Photo: Marc PoKempner for MEDICC

In March, three members of the UCSF School of Medicine community learned firsthand how Cuba is able to achieve high levels of health for its own people, as well as how they are able to extend a hand to others in need around the globe. Medical Education Cooperation with Cuba (MEDICC), an Atlanta-based non-profit organization, consults with academic institutions in the United States and Cuba on research programs such as this.


Associate Dean of Curriculum Helen Loeser, MD, Global Health Sciences' Coordinator of Educational Programs Tom Novotny, MD, and Jessica Evert, MD, a second-year resident in the Department of Family and Community Medicine, joined a group of 14 professionals from the US medical and public health community to research Cuba's role in global health.

This week-long research program included visits to Havana-based biotechnology and health facilities, as well as to rural and urban clinics, to investigate how post-revolution Cuba has built a health care system that weds primary care and public health, where doctors are placed in communities to practice a community-based model of health care.

Start with the philosophical and political conviction that education and health are inherent rights, add a commitment to free and equal access for all, and you have a system against which to weigh priorities, allocate resources, and deploy manpower.                                                              -- Helen Loeser, MD

Cuba was forced to build up its health resources after half of all doctors fled the country in the 1960's. Since 1984, all Cuban medical school graduates must provide primary care medical service before entering specialty training. This supply of physicians serves all of Cuba's rural and urban populations (at a ratio of 1 doctor for every 220 persons).

But the system also reaches out beyond its borders to educate and provide care for disadvantaged communities internationally. Cuban doctors and other health care workers can volunteer for two-year periods abroad, living and working in the local communities. Cuban doctors have been a presence in several countries for over 20 years.

Cuba has also trained 30,000 health care workers from developing countries at Cuban medical schools. In 1998, Cuba established the Latin American Medical School (ELAM), which focuses on training indigenous students from developing countries to return and serve in their communities of origin.

Low-income US students with good academic records and a commitment to work in underserved areas in the United States are also receiving fully-paid medical education at ELAM. The first of these US graduates has just been accepted into an Internal Medicine Residency at Albert Einstein University in New York. Cuba has also helped establish nine medical schools in developing countries.

Cuba has been instrumental in disaster relief for over 40 years, priding itself on sending teams to the most remote areas, such as the region of the Pakistan earthquake of 2005. In fact, Fidel Castro offered thousands of trained health professionals to New Orleans following Hurricane Katrina, but due to political concerns, the offer was refused.

While Cuban citizens face considerable barriers in terms of travel, trade, and housing, their health system appears fully functional.

There are lessons to be learned from Cuba's efforts to meet the needs of all its citizens, while providing health resources abroad as part of its international diplomacy efforts.

For more information, please come hear Gail Reed, Executive Director of MEDICC, speak at the Fifth annual Student Global Health Symposium, April 25, 2007, 4-7 PM in N-217. The talk will be followed by Cuban food, music, and a screening of the documentary film, SALUD!, describing Cuba's health system and medical education programs.

Source: Jessica Evert and Thomas Novotny