THE CUBA RE VI E W 



was the result of the American interven- 

 tion in Cuba in 1906, which terminated in 

 February of 1900 with the transfer of the 

 government to the chosen representatives 

 of the Cuban people. 



In the new government thus established 

 there was a secretary of public health and 

 charities in the president's cabinet, and the 

 president. General Jose M. Gomez, ap- 

 pointed Dr. Matias Duque to fill the posi- 

 tion. According to the law, the secretary 

 must be a physician. 



The elevation of the health department 

 to so prominent a position in the mechan- 

 ism of government had been for a few years 

 a subject of general discussion in America 

 and Europe. Probably the first movement 

 in this direction was started by Dr. John 

 S. Billings in 1879 with that masterful cre- 

 ation of his, the National Board of Health 

 of the United States. 



The propitious moment for the realiza- 

 tion of this ideal came in Cuba in 1909. 

 Here was a new, and in some ways an 

 experimental government. The initiative, 

 the decisions were mostly in the hands of 

 comparatively young men. There was an 

 ambient of success and triumph in sanita- 

 tion. The medical corps of the United 

 States Army had covered itself with glory 

 during the American administration of 

 Cuba after the Spanish-American War. 

 Yellow fever and smallpox had vanished 

 and malaria was under control. The influ- 

 ence of such men as Gorgas, Wood, Carter, 

 Kean and Havard was felt. The man who 

 had been the pioneer in opening the new 

 routes in tropical sanitation, Dr. Carlos J. 

 Finlay, was aided by a group of younger 

 and enthusiastic Cubans, earnest and active 

 co-workers in the noble undertaking. 



Such stimulating atmosphere must neces- 

 sarily have brought about the bold and suc- 

 cessful striking out in new paths and the 

 first department of health in any govern- 

 ment was created. 



Attempts have since been made in other 

 countries, but nowhere has such com- 

 plete and independent organization been 

 created as in Cuba. Elsewhere the new 

 creation has had to contend with pre-exist- 

 ing interests and local or regional opposi- 

 tion. The National Board of Health had 

 an existence of three vears. All the health 



activities in other departments of the gov- 

 ernment were against it. 



The recent enactments establishing de- 

 partments of health in England and France 

 had transferred to the new ministry a cer- 

 tain amount of restricted authority belong- 

 ing to pre-existing and subordinate organi- 

 zations; but the vast sanitary interest of the 

 respective colonial empires, the quarantine 

 restrictions and facihties for commerce in 

 these extensive territories are not under 

 colonial office, or are subject to more or 

 less restricted or local influence. 



In Cuba, on the other hand, not even the 

 medical departments of the army and navy 

 interfered in any way with the all per- 

 vading, uniform and powerful action of 

 the ministry of public health. 



Thus the experimental character of this 

 new departure insured for it all the ad- 

 vantages of being untrammeled at its birth 

 by pre-existing and contending interests: 

 but on the other hand, we cannot deny that 

 the placing of this new instrument in the 

 hands of a people who were learning the 

 first steps in self-government could not 

 fail to interfere with the most complete 

 success in practice. 



We may claim, however, that by the use 

 of this instrument we have kept sanitary 

 conditions in the republic, a rapidly grow- 

 ing community with intense commercial 

 and industrial life, at a level far superior to 

 that of tropical countries in general, and 

 not below that of many sections of the 

 United States and European countries. 



We have, unfortunately, with most, if not 

 all, the American states and countries al- 

 lowed ourselves to be invaded by the mild 

 form of variola that prevails over the con- 

 tinent ; but we have maintained the country 

 free from yellow fever, though under con- 

 stant menace from many places, and we 

 have likewise excluded plague, a threaten- 

 ing invader from neighboring islands and 

 from the mouth of the Mississippi and 

 littoral of the Gulf of Mexico; we have 

 kept malaria under control, and we present 

 a death rate of 16.49 for the influenza year 

 of 1918, and of 14.30 for the year 1919. 



Perhaps we pay for this more than we 

 should. The budget of the secretariat of , 

 health and charities for the current year ; 

 will amount to $6,072,554.85. 



