By Serge F. Kovaleski
                  Washington Post Foreign Service
                  Monday, March 29, 1999; Page A10

                  MATANZAS, Cuba—Swaying awkwardly to traditional Chinese music,
                  an elderly woman practices the age-old art of tai chi -- in her case, to treat
                  the neurological disorder known as Parkinson's disease.

                  Down the hall at the Clinic of Traditional and Natural Medicine, patients
                  with circulatory problems place their hands and bare feet on large blocks
                  of cobalt, a metallic element with supposedly curative properties.

                  On another floor, a man receives acupuncture treatment, which -- along
                  with doses of pumpkin seed extract -- is intended to shrink a tumor in his
                  prostate. Elsewhere in the clinic, doctors extol the virtues of passion flower
                  as a treatment for high blood pressure, basil and garlic for diabetes and
                  music therapy for digestive problems.

                  To the medical establishment in the United States and other prosperous
                  countries, such remedies might sound like quackery. But in Cuba, whose
                  communist government has long prided itself on the quality of its health
                  care system, doctors and patients are increasingly relying on the broad
                  category of treatments known as alternative medicine.

                  In some respects, Cuba is seeking to make a virtue of necessity. The
                  collapse of Cuba's Soviet patron, coupled with the protracted U.S. trade
                  embargo, have helped create dire shortages of drugs, hospital supplies and
                  equipment in this island nation of 11 million people. In many of Cuba's 273
                  hospitals, medical equipment sits unused for lack of spare parts. Even
                  aspirin is scare.

                  Consequently, the government of President Fidel Castro has been
                  encouraging the development and wider use of herbal medicines and
                  homeopathic remedies, as well as acupuncture, yoga and other Asian
                  therapies. At the same time, Cuba has moved to institutionalize this form of
                  health care despite lingering skepticism about its effectiveness.

                  In doing so, the Castro government -- which grants free health services to
                  all citizens as a constitutional right -- has been capitalizing on the abundant
                  supply of indigenous plants with medical properties in Cuba.

                  Cubans have a long tradition of treating common ailments with natural
                  remedies; such methods also have been encouraged over the years by the
                  country's small population of Chinese immigrants.

                  Today, each of Cuba's 169 municipalities has a state-run clinic that offers
                  traditional and natural medical services. Residency and master's degree
                  programs in the field have been established.

                  Many pharmacies, their shelves bare of modern drugs and other medical
                  supplies, are stocked with herbal and homeopathic remedies. According to
                  the Pan American Health Organization, about 5 million Cubans -- nearly
                  half the nation's population -- have sought traditional and natural treatments
                  over the last four years.

                  In part because other treatments are not available, one out of every five
                  doctors in Cuba reportedly prescribes natural products to patients.

                  Some observers draw parallels between the advent of alternatives to
                  conventional medical care and the explosion in the number of bicycles on
                  the island that followed the collapse of the Soviet Union in 1989 -- an
                  event that drastically reduced Cuba's oil supply and forced cutbacks in
                  public transportation and the use of private automobiles.

                  "Both cases involve going from a more high-tech, costly approach to a less
                  expensive and less sophisticated approach. And both moves were
                  undertaken out of necessity," said Max Castro, a Cuba specialist at the
                  University of Miami's North-South Center, a policy research organization
                  that specializes in U.S.-Latin American relations.

                  "But while admitting the issue of necessity, the government has also justified
                  the virtues of both, which in a way is ironic because the traditional
                  communist ideology has been about moving the country toward modernity,
                  science and technology, particularly in the area of health," Castro said.

                  Three years ago, Cuba's health ministry gave its seal of approval to
                  alternative medicine by including it among five core strategies designed to
                  improve the country's health care system. A division of natural and
                  traditional medicine has been established at the ministry with a director in
                  every province.

                  Much debate continues about the effectiveness of alternative medicine.
                  Some doctors argue that while its remedies can be useful in treating some
                  ailments, they are very limited, particularly when it comes to treating more
                  serious diseases.

                  Some aspects of Cuban medical care are highly advanced. Surgeons at the
                  Ameijeiras Brothers Hospital, for example, have performed more than 90
                  heart transplants over the last decade; Cuban researchers have developed
                  a vaccine for meningitis C and are working on one for cholera.

                  Through aggressive vaccination, Cuba has eradicated a large number of
                  common diseases, including polio, measles, mumps, diphtheria and
                  tuberculosis. Life expectancy in Cuba is an impressive 75 years -- just one
                  year lower than in the United States.

                  But alternative medicine has many supporters in Cuba. "Natural medicine is
                  less toxic and has a medical basis. The most important thing is that it has
                  scientific application," said Juventino Acosta, director of the clinic here in
                  Matanzas, a port city 60 miles east of Havana. "We do not accept anything
                  that does not have a scientific basis."

                  Among other things, Acosta said, alternative medicine can complement
                  conventional medical practices. He said that many, ranging from thyroid to
                  breast cancer procedures, were conducted last year using acupuncture
                  instead of anesthesia.

                  Anthony Kirkpatrick, an assistant professor at the University of South
                  Florida College of Medicine in Tampa who has studied Cuba's health care
                  system extensively, said that herbal medicine can be of value, if only for
                  psychological reasons.

                  "At the very least, the placebo effect can be very powerful in a child who is
                  wheezing and panicking from asthma, as opposed to running from one
                  pharmacy to another looking for an [inhaler] while the child is suffocating,"
                  he said.

                  "It is something. The government feels it has to offer its people something,
                  and something is better than nothing."

                  Patricio Alvarez said he has been taking Lycopodium, an extract from an
                  evergreen plant, for migraine headaches and is pleased with the results.

                  "Now the migraines come less frequently, and when they do I do not have
                  to live through long periods of time feeling like someone is driving an ax
                  through my head," said Alvarez, 49.

                  But Ramon Espinosa, 29, remains skeptical.

                  "I have been taking homeopathic drops for a sinus infection because
                  nothing else was available at my clinic. . . . And I feel just as bad as I did a
                  week ago," said Espinosa, who drives a taxi in Havana.

                  "I think most of us have more faith in pills than in drops, herbs or teas. But
                  for now we have to take what we can get."
 

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