President Allende Speaks On Health Care

SALVADOR ALLENDE was trained as a medical doctor, and he never abandoned the doctor's sense of compassion and concern. But, as he explains in this section of his speech, he went beyond the narrow conception of a physician's duties, and located the cause of the misery of the Chilean people in the social system. He looked for a cure, and came to embrace socialism.

Allende is speaking here to students at the University of Guadalajara in Mexico, urging them to follow him in abandoning middle-class professional careers and working with the people. He urges them to accept a broader conception of their responsibilities.

This speech, delivered in December 1972, was translated by Juan G. Duran, assistant professor of Romance Languages and Literatures, and Daniel Swanson. This is Part II: part III will appear Wednesday.

THE CASE OF MY country is eloquent: between the large mines--which had been in the hands of foreign capital--and the small and medium mines, we produced altogether close to 750,000 tons of copper. Zambia, Peru, Zaire and Chile--these four countries produce 70 per cent of the copper that is traded in the world, more than 3,000,000 tons per year. But copper prices are set in the London metal markets. Chile, three years ago for instance, got an average price for copper yearly of more than 62 cents per pound, and each cent that the price goes up or down means 18 million dollars more or less in income for our country.

In 1971, the last year of President Frie's government, the copper price was 59. In the first year of the Popular Government it was only 49, less than 49. This year, it probably will not go higher than 47.4; but in real value, after the devaluation of the dollar, this average will be, at most, 45. And our cost of production--despite that fact that our mines have a high mineral content and are close to the ocean for easy transport--is around 45 cents in some of them; it is, of course, higher in the small and medium mines due to inferior production technology.


I have given this example because it is very clear. We, who have foreign currency reserves superior to that in many Latin American countries, who have land that could feed, and should feed, 20 or 25 million people, we have had to import, since always--no one remembers when it started--meat, wheat, lard, butter and cooking oil: 200 million dollars a year.

And since we, the Popular Government, took office, we have to import more food; because we feel deeply that even importing--as did previous governments--200 million dollars yearly is not enough, because in Chile 48 per cent of the population was suffering from malnutrition.

AND HERE, in this place of brothers, I, who am a doctor, who has been a professor of social medicine and president of the Chilean Medical Association for five years, can give you a figure that doesn't embarrass me, but causes me pain. In my country--because there are statistics and we don't hide it--there are 600,000 children that have a lower than normal mental development. If a child in the first eight months of his life does not receive the necessary protein for his physical and mental growth, if that child doesn't receive that protein, he is going to develop in a different way from the child who was able to get it. The child who receives the necessary protein is almost always the child of a privileged group, of an economically powerful group. If that child who didn't receive sufficient protein, if he is given it after eight months, he is able to recover and normalize the growth of his body, but he is not able to reach the full development of his mind.

For that reason many times in their great work school teachers--I always associate teachers with doctors as professionals with great responsibility--many times teachers will see a child who does not assimilate, who does not understand, who does not learn, who does not remember. It is not because that child does not want to learn or study: it is because he grew up in disadvantaged conditions and that is the result of a social system; because, tragically, even the development of the mind is touched by the ingestion of food, fundamentally touched during the first eight months of life. Working-class mothers are not able to feed their children: we doctors know that the best food is the mother's milk and she is not able to give it because she lives in a shantytown on the edge of existence, because her husband is unemployed and because she also is under-nourished.

AS A MOTHER, she is not only oppressed in her life, but what is more unjust, in the life of her children.

Progressive governments, like ours, initiate social welfare programs, but undoubtedly they are only palliatives. For instance, in my country, we have the familiar pre-natal subsidy paid to the pregnant woman. Beginning in the fifth month of pregnancy, she will receive the money from the fifth month after it can be proved that she is really pregnant. The subsidy has a double objective: it is given to the mother in the hope that her own nourishment will be better, and, also, it allows her to buy clothes for the infant.

On the other hand, in order to receive this subsidy, which is in addition to the mother's salary, she must have medical supervision, and therefore the subsidy acts as an incentive for her to seek pre-natal care. And in some cases, if the mother is sick, and she is treated soon enough, the child will be born healthy. Moreover, she is given the most elementary instructions about child-care. We have also the family subsidy which is paid from birth until the child finishes school, if he goes to school.

But we have not been able to equalize the family subsidy, because a Congress which does not represent the majority of workers, established, as always, discriminatory laws. In my country the subsidies differed among bank employees, civil service employees, clerks in private enterprises, soldiers, workers and peasants. We propose the just idea: one equal family subsidy for all--with generosity. That the family subsidy is higher for people despite their higher incomes is unconscionable and a brutal injustice.

WE HAVE SUCCEEDED in equalizing the family subsidy for workers, peasants, soldiers and public employees, but is still far below the subsidies going to the employees of private industry. It is an advance, but it is not enough. We are providing for better conditions to protect the infant, but the successes in this program only emphasize our lack of enough medical professionals to give attention to all the people from a medical point of view.

There are 4600 doctors in Chile: there should be 8000 of us. Chile, then, lacks 3000 physicians. Chile also lacks more than 6000 dentists. There is no country in Latin America--and I speak with absolute certainty--there is not a single state medical service that provides adequate dental care. The service is limited in our countries, if they have it at all, to the simple, basic elementary process of extraction.