Birth control information and materials (an intrauterine device rather than pills, which were considered unsafe even in 1968) are freely available in hospitals and clinics, but there is no campaign to encourage their use. A sharp rise in the rate of infected abortions from 5.7 per 100,000 live births in 1959 to 30.7 in 1965 was explained "by a high ranking Ministry official" on the ground that during the first few years of the Castro regime, as more and more pimps and profiteers of organized prostitution were detected and emigrated or were imprisoned increasing numbers of their victims came to the attention' of authorities, women whose deaths would have passed unrecorded in previous eras.

By 1967 the septic abortion rate had fallen to 7.2. The problem had come under control the year before, with illegal abortion decreasing. Abortion is legal if the attending physician and one consultant certify that the operation is essential to safeguard the life or health of the mother or that a defective baby is probable, the decision being frequently left to medical opinion on the spot. Dr. Butler characterizes this practice as lying between the most restrictive and the most advanced United States practices; but in New York State especially these have advanced still further since his words were written.

Homosexuality, formerly treated with the utmost harshness, is beginning to be handled as a "medical problem," usually with "only violence or seduction of a minor" leading to police interference. The scarcity and high cost of alcohol limit its use; rum is for export, with each Cuban family allowed one bottle a year, at Christmas. Even beer is scarce. Illicit use of drugs is said to be minimal.

A sidelight on medicine in Cuba comes from the journal of the American Medical Association (October 29, 1969) reporting as a news item from Soviet sources that the number of hospital beds has nearly doubled since 1959. There are now 180 hospitals, including 47 in outlying mountain areas, as well as 38 regional clinics and 232 outpatient stations, with over 7000 physicians. Dr. Butler had mentioned earlier that of about 7200 trained doctors before the Revolution, "2500 found the idea of moving to Florida between 1959 and 1965 irresistibly attractive." There are still too few doctors in the country and too many in Havana, but “with 2100 new graduates on deck for the coming three years (50 per cent are women) the picture looks bright.”

Another note in the A.M.A. journal, for June 15, 1970, mentions a Cuban report to the WHO that there had been no polio in Cuba since 1964 and that malaria had been completely eradicated there since June, 1967. (see VD CONTROL MUST EMPHASIZE MORALS MORE THAN MICROBES PART VII)