From the Archive | On revolutionary medicine
Revolutionary physician Ernesto ‘Che’ Guevara, who died this month 53 years ago, speaks about what healthcare looks like for a liberated people.
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15 October 2020
Ernesto ‘Che’ Guevara became a revolutionary after witnessing people’s dispossession as he travelled through South America. In Cuba, he became a prominent insurgent, helping to bring about the revolution there before moving on to the Congo, and then Bolivia. He was captured in Bolivia where the Central Intelligence Agency used proxies to execute him in 1967.
This is a lightly edited excerpt from a speech Guevara gave on 19 August 1960 to the Cuban militia.
This simple celebration, another among the hundreds of public functions with which the Cuban people daily celebrate their liberty, the progress of all their revolutionary laws, and their advances along the road to complete independence, is of special interest to me.
Almost everyone knows that years ago I began my career as a doctor. And when I began as a doctor, when I began to study medicine, the majority of the concepts I have today, as a revolutionary, were absent from my store of ideals.
Like everyone, I wanted to succeed. I dreamed of becoming a famous medical research scientist; I dreamed of working indefatigably to discover something which would be used to help humanity, but which signified a personal triumph for me. I was, as we all are, a child of my environment.
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After graduation, due to special circumstances and perhaps also to my character, I began to travel throughout America, and I became acquainted with all of it. Except for Haiti and Santo Domingo, I have visited, to some extent, all the other Latin American countries. Because of the circumstances in which I travelled, first as a student and later as a doctor, I came into close contact with poverty, hunger and disease; with the inability to treat a child because of lack of money; with the stupefaction provoked by the continual hunger and punishment, to the point that a father can accept the loss of a son as an unimportant accident, as occurs often in the downtrodden classes of our American homeland. And I began to realise at that time that there were things that were almost as important to me as becoming famous or making a significant contribution to medical science: I wanted to help those people.
But I continued to be, as we all continue to be always, a child of my environment, and I wanted to help those people with my own personal efforts. I had already travelled a great deal – I was in Guatemala at the time, the Guatemala of Arbenz – and I had begun to make some notes to guide the conduct of the revolutionary doctor. I began to investigate what was needed to be a revolutionary doctor.
However, aggression broke out, the aggression unleashed by the United Fruit Company, the Department of State, Foster Dulles – in reality the same thing – and their puppet, called Castillo Armas. The aggression was successful, since the people had not achieved the level of maturity of the other Cuban people of today. One fine day, a day like any other, I took the road of exile, or at least, I took the road of flight from Guatemala, since that was not my country.
Then I realised a fundamental thing: For one to be a revolutionary doctor or to be a revolutionary at all, there must first be a revolution. Isolated individual endeavour, for all its purity of ideals, is of no use, and the desire to sacrifice an entire lifetime to the noblest of ideals serves no purpose if one works alone, solitarily, in some corner of America, fighting against adverse governments and social conditions which prevent progress. To create a revolution, one must have what there is in Cuba – the mobilisation of a whole people, who learn by the use of arms and the exercise of militant unity to understand the value of arms and the value of unity.
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And now we have come to the nucleus of the problem we have before us at this time. Today one finally has the right and even the duty to be, above all things, a revolutionary doctor, that is to say a man who utilises the technical knowledge of his profession in the service of the revolution and the people. But now old questions reappear: How does one actually carry out a work of social welfare? How does one unite individual endeavour with the needs of society?
We must review again each of our lives, what we did and thought as doctors, or in any function of public health before the revolution. We must do this with profound critical zeal and arrive finally at the conclusion that almost everything we thought and felt in that past period ought to be deposited in an archive, and a new type of human being created. If each one of us expends his maximum effort towards the perfection of that new human type, it will be much easier for the people to create him and let him be the example of the new Cuba.
It is good that I emphasise for you, the inhabitants of Havana who are present here, this idea; in Cuba a new type of man is being created, whom we cannot fully appreciate here in the capital, but who is found in every corner of the country. Those of you who went to the Sierra Maestra on 26 July must have seen two completely unknown things. First, an army with hoes and pickaxes, an army whose greatest pride is to parade in the patriotic festivals of Oreinte with hoes and axes raised, while their military comrades march with rifles. But you must have seen something even more important. You must have seen children whose physical constitutions appeared to be those of eight or nine-year-olds, yet almost all of whom are 13 or 14. They are the most authentic children of the Sierra Maestra, the most authentic offspring of hunger and misery. They are the creatures of malnutrition.
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In this tiny Cuba, with its four or five television channels and hundreds of radio stations, with all the advances of modern science, when those children arrived at school for the first time at night and saw the electric light bulbs, they exclaimed that the stars were very low that night. And those children, some of whom you must have seen, are learning in collective schools skills ranging from reading to trades, and even the very difficult science of becoming revolutionaries.
Those are the new humans being born in Cuba. They are being born in isolated areas, in different parts of the Sierra Maestra, and also in the cooperatives and work centres. All this has a lot to do with the theme of our talk today, the integration of the physician or any other medical worker, into the revolutionary movement. The task of educating and feeding youngsters, the task of educating the army, the task of distributing the lands of the former absentee landlords to those who laboured every day upon that same land without receiving its benefits, are accomplishments of social medicine which have been performed in Cuba.
The principle upon which the fight against disease should be based is the creation of a robust body; but not the creation of a robust body by the artistic work of a doctor upon a weak organism; rather, the creation of a robust body with the work of the whole collectivity, upon the entire social collectivity.
Some day, therefore, medicine will have to convert itself into a science that serves to prevent disease and orients the public toward carrying out its medical duties. Medicine should only intervene in cases of extreme urgency, to perform surgery or something else which lies outside the skills of the people of the new society we are creating.
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The work that today is entrusted to the Ministry of Health and similar organisations is to provide public health services for the greatest possible number of persons, institute a programme of preventive medicine and orient the public to the performance of hygienic practices.
But for this task of organisation, as for all the revolutionary tasks, fundamentally it is the individual who is needed. The revolution does not, as some claim, standardise the collective will and the collective initiative. On the contrary, it liberates man’s individual talent. What the revolution does is orient that talent. And our task now is to orient the creative abilities of all medical professionals toward the tasks of social medicine.
We are at the end of an era, and not only here in Cuba. No matter what is hoped or said to the contrary, the form of capitalism we have known, in which we were raised, and under which we have suffered, is being defeated all over the world. The monopolies are being overthrown; collective science is scoring new and important triumphs daily. In the Americas we have had the proud and devoted duty to be the vanguard of a movement of liberation which began a long time ago on the other subjugated continents, Africa and Asia. Such a profound social change demands equally profound changes in the mental structure of the people.
