Cuba

As the Bush administration continues to try and isolate Iran, it's worth taking a moment to examine the success of our last target for international marginalization:

The continuing hostilities with the US have played into Castro's hands. It was as an embattled nationalist leader of a small island, standing up to an aggressive, neighbouring superpower, that Castro preserved his revolutionary credentials most effectively. The shortcomings of life under his regime were, he argued, attributable mainly to the US embargo. Many swallowed the argument. He knew, too, how to capitalise on the latent anti-Americanism in Latin America, Europe and Canada to give his struggle more universal appeal.

Indeed, the embargo is so good for Castro's hold on power that he manipulates events to perpetuate it:

In fact, the regime seems to act with zeal to ensure that the embargo continues. When it looks as if the US government might consider ending it, some heavy-handed Cuban act ensues that the status quo prevails. In 1996, when Clinton was keen to initiate rapprochement, the regime shot down two US planes manned by members of a Cuban exile group rescuing those escaping the island on rafts. When, in 2003, an influential cross-party lobby in the US seemed set to dismantle the embargo, the Cuban government promptly incarcerated 75 prisoners of conscience and executed three men who hijacked a tugboat with a view to getting to Miami.

Meanwhile, Michael Moore's Sicko is coming out soon, and it includes a hefty section on the wonder of Cuban health care. I'm not inclined to trust such reports, mainly because so many reporters seem to exit the nation with stories like this one:

Healthcare and education are supposed to be the redeeming graces of the regime, but this is questionable. There are a large number of doctors, but, according to most Cubans I know, many have left the country and the health system is in a ragged state—apart from those hospitals reserved for foreigners—and people often have to pay a bribe to get treated. Michael Moore, the American film director, who has recently been praising the system should take note of the real life stories beneath the statistics. I went into a couple of hospitals for locals on my latest visit. In the first, my friend told me not to say a word in case my accent was noticed, as foreigners are not allowed in these places. I was appalled by the hygiene and amazed at the antiquity of the building and some of the equipment. I was told that the vast majority of Cuban hospitals, apart from two in Havana, were built before the revolution. Which revolution, I wondered; this one seemed to date from the 1900s.

What's interesting about the Cuban system is that their sparse resources force much more attention to early intervention and preventative health measures. Those are laudable efforts, and they've paid off handsomely. But the health system, in the way we think of a health system, is actually quite poor. Medicine is a technology-intensive practice, and Cuba lacks the resources -- in no small part because of our embargo -- to keep pace with new discoveries. There's no doubt that they do a lot with a little -- and invest quite a bit of thought and energy into presenting the best face of their system for foreigners -- but in the end, being a sick Cuban is no enviable condition. Castro, after all, had his surgery botched, and called in a Spanish specialist to correct the procedure.