Monday, February 5, 2007

The Cuban Abortion Scheme Debunked (epilogue)

The latest news shows that Brazil, who's infant mortality rate seemed stagnant, has finally seen a reduction. The latest numbers from the Ministy of Health reveal a reduction from 49.7 to 28.91 deaths per 1000 live births, from 1990 to 2002. The health minister, Humberto Costa, is giving the credit to Brazil's Family Health program which he plans to extend to poorer municipalities and ask for more funding. The study also attributes the decrease in infant mortality to increased funding of education programs and access to potable water and sanitation.

On the other hand, the latest report on US health from the United Health Foundation, the American Public Health Association and Partnership for Prevention shows that since 2000 "the rate of improvement in the nation’s health status has essentially stagnated."[graph above] They attribute this stagnation to continued smoking, high infant mortality, an increase in obesity, and increase in uninsured Americans.

Infant mortality in the US is 6.6 per 1000 births. The report's media release points out that "Our rate of 6.6 deaths per 1,000 live births is double that of Japan, Sweden, Finland, Monaco and San Marino. Countries such as the Czech Republic, France, Germany and Spain also have better rates of infant survival."

We can also add Cuba.

[source: America's Health Rankings Online Report]


South Florida Libertarian said...

Your Debunking

I don’t see how you came to the conclusion that the accusations leveled at the Cuban government are fraudulent, but maybe you can help me out. I read your entire posting on the subject and tried to find your logical argument but I can’t.

You appear to simply say, “The best thing to lower infant mortality is to provide health care to mothers. Brazil did this and it lowered their infant mortality rate. Cuba does this but also offers further health services to pregnant women and newborns. This is recommended by health organizations.” I assume you’re saying, “so this explains their lower infant mortality,” but please clarify.

Then you start talking about abortions and how women can’t get them legally in Latin America even though they want them for various reasons and then you conclude by seeming to imply that since abortion is legal in Cuba, “Most likely, these reasons also contribute to Cuba's abortion rate, not a government scheme.”

Listen, it’s a simple argument (with which I totally agree) that because abortions are legal in Cuba, it’s going to have a higher abortion rate than Latin American countries where it’s not legal. But that, ipso facto, doesn’t prove Cuban doctors aren’t automatically aborting sick fetuses. If the Herald’s article stated the only proof that Cuban doctors are doing this is Cuba’s increased abortion rate I’d say you have a good argument, but unfortunately it doesn’t. The article cites a doctor that used to work there, an economics professor, and a Cuban Studies expert basically stating “Cuban doctors automatically abort sick fetuses.”

I think your debunking also fails to address what I thought to be other important points the Herald’s article raises:

1. Why should anybody believe a report relying on complicated data compiled by a country in two days which, to ensure its accuracy, normally takes the U.S. Government two years to get right?

2. Are Cuba’s 1-5 years olds medically neglected due to its obsession with infant mortality rates?

3. Is Cuba’s lower infant mortality rate simply caused by misreporting babies who died in their first month of life?

4. Even if Cuba has the lowest infant mortality rate in Latin America if, “other countries in Latin America improved at a faster rate, and Italy and Spain bypassed Cuba,” when they had previously trailed, is the Cuban government really to be lauded for it?

Mambi_Watch said...

I'm encouraged by your interest SF Libertarian.

Concerning your points first:

1.We should be skeptical about the Cuban numbers, just as we should be skeptical of any government numbers. But, to what degree? Should we dismiss all the numbers? Is there SOME truth perhaps? What do PAHO and WHO say? The Herald article suggests that those agencies do not do independent audits. Yet, if you look at other sources, you will find that those agencies look favorably at the health programs in Cuba. I even believe some programs have been given official recognition. Check the online publication of MEDICC Review. Its there.

2.Check the numbers of CHILD (1-5) mortality rates, and compare them with the rest of Latin America. Cuba, in my opinion, doesn't seems to be neglecting their 1-5 year olds in comparison to Mexico, Colombia or Brazil, who have double or triple the number. Yet, if you mean direct national comparisons of Cuban infants to child, then that requires a methodology that seems complicated (food consumption?, access to care?...). But, I'm all ears.

3.Worth checking on. We should be very skeptical. Yet, we can only speculate. What do PAHO,WHO or any other health agency say?

4.It is a fact that many countries have reduced their infant mortality rates at a faster rate to Cuba's. Yet, there are many variables surrounding this. Let's take Latin America for example, where infant mortality has gone down in general, but NOT in all regions. The World Bank considers the Latin region as the one of the most economically unequal regions in the world. This also shows in the vital statistics, where the poor suffer from double or more the numbers of infant and maternal deaths. Yet, the richer parts enjoy a much lower number. Well, this is where the most improvements have been. These sectors have dragged down the overall numbers. Also, the general lower fertility rates have an influence. This reduction too mostly attributable to the rich. The poor suffer from high death rates in general. Well, in Cuba there is no rich sector to help drag down the numbers.

There are other external factors as well. PAHO faults the crisis of 89-93 to have affected "virtually all spheres of national life". They say: "The two determining factors underlying the crisis are well known": the collapse of the Soviet Union and the US embargo.

My first argument is that there is NO SCHEME. The explanations of low infant mortality rates in Cuba cannot be rolled into one simple government conspiracy. Instead, by my examples, I hoped to show that there is a complex structure to effective health care and its consequences: reduced number of deaths.

Brazil attributes its new numbers to health, education and potable water. I'm sure that there are many other variables involved, some marginal, some important perhaps.

But, I DO want to suggest that a health care system that addresses specific sectors of the population, effectively, will have a result. In the case of Cuba or Brazil, the sectors targeted were children.

About the abortion in Cuba. As, you read, the procedure has been embraced in a unique way by Cuban women. During the crisis, they decided to wait to have children. Now, its seems that many prefer it to contraception. That's a social phenomenon. Not a deliberate grand scheme.

I can't prove that Cuban doctors are deliberately forcing abortions on fetuses with congenital malformations, as much as the Miami Herald article can.

This is the question: Do you believe the DIRECT accusation of Jesus Monzon? (Because the other doctor DOES NOT make that same direct accusation, and the experts only SUPPORT Monzon WITHOUT evidence)

Or, do you believe a complex social phenomenon has occurred, which has been recorded in other parts of the world and supported by many other sources, as a result of a public health program aimed at mothers and infants?

Its up to you to. Weigh the facts.

Mambi_Watch said...

Any other questions just let me know.