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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.

This is something that I have felt and suffered both as a man and as a doctor. When I have gone to the shantytowns to see the working women, these proletarian mothers, shouting our slogans with hope and I realize, with sadness, that their mouths all lack teeth.

And children also suffer this. On the basis of only these simple examples, we have to understand that when we talk about an involved university, we are not only talking of a university that understands that in order to end this brutal reality that has weighed heavily on us for more than a century and a half, the economic changes will require professional people involved with social change. The future is going to require a professional who is not going to feel superior because his parents had enough money to send him to college. We need a professional with social awareness who understands that his fight--if he is an architect--is a fight for the construction of housing that the poor people need. We need a professional who, if he is a physician, raises his voice to demand that medicine will reach the poor neighborhoods and into the countryside.

WE NEED professionals who are not looking to fatten themselves on the public payroll in the capitals of our countries. We need professionals who go to the provinces, who immerse themselves in the provinces.

I speak here in the University of Guadalajara, which is a university in the forefront, and I am certain that you will do your patriotic obligation and work in the provinces, working with miners, industrial workers and peasants. The obligation of one who studied here is not to forget that this is a state university, which is maintained by the taxpayers, of whom the great majority are workers. And disgracefully, in this university as in the universities of my country, the number of sons and daughters of peasants and workers is still at a low level.

To be young at this time implies a great responsibility; to be young in Mexico or Chile; to be young in Latin America; a continent that, as I have explained, is a young continent in terms of the average age of its inhabitants. Youth must understand its historical responsibility; it must understand that there is no struggle between generations, as I told you a moment ago, that there is a social confrontation, which is very different. Youth can be on the same barricades in this social confrontation with those of us who are older--I am slightly more than 60, please keep my secret. People older than 60 and youths of 18 or 20 can be together.

There is no quarrel between generations, and it is important that I say this. Besides, a young person must understand the responsibility of being young, and if he is a student, must realize that there are other young people the same age who are not students. And if he is a college student, he must consider the young peasant and the young worker. He must speak the language of youth, not only the language of college students, to other college students.

HE WHO IS A student has an obligation because he has better opportunities to understand economic and social events and the reality of the world; he has the obligation to be a dynamic factor in the process of change; but he cannot lose the details of the overall reality during that change.

Revolution does not pass through the university; and this should be understood; revolution passes through the great masses; revolution is made by the people; revolution is made, essentially, by the workers.

I share the thinking that has been expressed here--and President Echeverria has mentioned this many times--and I have said it in my country. There we struggle for changes within the framework of bourgeois democracy, with much bigger difficulties in our case--the Judiciary, Parliament and the Executive. The workers who elected me are the Government; we control one part of the Executive power, we are a minority in the Congress. The Judiciary system is autonomous and our Civil Code is 100 years old. If I don't criticize the judicial system while at home, I am hardly going to do that here. But obviously those laws represent another epoch and another reality. They were not laws made by the workers who are now in the government; they were made by the sectors of the upper-class that controlled the Executive, the economic power, and that are still a majority in the national Congress.

HOWEVER, Chilean reality, its history and its idiosyncracies, its characteristics, the strength of its institutions, led us political leaders to understand that in Chile we had no other way to change but through an electoral struggle. And we won through that way, although many questioned our tactics. The guerrilla struggle and the popular army came to prominence in this continent after the Cuban Revolution, but there are tactical divergences that are not always understood.

My experiences are worthwhile. I am a friend of Cuba; I have been friends, for 10 years, with Fidel Castro, I was a friend of comandante Ernesto "Che" Guevara. He gave me the second copy of his book Guerrilla War, the first one was given to Fidel. I was in Cuba when it appeared, and in the dedication, he wrote the following. "To Salvador Allende, who by other means tries to obtain the same ends. If comandante Guevara signed the dedication in this way, it is because he was a man of broad spirit who understood that every nation has its own reality; that there is no recipe to make revolutions. And in addition, the theoreticians of Marxism--and I declare that I am an apprentice only, but I do not deny the fact that I am a Marxist--also show with clarity the different ways that can be followed in each society, in each country.

FOR THAT REASON, it is useful that the youth, especially university students who cannot pass through the university ignoring the problems of its people, understand that one cannot teach doctrine by mouthing doctrine; they must understand that the dense thinking of the theoreticians of the economic and sociological currents requires serious study. It is true that there is no revolutionary action without revolutionary theory and there cannot be a voluntary application or interpretation of the theory arranged to accommodate what the youth or the young man wants. The youth must look at what is happening in his country and beyond its frontiers and understand that there are social realities that demand deep thinking and analysis.

When some groups in my country, who are somewhat to the left of Popular Unity, made up of young companeros in whose revolutionary loyalty I believe, but in whose conception of the social reality I do not believe, say, for instance, that in my country the same tactics should be used that have been successful in other countries that have reached socialism, I have asked them the following question in a loud voice, 'Why, for instance, has a country like the People's Republic of China, a powerful country, an extraordinarily powerful country, had to tolerate the reality that Taiwan is in the hands of Chaing Kai-shek? Is it because the People's Republic of China does not have weapons sufficiently powerful in order to have, in two minutes, recovered Taiwan? Why hasn't China done this? Because, undoubtedly, there are more important problems of political responsibility; because acting so, the People's Republic of China could be charged with aggression that could damage the revolutionary process and perhaps touch off a worldwide conflict.

Who can doubt the will to act, the decisiveness and the revolutionary conscience of Fidel Castro? And why has he not taken back Guantanamo Bay from the United States? Because he cannot and should not do it; and he cannot do it because he will expose his revolution and his country to a brutal retaliation.

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