“The moral test of government is how it treats those who are in the dawn of life, the children; those who are in the twilight of life, the aged; and those in the shadows of life, the sick, the needy and the handicapped.”
I have just recently returned from a week-long trip to Havana, Cuba.
Even though I have been fortunate to legally travel to Cuba many, many times over the past 10 years, each opportunity is embraced with the thrill of being the first.
Without exception, I have centered every visit on the Cuban Health System: I have participated in Symposiums; presented at Conferences; and been involved in research on health equity and medical ethics.
Put simply, my fascination with the Cuban Health System stems from the similarities of their system, and our system of Medicaid and Medicare, and how Cuba has succeeded at making sure that Health care is a human right rather than a product for economic profit. Therefore, all Cubans have equal access to health services, and all services are free.
I have always envied how Cuba is able to provide high quality care to a poor population, with limited financial resources. Yet, the Cuban people enjoy better health outcomes in every category of measure: low infant mortality; low rate of depression and sickness in the elderly; and almost everything in between.
My interest was especially based on some of the more glaring similarities between the two countries in regard to this country:
- Cuba is a poor country with limited resources.
- Cuba’s population is diverse, large, and growing older.
- Poor, underserved, and many people of color in this country suffer disproportionately, have poor health status.
The trip was organized by MEDICC (Medical Education Cooperation with Cuba), a non-profit organization working to enhance cooperation between the US, Cuban and global health communities aimed at better health outcomes. I was traveling with a most spectacular group of individuals, selected by MEDICC, from a pool of applicants. To their credit, they could not have assembled a better mix of professionals, perfectly suited to both benefit, and contribute to, the success of the trip.
Having traveled last year with a MEDICC delegation looking at Aging and Health in Cuba, this trip, I was a part of an academic research program, looking at Gender and Health in Cuba. The specific purpose was to examine and observe how Cuba is handling diverse gender and sexual populations within the context of its’ healthcare system.
Our itinerary included, among other things, presentations and exchanges with researches, scientists, and professionals from the National Center for Sexual Education (CENESEX) at the National School of Public Health (ENSAP); a University Polyclinic; a Junior High School to visit and have exchanges with students and teachers on sexual education, HIV-ITS prevention, a Maternal Care Center for high risk pregnancies. and the Tropical Medicine Institute.
It was a personally special treat for me to spend time with Dr. Jorge Perez Avila, director of Cuba’s national AIDS program. Having done presentations, written on, and followed HIV/AIDS work globally Dr. Perez reputation preceded him. His work and expertise in the field has gained him the respect of his peers worldwide. He is recognized for having destigmatized HIV/AIDS in Cuba. We were treated to a rare opportunity to hear from him a brilliant overview of the current, groundbreaking HIV/AIDS research.
Most moving of the experiences was the activity at the Friendship Center with Dr. Alexis Cantero, nurses and members of the Alas por la Vida breast cancer support group. It was here, that the impact of the comprehensive nature of the Cuban Health System was most evident in the lives of the residents on a ground level, community basis.
And how could I not mention the students at the Junior High School? I was completely blown away by the demeanor, insightfulness, and the focus of the students. I mean, what do you say about 7th graders asking questions like, “ What is the teenage pregnancy rate in the United States”? Another, upon learning I was from Pennsylvania replied, “ oh, that’s near West Virginia”. Of course, I was disheartened as I thought of how little comparison there is to 7th graders in Philadelphia. I dare not ask one here in Southwest Philly how to get to Chestnut Hill!
Like almost everything else in Cuba (good or not so good), everyone attributes the progress in health care to the Cuban Revolution.
The Cuban health care model is a public health/holistic one. In other words, health care includes the whole person; the physiological, psychological, emotional, social (including family relationships), and environmental aspects of the person. The services are distributed in a public health triage model. If ten people are waiting to be served, rather than be seen on a first-come-first-serve basis, they are taken in the order of need.
The United States spends nearly 15 times more than Cuba on a per capita basis for health care – $7,410 to $503 – a larger percentage of its Gross Domestic Product – 6.2 percent to 11.8 percent – yet Cuba’s infant mortality rate of six per 1,000 lives birth is lower than the United States’ (eight) and the life expectancy in each country virtually equal, according to the Global Health Observatory. Men in each country live to be 76 years old while women in Cuba reach an average age of 80, just a year shorter than their U.S. counterparts.
The World Health Organization reports that Cuba has one of the lowest HIV/AIDS transmission rates in the world, with an estimated prevalence of 0.05 percent. The state provides free triple antiviral therapy to all people living with the disease. And its aggressive vaccination program had led to the eradication of polio, diphtheria, measles, whooping cough, rubella and neonatal tetanus.
Perhaps, the attention, recognition, and respect given to the LBGT population would be the biggest “takeaway” from this trip.
As we continue the political battles here in the United States on homophobic attitudes on Gay Marriage, Cuba is moving forward, acknowledging the right of ALL Cubans to good health, and has crafted and is implementing a health system which strives to insure excellent access and care for it’s citizens.
Along with my colleagues on this trip, I was continually emotionally overwhelmed to witness firsthand, what is possible.
This column cannot do proper justice in conveying the best practices of the Cuban health System, so I encourage you to explore, and support the work of MEDICC, without whom the work and progress in health, and carried out in Cuba would lost in time.
According to its’ Mission Statement, “MEDICC supports education and development of human resources in health committed to equitable access and quality care, providing the Cuban experience to inform global debate, practice, policies and cooperation in health.”
Take good care of yourself and live the best life possible!
Glenn Ellis, is a Health Advocacy Communications Specialist. He is the author of Which Doctor?, and Information is the Best Medicine. A health columnist and radio commentator who lectures, nationally and internationally on health related topics, Ellis is an active media contributor on Health Equity and Medical Ethics.
For more good health information, visit: www.glennellis.com
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