By way of prologue Q ho has visited Cuba knows that the Venezuelan flag to friendship between the peoples of the

Caribbean is historical: in full indepe ndence movement, Petion offers help to Bolivar, to reorganize the fight from Hai ti. Miranda had done likewise, bringing the original flag and crossing the same inland sea, the sea gets its name from our native peoples, Carib or Taino, and w e call up inside because our people one nation. This friendship is evident betwe en Venezuela and Cuba, now in separate twin revolutions progressives, whose comm on goal is also the origin of which is grounded in the pain of people long abuse d by the selfishness of those who once ruled their destinies. Anyone who has vis ited Cuba knows that the Venezuelan flag 5 L is very present in its streets and in the heart of the Cuban is very present in its streets and in the heart of the Cubans, and those who inh abit the earth Bolivarian are honored to have as many fellow employees, children of Martí. The year 2008 is emblematic because it is the 10th anniversary of the Bolivarian Revolution. Also be 80 years old, you have not left a trail imperish able in Bolivia, the doctor revolutionary Ernesto "Che" Guevara. And in 2008, th e Mission Barrio Adentro reached its fifth anniversary. This combination seems t o reaffirm the unbreakable bond that unites our peoples, especially considering it was the contribution of Cuba, with its contingent of doctors, who made this m ission possible. For these reasons and for reasons that do not fit in the paper, it is appropriate to advance this brief text explaining the achievements and ch aracteristics of the Misión Barrio Adentro, a major achievement of the Bolivaria n Revolution, with support from Cuba and medical mission. 6 7 Movement of Friendship and Mutual Venezuela-Cuba Solidarity utua Venezuela-Cuba is a meeting place for organizations and individuals committ ed to strengthening the bonds of brotherhood between the peoples of Venezuela an d Cuba. It is a volunteer charitable work done around the social and other initi atives launched by both governments and enhancing the friendship between Venezue lan and Cuban revolutions. It is an organized expression of the solidarity of th e hundred or a thousand different and individual expressions of it that appear d aily in our country. M E s making a voluntary solidarity work about the social 9 What is the origin of this movement? This movement has historical roots in the activities of various organizations of friendship with Cuba when diplomatic relations did not exist. The coming to pow

er of President Chavez and the extensive cooperation provided by Commander Fidel Castro created the conditions for the two governments and two peoples to assume the flags of mutual solidarity. The most direct antecedent of the Movement of F riendship and Mutual Venezuela-Cuba Solidarity is the Bolivarian Coordinator of Solidarity and Friendship (CEBES), established in 2000. The Movement of Friendsh ip and Mutual Venezuela-Cuba Solidarity was born in 2003, as Youth Coordinator o f Solidarity and Friendship, involving social and youth organizations. A nationa l meeting in November that year, which was attended by more than 40 organization s and individuals in 20 states, permitted the following conclusions 10 have guided the work of solidarity: 1) the new reality of the relations of frien dship between Venezuela and Cuba, 2) the various forms of joint work that surpas sed all previous experiences, 3) the need to build a plural reference to articul ate the efforts from different fronts, were developing in terms of strengthening the brotherly ties between the Venezuelan and Cuban revolutions and among our p eoples. What activities developed by the Movement of Friendship and Mutual Venezuela-Cub a Solidarity? Nearly five years after that founding meeting, the Movement of Mutual Friendship and Solidarity has promoted important actions in defense of our two revolutions , among which we mention: 11 Combating misinformation and the media blockade The private media use the hackneyed lies about Cuba to attack the Bolivarian Rev olution, especially as we approach elections, so that mutual solidarity has been promoting the dissemination of the truth about Cuba and Venezuela, and achievem ents of joint working is performed through the assignment and with the participa tion of grassroots organizations and health committees. Meetings of solidarity The participation of mutual solidarity in efforts to find every town has increas ingly been developing: the promotion of participation in the solidarity brigades to Cuba, organized by the Cuban Institute of Friendship with the Peoples (ICAP) , the development sports exchanges, cultural and culinary. and now the task of b ringing to Cuba delegations of people from different regions and representing va rious professions and occupations, to know the Cuban reality and disclose the Ve nezuelan reality, especially regarding to work together. This latest initiative, which bears the name Flight of the Bolivar-Marti Solidarity is a specific refer ence to the new ways of strengthening the ties of friendship and solidarity betw een Venezuela and Cuba. Combating terrorism The aftermath of the 2002 coup, the oil strike in Venezuela and the presence of facts very similar to the terrorist attacks of imperialism against Cuba have set the agenda for this work has three main flags: denounce the terrorist act of im perialism against Cuba and Venezuela, demanding the extradition of terrorist Lui s Posada Carriles and request the release of five Cuban prisoners of the empire. 12 13 Solidarity with Barrio Adentro Solidarity with the social, especially with Barrio Adentro, is a priority for mu tual solidarity. The results are so significant that it would be very difficult to present a summary and especially reflect the immense human value of the missi on. We dare to say that the Mission Barrio Adentro has become a benchmark for wh

at they can do Bolivarian and Cuban revolutions of the Venezuelan people and oth er peoples of the world. Some of the phases of Barrio Adentro and Mission Miracl e and the new Mission José Gregorio Hernández, open up many additional opportuni ties to work for mutual solidarity. What are your guidelines work? In all these areas of mutual solidarity works from three key strategies: 1) Info rmation: To bring the truth about the joint work of Venezuela and Cuba, both sce narios media and through the community level, 2) Community Action: search throug h volunteer work, become actors in-depth and continuous improvement of the socia l work and 3) Organizational: to build scenarios for the exchange and coordinati on of work, from local, which will promote the strengthening of solidarity and c onsciousness make it a higher value of performance of Venezuelan society. 14 15 The clinics in the Barrios on the physical environment in the communities conditioned and equipped with the necessary human and material resources to provide free medical care to the enti re population. The work of physicians and nurses is not limited to the Folk clin ics, but goes into the heart of the community and especially of households to pr ovide a truly comprehensive medical care. S E l work of doctors and nurses is not limited the clinics Popular First phase: Caracas On April 16, 2003 arriving in Caracas the first 53 specialists in general medici ne with over 10 years of personal experience, from the vast majority of internat ional medical missions in other 17 it enters the heart of the community around the world. They lived in the heart of the Venezuelan family with his mode sty and scarce resources, is the gateway to what was initially a plan and eventu ally became the basis of the burgeoning Mission Barrio Adentro, a symbol of heal th and union of our peoples. Many neighbors donated mattresses, curtains, tables and other tools to improve living conditions and medical work of the new neighb orhood, the neighbors took turns feeding responsibility, this process reached th e communities to organize health committees, structures were chosen in popular a ssemblies to protect and accompany the family physician on a daily basis. In May 2003, reaching more than a hundred Cuban doctors spread over the districts of t he hills of the Libertador municipality, this first pilot phase was carried out from April to June 2003 coincided with the formalization of the first six commit tees health. 18 Second and third phase: the entire national territory A second phase was implemented between June and August 2003, diversifying to dif ferent states (Miranda, Zulia, Barinas, Lara, Trujillo and Vargas).€In September , extends to the rest of the country and so the third phase, which amounted to m ore than ten thousand doctors around the country. In the first quarter of 2004 a

nd the country had 13 000 doctors located at 8,500 points for consultation, at t hree weeks into the plan begins to reach a strength of the drug 55 months was in creased up to 106 rubles among 23 groups drug to address major health problems. The mission was expanded, making himself available to most excluded families, po pular clinics, doctors, dentists, eye consultations and deliveries of medicines among other benefits. 19 Impact indicators • In 2003 Venezuela had 500 thousand doctors in the outpatient network of primar y care in 2008 in the popular consulting work Barrio Adentro 7878 specialists, 8 71 of them Venezuelans, in addition, 1,499 resident doctors of general medicine graduate. • In 2004 there was in the outpatient network of the first level one d octor per 17 000 333 inhabitants in the popular consulting today there is a doct or per 34 000 inhabitants. • In the outpatient network was counted in 2003 with 4,400 units in 2008 and already has 10 931. • In 2003 the delivery of medicines to the population in the outpatient units of the first level was very variable a nd depended on the availability, after Barrio 20 Inside is guaranteed free treatment to the entire target population and has 103 items of drugs. • Prior to 2003 were performed in the outpatient network, an ave rage of 15 million annual consultations, in the popular clinics are held today, on average, 70 million annual consultations. To date there have been in the Barr io Adentro 284 713 643 consultations, of which 124 417 303 home visits. • In 200 3, no information is collected from home visits made by physicians in the ambula tory network. Today's popular medical clinics averaged nine million visits to th e families. It has saved my life, in clinics, of 77 832 Venezuelans. • There hav e been, until 2008, 192 million advocacy and health prevention. 21 • By 2003 there were no grandparents clubs in primary care units in 2008, 5437 c onsist of grandparents circles Barrio Adentro. • By 2003 we had no teen clubs 45 93 and today operate such circles. • They are linked to the Barrio Adentro clini cs 6743 popular health committees. • have been built from 2004 to 3267 clinics p opular today, have graduated in 1013 Barrio Adentro Venezuelan specialists in ge neral medicine, of which remain embedded in Barrio Adentro 861 (85%). 22 Barrio Adentro "One Great University" n order to raise the scientific level of professionals working in Barrio Adentro and providing health care quality and excellence, and to lay the groundwork for the creation of the new National Public Health System is required to comply wit h the principles constitutional fairness, generosity, justice, ethics and moral, develop training programs both at undergraduate and postgraduate levels, allowi ng the formation and development of human resources of the mission. Thus there i s, as long-term strategy in meeting this purpose, training of human resources in the country, becoming the medical mission in the great university, the scenario s developed in all processes of undergraduate and graduate. 25 C P urpose, human resource training in the country, becoming Medical Mission in the great university

Postgraduate training programs (Cuban) Graduates: With a total of 5000 238 employees. 1. Superior Medical Education 2. Health Dire ctorate. 3. Health Economics. Master of wide access: With a total of 11 000 651 employees. 1. 2. 3. 4. 5. 6. 7. 8. 9. Comprehensive c are for children. Comprehensive care for women. Satisfactory longevity. Infectio us diseases. Medical emergencies. Dental emergency. Diagnostics. Oral health. Na tural Medicine and Bioenergetics. Doctors Training Programme in Public Health Sciences: With a total of 392 employees. Human Resource Training (Venezuelan) • Undergraduate: With a total of 21 902 high school Venezuelans. Master blended: With a total of 418 employees. 1. 2. 3. Superior Medical Education. Public Healt h. Pharmacoepidemiology. 26 • National Training Program for Comprehensive Community Medicine: In all states, 318 municipalities, 571 and 855 ASIC multipurpose classrooms. 27 1. 2. 3. First year: 5118. Second year: 6209.€Third year: 10 575. Where do they develop training programs and how? The training process of each program is developed in the popular clinics, medica l centers comprehensive diagnostic, full recovery rooms, the high-tech medical c enters and dental offices, and multipurpose classrooms, which have the means nec essary teaching career for Comprehensive Community Medicine, where the community itself also becomes a learning space, where future professionals acquire, in di rect work, skills and attitudes of the profession. It also emphasizes the implem entation of innovative teaching strategies in line with new forms of teaching, e xtensive use of new technologies and, above all, the close relationship between theory and practice, training both undergraduate and postgraduate in the scenari os of its future performance, which gives greater 29 • Postgraduate: With a total of 1,732 Venezuelan professionals. General Medicine . 2. Comprehensive General Dentistry. 3. Resident graduates from the Latin Ameri can School of Medicine in Cuba (Battalion 51). 1. Training and human resource development in the Medical Mission has a cascading a pproach from scientific and academic degree has the employee, allowing you to jo in these programs, which have educational institutions as arenas of health, whic h guarantees, with the development of teaching, providing an excellent service t o the Venezuelan population.

28 quality of both the teacher and care process, which was reversed in a better pre paration of students and health care to achieve levels of excellence. When will the first graduation of the whole medical community? Is expected to occur in 2011 the first graduation of the whole medical community who are in their third year of training, and these doctors that the country nee ds, trained with a holistic, humanistic and senior scientist capable of achievin g a high impact in solving health problems of the community. lenges that demand Venezuelan society in building a model of comprehensive care to individuals, families and communities, with the definitive collapse of the cu rative model of care and the emergence of new national public health system need ed to fulfill the mandate health as a constitutional right of the people. To thi s is added the great strength of our Cuban colleagues to return home, because th ey will have a higher level than they had in terms of scientific, technical, eth ical, humanistic, ideological, and provide new professionals, specialists, techn icians and teachers to our health system. This joint effort between Cuba and Ven ezuela can also contribute to helping others in America and the world, as it per tains to the necessary professional training, and health care of these fraternal peoples. What is the impact of Barrio Adentro and educational and social program? Barrio Adentro, a great university, breaks paradigms of higher medical education and has a high relevance in their processes, responding to desa30 31 "A step forward towards excellence" Integral Diagnostic Center What is an ICD? The Comprehensive Diagnostic Medical Center is a health care institution equippe d with modern and effective medical technology that has a team comprising medica l specialists, nurses and technologists, who assure the quality of comprehensive medical care for the Venezuelan population. E l Comprehensive Diagnostic Medical Center is an institution What does it do? It guarantees free drugs to all people attending the same regardless of politica l affiliation, religious or other status, shows that not exert any kind of exclu sion. Ensures medical and surgical services ur33 equipped with modern health and effective medical technology gence and complementary tests for 24 hours every day of the year. This organizat ion is a focal point in the process of training and betterment of the students o f medicine, nursing, technical and graduate studies related to the area of commu nity health. • upper gastrointestinal endoscopy. • Clinical laboratory: hematology tests are performed, hemochemical, urine and feces parasitology, as well as gases and ions . • SUMA: ultramicroanalytical. • Electrocardiogram with emergency department of cardiology.

Who pays for supplies and equipment necessary for their activities? The inputs required for the execution of his work, including reagents and other supplies for the realization of the complementary, are provided by the state bud get. Surgical clinical area • • • • • Area medical emergencies. ER. Life support. Intensive Care. Medical tr ansportation (ambulances). Surgical (One in four will have an operating CMDI) How is it made? Areas and services diagnostic Area • Imaging: X-ray stationary, portable X-ray (in the CMDI with surgery) and diagn ostic ultrasound. 34 • Operating Room • Transfusion Service. 35 Ward Room income. intensive care room.

osteoarthritis, fractures, spinal disorders. Ultrasound Displays deep organs, small parts studies and transrectal and transvaginal. Make s diagnosing pancreatic and liver damage, gallstones and kidney, and agenesis dy strophies, congenital malformations, tumors, cysts and abscesses, normal and ect opic pregnancies. What is each of the areas that make up an ICD? Description of the areas Imaging It has areas of radiology, ultrasound and endoscopy. Radiology Allows simple radiological examinations of head, thorax, abdomen and extremities as well as contrasting tests of the digestive and genitourinary tracts. This ar ea allows diagnosing pneumonia, pleural effusion, tuberculosis, emphysema, atele ctasis, tumor, abnormal size and shape of the heart, aortic aneurysm, fluid leve ls in intestinal obstruction, abscesses, signs of 36 • Endoscopy By gastroduodenoscopy directly displayed the esophagus, stomach and duodenum, al lowing accurate diagnosis of ulcers, tumors, hiatal hernias, inflammation of the esophageal-gastro-duodenal diverticula and polyps, among others. 37

Clinical laboratory Studies can be performed in blood, urine, feces and other fluids that provide in formation for diagnosis, prognosis, monitoring and screening of acute or chronic conditions: anemia, febrile bacterial or viral processes, diabetes mellitus, ch ronic kidney disease, dyslipidemia, liver disease, urinary tract infections, int estinal parasites. SUMA technology Immunochemical studies for the detection of a ntibodies against the virus, HIV, hepatitis B and C, dengue, and fetal diagnosis of congenital anomalies and inborn errors of metabolism. Clinical Ophthalmology Allows the diagnosis of conditions such as ptosis, cataracts, pterygium, glaucom a, diabetic retinopathy, retinitis pigmentosa and macular degenerative disease a nd the diagnosis and treatment of ophthalmological emergencies (removal of forei gn body from the cornea and corneal suture wounds) followed the patients operate d on in Cuba by the Mission Milagro. Emergency therapy and operating room In each CMDI, this service will have the following areas: Emergency, life suppor t, hospitalization, intensive care and one in four will have elective surgery an d emergency and ambulance. Is oriented to address those patients who require imm ediate medical attention by presenting conditions that may endanger his life, su ch as polytrauma, sharp pictures cardiovascular, respiratory, stroke, shock of v arious types, as well as other 39 Electrocardiograph The instrument measures and records the electrical activity rhythm and conductio n of the myocardium, contributes to the diagnosis, prognosis and monitoring of a cute coronary syndromes, arrhythmias, other shortcomings of the coronary circula tion and hypertrophy of the cardiac cavities. 38 of acute, clinical and surgical among which are: decompensated diabetes, dehydra tion, gunshot wounds or stab, appendicitis, cholecystitis, intestinal obstructio n, perforated ulcer colitis and crisis. 40 Diagnostic Medical Centers of High Technology What are CMDAT or CAT? Are high-tech medical centers that are characterized by providing highly special ized services for diagnosis, through methods and advanced technologies worldwide : MRI, multislice computed tomography, mammography, X rays, bone densitometry, v ideoendoscopy, echocardiography, automated clinical laboratory ultramicroanalyti cal system. These minimally invasive procedures are usually painless, with which you can make early and accurate diagnoses of conditions that are undetectable w ith conventional methods. C he entered high technology medical characterized by providing highly specialized 43 What is the relationship of the Mission Barrio Adentro and these centers? Mission Barrio Adentro includes the construction and operation of 35 such units in all states of Venezuela. What are the objectives of the CAT?

They are scheduled to meet the following objectives: • Provide medical diagnoses of excellence in the fields of radiology, cardiology, gastroenterology and clin ical laboratory. • Apply diagnostic techniques, minimally invasive, allowing eva luation and early detection of diseases. • Expand medical diagnosis and second o pinion consultation, through the exchange and continued collaboration with speci alists from the Integral Diagnostic Centers, Medical Centers Diagnostic Cardiolo gy and other medical institutions. • Dealing with high ethical and humane to peo ple who come to the institution. How do you get attention on them? Access to these sites is completely free, can be used not only by the people for merly excluded but for everyone who needs them and see them, without any degree of favoritism or preference, and its services completely free. The key feature o f these centers is that their work is adequate evidence of its service excellenc e, efficiency of management and professionalism of its staff. 44 45 • Promote continuous training, updating and training of doctors, nurses, enginee rs and technicians. • Manage the information from the diagnosis and research in each of the services and arrangements existing within the center, using Intranet services. • Contribute to the preclinical and clinical studies that require tec hnologies installed in the center. • Ensure and assess the diagnostic quality, e fficiency and effectiveness of technologies and services center. • Conduct surve illance technology to detect, early, equipment failures and malfunctions existin g in the CAT. • Conducting research in medical and scientific fields related to imaging, cardiology, gastroenterology and clinical laboratory. 46 What kind of tests are performed there and what each one? Some of the tests that are performed in the CAT are: • MRI: Implementation of diagnostic techniques for imaging through magnetic resonance d evice low field open, to provide diagnostic information. MRI is considered one o f the tests of choice for the study of intracranial diseases in general, and its main advantage the study of the tumor, degenerative, congenital abnormalities, vascular lesions and diseases of myelin. Studies contrasting simple and thorax, cardiovascular system, digestive system, urinary tract, osteomioarticular system and nervous system. 47 • Multislice computed tomography Imaging technique aimed at obtaining X-rays or imaging studies contrasting simpl e or chest, cardiovascular system, digestive system, urinary tractus, osteomioar ticular system or nervous system, using a computer tomography scan which reflect s different cuts, which turn locations to define depth of pathologies such as tu mors and other abnormalities. • Bone Densitometry Imaging of whole body, from studies at its marrow, which gives a sense of the co ncentration of calcium in bones and can detect indirectly the decrease it and he nce the possible presence of related diseases this phenomenon, such as osteoporo sis. • Echocardiography Imaging with noninvasive studies, x-rays of the heart and great vessels, using e

chocardiography techniques in different ways, such as one-dimensional, two-dimen sional or three-dimensional, Doppler, stress echo, pharmacological, and transeso phageal echocardiography. • X-rays Implementation of single or contrasting radiological images for diagnosis. • Mammography Taking high-resolution X-ray images or definition for the screening, diagnosis, monitoring and treatment of breast mass lesions. • videoendoscopy Technical intended for imaging studies and / or form of care for upper digestive tract (esophagus, stomach and duodenum) and lower (straight co49 48 lon) for diagnosis and treatment. It is used in a high-tech equipment, known as videoendoscope,€be able to notice through a display area of penetration of the i nstrument. • Electrocardiography Simple technique used to measure the heart's electrical activity, for which reco rds are entered on a paper tape which is then conveniently read by specialists. In the case of Sum, this is analysis, as evidenced by its name, using infinitesi mal quantities of products or reagents to give a satisfactory result, which make s it reliable, accurate and economical, especially for mass screenings, analysis large groups of people and other purposes. • Clinical and Laboratory ultramicroanalytical system (Sum) Using multiple techniques and facilities for the laboratory testing of patients from any level of care. The clinical laboratory studies can be performed in bloo d, urine, feces and other fluids that provide information for diagnosis, prognos is, monitoring and screening of acute or chronic. 50 51 Odontology, stomatology: smiles returning as clinics and consultation services stomatology (dentistry) are physical spaces equipped with dental units equipped and cared for by professionals who provide free care in oral health. Work in a ratio of one for every four popular clinics. L P rofessional who provide free care in oral health Background On October 28, 2003, come the first three Cuban dentists to the Bolivarian Repub lic of Venezuela. On November 2, the three, flying to Maracaibo, Zulia state, in order to identify for the installation of the chairs. How complicated and cumbe rsome for this task was given by the political situation contrary to the Bolivar ian Revolution in all official institutions of the state government. 53 So locals were recognized mainly in private residential environments and other d elivered by the community, where employees Cubans would have to become builders and effort and the support of the community and build revolutionary leaders of d ental services to meet the population. After the arduous task of organization, o

n 17 November 2003 began working in 190 seats installed in the municipalities Ca bimas, San Francisco and Maracaibo, Zulia state. A month later, 195 volunteers j oined Venezuelan dentists. This fact is of great significance, since in this per iod was inviting professionals to join Venezuelan Barrio Adentro and dentists we re the first who responded massively to the call. This development marked the cl ose integration of the activity that currently has 70% of chairs covered by Vene zuelan and Cuban dentists, displays of love and brotherhood of these professiona ls. 54 From July 24, 2004 we have dental services in the 24 states with achievements su ch as: • In 2003 Venezuela had 2371 dentists, both IVSS and the MSDS, since late 2004 in the Mission Barrio Adentro serving 3019 together with 2025 dentists den tists Cuban Venezuelans, who make a total of 5044 dentists working in the missio n. • IVSS in 2003 provided a total of 927 346 dental practices. In 2004 alone 6, 309,342 Barrio Adentro provided consultation, and in 2007 9,739,711. Until March 2008 Barrio Adentro has provided a total of 33,858,452 dental visits. • The con sultations per thousand inhabitants: The increase of four visits per thousand in habitants in 2003 to 354.4 in 2007. When compared with data from IVSS 55 observed an increase in dental coverage substantially, because in 2003 they offe red 36 visits per thousand inhabitants and gave Barrio Adentro in 2007 354.4 vis its per thousand inhabitants. • In 2003, to complete treatment to a patient trea ted at the dental services of the Mission Barrio Adentro, were required to 8.1 f illings (fillings) or abstractions, and in 2007 to discharge a patient was requi red to make 5.5 of these basic activities as translating a positive change in he alth status of the population. • In 2003, the total number of patients who came to our dental services, 43.4% obtained the highest dental care, and in 2007, 76. 9% of patients solved their basic problems of oral health in Barrio Adentro. • When analyzing the retention rate (filled teeth / teeth extracted) in 2004 for each tooth extracted teeth were saved 3.9, and in 2007 for each tooth extracted teeth were saved 09.06. • In 2003 each of the conventional network dentist and the Venezuelan Institute of Social Security provided an average of 3.3 times a d ay, Barrio Adentro today provides an average of 12.6 consultations per dentist p er chair per day. • Dentistry Barrio Adentro is present in 299 municipalities, i e 85% of all municipalities in the Venezuelan territory, with a total of 1,637 d ental services, with dentists' fixed and mobile, the latter representing 23.8% o f the total, ensuring mobility for carry out operations and journey to distant p opulations of the main settlements, and, above all, to reach indigenous communit ies. 57 56 • In the Mission Barrio Adentro has graduated as specialists in comprehensive ge neral dentistry dentists 837 Venezuelans, affecting this achievement in raising the quality of services provided to the population. 58 59 Integral Rehabilitation Rooms: Beating Life " Comprehensive Rehabilitation Facilities as are health institutions where rehabil itation services are provided on an outpatient population, which are equipped wi th technology selected by their displayed results in the rehabilitation treatmen t, guaranteeing the required drugs and supplies and equipment force formed by me dical specialists and health technologists comprehensively ensure the quality of

care. L T echnology selected by their displayed results in the rehabilitation treatment Services provided These centers apply Physical Medicine and Rehabilitation, which is the medical s pecialty responsible for providing rehabilitative care for people with motor imp airments and disabilities, communication, 61 psycho, visceral, deforming, widespread, local and other, with the ultimate goal of restoring the potential losses as a result of the injury. • Massage therapy: The use of massage for therapeutic purposes. • therapeutic physical culture: Under this category are included those exercises that are performed primarily to groups, but can be individualized, with common objectives, primarily aimed at healthy people with risk factors or chronic disea ses, being able to use other complementary techniques induce healthy lifestyles and facilitating their learning to systematize the patient in the community wher e it originated. Example: Exercise for obesity, hypertension, etc. Treatments applied Gym • Mechanotherapy: Use for therapeutic purposes of mechanical implements. Include d in this category table electric lumbar cervical traction, along with the rest of the mechanical equipment available to the room. • Physiotherapy: Using motion for therapeutic purposes. Included in this categor y: kine mobilization or passive exercises, active-assisted or kine. kine exercis es or actively resisted, exercises and active-resisted kine-assisted, free exerc ises, group exercises and group techniques. Electrotherapy: Treatment with therapeutic teams whose essence is given by the action of electri city in its various forms to be applied on the body surface for a particular pur pose. 63 62 • Magnet: Use with therapeutic purpose of artificially produced magnetic fields. Includes magnetic bed and table team magnet. multi-frequency ultrasonic generators and equipment combined therapy. • Electrotherapy: Use for therapeutic purposes of electrical current. At the mom ent included in this category electrotherapy equipment low and medium frequency and combination therapy equipment. • Laser therapy: Using the laser for therapeutic purposes. • Superficial Thermotherapy: Use heat for therapeutic purposes superficial. At t he moment included in this category only electromagnetic lamps. • Combination Therapy: Use in combination with

therapeutic purpose of ultrasound and electrical current. Hydrotherapy: • deep thermotherapy: Using purposes therapeutic deep heat produced by high frequency equipment. At the moment includ ed in this category, the micro wave. use of water for therapeutic purposes. The SRI are equipped with tubs for the tr eatment of upper limb (hand baths) and limbs (foot baths). MNT: • Ultrasound therapy: Use of ultrasound for therapeutic purposes. At the moment included in this category teams 64 Different treatment modalities frequently applied in this section, such as acupu ncture, moxibustion, acupressure, electro, bleeding, 65 suckers, microsystems, massage and traditional exercises. Some SRI are linked to these departments, full or part time, doctors who also perform traditional cons ultation. Occupational therapy: activities of daily living, coordination exercises, relaxa tion exercises and functional exercises. Defectology: The set of techniques to make in patients who are treated in these services are: psychotherapy, relaxation tec hniques, exercises articulatory phono, all functionals, the introduction of brea thing exercises for voice, psycho-therapy and family education. Podiatry: cutting nails, hyperkeratosis treatment, treatment of plantar warts, h eal injuries and foot massage. 66 67 Popular Opticians What are they and what these popular lenses? The optics are popular centers where expertise in optometry practice and optical evaluation of the ametropia of the patient and delivers the glasses for free. C urrently serving 459 popular optical distributed throughout the Venezuelan geogr aphy, including optical wireless. P ersonal specialized practice of optometry and optical evaluation of the ametropi a of the patient and delivers free lenses When and how does this initiative? In February 2003, Cuban medicine was called to fulfill Fidel what would become t he largest of the international missions in the world, the Mission Barrio Adentr o in Venezuela. Urgently needed to support the people 69 Venezuela, leading to the neighborhoods, communities, the most remote places a b

reath of light in their eyes, health and quality of life. In February 2004, deci ded to build the first three optical popular this mission, which were opened bet ween 23 and 28 March in Yaracuy state. Simultaneously, in March 2004, we began t o open 22 more in some states optical response to the needs of the population th at required it, and already at the end of April, there were 26 optical working. For the results of these optical and behavior at the level of immediate solution to the population, it was decided the creation of 224 optical, which was achiev ed fitting of a total of 250, this was at the beginning of May, and the July 11, 2004 had a total of 457 centers spread over 24 states. In November of that year , opened two new lenses in the Tachira State, to complete the 459, all located i n areas predominantly popular. 70 What is optometry and optics with a social? It is a specialty rehabilitative vision and his work in patient care is to study , diagnose, treat and deliver different types of visual aid at the optical level . What is the fundamental premise of this specialty? Provide specialized services for correction and visual rehabilitation needed for the Venezuelan population, which has several ametropias that prevent the proper visual development, through compensating optics. What are the • Achieve an eye disease through the 71 objectives of the optical popular? improvement of visual development of the Venezuelan population with and promote its incorporation into the country's social development following services:

• To facilitate the review of refraction, cutting and assembling frames and lens es in eyeglasses, repair of optical aids that the patient is in use. • Manage op tical and rehabilitative treatment to the Venezuelan people with impaired vision through optical corrections, protective and rehabilitative contribute to the re covery of visual capacity. How have you developed this program from its inception to today? From 2003-2008, there have been nine million 534 000 782 refraction tests were f ixed 267 000 912 eight million cases. Visual examination and delivery of the sol ution or optical correction ensures accessibility to health services of the popu lation, increasing the level of satisfaction, as it has fostered a new way of se eing and a stimulus that shows the pleasure of the people for this service it re ceives, where the variety and quality of products and the right to choose at wil l affect its quality of life and knowledge when it comes to eye health concerns, which makes maintaining a large influx of population the optical popular. There fore, we profess a better future, creating and developing all human capital capa ble of promoting the development of the Bolivarian homeland with the participati on of current and future generations. 73 What is Visual Aid Program? The work of optometry and optics within the Barrio Adentro Mission began as a fe lt need of the population, offers the following services: Refraction. Kerato metry. Cutout, assembly and repair (for glasses).€ Questions specialized in oph thalmology. 72 Who have been the greatest contributors to this program? With infinite love remember the contribution of the 250 young Venezuelan student s of Latin American Medical School in Cuba, who donated their vacation and were incorporated with 33 Optometrists Cubans to support this wonderful task, so all

 

 

 

thanks for walking the hills, fields, forests and cities. The result was superb: the tasks joined other young Venezuelans, who were raised in the fiber of love for his people. 74 75 MIRACLE MISSION: "From Darkness to Light" L to Mission Miracle is a feat of solidarity and humanity unprecedented in world h istory. It aims to restore or improve vision men, women, elderly and children in Venezuela, Latin America and the world for free. T iene target return or improve vision for men, women, elderly and children in Ven ezuela, Latin America and the world for free Introduction In early 2003, the Cuban Medical Vanguard was called to fulfill what later becam e the largest of the international missions that the world knew. The Cuban docto rs would be the protagonists of this epic is trying to achieve true health of th e Venezuelan people. 77 In this walk through the great country of Bolivar was very significant number of eye diseases that affect the quality of life of the population and scarce econo mic resources that had many of the patients who belong to those excluded from th is country. Going back to July 8, 2004, in the first flight carrying 50 passenge rs falls Capital District, the mother of the boy Samuel, the first blind child s erved by the Mission Miracle in Cuba, stated: "This is a miracle, it is best of miracles. " This expression endorsing the words of Fidel Castro 72 hours before, on 5 July when the Mission Milagro was born as one of the alternatives to conti nue helping solve the health problems of the Venezuelan people. Is that the stor y of the Miracle Mission. Since then he has transcended not only in health care, it has symbolized the return, improve the vision of thousands of people, giving the possibility of perceiving the world and the social project that enables you r life better. 78 In 2004, Cuba began to travel to patients with cataracts, pterygium, retinitis p igmentosa, glaucoma, strabismus, diabetic retinopathy, ptosis with abnormal cyto logy or who needed surgery at first. Write new message of love and friendship as a way to back strong steps hope, joy and life. Stories Shaking the hardest of h earts, the eyes of people who were in the darkness began to shine. Premises • Solve the problem of vision to all who need it, without charge, without consid ering race, religion, class or political position. • Follow the principle of equ ity and accessibility, enabling patients are operated every latitude of Venezuel an and Latin American geography. 79 • Demonstrate what people can achieve when there is political will. • Contribute significantly to the progressive control of blindness in Venezuela and Latin Am erica, helping the 50 million blind people that exist today in the world, to sol

ve 80% of them are in poor or developing, suffering 60 % cataract, which can be corrected surgically. Operation Miracle is more than surgery and return to view or see things better, it comes back the color of life, joining the family, work, society, contributing to the social construction of this project. in Lara State, to intervene patients with disorders of cataracts and pterygium. In July 2006, continue to increase surgical positions covering the states of Car abobo, Sucre, Miranda, Guarico, Zulia, Bolivar, Portuguese, Gran Caracas, Anzoát egui, Trujillo, Monagas, Tachira and Falcon. Today we have a total of 17 ophthal mology centers with 28 surgical positions, distributed as follows: • Opened on M arch 6, 2006 in West Ambulatory Dr. Daniel Camejo Acosta of the city of Barquisi meto. Which has two surgical positions. • Carabobo. Opened on July 17, 2006 in t he People's Clinic Mariara Simon Bolivar. It has three surgical positions. Ophthalmology centers In March 2006 surgical scenarios are moved to Venezuela with the first Eye Cente r by the Cuban Medical Mission, with two surgical positions 80 81 • Miranda.€Opened on July 22, 2006 at the Integral Diagnostic Center Fern Falls, located in the municipality of Los Salias, Miranda state. There are two surgica l positions. • Guarico. Opened on July 23, 2006 at the Integral Diagnostic Cente r José Gregorio Hernández, located in the town of Guarico Ortiz. There are two s urgical positions. • Sucre. Inaugurated on August 16, 2006 at the Integral Diagn ostic Center Julio Rodriguez in Cumana. There are two surgical positions. • Zuli a. Inaugurated on August 17, 2006, in the IPASME, with two surgical positions, t he September 18, 2006 was inaugurated the third surgical Integral Diagnostic Cen ter Amparo and November 17, 2006 was opened in fourth place in the surgical muni ci82 High Wind Miranda pio parish, the latter now located in the CDI Villa Baralt, Ma racaibo. • Bolivar. Opened on September 26, 2006 in the town of Peru, Bolívar st ate. It has three surgical positions: two at the Hospital of San Felix and a Rur al Hospital in the Gran Sabana. • Portuguese. Inaugurated on October 2nd, 2006 a t Acarigua Integral Diagnostic Center, located in the municipality Paez, Portugu esa state. It has an operating position. • Greater Caracas. Opened on October 16 , 2006 at the Integral Diagnostic Center Pinto Salinas, located in the parish of El Recreo Libertador municipality in Greater Caracas. It has three surgical pos itions. Two in the aforementioned CDI and the CDI Fort Tiuna. 83 • Anzoategui. Opened on October 19, 2006 at the Integral Diagnostic Center inns, located in the city of Barcelona, Anzoátegui state. There are two surgical posi tions. • Trujillo. Opened on October 28, 2006 in the Ambulatory Holy Water, loca ted in the municipality of Miranda Dividive, state. It has an operating position . • Monagas. Opened on July 23, 2007, is located in the town of Boqueron CDI Mat urin. It has an operating position. • Táchira. Opened on August 3, 2007, is loca ted in the municipality Jáuregui, La Grita, Táchira state. It has an operating p osition. • Falcon. Opened on August 6, 2007, is located in the Ambulatory 84 San Jose Parish, Choir. It has an operating position. In 17 ophthalmologic cente rs located in 14 states, 293 874 operations have been conducted in Venezuela by the surgical teams of the Mission, since 2004, accumulating a total of 498 605 p rocedures performed by Cuban personnel in Venezuela and Cuba, of which 125 010 c ataract , 26 368 347 227 pterygium and other eye diseases. These centers are equ ipped with high technology specialty, where screening is done after the fact in

line communities preoperative, surgery and evaluated postoperatively. Today the challenges are in turn each day into a miracle and every miracle in a victory fo r the people and all of America, and the island of hope with his troops advanced , is helping make it happen. 85 The results of the mission certainly not ever be achieved without the intensity and grandeur of this work as one team starring our colleagues in Cuba and the Me dical Mission in Venezuela, in the interests of the main pillar that is the huma n being. 86 87 José Gregorio Hernández Mission Background In December 2006, a delegation from the Ministry of Popular Power for Participat ion and Social Protection of the Bolivarian Republic of Venezuela took part in a meeting with the Working Group Care Program Disability and Development of Medic al Genetics of the Republic of Cuba, in Havana. There were some results of the C uban experience in the study of people with disabilities. In February 2007 the m inistry submitted a project for the study in Miranda state, in the framework of the Seventh Session of the Joint Commission Cuba-Venezuela Cooperation. In June 2007, a delega89 E ind the Programme Working Group Disabled Care Cuban tion visited the Bolivarian Republic of Venezuela for the assessment of po ssible actions to be undertaken to finalize the project. During those days, he v isited the town Acevedo, who had been rated to begin work and serve as a pilot. It was possible to make interesting encounters with doctors in Barrio Adentro, w ith young social activists of the Frente Francisco de Miranda, with members of t he Mission Negra Hipolita of that town.€The study begins on 24 July 2007 by the Acevedo Municipality, Miranda state and December 16 had concluded that state and Delta Amacuro. On January 17, 2008 is continued Zulia and Barinas states are co ncluded on 18 February and 20 February and begins Vargas and Libertador municipa lity and was withdrawn this March 20. On the 15th of March 2008, marking a miles tone in the history of this project, when in ceremony held at the Municipal Thea tre CA90 Raças President Hugo Chavez Frias, the launching of this action research as a mi ssion by the name of Dr. José Gregorio Hernández, who was a Venezuelan physician and scientist of great humanity. Mission Barrio Adentro has been, is and will r emain a fundamental basis from which this task has been developed, now converted into a special mission. Objectives Studying the universe of people with disabilities to give their consent, with hi gh scientific and social, in order to understand their health problems and their living conditions. To determine the causes of disability in the population studied to see its trend and focus on prevention of the occurrence of new cases.

91 Identify the main perceived needs of this population Promote strategies and respond to the greatest brevity, the critical issues identified, to ensure full protection of the revolu tionary state in this sector of the population. People are visited at home by a quartet composed of a genetic counselor, a defec tologists, a doctor in Barrio Adentro, a social activist in the Frente Francisco Miranda, accompanied by representatives of community councils, health committee s, and security committees social equity, and other community organizations. Study Characteristics It is not a census, is a study that developed a professional team composed of me dical specialists in general medicine and nursing graduates with master's degree s in genetic counseling, Defectology, Clinical Genetics specialists, computer sp ecialists and others who are integrated in each municipality Barrio Adentro doct ors, Francisco Miranda Front fighters, students of Comprehensive Community Medic ine, Black missions as Hippolyta, and with community councils and health committ ees, among others, creating a new experience of integration and cooperation. 92 Main results to the time In the six states completed until April 2008 (Miranda, Delta Amacuro, Zulia, Bar inas, Bolivar Vargas and municipality) and the work done so far in the states of Aragua, Carabobo and Guarico 100 057 people have been identified with different types of disability , 33 181 intellectual, physical and motor 35 153, visual 82 95, 8996, hearing, mental 6158, 1,492 visceral (CKD) and multiple 6782. 93 Of people with disabilities studied 37.13% were dependent for carrying out activ ities of daily life. We identified 18 427 disabled people with skills to work, o f which 74.31% have no employment relationship. In the studied group of people w ith disabilities, 5-19 years, 71.53% are not in school. 13.12% are people who ar e bedridden. There are 7729 people with disabilities without parental protection . 13 559 people with intellectual disabilities have no identity card. 8716 peopl e with disabilities live in homes with structural conditions poor to critical. H ave been visited, by genetic specialists from Cuba-10 621 disabled and 632 have been performed genetic studies in laboratories that brotherly country. 94 E S I G A Revolution! QU CONTENTS As a Foreword .............................................. ...... 5 Movement o f Friendship and Mutual Venezuela-Cuba Solidarity .............................. .......... .................... 9 What is the origin of this movement? ......... 10 What activities developed by t he Movement of Friendship and Mutual Venezuela-Cuba Solidarity? ................ ........................... 11 The clinics in the Barrios ................................ 17 First phase: Caracas ................................ 17 Second and third stage: throughout the country .......................... Impact indicators ...........

.................. 19 20 Barrio Adentro "One Great University" ................. 25 Postgraduate training programs ..... 26 Human Resource Training ................ . 27 Where development of these training programs and how? ................. 29 When will the first graduation of the whole medical community? ... 30 What is th e impact of Barrio Adentro and educational and social program? ........... 30 Integral Diagnostic Center "A step forward towards excellence" ................. .. 33 What is an ICD? ........................................... 33 What does it do? ................................... 33 Who pays for supplies and equipment necessary for their activities? ............ ....... 34 How is it made? ................................ 34 What is each of t he areas that make up an ICD? ................................ Clinical Laborato ry ...................................... 36 Electrocardiography ............... ........................ 37 Ophthalmology Clinic ............................... ...... 38 39 Emergency room therapy and operations ............................. ...... 39 Popular Optical ................................................ ...... 69 Diagnostic Medical Centers of High Technology .............................. 43 What are CMDAT or CAT? ....................... 43 What is the relationship of th e Mission Barrio Adentro and these centers? ..................... 44 How do you get attention on them? ............. 44 What are the objectives of the CAT? .... .............................................. . 45 What type of tests are perfo rmed there and what each one? .......................... 47 What are and what are the popular optical ?.................................... 69 When and how does this initiative? ..................................... 69 W hat is optometry and optics with a social? ..................................... .... 71 What is the fundamental premise of this specialty? ..................... .................. 71 What are the objectives of the optical popular? .......... ..................... 71 What is Visual Aid Program? ........................... ................ 72 How has developed this program from its inception to today? ...... 73 Who were the greatest contributors to this program? .................. 74 MIRACLE MISSION: "From Darkness to Light" ....... 77 Introduction ............................................. Assumptions ......... ....................................... 77 .... ............................. 79 ophthalmologic centers 80 Odontology, stomatology: smiles returning ...................................... ...... ...... 53 Background ................................................. 53 José Gregorio Hernández Mission .............................. 89 Background ............................................. Objectives ............ .................................... 89 ... Study Characteristics .............. ............ 91 Top 92 results to the time ..................................... . 93 Integral Rehabilitation Rooms: Beating Life "................................... .... ........ 61

Provided services .................................... Treatments applied 61 ... .................... 62