledge. In this regard, he expressed at the Closing of the First Congress of the Communist Party of Cuba, on December 22, 1975:
"[...] With the Revolution itself, universities are open to everyone... and there comes a moment when knowledge is the patrimony not only of a few individuals but of the masses.
[...] And our Revolution... marches on that path in which knowledge gradually becomes the heritage of the masses. Then there will be no such colossal differences between the knowledge of a few and the knowledge of the masses. And the time will come when these differences are minimal ...
[...] And in humanity itself there are no geniuses. There are brilliant men. You will have read that they have given somebody such and such an award; but the genius is not in the individuals: the genius is in the masses. When someone has excelled in mathematics it is because hundreds of thousands could not study mathematics. And someone has excelled in economics or in history or in any branch of human knowledge, it is because others did not have the opportunity to study. But when the masses have access to culture, they have access to study, they have access to knowledge, then the differences disappear, because instead of one genius there are 1,000, there are 10,000 geniuses. And where there are 10,000 geniuses there is no genius, there is a collective genius."
Furthermore, Fidel did not base the development of human capital in Medical Sciences only on national experiences, but rather promulgated the idea of seeking updates in the international arena, which reinforces his thinking as a constant researcher. For this reason he expressed on March 12, 1982, in constituting the "Carlos J. Finlay" Medical Sciences Detachment, "Medical science is constantly developing. As a result of experience and research, new methods and new techniques emerge; we have to integrate those techniques. This requires a great effort in international relations and exchanges, for us to say ‘which country is more advanced in this, which country is more advanced in the other, and in the other, and in the other,' and carry out continuous exchanges, simply so that we can occupy the vanguard positions in each of the medical branches. [...] because the doctor has to deal with human life, human health. On the doctor falls the immense, the infinite responsibility of taking care of the life of human beings: of a child, an old man, a young man, an adult, a woman, a man, who places himself in his hands to alleviate pain, to alleviate a disease or to preserve life."
He was consistent with the ideas he defended, he always conceived as key strategic actions, in his project, the activity of training and teaching the new generations, fundamentally in relation to study and the acquisition of knowledge. In this regard, Fidel spoke to the university students at the Closing Ceremony of the First Congress of the University Student Federation, on March 13, 1979, "... really one of the noblest ways of serving the country, of serving the people, of making revolution, to build the future is to dedicate oneself to study. [...] What and how should our contribution be to the effort and struggle of the other peoples of the world? How can we make our contribution and how much contribution is necessary in solving the future problems of our people and humanity? And what do we need? We need two things: we need conscience and we need knowledge."
With the same objective of achieving the improvement of the new generations, but analyzed from another angle, Fidel also demanded responsibility from the teachers in the formation of the medical model that the Cuban Revolution and people need, which was reflected in his speech at the closing of the Fourth Congress of Higher Education, on February 6, 2004, "... because a doctor who graduates today and does not study any more, in ten years time will be a dangerous practical doctor, an ignorant practical doctor...; therefore, both study and work with the doctor, you have to educate him ... We only have to look at contemporary technology and science to ask ourselves if it is possible to live and know that world of the future without an enormous amount of preparation and knowledge."
Two years later, on February 3, 2006, at the presentation of the UNESCO "José Martí" International Prize to Hugo Chávez Frías, he stated, "Creating human capital that is not exhausted ... they will know much more and will have multiplied this when they receive their degrees; they will have multiplied it again when they master a specialty; they will have multiplied it when they have completed one, two or as many internationalist missions as necessary; and they will have multiplied it when they have a master's degree or a doctorate as, in the not-too-distant future, our doctors will have massively."
The objectives set by the Commander in the strategic planning of the development of the Revolutionary Health System in Cuba always included tasks that were immediately completed and tasks that, with future projections, taught to think and dream of achieving superior results, always supported by sacrifice, and individual and collective improvement. For this reason, already 35 years ago, on June 11, 1982, he stated, "... we must get used to thinking about comparisons, not with third world countries... but with developed countries. [...] Becoming a medical power is not only a matter of prestige... firstly, the benefit that our people would receive... secondly, our collaboration with the Third World, for the extraordinary services that we can provide to other countries. [...] There is a need to delve into all disciplines, in all specialties... in each of the branches, and simply adopt the disposition and the will to put ourselves at the forefront...."
The development of scientific activity in the branches of health in Cuba, according to Fidel, also had to have a system of institutions where research could be carried out more and more in line with technological advances worldwide and where human capital could be developed. In accordance with this strategy, the biotechnology sector emerged as of 1981, when biotechnology itself was just being invented in the countries with the greatest technological advancement. This constituted a transcendental organizational innovation, which became the embryo of the Socialist Enterprise of High Technology, called on today to fulfill major tasks within our economic model.
1986. Fidel with a group of Cuban scientists at
the Inauguration of the Center for Genetic
Engineering and Biotechnology in Havana.
As in the years of the guerrilla struggle, before 1959, the Commander-in-Chief considered the development of science as a priority in the most difficult moments of the Revolution: for example, in 1991, when the crisis of the socialist camp was already unfolding and the gigantic task of defending our sovereignty was posed, he expressed, "Independence is not a flag, or an anthem, or a shield. Independence is not a question of symbols. Independence depends on development, independence depends on technology, it depends on science in today's world."
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Also in 1993, when the economic crisis of the special period hit the bottom, Fidel returned to the idea of the functions of science in the economy when he stated, "Science, and productions of science must one day occupy first place in the national economy. But starting from scarce resources, especially the energy resources that we have in our country, we have to develop the production of intelligence, and that is our place in the world, there will be no other."
The results of the research carried out by the unforgettable Commander in Chief have crossed the borders of Cuba and also constitute theoretical and practical contributions of global scope. Fidel himself declared as early as July 26, 1984, in the main event for the XXXI Anniversary of the Assault on the Moncada Barracks in Cienfuegos that the experience of Cuba, the Cuban Revolution, has made contributions to the solution of the problems of (global) health; I think the most important are the following: first the rural medical service; second, rigorous selection of medical personnel; third, extension of teaching to all hospitals in the country; fourth, participation of all the people in health tasks; fifth, I believe that the concept of comprehensive general medicine as a specialty will triumph; sixth, the programmed development of all specialties and, seventh, the family doctor.
To those mentioned by Fidel, we can add the theoretical contributions made regarding laws, norms, and rules that allowed the entire population to access free health services with a high scientific quality, as well as the design of the system and model of the Cuban National Health System, which would allow the structuring and interrelation of each of its components in order to provide a high level of medical care.
Fidel's investigative work has not concluded nor is it going to conclude, because as a good researcher, at each stage he knew how to reinforce his strategy, both with the results that were achieved and with the constant review of international literature and the use of observational and experimental methods. As a consequence, he supported the enrichment of the results of his research, keeping science in a privileged place and leaving to future generations, as a recommendation for a thesis for later studies, his last advice, presented during his speech at the Closing Ceremony of the Seventh Congress of the Communist Party of Cuba, on February 19, 2016, when he described as the main challenge, of current and future generations, the urgent need of the human being to "know more and adapt to reality," with the aim that "the species survives for a much longer period of time" and "know much more than we do."
That is the same Fidel that we all know, the guerrilla, the leader, the great man, but also, the intellectual, the researcher, ... the scientist who contributed an enormous wealth of knowledge to Cubans and to all humanity and who, even in the last days of his physical existence, was faithful to his research project.
(Espirituana Medical Gazette. Slightly edited for style by TML
This article was published in
Volume 50 Number 10 - November 25, 2020
Volume [volume] Number [issue] - [date]
Article Link:
The Scientific Research Project of Commander Fidel Castro Ruz - Geovanis Alcides Orellana
Meneses and Jenny Domínguez Nieto
Website: www.cpcml.ca Email: editor@cpcml.ca