Friday, November 14, 2008

Fidel´s WMDs versus Bush´s WMDs - World Medical Doctors are more powerful than Weapons of Mass Destruction

(originally written in June of 2007)
This is a confrontation that has been brewing for 45 years: the United States versus
Cuba. George W. Bush and Dick Cheney have been acting more and more belligerent, as if they believed that their WMDs, the most deadly collection of "weapons of mass destruction" in the world, are superior to Cuba's own brand of WMDs.

What the North Americans ignore, at their peril, is that Cuba's WMDs are "World Medical Doctors," an incomparable force for peaceful cooperation that is winning the admiration of people the world over (except in the United States, where almost everyone, including the media, is unaware of their existence.) How can the U.S. assortment of nuclear and biological warheads compete with tens of thousands of highly trained, humanitarian physicians?

One example of a superior weapon
One of the Cuban WMDs is a young ophthamologist working at a Barrio Adentro 2 diagnostic clinic in the town of Sanare in the mountains of Venezuela. Dr. Eulogio (his first name – all the patients seem to call the Cuban doctors by their first names) is one of over 30,000 medical professionals who are currently serving people outside of Cuba, and 20,000 of them in Venezuela alone. In January of 2007, he and his older colleague, Dr. Frank, spent about six hours talking about medical care and medical education.

The Cuban doctors are treating thousands of people each month at the various Barrio Adentro sites around Sanare. There are several small neighborhood medical offices that treat outpatients, and one new diagnostic clinic that has an intensive care unit and medical specialists, plus MRI and X-ray equipment.

But they also have another job – training the doctors who will one day replace them. At present 42 local residents of the municipality are going to medical school through an intensive training program known as “integral community medicine.”

Dr. Frank has four second-year students who follow him around on his medical rounds and appointments during the week, observing diagnosis and care while discussing physiology and pathology that are pertinent to their current studies. Their afternoons are spent in intensive classes which include CDs designed by the best professors at medical schools in Cuba. The CDs are available for the students to watch as many times as they like, allowing them to review the information and concepts in the lectures with local instructors such as Dr. Frank.

In January of 2007, Dr. Frank spent hours talking to three students from the Dickinson College in Pennsylvania about the concepts and practice of medical care and education in Cuba and Venezuela.

After studying six days a week for six years, these students will become family physicians who will treat everyone in this agricultural area. If, at some point, they want to become specialists, they would have to do another three years of study and residency.

Some of the local students recently completed high school and others, like Juan, are more than twice their age. A forty-seven year-old man in his second year of training, Juan says that he dreamed of going to medical school over twenty years ago but that was financially impossible for him and his family, so he worked for years as a nursing assistant in a local physician’s office. While he gets a small scholarship while completing his studies, Jose says he is only able to pursue his medical career because of strong financial and moral support from his wife and their extended families.

This physicians’ training program is being implemented nationwide on a huge scale, so that by 2012 there will be 23,000 new doctors in Venezuela, all educated to provide medical care in their home towns and barrios. Some of these physicians will undoubtedly become WMDs, or World Medical Doctors, and will be available to join their Cuban counterparts in deployment to Latin America and other parts of the globe.

Dr. Frank and Dr. Eulogio say that the Venezuelan students are the beneficiaries of a “revolution within the revolution” in Cuba, where the system of education is being radically changed. In Cuba, too, doctors are now being trained differently, and are starting go on rounds to see patients in their first year like in Venezuela, rather than in the fourth year as in the past. Other kinds of educational progress are also evident; for instance, increasing quality of primary and secondary schools, where class sizes are being reduced to 15-20 students per teacher.

The doctors think the scholastic achievements of their Venezuelan students are impressive, but they emphasized something else: “What is even more satisfying for us to see is the creation of moral and ethical values that allow them to really influence their own communities.”

I told the two doctors that I had talked to several people in the waiting room downstairs who were very happy with their care at Barrio Adentro II. They felt comfortable because the Cubans treated them as equals and enjoyed answering questions and chatting with them. During the lengthy time I spent talking with Dr. Frank and Dr. Eulogio, many people banged on the door and stuck their heads in just to say “Hi!”

“I think we and our students are creating a new model of what a medical professional is supposed to be,” explained Dr. Eulogio. “The old Venezuelan stereotype of a doctor, at least in the cities, was somebody driving around in a fancy car with black windows and air-conditioning. So nobody knows who they are -- people only get to see them in their offices if they can pay.”

One of the people responsible for this extraordinary investment in human capital is Dester Rodriguez, a military general and a director of PDVSA, the Venezuelan national oil company. He is responsible for overseeing the billions of dollars of oil profits that are channeled directly from PDVSA into the “misiones,” the social missions that are designed to lift the majority of Venezuelans out of poverty. He likes the idea that he is financing ultra-sophisticated human weaponry, but he doesn't refer to them as WMDs. He puts them in a category "more powerful than atomic weapons" and calls them "missiles of love." [see article on “Sowing the Oil”]

Fighting capital with human capital – the battle of WMDs is a “Battle of Ideas”

After the Soviet Union collapsed in 1989, the United States and George Bush the Elder announced that there was a “New World Order.” They expected to impose a global capitalist regime that would allow no room for any small, revolutionary nations like Cuba. The U.S. economic blockade had damaged Cuba in previous decades, but in the 1990s it became much more devastating because the Cubans no longer engaged in significant trade with the Eastern Europe and Russia. The Cuban economy sank into a true depression and the production of goods and services fell by at least 30%. The nation struggled to feed its people, and only by imposing strict food rationing did it prevent the health of its children from deteriorating. The capitalist world waited for Cuba to collapse.

When Cuba invigorated its tourist industry in a effort to attract dollars and euros into their economy, it did not allow capitalist values to overwhelm revolutionary values. But it wasn’t easy, particularly since some people working in the tourist industry were earning a lot more than professionals in various kinds of public and social service jobs.

Cubans decided to emphasize the kinds of social solidarity and humanistic concern for other people that distinguishes their society, and to contrast them with the materialistic and self-centered behavior that characterize advanced capitalist societies. When Fidel Castro addressed the nation on May Day in 2000, he told the Cuban people that Cuba would survive by engaging in a Battle of Ideas: "Our consciousness and the ideas sown by the Revolution throughout more than four decades have been our weapons. Revolution means …being treated and treating others like human beings ….it is challenging powerful dominant forces from within and without the social and national milieu …. it is a profound conviction that there is no power in the world that can crush the power of truth and ideas.¨

Interviewed four years later, Abel Prieto, the Cuban Minister of Culture, expanded on this theme and explained why the Battle of Ideas was connected to Cuba’s programs of international medical assistance. “… in contrast to the stupidity, barbarity and the law of the strongest that today intends to impose itself worldwide, we try to defend the idea that another world is possible. Against the neo-liberal model, this fierce version of capitalism that reserves for a small minority the luxury of consumerism and excludes ¾ of the population of the world, we propose the defense of the values of social justice and authentic democracy. We believe that what should be globalized are not bombs or hatred but peace, solidarity, health, education for all, culture, etc. That is why, when our physicians go to help in other countries, although their mission is to work for medical attention, they are also bearers of our values and our ideas of solidarity. This is the essence of the Battle of Ideas.”

As the United States has kept expending its energy and hundreds of billions of dollars on neo-colonial wars, it did little to engage the Cubans on the philosophical battlefield. Some State Department figures weakly declared in 2005 that the U.S. wanted to engage in its own “battle of ideas,” without pointing out that the Cubans had defined the terrain of the battlefield five years earlier.

There were some efforts at genuine humanitarian assistance by the U.S., such as military helicopters delivering medical aid to Pakistan in the wake of a terrible earthquake in late 2005. In 2007 the State Department played up the visit of a U.S. hospital ship to Panama where it dispensed free medical care. But these efforts paled beside he much more extensive aid that Cuba dispensed to Pakistan (1,500 doctors and nurses living in wintry conditions they had never experienced before) and to Latin America and the rest of the world.

Cuba has more than 45,000 students studying medicine, almost 20,000 of them coming from poor parts of Latin America and Africa (as well as a handful of students who come from poverty-stricken areas of the United States.) The U.S.A., almost thirty times bigger in population than Cuba, and hundreds of times greater in material wealth, has roughly 64,000 students in medical school.

For a refreshing look at the practice of Cuban medicine and medical education as they affect many parts of the world, see the feature-length film, Salud, directed by Connie Field. She is a veteran documentary film-maker who was previously nominated for an Academy Award for Rosie the Riveter, the story of working women in the U.S. during World War II.

Thursday, November 13, 2008

WMDs -- World Medical Doctors – now being produced in Venezuela (WMDs Part 2)

(originally written in October of 2007)

Jonas, left, with his brother and his father
Jonas lives on a tiny dairy farm on the hill above Monte Carmelo. His father is intensely proud that his son is studying to be a medical doctor. “He’s only in his second year,” he said, “and already he sees patients.”

“Remember, Papá,” cautioned Jonas, “we do see the patients and talk to them, but we don’t treat them yet. We’re just there to observe and assist our teachers and ask questions.”

“I know that,” his father responded. “What I mean is that it’s important that all of you are learning to talk to the patients, treating them like friends and fellow human beings.”

Jonas is not the first person in his extended family to attend medical school, according to his father. He tells the story of his niece, who many years ago dreamed of being a doctor. Her mother, who was very poor, worked constantly to save every penny and told her daughter to study hard. The extended family pitched in to help the mother.

“She really did go to medical school,” explained Jonas’ father, “at one of the big city universities. Then she her got her training in a specialty, and now sees lives and sees her patients in a rich neighborhood of Caracas. Of course, now, as far as she’s concerned, I don’t exist. In fact, my niece doesn’t want to associate with anyone in the family and doesn’t talk to any of us.”

This is why the government has introduced a totally new system of teaching doctors. The old system, centered around elite universities where only a tiny minority of poor and working class students are enrolled, has continued to turn out professionals who want to work in the urban centers and enjoy a fairly rich, upper-middle class lifestyle. These kinds of universities, home to many of the students who are currently protesting against the constitutional reforms, are not unique to Venezuela, for their counterparts exist all over the world.

The Venezuelan government has avoided the temptation to abruptly seize control of these older universities and force them to operate in a manner that serves the poor majority. Instead, it has simply bypassed them and constructed a new kind of university.

Where is this university? All over Venezuela, because it exists in the realm of ideas, not in a particular set of buildings. The Mission Sucre school of Integral Community Medicine trains students where they live, utilizing the local medical facilities and doctors in their towns and neighborhoods as the campus and professors. The students enter with the expectation that they are choosing a vocation that involves serving the people and their home communities after they finish their training.

This unique form of education could not exist without Cuban doctors. They arrived by the thousands to staff the Barrio Adentro neighborhood medical offices that sprouted up all over the country in 2003 and 2004 and brought free health care to poor barrios and rural areas that had neglected for many decades. The Cubans are helped by a four or five thousand Venezuelan doctors who were trained in the old system, but for reasons of social commitment and political conviction have chosen to work with the poor.

Party time for medical studentsAfter dancing, Doctor Barbara, takes a break at the feet of her students, Magale, Antonio, and Luisa.About a month ago Jonas invited me to walk up the mountain to his house where I joined him and his fellow students for a little rest and relaxation. It was Sunday, time for a little music and dancing, plus sitting and chatting and enjoying the view over the valley below. Barbara, the dynamic Cuban physician who holds the students to a rigorous schedule the other six days of the week, took charge of the family kitchen and prepared a big pot of tasty stew.

All of the students are residents of some part of the municipality surrounding Sanare (comparable to a county in the U.S.) and are enrolled in the second or third year of the Mission Sucre medical program (also see earlier article, Fidel’s WMDs) Their Cuban and Venezuelan teachers work in local “ambulatorios” (free public walk-in facilities in various neighborhoods and villages) or in the Barrio Adentro 2 Diagnostic Clinic in the middle of Sanare.

The medical career is demanding. After completing six months of classroom preparation to make sure everyone is starting out on an equal footing, the students commit themselves to a six-year program. Beginning in the very first year, the students are spending part of each day with patients in medical settings. They spend their mornings accompanying doctors as they see patients and offer treatments, looking after medical records and medications, weighing and measuring babies and children while the doctors attend to the rest of the family. Their afternoons are spent in the classrooms. Nights are for study, reviewing CDs that cover the material of each class lecture, and some sleep.

The first year serves to sort out the serious students, the ones who truly have a vocation for medicine, and the less committed drop out. Jonas thinks that the students who come from the rural villages and farms are most likely to stick with the program, perhaps because they are used to hard work. His fellow student Luisa comes from La Bucarita, an isolated coffee-growing village more than two hours out of Sanare by Jeep. She’s living with an elderly relative in Sanare and really misses the company of her large family, but she’s determined to get her medical degree.

Jonas had been out of high school for a number of years before the new integral community medical program began. During the early years of the Bolivarian Revolution, he and other recent high-school graduates were teaching as temporary rural “maestros,” even though they didn’t have college degrees. They served as literacy volunteers who went to the more isolated areas of the county to work for Mission Robinson, the basic education program that taught illiterate adults to read and now helps them and others to complete their elementary schooling. At the same time, he also continued helping his father with farm work and building a new house for the family.

Doctora Edita is a Venezuelan physician who was serving the poor before the Cubans arrived.

Some Venezuelans, like Doctor Edita Goyo, who trained as a pediatrician in the big city of Barquisimeto, were committed to providing health care to everyone before the Chavez government came to power. The Barrio Adentro program was the answer to Edita’s dreams. It has allowed her to practice medicine for the last three years with dedicated Cuban professionals in the walk-in medical office in Palo Verde, a village just outside of Sanare. Currently she’s works in the same room with the Doctor Barbara, who arrived five months ago and replaced the previous Cuban doctor. (The Cubans generally sign up for a two-year tour of duty, and many re-enlist for another round of service.) They and their six medical students make a formidable team.

Antonio and Luisa bring records and medications as Dr. Barbara consults with a family.Dr. Barbara served in four other countries, including Angola, before coming to Venezuela.Each doctor has a desk, one on each side of the room, where they receive a steady stream of patients while the students perform various tasks. One mother arrived with four little children, two on her knee and two standing and clinging to her. The medical students moved in and entertained the children one by one, then managed to measure them and examine their eyes, ears, and throats. Meanwhile Doctor Barbara took extensive notes on the medical history of the woman, for she was the one who was ill.

The files on individuals and families are extensive and allow the doctors and students to review the various trends within the community. They use this information to create wall charts describing the predominant health care problems in Palo Verde. This provides them with a comprehensive view of the most pressing local needs that “integral community medicine” must address. One important component of the medical team’s work is educating the public about preventative measures. Many of the common maladies enumerated on the wall charts – such as diabetes, asthma, and hypertension – are combated by introducing exercise programs and changing diets.

I saw the wall charts below three years ago in a Barrio Adentro office in Caracas. Volunteers from the local Health Committee had helped the Cuban doctors gather information on every family in the neighborhood. The charts showed exactly how many local residents (and the numbers were high) suffered from preventable afflictions such as malnutrition, hypertension, and asthma. The medical students were having good luck entertaining most of the kids, but this baby simply did not want to get weighed by Jonas. Fellow student Vanesa is amused by the proceedings.

Wednesday, November 12, 2008

The World Medical Doctors down the street (WMDs part three)

(originally written in January of 2008)

An innocent, beautiful little village nestled into the mountains at the northern end of the Andes. Hardly the place anyone would look for one of the greatest concentrations of WMDs in the world. Should we leave town before Bush tries to retaliate?

The new generation of WMDs in Venezuela (for those of you who have not encountered them in two previous posts on Venezuela Notes) are World Medical Doctors in training, and they’re living on all sides of us. Monte Carmelo, a village of about 700 people, has 8 residents who are studying Medicina Integral Comunitaria, or Integral Community Medicine, in the Mission Sucre program of higher education that serves this municipality. A ninth resident is studying medicine in Cuba.

On the left, Mariela, Arelys, and Milena live in Monte Carmelo. Next, Inez is from the nearby village of Bojó, and Karen comes from Peru.

    Milena and Mariela began studying three and a half years ago as part of the first class that now includes twenty-eight students. They responded to public announcements inviting interested people to take an exam that would qualify them to enter the medical training program. Mariela, who had just finished liceo (or high school), had always dreamed of being a doctor but doubted that she would have the opportunity to study at one of the big city universities. “So, when I heard that we could take the test to enter the program in Medicina Integral Comunitaria, I raced down into Sanare to sign up.”

Milena on the other hand, was already out of school, married and the mother of a two year-old daughter when she took the exam. When she and Mariela passed and were accepted into the medical program, they faced a rigorous 6 month preparatory course that was designed to get all students, those fresh from high school and those who had not attended classes for a long time, performing at more or less the same level.

Then they were ready for the course of study itself, a serious commitment that involves completing six years of work, the same amount required by medical schools at many other universities in Europe and around the world.

Their school, however, is unique in two ways. For one, the university training comes to them in their hometowns and prepares them for spending their careers serving the areas they live in or other parts of the country (or world) that have a shortage of doctors and good health care.

Secondly, they begin spending time with patients in their very first year, working three or four hours in the morning, Mondays through Fridays, in the ambulatorios (walk-in offices) and the larger diagnostic clinic created by the Barrio Adentro program. Besides taking note of various kinds of treatment, the students begin developing their communication skills and abilities to interact sensitively and humanely with patients.

In the afternoons, all the students working in various locations converge on a building in Sanare, the large town in the area, for their formal classes. These consist of watching DVDs of lectures from Cuban medical schools, discussing the material and things they have observed with the Cuban doctors who are their local instructors, reviewing other medical information on computers, and also taking weekly exams.

When Mariela and Milena completed their second year, they and all the other students entering the third year were rewarded with gifts: their own computers to use at home. This allows them to take DVD copies of the Cuban lectures and various readings and films with them for night-time review. They were delighted, of course, because few people in Monte Carmelo are lucky enough to have their personal computer and because they feel the complexity and intensity of their work has increased this year. The two of them mentioned their current physiology course in particular since it demands a lot of rapid memorization -- all those bones, organs, muscles, tendons, ligaments and their various functions.

Every fifteen days, two of the third year students have to be on call all night at the Yacambu Diagnostic Center. From 8 pm to 8 am, they help admit emergency patients and assist the lone Cuban doctor who is on call. Sundays, though they are supposed to be a days of rest, are sometimes devoted to a quick medical tour to one of many isolated villages and hamlets in the area. Students will hop into a jeep with a doctor and plow through the muddy mountain lanes to reach people who seldom ever get to Sanare, let alone to a doctor’s office.

All in all, this is a grueling regimen, so I asked how many had dropped out. “Four of five out of the 39 of us,” the students said, “are no longer with us. There was only one who thought it was too simply much work. Another having a baby. The others felt the financial or family pressures were too great. And then, of course, there are six of our original group who aren’t with us here, but are still studying. They’re at the Latin American University of Medicine in Cuba.”

There are other health care students in Monte Carmelo, such as Elsy Perez, a middle-aged nursing student who helps out at the ambulatorio. She was an original member of the village health committee that worked with the first Cuban doctor who arrived in 2003. Now she and 52 other students from the Sanare area, four of them from Monte Carmelo, are enrolled in the Mission Sucre nursing program. Elsy Perez said that previously only one Monte Carmelo resident had completed her nursing degree by commuting an hour and half to the big city of Barquisimeto.

Elsy also works three days, in 7am to 7 pm shifts, at the small municipal hospital in Sanare that is staffed by two Venezuelan doctors. She says that they, possibly because they were trained years ago in the established medical schools in the big cities, are often unsympathetic and harsh with their patients. The nurses notice that some patients are treated much better than others, and this seems to be due to class prejudices held by the doctors, who sometimes will hardly speak to the poorest campesinos. This is in stark contrast to the Cuban doctors Elsy has worked with who give everyone equal attention and treatment, and often put people at ease with their friendly style.

“This is what we want to do, too,” added Arelys, another mother who is now in her first year of study to become a doctor. “We are thinking of medicine as a vocation, our calling in life, our way of serving the people and building socialist values. We don’t want a profession in the old sense, like some of the older Venezuelan doctors, who are motivated by a desire for money and prestige, and want to feel that they are superior to the patients, the nurses, and everyone else.”

This year, a new development in WMDs

Just arrived in Monte Carmelo last week: Karen from Peru and Georgo from Surinam

This week another 335 World Medical Doctors-in-training were thrown into the potent Venezuelan mix of WMD production. If you will recall from the previous posts on this site, about 23,000 Venezuelans are now studying Integral Community Medicine at home and another 4,000 are in medical school in Cuba as part of the 20,000 foreign students training to be physicians under the auspices of Raul and Fidel.

Nine months ago the foreign students started arriving in Venezuela as well, so they could be prepared to study within the Integral Community Medicine program. Now that they have finished the pre-medical course, they are being dispersed around the country. Seven of them have just arrived in Sanare, including Karen and Georgo, pictured above. The two of them were at work in Monte Carmelo on Thursday when I visited the ambulatorio.

No wonder Bush and Cheney are quivering in their cowboy boots. They thought they had knocked off Doctor “Che” Guevara 40 years ago, and now he’s back, multiplied a thousand-fold. As you may recall, after the young Ernesto Guevara finished his motorcycle journey around South America, he quickly completed his medical school exams, and took off again. This time he was determined to put his training as a doctor to work in the service of humanity, so he headed to the one place in Latin America that was having a peaceful social revolution. Guatemala.

Soon after his arrival in 1954, U.S. intervention put an end to Guatemala’s successful experiments with land and labor reform and unleashed a half century of pro-capitalist brutality in Central America. Ernesto had to flee the country to Mexico where he met a new group of friends who were amused by his Argentine habit of saying “che” all the time. Thus, “El Che” was born, the internationalist physician who picked up a gun, joined the Cuban guerrilla fighters, and became a leading “comandante” in their Revolution. He would later die fighting with a small band of revolutionaries in Bolivia.

So it is interesting that, out of the 335 students who left Caracas this week to begin their six years of training in various parts of Venezuela, about half are Bolivians. Perhaps the CIA, which had a direct role in murdering Che after he was captured by the Bolivian Army in 1967, is alarmed by this new threat. Last week, in an intelligence report to the U.S. Senate, the CIA claimed that Cuba and Venezuela were having a negative effect on the governments of Bolivia, Ecuador, and Nicaragua. The chancellor of Bolivia quickly responded, “I don’t know where they are coming from and where they get their information. The people of Bolivia know what relations are like with Cuba and Venezuela.”

Joining the Bolivians who are studying medicine in Venezuela are students from many Latin American countries, including some who are not native Spanish speakers: a large contingent from Brazil, eight from Surinam, and even some Guaraní speakers from Paraguay. They were enrolled in intensive Spanish courses while completing their six-month preliminary training in Caracas.

Georgo, from Surinam, is now speaking pretty good Spanish after completing his intensive course, and he identified me right away. “I think I detect Spanish with an American accent,” he said in very good English, also with an American accent. He explained that in Surinam, once a Dutch colony, English has become the main educational language.

Georgo heard about the medical training in Venezuela and went directly to the Venezuela Embassy to apply for admission to the program. Karen said that she and most of the other forty Peruvians who arrived with her had applied through various revolutionary youth groups to which they belonged. Many of them had previously applied for admission to the Latin American School of Medicine in Havana, but were put on waiting lists because their was such a backlog of interested and qualified young people. Karen herself had been waiting for two years, so was happy to land a spot in the group that came to Venezuela instead.

The enthusiasm for this revolutionary vocation is clearly contagious and spreading rapidly through all the Americas, not to mention Africa, which is home to many other students studying in Cuba and the site of other medical schools that are staffed by Cuban physicians. A number of U.S. students are now attending medical school in Cuba, and one of them finished his studies and passed his state medical board exam to practice medicine last year.

According to Karen and Georgo, another contingent of 650 foreign students will be enrolling in the Integral Community Medicine program in the next two months. And who knows, perhaps there will be some U.S. students joining the others in Venezuela within the next year. If so, we can expect to hear from Washington that Hugo Chavez and Fidel are promoting one more “negative influence,” this one aimed at young U.S. citizens.

Still it’s doubtful that the U.S. health care system will be inundated with socialist doctors anytime soon. But here in Venezuela, it is a different story. Our little village of Monte Carmelo could be the WMD champion of the world, with one out of a hundred people becoming a World Medical Doctor.

(don´t forget to look for the great film on Cuban health projects around the world, Salud.)

Tuesday, November 11, 2008

World Medical Doctors go to class (WMDs, part 4)

(originally written in February of 2008)

After spending the morning helping Dr. Tomasa attend to families at the walk-in office in Monte Carmelo, Jonas will jump on his motorcycle and head for Sanare for afternoon medical school classes.

Last Tuesday afternoon I joined the first-year medical students for classes. There are thirteen students from the Sanare area and seven new foreign arrivals from ELAM, La Escuela Latina America de Medicina (“the School of Latin American Medicine”) which has been training 20,000 foreign students in Cuba and now has opened up an associate branch in Venezuela this year. The idea is to give these new ELAM students the same training that Venezuelans are receiving in Integral Community Medicine.

Doctora Alina, the short, spunky Cuban who was teaching the class, looked a little grumpy when Doctor Umberto, the Cuban director of the local program, told her that I was going to sit in on her class. Perhaps she was wondering if her thirteen Sanare students would perform well on a short quiz on molecular genetics, the previous week’s focus of study; or perhaps she was skeptical about letting a curious, and possibly untrustworthy gringo observe the group. The seven new students – three from Surinam, two from Colombia, one from Brazil, and one from Peru – waited patiently outside while the others took the test because they had not been present for all of the classes during the previous two weeks.

After the quiz, Doctor Alina asked the students to orally explain concepts related to the quiz. Arelys, one of the students from Monte Carmelo, seemed to have no problem explaining the interactions among XX and XY and XYY chromosomes. Then the doctor turned to one of the foreign students, who have been catching up on the readings, and told him to set up a six-part chart related to “operadores, promotores, regulatores, y cistrones.” Frankly, I was a bit lost and so was this particular student, who had a large and sheepish grin on his face as he struggled to write things on the board. The grin didn’t appear to make the doctor happy, and while she refrained from scolding him personally she did suggest to the whole group that a serious commitment to study was necessary. One of the students from Surinam was asked to answer the same question and had no difficulty charting a diagram and explaining the required processes in detail.

Now it was time to change rooms. Up until this point we had all been squeezed into a crowded reception room which had a street entry door on one side, and in the opposite corner, a desk and a computer for Dr. Umberto, the director. He and Dr. Frank, the intensive-care doctor from Sanare’s Diagnostic Clinic were having a discussion about cardiac and arterial blockages. They were searching the internet for discussions of new procedures and then jotting down extensive notes related to the problem they had to solve.

The Sanare area had no intensive care doctor until Doctor Frank arrived from Cuba a few years ago. Now he works in the new Diagnostic Clinic that is equipped with sophisticated imaging equipment and other resources that previously could be found only in the big cities. He dropped by the offices of the Integral Community Medicine program to discuss new emergency treatments with the director.  (Very observant readers will note that he is not the only Dr. Frank working in Sanare. The other, an ophthalmologist, appears in the first blog article about Cuban World MDs.)

When the third-year students came out of an adjoining classroom, our group of first-year students moved in there. This room was larger, quieter, and equipped with old-fashioned school desks and a computer and projector that was set up to show a DVD film to the students. Doctor Alina and the film split the lecture time -- about 65% for the Doctor and 35% for the film -- over the next two hours. The film was well-made, a succinct and informative discussion by a female narrator accompanying charts, drawings, and cartoons. This was different than what I had expected. I had developed the impression, in discussions with other Cuban doctors a year ago, that the new films used in classes were going to be videos of live lectures that had been presented by professors in Cuban universities.

This was not the case. The Cuban medical universities have prepared a whole set of video films designed specifically for the six-year program in Integral Community Medicine in Venezuela. We were watching “Morfofisilogia Humana (human morphophysiology): 1st trimester, 1st year.” Previously the Cubans have gained international recognition for the advances they have made in audiovisual education, especially with their new concepts of how to teach language and reading. While I am
ill-equipped to tell you whether this sophisticated or unsophisticated treatment of human morphology, I can say that I was captivated by the class.

Clearly the film was designed to be an interactive tool, and Doctor Alina made frequent use of the TV remote control to stop and start the action whenever she felt like it. She was very sharp and animated as she added detail, emphasized related material, or repeated the information in a fresh way to make sure the students were comprehending things. They felt free to ask questions at any time.

The general theme, which followed naturally on the previous week’s material, was human reproduction: how the cells of a baby are formed, and how a normal pregnancy is achieved. The “sumario” of the film announced associated themes: “Gametogenesis, Fecundacion, Desarollo de Cigoto, Alteraciones, Contracepcion.” After the film presented the different patterns of chromosomal joining and the exceptional cases, Doctora Alina pointed out some of the abnormal processes which were most likely to lead to birth defects. Later, when the film discussed the way in which the fertilized egg is implanted on the wall of the womb, she spent considerable time answering questions from students about unsuccessful pregnancies and the kinds of incorrect implantation that lead to spontaneous abortions, ectopic pregnancies, etc. “This is the kind of material you need to master,” she said, “because some day you’re going to have to explain these processes to some of your patients.”

After the doctor delved into “blastocistos, zona pelucida, trofoblasto” and other exotic (for me, at least) definitions, there was considerable discussion of the “feminine sexual cycle” and various ways to help women understand their individual variations from the average length of the period and the time of ovulation, including the use of a rectal thermometer. As it turned out, this discussion was related to the homework assignments. After Doctora Alina gave them the straightforward assignment of describing in detail the processes of “ovogenesis” and “spermatogenesis,” she went into different territory.

She gave them the hypothetical case of a long distance truck driver who is on the road most of the month and is married to a woman who travels throughout the country regularly to promote one of the new social missions in Venezuela. They’ve been married for three years and she can’t get pregnant. “What would you, as their doctor,” she asked, “advise them to discuss? And what measures could they take to better their chances of having a child?”

One of the students anxiously waved his hand and said, “I think I read an article about long-distance truckers and the possibility that because of all the time they spend sitting immobile in the cab this is cutting down on their sperm production.”
The doctor rolled her eyes toward the ceiling, and then shook her head emphatically, “No, no, no, that’s a bit of hypothetical speculation and it’s not the avenue of inquiry you should be pursuing, since there is a more straightforward approach that should probably solve this couple’s problem.”

Her last homework question was also intended to make them, as young medical people, practice sharing their knowledge and developing sympathy for the people they will treat: “You are in the walk-in clinic in some little village or in a Barrio Adentro office in a poor barrio, and a young woman comes in and says, ‘I’m think I’m pregnant. But I don’t know how I got pregnant.’ What do you need to ask her? What do you need to explain to her?”

The program of Integral Community Medicine is designed to mix intensive practical experience and intensive classroom study in each year of the six-year course. In another three years or so, when those students who are now in their third year graduate, we will see if this new course of study has produced a new kind of doctor. For now, from my visit to the first class in the first trimester of study, I can say that special attention is being devoted to the concepts of “integral” and “community.” In this process, both the curriculum and the professors are coordinated in a systematic effort to develop the humanitarian and humanistic potential of this very special vocation.
Dr. Alina provides the broad humanistic perspective without giving an inch on rigorous expectations of her students. They say she's the toughest taskmaster of the Cuban doctors in Sanare, all of whom demand the strictest attention and professionalism from the students whether they are in the classroom or assisting in the medical offices. After the class, however, she was all smiles and invited me to come visit her at her morning job, the Barrio Adentro clinic in one of the poorest neighborhoods of Sanare.

Who can aspire to this vocation?
Anyone who passes the preliminary exam and the six-month premedical training course is admitted. One of the first-year students in Sanare is José, a fairly old guy -- according to his fellow classmates, he's either seventy-one years old right now, or will be seventy one when he graduates in six years. He told me that forty-five years ago he was a supporter of the revolutionary guerrillas and was carrying supplies to them in their hideouts in the mountains in this region. “I was born a socialist,” he said as we walked away from the classroom building, “so this is a good way for me to finish out my life.”

The younger students say they are proud of him and glad he got a chance to qualify for the training in spite of his age. He says, with a big grin, that he hopes to practice medicine til he’s one hundred.

José wanted to know what was new with the primary elections in the United States, and I replied that Obama appeared to be edging out Hillary. “That’s good,” José said, “but do you think he wants to end that insane war in Iraq?”

“I wish I could say yes, but I really don’t know,” I said.

“Well, if he gets elected and says he’s going to pull the troops out, he had better watch his back. I am afraid they’ll try to assassinate him within five months.”

Friday, March 21, 2008

Meeting at Las Lajitas: Mario Grippo and Fred Magdoff

Mario, Fred, Rosa Elena and three of her students from the high school agroecology course meet at the farm to discuss farming methods and the world food crisis

This past Wednesday, Fred Magdoff and I scaled the steep hill from Monte Carmelo and talked with Mario Grippo, one of the founders of La Alianza cooperative who works at the Las Lajitas organic farm.

We hadn’t been talking for long when the fourth year agroecology class from the liceo (or high school) in the village of Bojo joined us. They had come walking up the other side of the mountain valley to reach the Las Lajitas farm. The students and Rosa Elena, their teacher, meet regularly with Mario, and he had advised them that there was a special visitor in town who could talk to them about problems in agriculture on the global level.

When Fred Magdoff explained that the world was entering a dangerous period of food scarcity, with prices climbing so high in the last year or two that many poor people could not afford to buy nourishing food, the students had some ready questions. They had heard explanations of the problem by their President, Hugo Chavez, on television and they wondered if the North American could confirm them. “Is it true,” one of them asked, “that using corn to produce ethanol in order to provide fuel for cars is causing problems in the global food markets?”

“Absolutely,” said Fred. “Today 20% of the corn in the United States is being diverted to ethanol production. This is a major reason why the price of corn has jumped an estimated 70% in the past year. Now, this isn’t the only problem driving up world food prices. For instance, the demand for soy products for feeding animals in China, especially the tens of millions of pigs, has helped drive the price of soy prices up by 100%.”

Then Fred asked them if they knew what many people in Haiti were eating these days. Nobody knew. “Cookies,” he said. “Cookies made of soil, cooked with a little baking soda and salt. These can fill up empty stomachs but have absolutely no nutritional value. People can’t afford rice in Haiti because its price on the world market as gone through the roof, too, just like the other basic food commodities.”

The exchanges between the students and Magdoff not only touched on world affairs, but also on practical things like composting and manure. Fred told them a story about a farmer he knows (in Virginia, I think) who slips seeds of corn into his compost piles, then turns his pigs loose to root through the piles for the kernels. When they’re done trampling and rooting for every last one, the whole compost pile has been effectively turned over, so the farmer never has to pick up a shovel and do it himself.

Similar Interests

Father Mario Grippo, who came to Latin America from Italy forty years ago, is a priest who preaches liberation theology and teaches sustainable agricultural and the virtues of organic farming based on his thirty-two years working at Alianza and Las Lajitas. (See earlier articles on La Alianza Cooperative, La Dia de La Semilla, and Campesinos as professors.)

Fred Magdoff, professor of plant and soil sciences at the University of Vermont, arrived in Venezuela for the first time last week. When not teaching, he is preaching a related brand of liberation in his anti-capitalist articles in Monthly Review, the excellent independent socialist magazine that was edited for years by his father, Harry Magdoff, Leo Huberman, and Paul Sweezy. (For those of you who are not familiar with Monthly Review and its books, look for MRzine and Monthly Review Press on-line. Monthly Review has been producing highly readable, non-dogmatic, non-sectarian Marxist analysis of the U.S. – and global - political economy for almost sixty years. Don’t miss Albert Einstein’s essay, “Why Socialism,” published in the very first issue of the magazine in 1949.)

For many years Fred has taught the virtues of sustainable agriculture and the methods of restoring and maintaining healthy farmland. Some of his books and articles are written specifically for farmers and laymen; for instance, Building Soils for Better Crops, soon to be published in a new third edition. My farmer friends tell me this is “the Bible” of organic farmers all over the United States.

As the three of us discussed a variety of agricultural, political, and philosophical issues, Mario decided to tell us how he and Arturo Paoli, two Italians, happened to end up in South America, first in Argentina, then in Venezuela.

Mario shows Fred around some of the many worm bins which produce the rich soil and fertilizer at Las Lajitas

Where did Mario come from?

Mario briefly reviewed the history of his religious order, the Fraternity of the Little Brothers of the Gospel (La Fraternidad de Los Hermanitos del Evangelio, founded on the teachings of Charles de Foucauld in France in the early 20th century as an order of worker priests: they dedicated themselves to living with and working side by side with the poor and working classes in various kinds of manual and agricultural labor.) One of their priests, Arturo Paoli, worked in Argentina beginning in the early 1960s and became involved in organizing campesino groups in an area in the North that had been dominated by a giant English food production corporation — the campesinos had lived and worked under serf-like conditions on the vast tracts of company land and were obligated to follow strict company rules, buy from company stores, and labor for poverty wages under oppressive conditions.

When the government took over the company’s land, selling most of it in large parcels to local Argentinian landlords and farm labor contractors, Arturo campaigned to buy one large piece that would be owned and worked by the campesinos themselves. Since Arturo was a personal friend of the Pope, Pablo VI, he was able to secure funds from the Vatican to buy the land on behalf of the campesinos so they could develop a commune.

The Argentine government was agreeable to the sale, but not on terms providing common ownership, which sounded far too “communist” to them. Thus the large parcel was divided up into many individual parcels campesino families. Arturo was joined by other members of the religious Fraternity (including Mario Grippo), who helped the peasants organize cooperatives nevertheless. There was a marketing cooperative that allowed them to sell their agricultural products at a fair price and a buying cooperative that allowed them to set up their own bodegas that did not charge the exploitative prices that were common in the “company stores” owned by the big landlords that surrounded them.

Mario pointed out that Arturo Paoli, who was writing books and articles about Liberation Theology, was anxious to be as inclusive as possible, perhaps naively thinking that anyone who wanted to join the peasants’ cooperatives must be motivated by their Christian faith. Thus he made a key mistake: he allowed relatives of the local big landlords to join the other peasants in owning small parcels of land and working with the cooperatives. These people started undermining the egalitarian nature of the campesino organizations and instead looked for ways to consolidate the economic power of the latifundios (large estates) owned by the landlord class.

One new member appeared to be a very sincere, hard-working fellow and an enthusiastic Christian who inspired others, while all the time he had a secret relationship with one of the latifundios. He was elected to a management positions in one of the cooperatives and began to undermine its financial stability by entering into covert and wasteful business arrangements with the big business owners in the area. By the time his sneaky manipulations were discovered, he had not only damaged the economic viability of the cooperative but had also sown a great deal of mistrust among the other members.

Mario feels that the semi-feudal history of the people in this part of Argentina, who lived for centuries on large estates under brutal regimes imposed by Spanish, British, and Argentine owners and their overseers, had conditioned people to be passive and obedient to authority. Not that this was surprising, since those who spoke up and showed initiative usually did not survive.

While Mario and the Fraternity were working with their cooperative, one worker on a neighboring latifundio questioned a bill that had been written up by the landlord. The columns of numbers simply didn’t add up to the exaggerated figure the owner had entered at the bottom of the page. “Of course that’s the correct number,” said the boss.

“No, it’s not,” insisted the campesino. A few days later, he was dead. When other campesinos complained to the local police about such crimes, they were told they should shut up or they would be arrested for false accusations and disturbing the peace. The police, in their own way, had been conditioned by hundreds of years of rural feudalism.

By the mid 1970s, the slowly rising consciousness of the campesinos, encouraged by radical church people and young revolutionaries from the cities, was breeding a counter-response among the upper classes, the armed forces, and the traditional Church. It would culminate finally in Argentina with the sadistic and murderous rule imposed by the military dictatorship that took power in 1976 (with the quiet backing of the United States. It was not a coincidence that in 1976 Dick Cheney was Gerald Ford’s chief of staff in the White House, Donald Rumsfeld was Secretary of Defense, and George Bush the Elder was head of the CIA.)

In the years before the military junta was constructed by General Varela and his pals, the local, rural oligarchies in many parts of the country were creating their own paramilitary forces to suppress leftist dissent. Using a combination of their own hired thugs and the local police, they started meting out punishment to those who defied the established order. Many campesinos were killed, as well as a few priests and religious workers. Arturo Paoli, Mario, and other members of the Fraternidad decided that they had better leave.

Arturo somehow found his way to Venezuela and then to the mountains of the state of Lara where he settled in the little village of Bojo, which lies below Las Lajitas farm and over a hill from Monte Carmelo. Mario soon followed with another member of the Fraternidad and they moved into a decrepit farmhouse on the edge of town. This hamlet had been established in the 1960s after a land reform program initiated by the Accion Democratica political party (which once had some genuine social democratic tendencies) had bought out a big landowner and redistributed small parcels to campesino families, most of whom were newcomers who came from another part of Lara. Mario says the people from neighboring Monte Carmelo were more spunky and adventurous, probably because they were well-established in the area years before Bojo was formed and had learned how to fight and work to build their own community.

Arturo and Mario, reflecting on their experience with a peasantry in Argentina, whose minds had been reduced to thinking (or not thinking) like serfs, felt that these local campesinos demonstrated an independence of mind and openness to new ideas that they had not encountered in Argentina. Within a year of Mario’s arrival, they were talking about forming a cooperative again. It would be called La Alianza: 12 members forming an alliance, 6 from Bojo and 6 from Monte Carmelo.

The young men in the Brouwer family plowing a steep hillside at Las Lajitas - Ari on plow, Jan leading the horse. After Christmas the boys started working every day on the cooperative farm, from 6am to 2pm- they will be working there until June. The 23 cooperative members are very happy with their efforts. Even though they are supposed to be working on a volunteer basis, the cooperative voted to pay them last week.

Thursday, March 20, 2008

The Booming Venezuelan Economy, and how it affects Monte Carmelo

A local mason is putting the finishing touches on a wall next door, where our neighbors are adding a large room to their house.

The major media in the United States and Venezuela are overflowing with misinformation about Venezuela and its social and economic indicators, so it was relief to see a reliable appraisal of Venezuela’s economic growth appear recently: “The Venezuelan Economy in the Chávez Years,” by Mark Weisbrot and Luis Sandoval at CEPR, the Center for Economic and Policy Research in Washington, DC, February 2008. ( For those of you who are not familiar with CEPR, you should visit their website at, since they are primarily engaged in producing reliable information, analysis, and prognostication concerning the U.S. economy – they predicted the dangers of the stock market bubble in the late 1990s, and the housing bubble of the 2000s, when most economists were ignoring the problems because they were giddy with the joys of short-term profit-taking; likewise, they are one of the best, non-hysterical guides to understanding the current state of the U.S. Social Security system.)

In their report, which reviews solid statistics gathered through 2007, they note that Venezuela’s economy has been one of the fastest growing in Latin America and the world over the past five years: “since the first quarter of 2003, Venezuela's real (after adjusting for inflation) GDP has grown by 87.3 percent.”

“…employment in the formal sector has increased to 6.17 million (2007 first half), from 4.40 million in the first half of 1998 and 4.53 million in the first half of 2003. As a percentage of the labor force, formal employment has increased significantly since 1998, from 45.4 to 50.6 percent (2007).”

The figures above indicate, according to my handy calculator, that total employment, including both the formal and informal sectors, was 12.19 million in the first half of 2007, versus 9.69 million in 1998. This is an increase of 26% in nine years, a remarkable achievement for any country.

Such numbers are enough to drive Bush, Cheney, and their gang wild with envy, and makes them determined to destroy Venezuela’s experiment in developing “21st century socialism.” Too bad they only read opposition newspapers and bogus CIA and State Department reports instead of real information from CEPR, where they could find out that one major effect of Chavez’s “dangerous,” “destabilizing,” and “dictatorial” tendencies (the U.S. government’s words) has been to bolster the private sector.

The United States, given its paltry economic growth over the past eight years and its current economic downturn, should be coming to Venezuela for lessons in how to create jobs. Republicans and Democrats alike could re-learn the strategies that were once implemented in the United States through Franklin Roosevelt’s New Deal: government policies that redistribute income, democratize and support public education, and invest in broad systems of public works will also stimulate the private sector. Most job growth in Venezuela has taken place in the private, not the public sector. In fact, the private sector is growing faster than the public sector. “Private employment was a larger percentage of the labor force (75.0 percent) in the first half of 2007 as compared to the first half of 1999 (71.6 percent).”

Most U.S. Republicans, of course, would be adverse to the kind of income growth that has taken place. The bottom 80% of the population has seen its incomes increase by 60% to 100% over the past nine years (figures adjusted for inflation – see my previous November article on incomes and social classes). Middle-class income growth has been positive, but not as great as among the lower classes, and upper-class incomes have risen at the most modest rate. A recent article in the opposition newspaper, El Universal of Caracas, has a table of economic analysis indicating that the poorest sector of the population, level E, which represents almost half of the population, enjoyed income growth at more than twice the rate of the highest level AB, which amounts to 2% or less of the population.

Economic activity in the village of Monte Carmelo: a mini-boom in construction

One sure sign that economic growth is benefiting poor and working class people is the amount of construction activity that can be found all around the country. People in the lower-income barrios of the big city of Barquisimeto report that they have never seen so much activity undertaken by homeowners: they are replacing old make-shift construction of tin and boards with concrete and steel, adding on additional rooms or second stories, and re-plastering and repainting entire houses inside and out.

The campesinos of Monte Carmelo are also busy with building projects because they now have a little extra money to pay for materials, and because it’s summertime here. During the three dry months – January, February, and March, many campesinos don’t have enough water to cultivate vegetables for the market, so they take advantage of the dry weather and some free time to fix up their property in various ways. Some are also taking advantage of government loans and credits that are designed to help low-income homeowners and farmers. Alexis and his son are building a new hen house for 50 egg-laying chickens, making use of a government program that is giving small grants and loans to expand agricultural production on small plots adjacent to people’s homes.

The three bodegas (little stores) in town are doing a brisk business. One bodega is located in the front room of a family’s house, and they just decided to lift the roof and create a small, bamboo-walled garret for a couple of teenagers (it’s comfortable during the cool evening and nighttime hours, but baking hot between 10 and 3 in the daytime when the summer sun is blazing.)
The local construction boom means more activity for local carpenters: new rooms and houses will need furniture. Luis and two other 20 year-olds started up production in the carpentry shop at the Las Lajitas farming cooperative where the space and tools had been underutilized in recent years. They used a loan from the Monte Carmelo’s community council (“consejo communal”) to purchase an inventory of high-quality hardwoods, and the orders for furniture immediately started coming. Double beds seem to be their most popular items: they’ve already sold and delivered six, with another six are on order.

Diluvin, the village’s master welder and master folk violinist, and his nephew stand by the new concrete-block tank that will hold 6,000 liters of water to slake the thirst of 4 pigs who will soon be taking up residence in Monte Carmelo.

Local residents eat pork, but campesinos here are not used to raising pigs (they do raise chickens and cows for meat) because they can be dirty and smelly. However, a new program promoted by the Ministry of Agriculture is demonstrating that it is possible to raise pigs in small numbers without damaging the environment or offending your neighbors. In fact, if the pigs are incorporated into a small-scale system that includes organic gardening, overall production of healthy foods can be increased while also enhancing the quality of the local environment.

Diluvin and family just received a government loan that has allowed his family to initiate such a project on their four or five acres of land. In addition to the water tank above, they are constructing a small concrete residence for the pigs and concrete bins where compost, pig manure, and worms (vermiculture) will be combined to produce very high quality organic soil and liquid fertilizers. The new organic material will be used to cultivate an acre of vegetables and fruits while also enriching the soil of two more acres which are already planted with mature and fledgling coffee trees. And the pigs, besides producing valuable manure, will be reproducing little piglets which will be sold to neighbors who can fatten them up for ham, pork roasts, and bacon.
The Brouwer boys took a day off from farm work at the cooperative in order to level the terrain outside a new four room house. The campesino family that owns the property already has an older house next to the main street, and built this new “casita” with savings that they had accumulated over the past several years.

Other kinds of economic activity in the state of Lara
(you will have to wait a couple of days for the photos in this section)

The little village of Monte Carmelo, population 800, has three shops, all little bodegas that sell food and household items. They are doing well.

Ten minutes away in the town of Sanare, population 25,000, there are hundreds of stores and shops, but no supermarkets or malls, so it’s much like a U.S. town circa 1955. Business is good.

The big city of Barquisimeto, with a million inhabitants, has all sorts of shopping centers that are booming: supermarkets, hypermarkets (similar to the big WalMarts in the U.S., only fancier), fast food outlets, big discount warehouse stores, and car dealers – consequently shoppers can buy most anything that we can buy in the United States. There is a huge new, ultra-spiffy mall called Sambil, part of a chain that began in Caracas, but we thought the Metropolis, also quite new, was prettier.

Although we have been living continuously in Venezuela since September, we didn’t venture into a shopping mall until a few weeks ago when we accompanied our friend Ruben to his university classes in Barquisimeto. After an hour or two in these pseudo-environments, where we purchased nothing except some really awful Italian lunches, we happily escaped. But we can report that the middle and upper classes of Venezuela (about 20% of the population, mostly anti-Chavez and continuously complaining about their endangered economic status) are doing well financially and spending their money with wild abandon.

The Metropolis, snazzier than PA malls

A medium-size, well-maintained mall very similar to the kind we have at home in central Pennsylvania

New construction in a middle-class area near the Barquisimeto Zoo

Venezuelan shopping centers have several things in common with U.S. malls: for instance, terrible meals are served at the food courts. Also, most goods are sold in the same multinational brand-name stores -- Levis, Skecher, and Adidas – that you would see in the States or many other parts of the world. While the biggest malls are spiffier than those we have in south central Pennsylvania, they are also much more expensive – you have to pay twice as much here for brand-name shoes and brand-name burgers like Burger King. We did not sample the food at Burger King because there were long lines, and later that night we ate giant hamburguesas and Vikingos (super “Viking size” burgers) for one quarter the price at a small roadside stand along the main road from Barquisimeto to Sanare.

We went to the second shopping center shown above, which looked like any well-kept, medium-sized mall in a middle-class area of the U.S., because our teacher friend, Ruben, wanted to buy his wife a pair of shoes. The mall was busy, although you can’t see the crowds in the picture because everyone was standing around the corner in another corridor waiting to get into one of three shoe stores. The stores were having sales for El Dia de Amor (“Love Day” or Valentine’s Day on February 14) because it seems that a sure-fire way to a woman’s heart in Venezuela is through her feet. There were guards holding back the waves of would-be shoppers and limiting the number of people who could enter a store at any one time. Most customers were women accompanied by their husbands or boyfriends, but a few men, like Ruben, were feeling bold enough to pick out the perfect shoe all by themselves. We were in a hurry to get to a meeting, however, so Ruben decided he had to pass up the shoes in favor of a purse in an empty leather goods store down the corridor.

A Ruined Economy?
There are some faults with the Venezuelan economy, such as high inflation and occasional shortages of food in some stores, but most people are still earning much more (after adjusting for inflation) and eating much more than they did ten or twenty years ago. For this reason, although commentators in the opposition press and the U.S. are constantly claiming that Chavez is ruining the economy, these anti-Chavistas are unable to produce any reliable data to back up their arguments. Besides, they are constantly disproving their contention by engaging in their favorite recreation: going shopping.

Meanwhile, back in the U.S., working people are losing: in the last quarter of 2007 there was 5.6% annual rate of inflation in CPI, and only a 2.3% annual rate of increase in wages – that is, a decrease in income after it’s adjusted for inflation. CEPR recently reported that manufacturing employment in the United States hit a low point, for less than 10% of the working population now labors in factories, the lowest figure ever recorded since statistics were first gathered a century ago:

The loss of manufacturing jobs continues the downward trend of the last decade. Manufacturing employment has fallen by 3,880,000 jobs, or 22.0 percent, since January of 1998. It lost 279,000 jobs in the last year. The newly revised data show that employment in manufacturing fell below 10.0 percent of total employment in October. The loss of jobs has hit every sector of manufacturing, although the auto sector has been especially hard hit, losing 57,400 jobs or 5.6 percent of
employment in the last year. The loss of 18,300 jobs in textile mills and 20,300 in apparel (10.1 and 9.1 percent of employment, respectively) also stand out.

And his recent column in The New York Times, economist Paul Krugman indicated that worse news is yet to come, a product of the insane U.S. government policies that deregulated banking, mortgage, and financial transactions over the past three decades. The American taxpayers, he says, will be forced to bail out some of the biggest U.S. banks, the ones that wasted a large proportion of U.S. savings on bad loans:

“The result of all that bad lending was an unholy financial mess that will cause trillions of dollars in losses.”

Tuesday, February 19, 2008

‘Consejos Comunales’ – Community Councils – Participatory Democracy (or direct democracy) as practiced by campesinos in Venezuela

Counting me and the two young fellows, there were 38 people at the meeting of the Consejo Comunal, or Community Council, in Monte Carmelo on February 12, 2008.

Probably the most important development in Venezuela in the past year, in terms of pushing the Bolivarian Revolution forward, is the creation of “Consejos Comunales” or community councils, in thousands of city neighborhoods and rural villages throughout the country. The idea is to create institutions of participatory democracy (or direct democracy), starting from the ground up, so that people will have a direct voice in many decisions that effect their everyday life. Representative democracy (what the Bolivarians would refer to as limited or indirect democracy) still exists. That is, governors, mayors, and local representatives are still elected at the state and municipio (county) levels, but now a significant amount of power is being transferred directly to small groups, usually 200 to 400 families in the cities, and 100 to 200 families in the rural areas.

In these small groups, the “consejos comunales,” every citizen who shows up gets to speak and vote. They also get to control significant amounts of money for various kinds of local development through their committees, including one, the “banco communal,” that oversees grants and loans for various projects. Since the “consejos” are a new concept, their development is still uneven in the first year: the most advanced are flying forward with lots of activity; others are slowly building up the participation level of local families; and in some locations, they are yet to be formed, that is, local citizens have not taken the initiative to start them.

Participation here and in the U.S.
In our village of Monte Carmelo, at the various Community Council meetings that I have attended since last May, attendance has ranged from 51 to 35 people out of a local population of about 800 in 130 families. An informal rule, usually heeded, suggests that just one member per family should attend. The Council meets often, once a week on Tuesdays at 5 pm.

Some residents are concerned that attendance is dwindling, but by my standards it is extraordinarily high. In our part of Pennsylvania, in a half rural, half suburban township of 15,000 people about 20 miles from the state capital, there is one meeting of the township board per month (and another might be scheduled if there is pressing business). Ten to twenty residents show up at the typical meeting along with the five board members, some of whom are motivated by their own real estate interests. Once I recall going to meeting with a big turnout, when about 50 residents showed up to protest some extra charges that had been imposed in a sneaky way by the local water and sewage authority. This is typical representative democracy: the board members are elected every few years; they dominate the public meetings and allow very limited speaking time for residents; they have most of their interactions with developers, businesses, and lawyers who are seeking board approval for their projects; and they occasionally respond to public pressure when enough people turn out at a meeting.

The Pennsylvania example is certainly limited democracy, but this does not necessarily distress my neighbors. They are generally satisfied with the maintenance of the roads and a couple of public parks, and although they grumble about the excessive cost of sewage treatment, the system works. On the other hand, they have little control or say in the haphazard and wasteful development of the township and county, so that some of the most beautiful farmland in the eastern United States is being rapidly destroyed.

Here in Venezuela, where at most 20% of the population enjoys anything approaching a comfortable First World existence, the majority is participating directly in their democracy in order to solve a variety of Third World problems.

The group above includes two professors who teach at different universities in Barquisimeto and four residents from the “paroquia” of Juares: two of the latter are grade school teachers, and the other two are “voceros,” the spokespeople for local community councils in a rural area with villages named “Crocodilo” (Crocodile) and “Piedra del Tigre” (Stone of the Tiger).

Even as community councils are being formed, people are working on the next challenge: how to organize the collective power of various councils to demand services that are needed by all the other people who inhabit their larger geographical area. I attended the meeting above, held at the Museum of Art and Culture in Barquisimeto, which brought university people together with representatives from 22 of the 36 “caserios” (hamlets and villages) from a rural, coffee-growing area of the state of Lara. (The other 14 “caserios” have not yet formed community councils.) The meeting was convened with a concrete project in mind: how to provide public transportation, especially for school children and university students, in a rugged “paroquia” (township) that has no buses and only one paved road. The current condition of the roads and transport means that most local adolescents (up to 80%) never get a chance to attend high school or university.

Some notes on Participatory Democracy in the “Consejo Comunal,” or the Community Council, in Monte Carmelo
January 30
When I attended local community council meetings recently there were about 35 residents in attendance. Nearly 30% of households were represented and everyone was able to speak and vote on all items of business. (Some comparative math concerning my township in Pennsylvania: 15,000 residents and 15 who go to meetings; that is, about 1/10th of one percent of the population, or 1/3 of one percent of all families, attend. And, of course, they don’t get to vote.)

People here, however, are concerned about the decline in attendance since last May, because they are participating in direct democracy, not watching representative democracy. Consequently, at the January 30th meeting, people spent most of the time reflecting on their experience to date. They discussed the quality of their meetings and the things they should do to encourage more attendance. Over the previous two months they had taken the time to go door to door and conduct a survey of their neighbors (who wrote their comments privately in order protect their anonymity), so they had some feedback on how well the “consejo” process was working. On the chalk board at the front of the meeting room, members taped up large sheets of paper with lists of the most common comments.

“Positivos,” good things:
1) The “consejo” was advancing of socialism through direct democracy by letting everyone give their opinions and participate in development
2) There were tangible benefits in terms of granting credits for practical projects and giving help to those who needed it.
3) We are learning to do more things for ourselves.

“Negativos,” bad things:
1) Not enough people participating
2) There was feeling of chaos and too many people talking.
3) Rules were made, then not followed, re: the distribution of light bulbs.
4) While it's good for those who are getting loans, it does little for others.
5) People with old unpaid debts (from pre-Council days) are getting credits.
6) Some members are making derogatory comments about others.

Why not attending
1) Too busy with work or classes
2) overwhelmed by personal problems
3) family and childcare obligations
4) annoyed by people who dominate or sabotage discussions
5) don’t have anything to say

Possible Solutions
1. Streamline discussions, keep people on topic.
2. Spend more time chatting about Council topics with other neighbors (those who are not attending) in order to make them feel like they are being consulted. Maybe some will then be more comfortable attending.
3. Don’t let your arguments sound like personal attacks.
4. Have biweekly, instead of weekly meetings.

February 12 meeting
The community council began with a brief review of the minutes from the previous week’s meeting. Then some announcements: there will be more discussions next week in Sanare, the nearby larger town, about village transportation and the fares for the “taxi” vans and pickup trucks that transport residents to and from Monte Carmelo and the other small villages; the Casa de Cultura in Sanare is offering grants to individual families for such things as the purchase of a musical instrument needed by a school child.

Next there was a report on the environment by Cesar Garcia and two classmates in the Mission Sucre adult education program. Their research for their course in ecology showed five major problems in Monte Carmelo. The council discussed the items and decided that all five are valid concerns, then voted to determine which ones deserve the highest priority. One member emphasized the importance of the forest on the mountain, not only for preventing local erosion on the steep slopes in this area, but also because, on a global level, forests are the primary oxygen producers for the earth’s atmosphere. The meeting prioritized to the environmental problems in this order:

1) deforestation on the mountain above the village
2) deterioration of the sewage oxidation lagoon below the village
3) the use of pesticides by some residents is still too high
4) the contamination of the major stream with the waste from coffee production
5) improper sorting of garbage

One of the three Mission Sucre students proposed a project he hopes the council will consider in the future – giving local high school kids the job of completing a 5 year reforestation project in order to restore trees on the mountain, with the community supplying funds for seedlings and other necessary materials.

Next, Narcisa, who had arrived late, wanted to make another announcement. She informed residents that there would be a new educational program at the university level in Agroecologia, or Agricultural Ecology, and that it would be offered as a pilot program in Monte Carmelo by the Bolivarian University of Caracas. She said it might even start next month, in March, but for sure there would be regular classes getting under way in October. The Bolivarian University is hoping that at least 10 people from Monte Carmelo and 10 from Bojo will sign up, 20 to 30 in all. Someone mentioned that getting enough students should not be a problem, since several people from nearby Sanare are also interested in enrolling.

Elsy, who was acting as secretary and taking notes at the meeting, announced that she needed to collect some payments for water. Most residents were keeping current, she said, but some present at the meeting were not – so they came forward and handed over cash payments.

Speaking of water: a few minutes were devoted to the “aqueducto.”

About thirty residents of Monte Carmelo helped repair the ‘aqueducto’ and water collection system in the cloud forest on top of the mountain. First of all they had to carry all the materials – sand, cement, pipes, and fittings – along a narrow, three kilometer path that winds up and down through ravines and thick forest.

At the top of the mountain, it was necessary to build a new catch basin to receive the water coming from a pure water stream and two springs.

The “aqueducto” is the village water system, a series of pipes, pumps, holding tanks, and valves that carries water for several kilometers across the side of the mountain and then down the steep road into Monte Carmelo. Divulin, the master mechanic in town, presented a series of more than 40 photos of the “aqueducto,” some of which I had taken when I accompanied him on a seven-hour hike up the mountain. Other photos, showing about 30 residents of Monte Carmelo working on this repair project, were taken when the work was underway several months ago. This was one of the first major projects funded by the community council making use of discretionary funds it receives directly from the central government (thus bypassing the wasteful and slow bureaucracies at the state and municipal levels.) The council has to submit photographic evidence of the work and the receipts for materials.

Another major project completed last summer was the installation of lights around the “cancha,” the paved outdoor sports area where young people play soccer, volleyball, and basketball almost every night.

The “Viviendas” or housing committee, reported that government money from the Ministry of Housing in Caracas will be available to build new houses for 11 families who are currently living in crowded conditions with their relatives, but the grants are being held up in the pipeline due to reorganization in the Housing Ministry (new cabinet members).

Next, there was general discussion of the other grants and loans that the Council has given to individual, families, and businesses. It was announced that there would be a meeting of the Banco Comunal, the banking committee, on Thursday the 21st to review projects and get documentation of their progress or completion.

One community member who works in a cooperative wanted to know what level of responsibility and “compromiso” (commitment, dedication) the community should expect from those who are given grants and loans. He thought that the community should have a high level of expectation, just like he has with his fellow cooperative members, so that there would be very little shirking of responsibility on the part of those who get money through the council. He wanted there to be adequate monitoring so that the community can make sure that funds are not used for something other than their intended purpose, so that machinery that is purchased is not broken and left unrepaired, and so that projects do not get so far behind schedule that they never get completed at all.

Now the meeting got very animated as almost everyone participated, sometimes all at once. Occasionally there were interruptions and loud side discussions, but in general people were respectful of each other. The basic fabric of the new “Consejo” was being tested as people asked: what kinds of expectations do community members have of others and themselves? What level of socialist consciousness needs to be created and nurtured so that citizens can trust in their collective ability to get things done?

In general, the group agreed with the very first speaker: we need to find ways to hold people accountable. On the other hand, various residents pointed out that this cannot be done in a personal, accusatory way, or the interactions at Council meetings will disintegrate due to grudges and animosity.

Luz Marina, who is only twenty, demonstrated one way to promote good will and share information with the community. She spoke on behalf of three other young people, including her cousin Sandino, who were unable to attend the meeting. The three have started a carpentry business using a loan from the Council to buy wood and other materials. Luz said that Sandino has been keeping a folder concerning the progress of their work at the carpentry workshop at the Las Lajitas cooperative, and that he would bring it to the next meeting of the Communal Bank.

The Bolivarian Revolution is called “El Proceso” because it is continually in the process of creating itself.
For some of foreign friends of Venezuela, it is enough to know that the nation has resisted the disapproval and meddling of the United States for nine years and has inspired the rest of Latin America to stand up for itself. But it’s worth pointing out that the Bolivarian Revolution has made significant progress, not without some false steps and mistakes, as it has passed through three overlapping processes:.

Consolidation of power, 1999 to 2004: This initial process included passing the new Constitution of 1999, reasserting government control over the nationally-owned oil industry, and instituting the Law of the Land that allowed the government to purchase and redistribute unused agricultural land. The opposition and the oligarchy, angered at such affronts to their power, failed in their attempts to stop the revolutionary process, first in their coup of 2002 and then in the managers’ shutdown of the oil industry in 2002-3. The Chavez supporters, after winning the presidential recall election of 2004 handily, were able to elect their representatives to the National Assembly, Governors’, and Mayors’ offices in 2004.

The social democratic stage, 2003 to 2007: In a many ways, the way the Chavez government has used it resources to bring economic and social benefits directly to the poor and working classes is reminiscent of the New Deal programs enacted under Franklin Roosevelt in the U.S. in the 1930s. One difference is that Venezuela has mobilized a much greater share of its economic resources than the U.S. did when it helped some of the poor during the Great Depression in the U.S.; the benefits are being dispersed to a majority of Venezuelans in the form of health care, higher wages, cheap food, and extensive education programs.

The creation of participatory socialist democracy, 2007 to 2012: President Hugo Chavez declared that he wanted to lead the country in a new socialist direction at the beginning of 2005 (21st Century Socialism), and campaigned on this program when he was reelected by an overwhelming margin at the end of 2006. Since a central premise of 21st century socialism is that it should avoid the undemocratic tendencies of 20th century socialism, the Bolivarian Process needs new models of popular participation at the grassroots levels. This time, unlike some earlier, wasteful experiments with oil profits, the government looked for practical models that were already working. It found a very important prototype for socialist organization at the grassroots level in the city of Carora, here in the state of Lara. A few years ago the mayor there began distributing the vast majority of municipal funds to neighborhoods that established small, self-governing bodies – they were called “Consejos Comunales.” Because this model of popular sovereignty worked, these community councils are now being replicated all over the country.

[There will be more on Carora in a later post]