Cuba Reconstruction (Powerpoint presentation)

Transcription

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Proyectto Cuba
¾
¾
¾
¾
Who we are.
What have we done.
Current problems exxisting in Cuba.
Information about Cuba.
C

General information
Communications
Provinces of Cuba
General Population p
per Province
Cuban Health System
m.
¾ Recommendations foor Humanitarian Aid.
¾ How to Implement O
Our Recommendations.
¾ Hospital and Health Clinics Needs.
5
Miami Medical Team Foundation (MMTF)
Who We
W Are?
Non-Profit Corporation
The work of the Miami Medical Team started in 1982 as a humanitarian
organization and became a Foundation
n on April 6, 1989, under the Corporate
Florida Status. The Miami Medical Teaam Foundation (MMTF) was granted, by
the IRS, a Federal Tax Exception becau
use it met the criteria in Section 501(a) of the
Internal Revenue Code as an organizattion described in Section 501©3.
Areas/countries of the World Aided
We have worked in 4 continents, in morre than 23 countries, among which are:
America (North, Central, South and the Caribbean):
North America: South Florida
Central America: Honduras, Belize,, El Salvador, Costa Rica, Nicaragua,
Panama
South America: Colombia, Ecuadorr, Peru, Paraguay, Chile
Caribbean: Bahamas, Cayman Islan
nds, Haiti, Cuba, Dominican Republic,
Antig a and St
Antigua
St. L
Lucie
cie
Africa: Angola
Asia: Afghanistan Europe:
E
Poland and Russia
6
Past Acctivities
¾ 1982 - 1990 - Medical/Surgical Asssistance and Transportation
off donations
d ti
to
t Nicaraguan
Ni
refuge
f ees in
i Honduras
H d
andd Costa
C t Rica.
Ri
¾ 1985 - Donation of 10 tons of hum
manitarian supplies to Chile after the
earthquake.
¾ 1986 - Medical Assistance to El Saalvador after the earthquake.
¾ 1986 - Donation of 15 tons of meddical equipment to Lima, Peru, in
conjunction with the women auxiliiary of the Dade County Medical
Association, Miami, Florida.
¾ 1987 - 1988 - Medical, dental, surggical assistance, donation of hospital
eq ipment and medications to Anggolan refugeees.
equipment
ref geees
¾ 1989 - Donation of complete 50 beed field hospital to the interim
government of Afghanistan.
7
Past Activitiess (Continued)
¾ 1990 - 1991 - Medical/Surgical asssistance and donation of equipment
in the reconstruction of Panama.
¾ 1990 - Present - Medical/Surgical assistance and donation of
equipment in the reconstruction of Nicaragua.
¾ 1992 - 1993 - Medical/Surgical asssistance in conjunction with the
Catholic Universityy of Guayaquil,
y q , Ecuador.
E
¾ 1991 - Medical/Surgical assistancee to Poland.
¾ 1992 - 1993 - Medical/Surgical asssistance and donation of equipment,
Hospital of Bayaguana,
Bayaguana province of Monte Plata,
Plata Dominican Republic.
Republic
¾ 1992 - Medical assistance to victim
ms of Hurricane Andrews, South
Florida.
¾ 1992 - Program Welcome to Freedoom: Cuban rafters.
¾ 1995 - Present - Program Faith in Action
A
in conjunction with the
Ermita de la Caridad,, medications sent to the ppeople
p of Cuba through
g
the Catholic Church.
8
¾ 1994 - 1995 - Joint Task Forcee 160, Guantanamo Naval Base,
Cuba, Haitian and Cuban raffters crisis.
¾ 1995 - Humanitarian
H
it i help
h l to
t th
h Island
he
I l d off Antigua
A ti
after
ft a
hurricane.
¾ 1995 - Humanitarian program with the Ministry of Social Services
of Haiti, donation of equipmennt to the Social Services Hospital.
¾ 1996 - Delivery of medicines and
a toys to the Ministry of Social
Services of Haiti.
Haiti
¾ 1996 - Delivery of medicationn and medical supplies to Cubans in
Pachacamiya, Peru.
¾ 1996 - Medical
M di l Team
T
back
b k up to
t the
th flotilla
fl till "Democracy"
"D
"
¾ 1996 - Monthly shipment of medication
m
to political prisoners in
Cuban jails.
9
¾ 1997 - Monthly delivery of a 40 feeet container with medication and
equipment to the Presidency of Nicaragua.
¾ 1997 - Medical
M di l h
help
l tto "F
"Friends
i d of
of Altai,
Alt i Inc.",
I " tto th
the Alt
Altaii region
i in
i
the former Soviet Union, to people exposed to 470 nuclear explosions
from 1949 to 1967.
¾ 1997 - 1998 - Donation of medicin
nes and medical equipment to
Ecuador to alleviate disasters cau
used by "El Niño" phenomenon.
¾ 1997 - 1998 - Donation of medicin
nes and medical equipment to Peru
to alleviate disasters caused by "E
El Niño" phenomenon.
¾ 1998 - Hurricane George, donatioon of 2 tons of medication, clothing
and food to Santo Domingo,
Domingo Dom
minican Republic.
Rep blic
¾ 1998 - Seminar in Preparedness foor Biological, Chemical and
Radioactive Warfare, in Coral Gaables Hospital, Miami, Florida.
10
¾1998 - Hurricane Mitch - Operation
n Central America, monthly
medical teams traveled to Honduraas and Nicaragua to provide
medical services to victims, also don
nation of medications.
¾1999 - Donation of a 40 feet contain
ner with hospital supplies and
computer set, medications, to the General
G
Hospital of Belize,
Ministry of Health, Belize, C.A.
¾1999 - "Operation Central Americaa" continued visits to the region of
Honduras and Nicaragua,
Nicaragua of teamss of doctors to provide medical
services to the victims of Hurricanee Mitch.
¾1999 - Donation of a Meddars 300 computerized
c
catheterization
laboratory and its components to th
he Ministry of Health of Managua,
Nicaragua, to provide services to th
he poor.
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¾ 2000 - Seminar "Terrorism: Prreparing the Community",
conducted at the Koubek Center of the University of Miami.
¾ 2000 - Donation of 5 Unitek Meetalcraft Dental Chairs, 5 Casalt
Lamps, chairs and other small dental equipment and
mammogram unit to the "Inter
Interrnational Foundation of the
People of Nicaragua".
¾ 2000 - January to August Program "Despertando Sonrisas"
together with the "Elena Medeeros Foundation" from Spain
Spain, to
send medicines to sick children
n in Cuba.
¾ 2001 - January 13 to June Earrthquake in El Salvador with an
intensity of 7.5 on the Richter scale.
s
The M.M.T.F. sent teams of
physicians and nurses with onee ton of medications on each trip.
Visits
V
s s to
o rural
u areas
e s dev
devastated
s ed
d by thee quake
qu e in a monthly
o
yb
basis
ss
from January to June 2001.
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¾ 2001 - March - Trip to Haiti. Visiteed the General Hospital at Ft. Liberte
and donated medications and mediical supplies.
¾ 2001 - June - Dominican Republic. The M.M.T.F. sent a team of
physicians and nurses with medicaations to San Cristobal province and
Haina, to help poor people in the area.
a
¾ 2002 – June – August – In responsse to a call to the Cuban exile by the
President of the Republic of El Sallvador asking for help in the fight
against a Dengue epidemic the MM
MTF teams of doctors, nurses, logistic
personnel and medicine to the affected areas.
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¾ 2003 – April, June, August – Doonations of medications to an AIDS
patient in Honduras, C.A.
¾ 2003 – January
J
tto December
D
b – Humanitarian
H
it i donations
d ti
off
medications to “Municipios in Exile”,
E
to be sent to their
counterpart in Cuba.
¾ 2003 – June – Seminar in Terrorrism: General Information, by Dr.
Henry J. Siegelson, of Disaster Planning
P
Intl., at the Cuban
Medical Association in Exile Coongress in Miami Beach.
Beach
¾ 2004 – January to July – Donatioon of medications and medical
supplies
pp
to Managua,
g Nicaragua
g a. Delivered to Professor Dario in
Miami, to be distributed to dispeensaries for the poor in various
municipalities of Nicaragua.
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Past Activities (Continued)
¾ 2004 – March – Donation of meedications to an AIDS patient in
Tegucigalpa, Honduras. The MM
MTF has been helping this patient
for about five years.
years The patient passed away in May 2004
2004.
¾ 2004 – May – Donation of mediications and clothes to the
Dominican Republic, to help thee victims of massive floods.
¾ 2004 – June – Donation of mediications to Haiti, to help the victims
of massive floods in the town off Gonaives on May 2004, which
killed 3,000 people.
¾ 2004 – August – Donation of meedications and equipment to the
Paraguay, to rehabilitate burned victims. Delivered to the Consul
of Paraguay
g y in Miami,, Florida. Fire
F at a shopping
pp g center in
Asunción, Paraguay. Visit of MM
MTF physicians to asses needs of
victims and delivery of medicatiions.
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Past Activitiees (Continued)
¾ 2004 – Weekly radio programs to
t broadcast updated medical
information of all specialties to the
t medical community in Cuba
and to the population at large thrrough Radio Martí.
¾ 2005 – All year – Donation of medications
m
to the “Municipios in
Exile” to send to people who neeed them in Cuba.
¾ 2006 – All year – Donation of medications
m
to “Municipio
Municipio of
Placetas in Exile” to be sent to people in need in Cuba who have
requested them and to political prisoners
p
and their families.
¾ 2006 – Donation
D ti off school
h l suppllies,
li
l
desks,
d k blackboards,
bl kb d uniforms
if
and books to equip a church halll to teach very poor children living
in “Anexo del Paraiso” in Managgua, Nicaragua.
¾ 2006 – Donation of medications to a group affiliated to
“Independent Libraries” in Cubaa.
¾ 2006 – Donation of medications to a ggroupp of wives of ppolitical
prisoners which called themselvees “Damas de Blanco”.
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Past Activitiees (Continued)
¾ 2006 – Weekly training program
ms at the “Municipios de Cuba in
Exile” to a volunteer group of members
m
for “Proyecto Cuba”
program.
¾ 2006 – November - Graduation of
o 148 volunteers in above
mentioned courses. Diplomas coonferred to the members upon
completion.
¾ 2006 – 2007 – Radio Broadcasting, weekly MMTF medical
pprograms
g
to Cuba through
g Radioo Marti. Directed as a ppublic service
and as orientation to health workkers and the general population.
Two additional weekly radio brooadcasts about general topics related
to medicine and the work of the MMTF in different pparts of the
world and the plans for the mediical reconstruction of Cuba.
Transmitted by: Radio Ritmo, Radio Miami International, short
W ve.
Wave.
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Past Activities (Continued)
¾ 2007 – All year – Donations of medicaations and medical supplies to
municipalities in Cuba through “Municcipios de Cuba in Exile”.
¾ 2007 – August
g – Earthquake
q
in Cusco ((or Cuzco),
), Perú. Massive drive to collect
food, clothing and medications for the victims
v
in collaboration with the
“Municipios de Cuba in Exile”. Donatiions were delivered in 72 hours.
¾ 2009 – Monthly basis – Donation of medications to the “Asociación Hijos y
V i
Vecinos
dde Pl
Placetas”” (a
( Non-Profit
N P fi org
ganization
i i which
hi h distributes
di ib
medications
di i
to municipalities in Cuba to families off political prisoners and others upon
request, not able to find medications on
n the island or not able to participate in
government run plans).
¾ 2009 – Humanitarian trip to Honduras and donation of medications, surgical
Fundación Di Battista” an NGO in
supplies and small equipment to the “F
Tegucigalpa, Honduras to distribute to the victims of floods and poverty.
¾ 2010 – “Operation Haiti” in association
n with the Archdioceses of Miami and
Haiti. To provide medical services and donations of medications to the victims
of the earthquake of January 12, 2010.
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Cuba – Generaal Information
2 the size of
¾ Cuba is an island with approxiimately 110,860
110 860 Km2,
the state of Louisiana.
¾ Cuba is 1250 Kms. Long and between
b
35 and 190 Kms. wide.
¾ South of Cuba is the Island of Youth (former Isle of Pines) with
2200 Km2.
¾ Cuba is divided into 14 provin
p
nces and the Municipio
p Isla de la
Juventud. The provinces are diivided into "municipios"
(municipalities or counties).
¾ The total population of Cuba is about 11
11.5
5 millions
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Cuban Resources – Infrastructure
1.
Air Transportation: There is a net of national airports with capacity for lodging all types of
aircraft, located in all provinces.
2
2.
Railroad: There is a central railroad from Pinar del
d Rio to Santiago de Cuba in the oriental
province.
3.
RR Branches: Are interconnections between twoo lines to reach the population in the north
and south shores of the country.
country
4.
Roads:
a) There is a Central Highway extendingg from Pinar del Rio to Santiago de Cuba,
passing through the capital cities of the
t old provinces.
provinces
b) Circuito Norte (North Highway): Extending from Havana to Matanzas and the
Northern part of Las Villas to Yaguajjay.
c) There is also "Ocho Vias" (Eight Lanes) extending from Havana to Sancti Spiritus
and ending short of Ciego de Avila, inn the province of the same name.
d) Circuito Sur (Southern Highway): Coommunication between Trinidad and Cienfuegos
in the southern shore of Las Villas, exxtending up to the southern part of Matanzas
and to Havana.
e) There is a net of paved and non-pavedd roads interconnecting the northern and
southern shores of Cuba with a centraal highway.
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Cuban Provincces - BC and AC
Pinar
i a del Rio
io
P
Pinar
del Rio
La Habana
City of La Habana
C
H
Habana
Campo
Matanzas
M
Matanzas
Mayabeque
Artemisa
C
Cienfuegos
Las Villas
V
Vill
Villa
Cl
Clara
S
Sancti
Spiritus
C
Ciego
de Avila
Camagüey
C
Camagüey
L Tunas
Las
H
Holguin
G
Granma
Oriente
S
Santiago
de Cuba
G
Guantanamo
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Cuban Provinces Before Castro
Pinar del Rio
La Habana Matanzas
Las Villas
Camagüey
Oriente
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Cuban Provincees After Castro
Pinar del Rio
Island of
Youth
La Habana Matanzas
Cienfuegos Sancti
Spiritus
Villaa Clara
Las
Tunass
Ciego de
Avila
Granma
Camagüey Holguin
Santiago de
Cuba
Guantanamo
23
Population per
p Province
Pinar del Rio
City of La Habanaa
La Habana
Island of Youth
735,000
2,400,000
672,764
,
70,000
Matanzas
642,221
Villa Clara
879 336
879,336
Cienfuegos
374,791
Sancti Spiritus
459,303
Ciego de Avila
368,591
Camagüey
766,462
Las Tunas
502,316
Holguin
1,043,130
Granma
848,792
Santiago de Cuba
Guantanamo
1 043 622
1,043,622
525,388
24
Population Of
O Some Cities
Bayamo
B
Camagüey
Cardenas
Ciego de Avila
Cienfuegos
Ciudad Habana
Gibara
Guaimaro
130,000
Mayari
23,000
300,000
Moron
45,000
Nuevitas
Pinar del Rio
37 000
37,000
75,000
85,000
125,000
2 000 000
2,000,000
16,000
20,000
124,000
Remedios
20,000
Sancti Spiritus
Santa Clara
80,000
200,000
Santiago de Cuba
420 000
420,000
Guantanamo
Holguin
Manzanillo
205,000
110,000
Tunas
120,000
Matanzas
115,000
Yara
10,000
230,000
Trinidad
50,000
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Cuba – Health Syystem Resources
Garrbage
g Vehicles
Ambulances
Ciudad Habana
Province of Havana
210
258
64
134
Pinar del Rio
70
104
Matanzas
61
104
Villa Clara
84
98
Cienfuegos
Sancti Spiritus
36
68
40
68
Ciego de Avila
36
80
Camagüey
72
98
Tunas
48
68
H l i
Holguin
100
104
Granma
81
98
Santiago de Cuba
Guantanamo
100
74
50
80
6
6
Isla de Pinos
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¾ Well organized – It is logical to use the same infrastructure
i
and health personnel to treat the
population.
¾ Health System is organized in 43 Health Regioons, then 332 areas (each area covers 25,000 to
35,000 people), then each area is divided in 400 sectors (each sector covers 600 to 700 people).
¾ Number
N b off medical
di l and
d ttechnical
h i l personnel:
l
Medical doctors:
65,000
Dentists:
9,000
Nurses:
85,000
Medical
M di l technicians:
t h i i
80 000
80,000
Health workers:
80,000 to
t 100,000
¾ Health system facilities:
Hospitals:
284 (Ciity of Havana 36, Province of Havana
46 Thee rest of Cuba 202)
46,
Out-patient clinics:
440
Blood banks:
22
Nursing homes:
182
Biotechnology centers:
12
Total number of hospital beds: 60,0000
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Possible Scenarios Accord
ding to Andrew S. Natsios
Scenarios according to Natsios:
1. A stable democratic transition goveernment takes over, with public support
minimal opposition from the old order,
der no violence or unrest.
unrest
2. An unstable democratic transition government
g
takes over, with sporadic
violence and disruption from renegaate military units but no immediate
threat
h
to national
i l stability.
bili
3. An unstable democratic transition government
g
takes over which
dissembles into a failed state,, with violence
v
from a national militaryy
divided into factions supporting diffferent elements of the old party elite,
increasing the human rights abuses occur and the political and economical
system collapse.
collapse
Humanitarian Aid will be the com
mmon denominator for
anyy of the above or anyy other scennarios.
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Cuba: Current Problems
There is a lack of food and healthh care services in the island:
a) Nutritional related needs..
b) Lack of medications, meddical equipment for diagnosis and
treatment and medical suupplies for health care facilities.
c) Lack of medical and solid
d waste disposal.
d) Insufficient potable (drinnking) water supply.
e) Contamination of environnment and water table due to a poor
sewer system
system.
f) Prisons over populated annd inhumane conditions.
g) Lack of medical personneel
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Brief Recommendations for Humanitarian Aid
¾The nutrition
¾Th
i i off the
h people
l andd a fu
functional
i l health
h l h system to provide
id
real care to the population will be the
t basic programs to start a more
broader pprogram
g
of reconstruction.
¾The health system as it is now, is non-functional, therefore our main
task is to upgrade the physical instaallations,
allations provide medical equipment
for diagnosis and treatment, providde medications to pharmacies in
hospitals and clinics, to provide meedical supplies, allowing Cuban
d
doctors
to treat their
h i patients.
i
¾It is our experience
p
in the reconstru
ruction of Nicaragua,
g Poland, Panama
and many other countries after seveere natural disasters (Honduras, El
Salvador, Haiti, Dominican Republlic, etc), children have grown without
toys therefore,
toys,
therefore we consider it very important,
important that humanitarian
donations include toys for the childdren. These will bring happiness to the
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children and their families.
Brief Recommendations for Humanitarian Aid
¾The distribution
¾Th
di ib i off medications
di i
andd the
h consultation
l i off patients
i
must be
b
done orderly by the already establisshed infrastructure of the Cuban
Health System.
y
¾The MMTF considers that the arrivving of humanitarian goods to Cuba
must be distributed from the basis of
o the country and up to the top.
top We
advise to use the equivalent of the county
c
system (Municipios) of Cuba
to distribute uniformly.
¾It is important also, to have the coooperation of the Cuban civil society,
to helpp in warehouses, securityy andd in the distribution. It is advisable to
recruit the help of church memberss, masons, Caballeros de la Luz, local
dissidents and civilian volunteers.
31
Brief Recommendationss for Humanitarian Aid
¾ Food. The actual government is prohhibiting the sale of food directly to the
people. It is necessary to open the tow
wns and cities public markets, where the
ppeasants will bring
g their vegetables,
g
, rice,
r , beans,, etc. for the people
p p to buy.
y
¾ Government. Poultry, pigs, cows, fissh farms, will deliver their products to
the public markets for the people to buy
b eggs, chickens, meat, etc.
¾ Fishing Fleet. It will deliver the catchh to the public markets for the people to
consume.
consume
¾ Donations of food supplies. Will reinforce the basic products obtained in
the Cuban country side.
side
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Brief Recommendationss for Humanitarian Aid
¾ Medical waste disposal. It is necesssary to establish plants to sterilize and
compact medical waste to prevent contamination
c
of people and infectious
t
transmitted
itt d diseases
di
(diarrhea,
(di h chole
h lera)) by
b vectors
t (flies,
(fli mosquitoes,
it
rats,
t
dogs, cats, etc.) and to stop the enviironmental contamination to the water
table, rivers, sea coasts, lagoons, etcc.
¾ General waste disposal. At the preesent time the general waste is abandoned
in the streets, corners and backyardss of towns and cities. It is necessary to
gather and dispose waste properly to
o assigned areas for treatment
treatment, to prevent
infectious diseases.
¾ P
Potable
t bl water
t supply.
l Many
M
cities
iti have
h
aqueducts
d t but
b t they
th supply
l water
t
one or two days a week because of lack
l
of fuel to pump the water and lack
of chlorine to potabilize it. Provide power supply and required chemicals.
¾ Unsanitary sewage systems. Proviide proper treatment of raw sewage.
33
Implementation: Gen
neral Considerations
¾ The Cuban island should be divideed into three Regions, in order to
assist better the p
population.
p
Each Region
R g
has a total p
population
p
of
3,500,000 to 4,000,000 people, apprroximately.
¾ Each province in the Region should be divided into municipalities
(counties) (See Addendum).
Addendum)
¾ Each municipality has a hospital foor support of the existing population
(See Addendum for Hospital classiification and number of beds).
¾ Food, clothing
i and toys should be distributed
i i
by MMTF network at
churches, lodges and schools.
pp
p
at the
¾ Medications and medical supplies
must ggo to the hospital
province level and then distributed
d down through the health system
infrastructure.
¾ Two phases of implementation: Em
mergency phase and Saturation
phase.
34
How To Implement Our
O Recommendations
I – Emergency Phase
¾Initial air transportation of humanitarian
h
donations.
¾Establish warehouses in Cuuba.
¾Identify and utilize current infrastructure as well as
local personnel.
II – Saturation Phase
¾Non perishable supplies viaa sea transportation
¾Non-perishable
transportation.
¾Transportation of supplies by
b RR and highway.
¾Continue and broaden the use
u of the existing
infrastructure and local perssonnel as in the Emergency
Phase.
35
Distribution of Regions
Province
(Western) Region I
14
735 589
735,589
Mayabeque & Artemisa
19
672,764
City of Havana
14
2,215,448
Matanzas
14
642,221
61
4,266,022
Villaclara
13
880,000
Cienfuegos
8
375,000
Sancti Spiritus
8
460,000
Ciego de Avila
10
369,000
Camagüey
13
766,462
Las Tunas
8
502,316
60
3,352,778
Holguin
14
1,043,130
Granma
13
850,000
9
1 045 000
1,045,000
10
525,388
46
3,463,518
Total
(Eastern) Region III
Santiago de Cuba
Guantanamo
Total
Total Population
Pinar del Rio
Total
(Central) Region II
Municipalities
36
Emergen
ncy Phase
¾ This
Thi phase
h
might
i h last
l from
f
four
f
to six
ix months.
h
¾ The arrival of humanitarian aid must be
b airlifted to pproduce a ppsychological
y
g
impact in the population that by this tiime might be very restless. The airlift
operation must be advertised on local TV stations and TV Marti for
information.
information
¾ Planes should arrive to pre-establishedd airports, located in the different
R i
Regions.
¾ Humanitarian donations ((medicines, medical
m
supplies,
pp
medical equipment,
q p
food and toys), will be warehoused inn airport hangars and then transported
and warehoused in the provincial and municipal hospitals and from there
will be distributed by the Cuban healtth system infrastructure
infrastructure. Food,
Food clothing
and toys will be warehoused in airporrt hangars and from there taken to
37
places of distribution in churches, loddges and schools.
Emergency Phaase (Continued)
¾ Warehoused
W h
d in
i airport
i
hangars
h
andd fro
f om there
h taken
k to places
l
off distribution
di ib i
in churches, lodges and schools.
¾ From the pre-established airports shouuld be airlifted by helicopters to the
different municipalities of the provincce and same distribution as before:
hospitals churches,
hospitals,
churches lodges and schools.
ls Helicopters are fast delivery and
can make several trips a day covering extensive areas. The psychological
and material impact needed, can be obbtained in this phase. Also, will prevent
d l convoys that
delay
h can be
b assaulted
l d by
by people
l in
i needd or criminals.
i i l
¾ There are Cuban Air Force helicopters
p s that can be used and others rented in
the U.S.A. for the task force air workss.
¾ Cuba is a long and narrow island and all municipalities will be close to the
main base in the province capital. (See Addendum Helicopters)
38
Equipment of the Republic of Cuba
This iis a li
Thi
list off air
i assets available
il bl in
i Cuba,
C b which
hi h could
ld b
be used
d iin
missions of the Emergency Phase.
AN-2
AN-26
AN
26
IL 18
IL-18
MI-8
Single Engine Transport STOL
Empty weight:
7,605 lbs.Gross weighht:
12,125 lbs.
Payload:
4,520 lbs.Maximum speed:
s
160 MN/hr. loaded.
Range:
560 MN
Multi-Engine
Multi
Engine Transport
Empty weight:
29,320 lbs.
Grross weight:
46,300 lbs.
Payload:
16,980 lbs.
M
Maximum
speed: 267 MN/hr. loaded.
Range:
341 MN
M lti
Multi-engine
i Transport
T
t (4 engines)
i )
Empty weight:
90,000 lbs. approx. Grross weight:
90,000 lbs. approx.
Payload:
90,000 lbs. approx. Maximum
M
Range:
g
4500 MN
Helicopter
Empty weigh:
15,026 lbs. approx. Grross weight:
25,455 lbs. approx.
Payload:
10,429 lbs. approx. Maximum
M
Range:
298 MN
To be updated
39
Targeted Airports
Latitude
Longitude
Districct ID/
Frequ
uency
Ð
Rancho Boyeros
23o 00’ N
82o 24’ W
UHA 348
3
Ð
San Antonio
22o 58
58’ N
82o 13
13’ W
UZG 2283
Ð
Varadero
23o 23’ N
81o 26’ W
UVR 430
4
Ð
Santa Clara
22o 29’ N
79o 56’ W
USC 240
2
Ð
g
Cienfuegos
22o 09’ N
80o 24’ W
UCF 212
2
Ð
Camagüey
23o 00’ N
77o 51’ W
UCM 370
Ð
Holguin
20o 53’ N
76o 16’ W
UHG 353
Ð
Santiago de Cuba
19o 58’ N
75o 50’ W
UCU 339
3
Ð
Guantanamo
20o 04’ N
75o 09’ W
UGT 300
3
40
Distances and
d Coordinates
The distances and coordinates of the key position
ns for supplying the operation are as follows:
CITIES
PINAR DEL RÍO
Pinar del Río
SAN JULIÁN
MARIEL
Artemisa W.
La Coloma
Mantua
LA HABANA
HABANA
(Columbia)
S. ANTONIO BAÑOS
Boyeros
MANAGUA
BARACOA
Batabanó
SAN PEDRO
MATANZAS
VARADERO
Colón
C
Cayo
L
Largo S
Sur
LAS VILLAS
Santa Clara
Caibarién
Cienfuegos
Trinidad
Sagua
COORDINA
ATES
DIST.(NM)
IDENT. FREQ
22º25'N - 833º40'W
22º05'N - 844º09'W
23º00'N - 822º46'W
22º45"N - 83º46'W
22º41'N - 833º40'W
22º18'N - 844º19'W
276
308
---------------------
--USJ
--UCY
-----
23º08'N
23
08 N - 8222º20'W
20 W
195
UHA
348
22º52'N - 822º30'W
23º00'N - 822º24'W
22º58'N - 822º13'W
23ºO1'N - 82º35'W
8
22º44'N - 822º17'W
21º44'N - 799º47'W
-------------------------------
UHA
UHA
UZG
UPB
UBO
UHA
348
348
283
250
296
348
23º023'N - 81º26'W
8
22º44'N - 800º54'W
21º37'N - 811º32'W
180
-----------
UVR
--UCL
430
22º29'N - 799º56'W
22º32'N - 799º28'W
22º09'N - 800º24'W
21º48'N
21
48 N - 7999º59'W
59 W
22º48'N - 800º04'W
299
200
218
------------
USC
--UCF
--UIS
240
402
380
230
212
305
41
Distances and Coord
dinates (Continued)
The distances and coordinates of the key position
ns for supplying the operation are as follows:
CITIES
CAMAGUEY
CAMAGÜEY
Ci
Ciego
de A
Avila
i
Macareño
ORIENTE
Manzanillo
GUANTANAMO
GUANTANAMO BAY NS
Baracoa
HOLGUIN
Bayamo
Santiago Cuba
Moa
Tunas
Nicaro
ISLA DE PINOS
Gerona
SIGUANEA
COORDINATES
S
DIST.(NM)
IDENT.
FREQ
21º25'N - 77º51'W
W
22º01' - 78º47'W
22º01'N
8º4 'W
20º46'N - 78º52'W
W
294
-----------
UCM
UCA
CA
------------
370
390
20º17'N - 77º05'W
W
20º04'N - 75º09'W
W
19º54'N - 75º12'W
W
20º22'N - 74º30'W
W
20º53'N - 76º16'W
W
20º23'N - 76º37'W
W
19º58'N - 75º50'W
W
20º39'N - 74º55'W
W
20º59'N - 76º56'W
W
20º41'N - 75º32'W
W
370
440
-----455
368
380
423
----------------
UMZ
UGT
-----UBA
UHG
UBY
UCU
UMO
UVT
------
232
300
21º05'N - 82º47'W
W
21º38'N - 82º58'W
W
-----------
UNG
-------
278
353
268
339
212
296
412
Note: Capital letters designate Military Airports,
A
Distances are from Miami in
N ti l Miles
Nautical
Mil (NM),
(NM) Radio
R di Frequencies
F
i are
a for
f A
Automatic
t
ti Di
Direction
ti
Finders
Fi d
(ADF) located at airports or nearby.
42
Warehousing an
nd Distribution
¾ Expected humanitarian donations of medications, hospital supplies,
hospital equipment, clothing, food and toys, will be orderly classified
after landing in the target airport and
a placed in hangars for
protection from losses and weatherr.
¾F
From the
th ttargeted
t d airport,
i
t medical
di l goods
d will
ill be
b airlifted
i lift d to
t the
th
municipalities and delivered to the hospitals at the province level and
hospitals at the municipal level.
¾ Food and toys will be airlifted to municipalities
m
where the “reception
committee” will warehouse it in ch
committee
hurches, lodges and schools.
¾ Security is necessary to prevent losses. Local police and members of
churches
h h and
d llodges
d
and
d volunteer
l t rs will
ill be
b organized
i d to
t perform
f
these tasks.
43
Saturatioon Phase
¾ This phase will start at the same tiime but will need more logistic
preparation. This phase will overlaap the emergency phase and will
last after the first six months, until stabilization of the country is
secured.
¾ The saturation phase will deliver same
s
humanitarian donation as
previous phase.
¾ The shipping should be by sea freiighters and delivered at predetermined ports, characterized foor the capacity and number of
cranes, warehouses facilities and proximity
p
to the highway system
and railroad systems of Cuba. Thee tonnage must be moved by land
too same
s ed
distribution
s bu o lines,
es, oorganiz
g zed
ed du
duringg thee “emergency
e e ge cy phase”.
p se .
44
Targeteed Ports
Bay/Harbors
Latitude
Longitude
Mariel
23o 00’
N
82o 59’ W
Havana
23o 09’
N
82o 20’ W
Ð
Matanzas
22o 05’
N
81o 31’ W
Ð
Nuevitas
22o 29’
N
77o 15’ W
Ð
Cienfuegos
22o 04’
N
80o 28’ W
Ð
Santiago de
C b
Cuba
20o 00’
N
75o 52’ W
Ð
Guantanamo
19o 54’
N
75o 10’ W
Ð
Ð
45
Targeteed Ports
¾ Mariel
M i l Bay:
B
C
Connection
ti with
ith railroad
il d andd highw
hi hways for
f distribution
di t ib ti to
t the
th provinces
i
off Pinar
Pi
del
d l
Rio, Havana Province, Isle of Youth and Provincee of Matanzas.
¾ Havana Harbor: Will supply
pp y the Cityy of Havanaa and its municipalities.
p
¾ Matanzas-Cardenas Bay: Connection with Nortthern RR line, Central Hwy., Northern Hwy.
(Circuito Norte), Eight Lanes (Ocho Vias) and disstribution to parts of the provinces of Villaclara,
Cienfuegos Sancti Spiritus
Cienfuegos,
Spiritus, Ciego de Avila and Camagüey
C
Camagüey.
¾ Cienfuegos Bay: Connection by RR lines in the south
s
shore, by Ocho Vias Expressway, Southern
Circuit (Circuito Sur) connecting with Trinidad City.
C The above will supply part of the provinces of
Cienfuegos, Sancti Spiritus and Escambray Mounntains.
¾ Nuevitas Bay: Connection with RR and highwayys for supplying the provinces of Camagüey, Las
Tunas Holguin and part of Granma (Manzanillo
Tunas,
(Manzanillo, Campechuela,
Campechuela etc
etc.).
)
¾ Santiago de Cuba Bay and Guantanamo Bay: RR
R connections and highways for supplying
provinces of Guantanamo, Santiago de Cuba and parts of Granma.
46
Cuban Ports: Currentt Activities (in Tons)
Puertos de Descarga
Destino de las Cargas
Total
C.
Habana
Mariel
Matan
nzas
Cienfuegos
Nuevitas
Santiago
City of Havana
45.6
45.6
Pinar del Rio
15.4
Matanzas
12.9
Villa Clara
17.8
17.8
Cienfuegos
8.0
8.0
Sancti Spiritus
9.5
9.5
Ciego de Avila
7.9
7.9
Camagüey
16.2
16.2
Las Tunas
9.9
9.9
Holguin
21.0
Granma
17 1
17.1
17 1
17.1
Santiago de Cuba
21.1
21.1
Guantanamo
10.2
La Habana
14.7
14.7
Isla de Pinos
2.3
2.3
Total
229.6
62.6
Antilla
Gtmo.
15.4
12.9
21.0
10.2
15.4
12.9
35.3
34.0
38.2
21.0
10.2
47
Cuban Ports (Continued)
Observ
vations
¾The Port of Havana receives shipmeents bound to Gerona and the
Havana Province.
¾Supplies consigned to the Province of
o Matanzas can also be received
through the Port of Cardenas.
¾Supplies for Villa Clara can also be received
r
through the Port of
Isabela de Sagua.
¾Supplies designated for Las Tunas can also be received through the
Port of Puerto Padre.
¾The Province of Holguin may also reeceive supplies through the Ports
of Felton and Moa.
¾The Province of Granma may also receive
r
supplies through the Port
of Manzanillo.
48
49
National Inciden
nt Management System
NIM
MS
NIMS – Comprehensi
C
h
ive national
ti
l approach
h
to Incident Manageme
ent at all jurisdictional
levels. Natural or Terrrorist incidents
improving cooperation
n between public and
private entities.
50
Emergency Op
peration Center
EOC – Coordination,
dispatching and tracking,
communications, information
collection analysis
collection,
analysis,
dissemination.
EO
OC
Same as ICS
Finance
Transport
Safety
51
Area Comm
mand System
ACS – Oversees the
management of multiple
incidents that are being
managed by ICS and UCS
AC
CS
Planning
Logistic
Aviation Coordinator
Safety
52
Unified Comm
mand System
UCS – Oversees the work and
coordinates ICS when more
than one incident occurs
simultaneously.
y Incidents
cross political jurisdictions.
U
UCS
Operations
Planning
Lo
ogistic
Finance Administration
Safety
53
Incident Command Sysstem
ICS
Planning
Operation
Resources Unit
ICS – Defines operation
characteristics, management
components and structure of
components,
incident management
organizations throughout life cycle
of incident.
Logistics
Safety
PIO
Public
Information
Officer
Supply Unit
Situation Unit
Food, Clothing
g Unit
Documentation Unit
M
Medicine
Equipment Unit
Demobilization Unit
Facilities Unit
Ground Support Unit
Com
mmunication Situation Unit
54
EOC
Cuba
MCS
ACS
Regions I, II, III
ACS
Regions I, II, III
UCS
Provinces
UCS
Provinces
ICS
Municipalities
ICS
Municipalities
Miami
55
Miami
MCS
S
Miam
mi
Public Information
System
PIS
Multi-agency Coordination
System
ACS
Region III
ACS
R i
Region
II
ACS
R i
Region
I
UCS, Pinar del Rio
UCS, Oriente
UCS, Camagüey
UCS, Las Villas
UCS, Ciudad Havana
Cienfue
egos
Ciego de Avila
Holguin
UCS, Provincia Havana
Villa Clara
C
Camagüey
Bayamo
UCS, Matanzas
Sancti Sp
piritus
Tunas
Santiago de Cuba
Guantanamo
ICS
M
Municipios
56
Cu
uba
EOC Havana
EOC,
H
ACS
R i
Region
II
ACS
R i
Region
I
ACS
R i
Region
III
UCS, Pinar del Rio
UCS, Cien
nfuegos
Holguin
UCS EOC
UCS,
Ciudad Habana
UCS, Villa
a Clara
Bayamo
UCS
Provincia Habana
UCS, Sanctti Spiritus
Santiago de Cuba
UCS, Matanzas
UCS, Ciego
o de Avila
Guantanamo
UCS, Cam
magüey
UCS, Tunas
ICS Municipios
57
Preparredness
Preparedness
Contingency
Plans
Classification and
Certification
Of Volunteers
Procedurres
Training
g Exercises
Certification
of
Equipment
58
Air Operation
Operation Section Chief
Air Operatio
on Director
Air Support Group
Supervisor
Helibase
Heliport
Fixed Wing
Base Field
Air Tactical Group
Helicopter
Coordinator
Fixed Wing
Coordinator
Helicopters
Fixed Wings
Aircraft
59
Additional Programs for th
he Reconstruction of Cuba
“Cuban Municipalities in Exile” (Municip
pios Cubanos en el Exilio) is a massive
Cuban organization
g
founded in the sixties du
uring
g the first waves of Cubans arriving
g to
Miami. Cuba was organized democratically under the Constitution of 1940 by
municipalities (or counties, 129 in total), theese counties into provinces. When the
communist took over Cuba in 1959, the gov
vernment left the same divisions, at the
present time however, there are 16 provincees and 169 counties.
Well, Cuban municipalities in exile is an org
ganization following the development, day
by day, of what is happening in their sister municipality
m
in the island. There are many
off them
h with
i h representation
i on the
h Isle.
I l Dr.
D Manuel
M
l Al
Alzugaray was elected
l
d President
P id off
the “Cuban Municipalities in Exile” (coun
nties) in the year 2006 – 2007 and was reelected in 2009 – 2010.
He re-organized
re organized the “Patronatos”
Patronatos (non-profi
(non profiit civic organizations) located in a
municipality in exile (county) and sister of the
t same municipality in the island of
Cuba. The purpose of the Patronatos is to help in the reconstruction of all and each
municipality.
municipality
60
The Program
ms Will Include:
1 HEALTH: a) Ambulatory emergency facilities (Caasas de Socorro):
1.
Assisting in donation of paint, furniture, equuipment, medications, supplies, etc.
b) Local hospitals: same as above.
c) Nursing homes: same as above
d) Policlinics (out patient care centers): sam
me as above.
2. ENVIRONMENT: Programs to improve the envirronment, trash collecting, black waters, drinking
water, campaigns against insects, mosquitoes, flies, rats, etc.
3 SCHOOLS: Cleaning,
3.
Cleaning maintenance.
maintenance Furniture,
Furniture boooks,
ooks computers Sports Scholarships
Brotherhood programs between U.S.A. schools andd schools in Cuba.
4. CHILDREN: a) Program to deparasite children in collaboration with the Ministry of Health and
Education.
b) Provide children a glass of milk daily in Public Schools.
c) Children amusement parks.
5. FIRE FIGHTING DEPARTMENTS: Brotherhoood programs between Fire Fighters in a U.S.A.
county or City and those in a
Cuban municipality, for donations of equipment, training,
ambulances, etc.
6. POLICE DEPARTMENT: Brotherhood program
ms between Police Departments in counties
and/or cities/towns in the U.S.A. and Police Departtments in municipalities (counties) in Cuba for
d
donations,
i
training,
i i
etc.
61
¾Also, during the Presidency of Dr. Alzzugaray, it was possible to approve a
program to establish a Lions Club in each
e
municipality in Cuba,
simultaneously, to increment the civic influence of help and independence in
th population,
the
l ti promote
t donations,
d ti
etc
tc.
¾Finally, Dr. Alzugaray concerned abouut the savage indoctrination of the
children and Cuban youth, has been prromoting programs to substitute the
existing “Red Pioneers”, “Camilitos”, etc. (all communist indoctrination
groups) with Boy and Girl Scouts proggrams.
¾There has been a very extensive progrram of intelligence, all based in
actualized data of infrastructure and minimally
m
necessary for the institution of
a Reconstruction Program nationwide..
62
Municipios Info - Front
63
Municipios Info - Back
64
65
ACCESS ROUTES:
R
AIR, LAND & SEA
66
Province of Pinar
P
del Rio
P i i Pinar
Provincia:
Pi
del
d l Rio,
Ri Population:
P
l ti
735,385
735 385
Capital: Pinar del Rio,
Population: 154,860
Distance from Havana: 147 Kms.
Hospitals of Pinar del Rio
Means of Transportation Available:
¾ Distance from Havana: 182 Km.
¾ Airports: Pinar del Rio
¾ Highway (Central and Roads)
¾ Railroad (Central track and Connections)
¾ Seaport: Bahia Honda
¾ Municipalities: 14
67
Province of Ciudaad de La Habana
Provincia: Ciudad de La Habana
Population: 2,215,448
Hospitals of Ciudad de La Habana
¾ Military Airport, Fuerza Aerea
Revolucionaria (Columbia) and
Jose Marti Airport (Intl)
¾ Highway (Carretera Central)
¾ Railroad
¾ Seaport: Port of Havana
68
Province of Havana
Provincia: Habana, Population: 672,764
Hospitals of Province Habana
¾Military Airport: San Antonio (La Cayuga)
¾ Highway
¾ Railroad
¾ Seaport: Cabañas, Mariel, Batabanó
69
Province of Matanzas
Provincia: Matanzas,
Matanzas Population: 116,692
116 692
Hospitals of Matanzas
¾Airport: Juan Gualberto Gomez (Intl), Varaderoo
¾Access Via Blanca Central Highway
¾
Northern Circuit to Sagua
¾ Railroad: North Line, Central Line,
Connections to the Province and
Cienfuegos Province
p
Matanzas,, Cardenas
¾ Seaport:
70
Province of Cienfuegos
C
Provincia: Cienfuegos, Population: 374,791
Capital: Cienfuegos, Population: 120,669
Hospitals of Cienfuegos
¾Airport: Jaime Gonzalez (Intl), Cienfuegos
¾
¾Access:
Connections to Central Highway
Connection to 8-Lanes, connection to
Southern Circuit, Highway to Trinidad
¾ Railroad:
R il d C
Connections
ti
with
ith M
Matanzas
t
RR
and Central RR Line.
¾ Seaport: Cienfuegos
71
Province of Villa
V
Clara
Provincia: Villa Clara, Population: 879,336
Capital: Santa Clara, Population: 198,489
Hospitals of Villa Clara
¾Airport: Abel Santa Maria, Santa Clara
¾Access: Northern Circuit Hwy, 8-Lanes
Hwy, Connecting Hwys
¾ Railroad: Northern Line, Central Line,
Interconnecting Lines (Ramales)
¾ Seaport: Sagua La Grande, Caibarien
72
Province of Saancti Spiritus
Provincia: Sancti Spiritus, Population: 459,303
Capital: Sancti Spiritus
Spiritus, Population: 110
110,528
528
Hospitals of Sancti Spiritus
¾Airport: Sancti Spiritus
¾Access: Central Hwy, 8-Lanes Hwy,
Connecting Hwy to Trinidad and Yaguajay
¾ Railroad: Northern Line,
Line Central Line
Line,
¾ Seaport: Casilda
¾ Municipalities:
i i ii 8
73
Province of Ciiego de Avila
Provincia: Ciego de Avila,
Avila Population: 368,591
368 591
Capital: Ciego de Avila, Population: 95,559
Hospitals of Ciego de Avila
¾Airports: Maximo Gomez (Intl)
Cayo Coco (Intl), Jardines del Rey
¾Access: Ciego Central Hwy, 88-Lanes
Lanes Hwy
¾ Railroad: Northern Line, Central Line,
¾ Seaport:
S
t _________________
74
Province of Camagüey
C
Provincia: Camagüey, Population: 766,462
Capital: Camagüey, Population: 269,732
Hospitals of Camagüey
¾Airport: Ignacio Agramonte (Intl)
¾Access: Central Hwy
¾ Railroad: Central Line, Interconnecting
Lines (Ramales)
¾ Seaport: Nuevitas (North), Santa Cruz del
Sur
75
Province of Las Tunas
Provincia: Las Tunas,
Tunas Population: 502,316
502 316
Capital: Las Tunas, Population: 128,441
Hospitals of Las Tunas
¾
¾Airports:
Hnos. Ameijeiras
¾Access: Central Hwy
Lines (Ramales)
¾ Seaport: Puerto Padre (North)
¾ Municipalities:
M i i liti 8
76
Province off Holguin
¾ Provincia: Holguin,
Holguin Population: 11,043,130
043 130
¾ Capital: Holguin, Population: 249,107
¾ Distance from Havana: 734 Kms.
¾ Hospitals of Holguin
¾ Means of Transportation Available:
¾Airport: Frank Pais (Intl) , Moa
¾Access: Central Hwy.
Lines (Ramales)
¾ Seaports: Gibara, Banes, Antilla, Mayari,
g de Tanamo
Moa,, Sagua
77
Province of Gran
nma (Bayamo)
Provincia: Granma,
Granma Population: 848,792
848 792
Capital: Bayamo, Population: 172,354
Hospitals of Granma
¾Airports: Sierra Maestra, Manzanillo
Carlos Manuel de Cespedes, Bayamo
¾Access: Granma Central Hwy
Lines (Ramales)
¾ Seaport:
S
t M
Manzanillo,
ill Campechuela
C
h l
78
Province of San
ntiago de Cuba
Provincia: Santiago de Cuba, Population:
1,043,622
,
,
Capital: Santiago de Cuba, Population: 419,846
Hospitals of Santiago de Cuba
¾ Airport: Antonio Maceo (Intl)
¾ Access: Santiago Central Hwy
Lines (Ramales)
¾ Seaport: Santiago de Cuba
79
Province of Guantanamo
G
Provincia: Guantanamo,
Guantanamo Population: 525
525,388
388
Capital: Guantanamo, Population: 209,691
Hospitals of Guantanamo
¾
¾Airports:
Mariana Grajales, GTMO Navy Base
¾ Access: Central Hwy (Guantanamo)
Lines (Ramales)
¾ Seaport: Caimaneras
¾ Municipalities:
M i i liti 10
80
81
PLURALISTIC
C MEDICINE
82
Experiencia del Miami Medical
M
Team Foundation
28 Años
Guerras
Desastres
Naturales
Experiencia
Miami Medical Team
Foundation
Nicaragua
Angola
g
Afganistan
Ciclones
Terremotos
Maremotos
Volcanes
America del Norte
America del Sur
Caribe
Africa
Asia
Europa
Refugiados
g
Masivos
Reco
onstrucciones
26 Paises
Balseros Cubanos
B l
Balseros
Haitianos
H iti
Nicaragua
P
Panama
Polonia
Rusia
Angola
83
Miami Medical Team Foundation
F
Experience
¾ Transformation of medicine in
i Nicaragua after the fall of the
Sandinistas,, since 1990.
¾ Visited, studied and worked in
n the“ sistema de seguro social “
(social security system) in Panama,
ama Nicaragua,
Nicaragua El Salvador
Salvador,
Costa Rica, Ecuador and Haitti, in the decade of the 90’s.
¾ Visited, studied and worked in
n the transformation of medicine
in Poland and Russia, since 19990.
¾ Visited and studied medical syystem in Finland and Sweden in
1993.
84
Miami Medical Team Foundation
F
Experience
¾ Visited and studied transformation of medicine in the Czech
Republic,
p
, Slovakia and Hungar
g ry
y in 1994.
¾ Visited and studied medical system in China in 1998.
¾ Consultations with Cuban mediical authorities in exile, about
Cuban medical system before 1959
959.
¾ Consultations with independentt groups of Cuban Physicians
and other health care workers inside
i
Cuba, to asses all the
needs and advises in order to acctualize a proper system for
restoration
t ti off a pluralistic
l li ti medi
diicine
i i in
i a democratic
d
ti Cuba.
C b
85
Actual Cubaan Medicine
¾MEDICINA DE LA NO
OMENCLATURA
Nomenclatu
ure Medicine
¾MEDICINA DE TURIISMO
Tourism Medicine
¾MEDICINA INTERNA
ACIONALISTA
Internationaalist Medicine
¾MEDICINA DE LA PO
OBLACION GENERAL
Population at Large
L
Medicine
86
How Is The Health Systtem In Cuba Organized
¾ Medicine to high ranking government
g
officers
(Nomenclature) members of the communist party and
(Nomenclature),
high ranking military officcers and their families in
specific state of the art hosspitals
¾ Medicine and tourism: dolllar paid medicine
medicine. For
services to foreigners in eliite hospitals.
¾ Hospitals and health centeers conditioned for state of
the art medical privileges.
p
g
87
How Is The Health Systeem In Cuba Organized
(Contin
nued)
¾International medical proggram: regular doctors and
health care providers are sent overseas with contracts
with other countries. Paym
ment in dollars from
government to governmentt. (The Cuban professional
is paid by the Cuban government at their usual
Cuban rate.
¾Medical care for the generral population. (General
Hospitals
p
lacking
g equipmen
q p nt and medications).
)
¾Cubans in exile and other countries supply
medications to relatives in Cuba.
88
¾ Well organized – It is logical to use the saame infrastructure and health personnel to
treat the population.
¾ Health System is organized in 43 Health Regions, then 332 areas (each area covers
25,000 to 35,000 p
people),
p ) then each area is
i divided in 40 sectors ((each sector covers
600 to 700 people).
¾ Number of medical and technical person
nnel:
Medical doctors:
70,000 - 74,000
Family Physicians:
15,000
Dentists:
9,000
Nurses:
120,000
Health technicians:
100,000
Other
Oth H
Health
lth workers:
k
100 000
100,00
¾ Health system facilities:
Hospitals:
City off Havana 36, Province of Havana
46, The rest of Cuba 202
Policlinics:
440
Blood banks:
22 (8 in
i the City of Havana)
Elderly homes:
182
Biotechnology centers: 12
89
Cuba – Health System Resources
R
(Continued)
¾Well organized – It is lo
ogical to use the same
infrastructure and heallth p
personnel to treat the
population.
¾Health System is organ
nized in 43 Health
Regions, then 332 areas (each area covers
25,000 to 35,000 peoplee), then each area is
divided in 40 sectors (eeach sector covers 600 to
700 people).
90
R
(Continued)
Cuban Health Sysstem Organization
43 Health Regions
g
332 Areas per Region (25,00
00 to 35,000 inhabitants)
40 Sectors p
per Area (600 to
o 700 inhabitants)
91
R
(Continued)
¾Number of medical and
d technical personnel:
Medical doctors:
72,000
Dentists:
9,000
Nurses:
N
120 000
120,000
Medical technicia
ans: 100,000
Health workers: 80,000 to 100,000
92
R
(Continued)
Professioonal Salaries
¾ Physicians Salaries:
Resident Physician: 300.00 Cuban Pesos/Month = $10.00
US Dollars
Family Physician: 350.00 Cuban
C
Pesos/Month = $11.67 US
Dollars
Specialist Physician: 400.000 Cuban Pesos/Month = $13.33
US Dollars
Teaching
T hi Physician:
Ph i i
400.00
400 00
0C
Cuban
b P
Pesos/Month
/M h = $13.33
$13 33
US Dollars
93
R
(Continued)
P f ionall Salaries
Professi
S l i
¾ Nurses Salaries:
General Nurses: 180.00 Cubban Pesos/Month = $6.00 US
Dollars
Licensed
Li
d Nurses:
N
300.00
300 00 C
Cu
uban
b Pesos/Month
P
/M h = $10.00
$10 00 US
Dollars
Night
Ni ht Guards:
G d 20.00
20 00 Cuban
C b Pesos/Night
P
/Ni ht
Administrative Personnel: 340.00 Cuban Pesos/Month =
$11 33 US Dollars
$11.33
94
R
(Continued)
¾Health system facilitiess:
Hospitals: 284 (C
City of Havana: 36,
Province of Havana: 46,
Thee rest of Cuba: 202)
Out-patient cliniccs:
440
Bl d b
Blood
banks:
k
22
Nursing homes:
182
Biotechnology cen
nters: 12
95
Biotechnologgical Centers
¾Center of Genetic Eng
gineering (Cubanacan)
¾BIOCEN – Vaccines (Bejucal)
¾Carlos Finlay Institutee – Vaccines (La Lisa)
¾Institute of Tropical Medicine
M
¾Center of Molecular Immunology
¾Institute of Zoology (R
Reparto Atabey)
96
Generall Budget
¾Physicians in general: 30
00.00 (Cuban Currency)
¾R id t Physicians:
¾Resident
Ph i i
3550.00
50 00 (C
(Cuban
b C
Currency))
¾Specialist Physicians: 40
¾Teaching Physicians: 40
¾Nurses

Nurses in general: 180.000 (Cuban Currency)
Licensed:
300 00 (Cuban Currency)
300.0
Night guards:
+20
Administrative personnel: +40
97
Organization of the Mediccine in a Democratic Cuba
((Pluralistic Medicine))
¾Ministry Of Health (M
MINSAL)
¾Institute Of Retiremen
nt And Socio-Medical
Security (IRSMS)
¾Central Administratioon Of Hospitals (CAH)
¾Private Medicine
¾Medicine of the Armed Forces
98
Organization of the Mediciine in a Democratic Cuba
(Pluralistic Medicine)
M
Introduction to new
n concepts
¾ Ambulatory Surgery
¾ Home Health Care
¾ Ambulatory Emergency Rooom (Casa de Socorro)
Socorro).
¾ Department Of Foreign Heealth Donations.
¾ Municipalities Brotherhood
d Program (Patronatos).
(Patronatos)
¾ National lottery for health, education and sports.
¾ Telemedicine Programs.
Programs
¾ Biological Waste Disposal.
99
Department Of Health
H
(MINSAL)
General Health Insurance
I
Ins
rance (GHI)
¾ Providing medical carre to:
Pooor People
Low
w Income Population
p
Disaabled
Rettirees Without Other Coverage
Citiizens Without Any Coverage
¾ Supervision Of:
Hosspices, Nursing Homes
Orp
phanages, Homes For Lepers,
Aid
ds, Tuberculosis, Etc.
100
H
(MINSAL)
¾Supervision of health policclinics providing care for GHI.
¾Ambulatory emergency rooom facilities (casas de
socorro): emergency facilitties strategically located in the
cities and towns, to reduce patient load to hospital
emergency
g y rooms.
¾Doctors employed by the national
n
health system will
receive salaries for their woork.
101
H
(MINSAL)
¾Doctors and Consultants sp
pecialists associated to the
national health system percceive no salaries but can
register and treat patients of
o (GHI) accepting only preestablished fees by the instiitution (MINSAL).
¾MINSAL will supervise graaduated medical and dental
students
t d t working
ki iin rurall areas.
a
¾Diagnostic tests and mediccines will be dispensed in pre
preestablished places.
¾Dental services as above.
102
H
(MINSAL)
¾Minsal will coordinate prrograms between private
and
d religious
li i
institutions
i tit ti
and
d national
ti
l and
d
or the population.
international donations fo
103
H
(MINSAL)
Health system in the field of hygiene and public health
I - Preventive Medicine:
¾Vaccination Programs
g
¾Campaigns Against: parasiites, tuberculosis, aids,
leprosy, etc.
¾Cancer Prophylaxis for maales and females.
¾Radio, TV, Newspapers Caampaign.
¾Health Education Program
m for children
children, Ministry of
Education in coordination with
w Ministry of Health
104
H
(MINSAL)
Health system in the field off hygiene and public health:
II - Enviromental Programss:
Biological waste
w
Regular waaste
Mosquito-iinsects-lice campaign
Water seweer
Water-sewe
¾MINSAL and the Central Administration of Hospitals
are responsible for high staandards for the care of
patients in hospitals and private centers in order to
qualify
lif for
f the
th coverage off Medicare
M di
and
d private
i t health
h lth
care insurances. (USA Stan
ndard)
105
Institute of Retirement an
nd Social-Medical Security
(IRS
SMS)
¾
¾
¾
¾
¾
Coverage for worker, wife and chhildren to age 18.
Other family members in the sam
me household will pay a premium.
Payments deducted equally from
m employer and employee.
Benefits: Health insurance, Retirrement plan.
H lth Insurance
Health
I
(IRSMS)
Medical and emergency assiistance
Hospitalization
Medications
¾ Compensation
p
Injury
j y Insurance ((Workers Compensation):
p
)
Will cover the worker in casse of an accident at work.
106
IRS
SMS
¾ Doctors employed by IRSMS will be assigned a salary.
¾ Can work in own office.
¾ Can work in other private health
h
organization.
¾ Doctors and Consultants speecialists associated to IRSMS
are registered physicians an
nd will care for patients
accepting a pre
pre-set
set fee
fee.
107
Private Health Orgganizations (PHO)
¾ Free access of patients and docctors to these Insurances.
¾ Agreement between Minsal-Cu
uban Medical and Dental
Associations and private insurers to adjust prices.
¾ Mutualistic Associations
¾ Private
P i
Medical
M di l Insurance
I
¾ Medical Clinics
¾ Private Medical Offices
¾ Workers Compensation Insuraance
108
Central Administration
n Of Hospitals (CAH)
Government owned hospittals can offer services to all
health agencies.
Personnel paid by CAH
Nursing
g
Staff Doctors
g y
Surgery
Emergency Room
y
Laboratory
Radiology
Rehabilitation
General Hospital
Employees
Pharmacy
109
Central Administration
n Of Hospitals (CAH)
Services To Cover
Personnel
GHI (MINSAL)
G
IR
RSMS
PRIVATE
IN
NSURANCES
PRIVATE SERVICES
3 Shifts of 8 Hours
110
Medicine Of The Armed Forces
The Armed Forces have their private hospitals
h
where they treat their own.
We envision a type of HMO which couuld be organized in the Armed
Forces hospitals to provide services to its active personnel and their
families and to its retirees and their fam
milies The following are considered
milies.
Armed Forces:
Army
Air Force
Navy
Coast Guard
Police
When these people are located in differrent cities, towns or the countryside,
they would use the services of their HM
MO hospitals
hospitals, those of the MINSAL
(Ministry of Health) or of the DGH (G
General Department of Hospitals).
Funding by: Ministryy of the Armed Forces
111
Bud
dget
¾ According to a 1999 Cuban govvernment report, the cost of
medicine was 1.8 billion pesos equal
e
to 22.3% of the national
budget.
¾ MINSAL: Assigned from natioonal budget. Tax on tourism to
be divided between health,, edu
ucation and sports.
p
¾ Department for International Health
H
Donations.
¾ National lottery for health, edu
ucation and sports.
¾ Donation
i programs sponsored by Cuban
C
Municipalities
i i i i in
i
e Exilio) are geared to the
Exile (Municipios de Cuba en el
respective municipalities in thee island.
¾ “Patronatos” programs.
112
Budget (C
Continued)
¾ General Health Insurance (MIINSAL): Provided by the
Government.
¾ IRSMS: Money provided by W
Workers and Employers.
Employers
¾ Private Insurance: Paid Byy Th
he People
p
¾ Central Administration Hospitals: will provide services to
MINSAL, IRSMS and Privatee Sector and will be reimbursed
by those agencies.
113
114
IN SITU HOSPIT
TAL INSPECTION
& EVAL
LUATION
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
Biblioggraphy
¾ Brian Bell and Bob Heyman: "Clinical
Clinical Cuba. Images of the Cuban Health
System".
90.
¾ Nursing Standard Vol. 4, #30, USA 199
¾ Juan Clark, "Cuba: Mito y Realidad. Teestimonios de un pueblo".
¾ Jose A. Albertini, "Miami Medical Team
m. Testimonio de Humanidad",
Ediciones Saeta, 1992
¾ Organizacion Mundial de la Salud (World Health Organization), Statistical
Annual, Ginebra, Suiza.
¾ Planos de Cuba, Freytag and Berndt.
¾ Fodor's Cuba, 1997
¾ Cuba Official Guide, A. Gerald Gravettte, 1993
¾ Institute for Cuban and Cuban-Americaan Studies, "Cuban Transition Project",
University of Miami
¾ Andrew S. Natsios, "Humanitarian Assistance During a Democratic Transition
in Cuba"
Cuba .
¾ Mapas de Cuba sacados de un Mapa dee “La Moderna Poesia, Inc.”.
Notes: All the Numerical figures in thiss presentation are approximate and
subject to change.
152
153
154
155
OPERATIONS CENTER MIAMI
Organization Diagram
OPERATIONS CENTER CUBA
PROVINCIAL OPERATIONS CENTERS
C
RECEPTION
COMMITTEE
WAREHOUSES
CHURCHES
MASONS
CIVIC ORG
DISSIDENTS
PROVINCES
MUNICIPALITIES
REPRESENTATIVES
C.H.O.
PHYSICIANS
HEALTH
MINISTRY
RAILROAD
D
HIGHWAY
YS
MI-8
SECURITY
WAREHOUSES
TRANSPOR
T
CITIES
CITIES
TOWNS
TRANSPOR
RT
TOWNS
PROVINCIAL
HOSPITAL
PERSONNEL
PRESS
T.V.
RADIO
NEWSPAPE
R
COMMUNICATIONS
NATIONAL
PROVINCIA
L
CITIES
TOWNS
CHURCHES
TEMPLES
DISTRIBUTION
GENERAL HOSP
PARISHES
RURAL HOSP
LODGES
POLYCLINICS
SCHOOLS
156
Organizatioon Diagram
FEDERAL, STATE, COUNTY,
C
CITY,
CIVIC & RELIGIOUS ORGANIZATIONS
O
FOUNDATION
NS, ETC.
EUROPE
OPERATIONS
S
CENTER
MIAMI
(OCM)
COMPUTER
CONTROL
CENTER
WAREHOUSING
&
PACKING
LATIN AMERICA
TRANSPORT
(AIR & SEA)
REPRESENTATIVES
OF EXILED
ORGANIZATIONS
SECURITY
MUNICIPALITIES
MASONS
LIONS
ROTARIES
MEDICAL ORG
ORG.
CIVIC ORG.
KIWANIS
PARAMILITARY
INFORMATION
&
PRESS
OPERATIONS
S
CENTER
CUBA
(OCC)
RECEPTION
COMMITTEE
WAREHOUSES
TRANSPORT
T
&
DISTRIBUTIO
ON
SECURITY
PRESS
&
COMMUNICATIONS
157
OPERATIONS CENTER
R MIAMI
OPERATIONS CENTER
R CUBA
C
Reception
Committee
Warehouses
Churches
Masons
Civic Org.
Dissidents
Municipalities
Representatives
C.H.O.
Physicians
Health
Ministry
Security
Press
Railroad
Highway
MI-8
Warehouses
TV
Transport
Radio
Personnel
Newspaper
Cities
Cities
Towns
Transporrt
Towns
Provincial
Hospital
Communications
National
Provincial
Cities
Towns
Churches
Temples
Distribution
General
Hospital
Parishes
Rural Hosp
Lodges
Polyclinics
Schools
158
OPERATIONS CENTER MIAMI
Organization Diagram
OPERATIONS CENTER CUBA
C
RECEPTION
COMMITTEE
WAREHOUSES
CHURCHES
MASONS
CIVIC ORG
DISSIDENTS
PROVINCES
MUNICIPALITIES
REPRESENTATIVES
C.H.O.
PHYSICIANS
HEALTH
MINISTRY
RAILROAD
D
HIGHWAY
YS
MI-8
SECURITY
WAREHOUSES
TRANSPOR
T
CITIES
CITIES
TOWNS
TRANSPOR
RT
TOWNS
PROVINCIAL
HOSPITAL
PERSONNEL
PRESS
T.V.
RADIO
NEWSPAPE
R
COMMUNICATIONS
NATIONAL
PROVINCIA
L
CITIES
TOWNS
CHURCHES
TEMPLES
DISTRIBUTION
GENERAL HOSP
PARISHES
RURAL HOSP
LODGES
POLYCLINICS
SCHOOLS
159
FEDERAL, STATE, COUNTY, CITY,
CIVIC & RELIGIOUS ORGANIZ
ZATIONS
FOUNDATIONS, ETC.
EUROPE
OPERATIONS
CENTER
MIAMI
(OCM)
COMPUTER
CONTROL
CENTER
WAREHOUSING
&
PACKING
L
LATIN
AMERICA
TRANSPORT
(AIR & SEA)
REPRESENTATIVES
OF EXILED
ORGANIZATIONS
SECURITY
MUNICIPALITIES
MASONS
LIONS
ROTARIES
MEDICAL ORG.
CIVIC ORG.
KIWANIS
PARAMILITARY
INFORMATION
&
PRESS
OPERATIONS
CENTER
CUBA
((OCC))
RECEPTION
COMMITTEE
WAREHOUSES
TRANSPORT
&
DISTRIBUTION
SECURITY
PRESS
&
COMMUNICATIONS
160
Organizatioon Diagram
FEDERAL, STATE, COUNTY,
C
CITY,
CIVIC & RELIGIOUS ORGANIZATIONS
O
FOUNDATION
NS, ETC.
EUROPE
OPERATIONS
S
CENTER
MIAMI
(OCM)
COMPUTER
CONTROL
CENTER
WAREHOUSING
&
PACKING
LATIN AMERICA
TRANSPORT
(AIR & SEA)
REPRESENTATIVES
OF EXILED
ORGANIZATIONS
SECURITY
MUNICIPALITIES
MASONS
LIONS
ROTARIES
MEDICAL ORG
ORG.
CIVIC ORG.
KIWANIS
PARAMILITARY
INFORMATION
&
PRESS
OPERATIONS
S
CENTER
CUBA
(OCC)
RECEPTION
COMMITTEE
WAREHOUSES
TRANSPORT
T
&
DISTRIBUTIO
ON
SECURITY
PRESS
&
COMMUNICATIONS
161