American Public Health Association

There are many ways in which rich and powerful nations use heavy-handed sanctions to force weaker nations to comply with their demands. One of the most devastating sanctions is the embargo, which can reduce a country’s income from exports and block import of critically needed medicines, food, and other goods. The result is spiraling economic hardship, a breakdown of health care and other public services, and growing poverty, hunger, disease, and social unrest. As ever it is the poor and most vulnerable who suffer most. Two countries where embargoes have eroded the well-being of the populace, especially children, are Iraq and Cuba.

Iraq. The death toll of Iraqi soldiers and civilians during Desert Storm was unconscionably high and involved heinous violations of human rights (such as when American tanks buried alive Iraqi soldiers who had surrendered). But the toll and atrocities of the war itself pale in comparison with

the aftermath. According to recent research by the UN Food and Agriculture Organization, “As many as 576,000 Iraqi children may have died since the end of the Persian Gulf war because of economic sanctions imposed by the Security Council.” (NY Times Int. Dec. 1 ‘95, p. A6). Rising malnutrition among children means damage will extend for many years. The study found that

this August in Baghdad, 28% of children under age 10 are stunted, up from 12% in 1991. The percentage of ‘wasted’ or emaciated children requiring urgent attention has risen to 12% in 1995 from 3% in 1991, and child deaths from diarrhea have tripled. Water and sanitation systems have deteriorated, hospitals are running at 40% capacity, food prices are high, and many people live on starvation diets of only 1000 calories a day.

“These findings illustrate a strong association between economic sanctions and increase in child mortality and malnutrition rates,” the study says. “The United Nations humanitarian arm offers palliatives for the alleviation of suffering while the UN Security Council is intent on continuing the sanctions [until the Iraqi government yields to its demands for arms control].” However, little attempt is made to limit the massive, lucrative sales of arms from rich countries to poor. Meanwhile, millions of children pay the price with their health and their lives.

Cuba. The US embargo against Cuba has likewise caused huge economic dislocations. These are described in a revealing new booklet called The Politics of Suffering: The Impact of the US

Embargo on the Health of the Cuban People, by Diane Kuntz and published by the American Public Health Association. The devastating impact on Cuba’s economy was intensified by the demise of the Soviet Union (formerly Cuba’s main trade partner). And it was further aggravated by the so-called “Cuban Democracy Act of 1992” with which the US government further tightened and tried to globalize the embargo. As a result, food supply has diminished and the Cuban diet is less adequate both in quantity and quality. Medicine and medical supplies are scarce. Power shortages are frequent, factory production is often disrupted, and under- and un-employment have increased significantly.

Only because of Cuba’s excellent health system and political commitment to Health for All, has the small island nation so far been able to sustain its remarkably high health indicators. Cuba, with a GNP (national income) per capita only 1/20 that of the USA has managed to achieve—and, in spite of the embargo, sustain!—child mortality and life expectancy rates equivalent to those of developed countries. Its immunization and prenatal care rates are far superior to those in the US, and Cuba has fewer hungry children.

Yet despite Cuba’s enormous efforts to safeguard the health of its citizens, the embargo is taking its toll. Hospital admissions have increased, as have crime, prostitution, the black market, and social unrest. Some infectious diseases such as sexually transmitted diseases, diarrhea, and hepatitis A are on the rise. Anemia in pregnant women and children has increased due to reduced availability of iron rich foods (meats, eggs, etc.), and there are more low birth-weight babies. An epidemic of nutrition-related neuropathy also emerged, but has been largely corrected through vitamin/folate supplements. The nation has been able to sustain the population’s overall high level of health only through closely controlled rationing, which contributes to a groundswell of unrest (which is, of course, one of the goals of embargoes and other means of ‘low intensity conflict.')

The study concludes that “While the overall health of the Cuban population has not yet seriously eroded as a result of the economic decline, severe problems threaten to emerge in the future.”

Today, so-called ‘health care reforms’ are cutting back and privatizing public services and transferring more of the costs of health care to those who can least afford them while the gap between rich and poor widens. Despite these overwhelming obstacles, Cuba still provides the world with a model of good health at low cost, through equity. It is this viable alternative to the greed-centered health and development model of the global marketeers that most threatens the USA and spurs the tightening of the embargo.

What You Can Do About the U.S. Embargo Against Cuba

It is unconscionable that millions of children suffer, hunger, and die as result of political sanctions such as embargoes. There are proposals in the United Nations and among human rights organizations to pass international laws limiting embargoes and economic sanctions that jeopardize the health and lives of civilians, especially children.

Write to President Clinton, your Congress-persons, and the United Nations urging that economic sanctions and embargoes that cause mass suffering of civilians and children be halted and outlawed. And inform others to rally in a public outcry. Because the forces of wealth and power that sustain the embargoes are so colossal, we the people will need a loud and united voice if we are ever to be heard.

Join one of the solidarity groups or interchanges in support of Cuba. For information,write

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