Sixteen UCSF faculty members got a rare, firsthand look at the Cuban health care system on a recent visit to the insular nation, the first of three trips under a special grant promoting health diplomacy.
The itinerary included a conference on medical education as well as site visits to a variety of health care institutions in both rural and urban areas. Nearly all of the participants — who applied earlier this year for the chance to participate — were first-time visitors due to the travel restrictions that have kept most Americans out of Cuba.
What they found, they said, was a country that has overcome some significant hurdles — such as widespread poverty and a 46-year-old US economic embargo — and built a health care system that serves all citizens free of charge, a thriving biotech industry and a medical diplomacy effort that has greatly strengthened Cuba’s foreign relations.
“They’ve really developed a survivor mentality and have been very resourceful in the face of the US blockade,” said trip leader Tom Novotny, MD, MPH, a professor in residence and director of international programs in the UCSF School of Medicine.
The trip, which took place in early December, was Novotny’s second visit to Cuba. He said that on both occasions, he was struck by the Cuban government’s commitment to the health of not only its own citizens, but also citizens of the global community.
Cuba’s Latin American School of Medicine (Escuela Latinoamericana de Medicina), for example, serves more than 10,000 students from dozens of countries and charges them nothing for tuition, board or accommodations. The school’s stated mission is to train medical professionals to serve impoverished communities outside Cuba.
“We really did see evidence of a commitment to addressing health inequalities, and I’m convinced that is the underlying purpose for Cuba’s health diplomacy efforts,” Novotny said.
In addition to training foreign health care providers, the government has established an internal system in which Cuban medical school graduates are required to work for several years in underserved parts of the country.
As a result, “there is really no shortage of medical care,” Novotny said.
Fellow trip participant Maxine Papadakis, MD, UCSF’s associate dean for student affairs, said she was struck by the visual evidence of Cuba’s long history of economic troubles, such as the “tremendous amount of wear and tear on the physical structures. But life has gone on amid some very difficult stuff,” she said. “Regardless of the poverty, their health care system is strong, and that speaks to the country’s priorities.”
The weeklong trip was made possible by a $150,000 grant from the Atlantic Philanthropies, which funds initiatives aimed at improving the lives of disadvantaged and vulnerable people around the world. The grant will extend over three years and cover two more trips to Cuba.
In order to cut through US government-imposed red tape, the UCSF team enlisted the help of the nonprofit, Georgia-based group Medical Education Cooperation with Cuba, which arranges trips to Cuba for health education purposes.
Once they arrived at their destination, the participants said they found only open doors.
“There were no restrictions whatsoever,” Papadakis said.
That all-access pass facilitated real, meaningful exchanges with Cuban medical professionals, Novotny added.
“We were able to make a lot of contacts there,” he said. “We hope that will grow into collaborative relationships in teaching and practice, especially as Cuba-US relations change under the new [US presidential] administration, as we expect them to.”
President-elect Barack Obama has called for rolling back the Bush administration’s steps in recent years to tighten travel restrictions and remittances to Cuba. So far, he has not supported removing or easing the economic embargo, but has said he would meet with Cuban President Raúl Castro without preconditions.
Novotny will be leaving UCSF on Jan. 8 to transfer to San Diego State University’s College of Health and Human Services, but he will continue to serve UCSF in an adjunct capacity and will lead the two remaining trips to Cuba, the first of which is scheduled for December 2009. He hopes to include faculty from other UC campuses on future visits to the country so that they, too, can take part in what he described as a one-of-a-kind experience.
“Cuba is a fascinating place with very warm and accepting people, an amazing health care system that serves all its citizens and a remarkable effort in health diplomacy that we can all learn from,” he said.
