Post number one on my new blog!
Conner Gorry exists as an anomaly in what can surely be considered one of the most highly politicized countries in the world. She is a freelance journalist whose visa allows her to work in Cuba. This status alone is enough to make her a bad ass in my mind, but after hearing her sharp and eloquent presentation on issues surrounding the healthcare system in Cuba, I definitely have a new role model. She currently writes for the US-based publication MEDICC Review, is the author of the iPhone app Havana Good Times, and has also written for the travel guide Lonely Planet.
I consider the information that Conner presented to us as highly informed and fairly unbiased. She has her own ideas about Cuban politics, a stance that was clearly reflected in her talk, but she is in no means an extremist on either side. I guess I feel it necessary to begin by saying this because of how touchy politics, and especially US-Cuban relations, are here. I have also had the (mis)fortune to make over ten visits to two Cuban clinics in my short time here, and from that and some independent research that I have done, I can personally verify some of the information that was offered by Conner.
There are a few basic tenets of the healthcare system in Cuba that were established after the triumph of the Revolution in 1959. Firstly, medical care is considered a right, not a privilege, meaning that it is universal, nationalized and free. Medicines are highly subsidized and there are neighborhood family doctors within easy access of any residence in the country.
Secondly, there is a strong emphasis on preventative medicine. After the Revolution, a massive brain drain took around 75% of Cuban doctors along with many other professionals.Ā At the same time, resources stopped coming in from the United States. These conditions made for a very difficult overhaul of the entire system in which careful priorities had to be made, and so the Cuban government first dedicated its resources to eradicating preventable diseases.
Thirdly, revolutionary Cuba has given priority to serving the most vulnerable populations- primarily pregnant women, infants, and the elderly- through national programs. There are an increasing number of these programs that serve any group of people that is considered vulnerable, no matter what percentage of the population. As an example, any child who qualifies for cochlear implants, approximated value of $30,000, will receive them free of charge along with the frequent adjustments that will have to be made for the rest of his or her life. Deaf or near-deaf children with the potential to be helped by cochlear implants are a very small but vulnerable portion of society, and so they receive the best medical care that Cuba has to offer. This is an interesting example as well because of the debate surrounding cochlear implants in the US. Some members of the deaf community feel that itās unethical to displace a child from the legitimate deaf culture to which she belongs without her consent. As far as I can tell, this debate would be laughable in Cuba, almost like the politico-religious war on abortion.Ā (Abortion here is as common, safe, and of course, free. A stigma does not accompany the procedure as it does in the US.)
They also have a Program for Integrated Transsexual Health, spearheaded by the inspirational Mariela Castro, head of CENESEX. Throughout a two-year process, individuals are first required to complete a āreal life experience,ā of acting out their gender, during which they are given consultation that might include emotional and life-changing family counseling sessions, and finally, the operation is- guess- free! I could ramble on about this for a while because itās so amazing. They have workshops on how to walk in high heels and workshops that emphasize the importance of being yourself instead of feeling pressured to act out gender stereotypes. Oh, and the doctors are trained by Belgian gender-reassignment surgeons who are the best in the world in their field.
Cuba is currently experiencing another huge overhaul of the medical system due largely to the dire economic straits that have continued to dampen the countryās progress since the collapse of the Soviet Union. Still withstanding however, is a biotechnology industry that cannot be overstated. Currently, every Cuban child is given 13 vaccinations, 10 of which are Cuban made. They have the only meningitis B vaccination in the world (and it is not available in the United States because of the embargo- a good example of how the stubborn policy affects the US negatively as well as Cuba). The island is on par with industrialized countries in terms of WHO certified statistics- 4.8% infant mortality rate and a life expectancy that is as high or higher than that of the United States, for example.Ā
The one indicator that was uncharacteristically high in the past was maternal mortality, an inconsistency in the quality of healthcare that generated a national campaign for mothersā health. They want all Cuban women to give births in hospitals, and if a pregnant woman is a teenager, over 35, overweight, lives far from a hospital, or is vulnerable in general because of unreasonable expectations from her family, it is recommended that she live in a maternity home. Under this national program, women are given healthy and calorie-rich diets, and offered plenty of other services such as exercise courses and parenting workshops. In the current systemic overhaul (they refer to it as ācompactación,ā which Conner translated to mean ādownsizingā), there are less maternity homes, but they ones that they have are larger. I personally havenāt visited one, but it sounds like a pretty cushy living situation!
There are a few other characteristics of the healthcare system that Iāll mention. There are huge population surveys that take place in order to paint a clear picture of the nationās health statistics. Not only is this extensive information used to implement efficient changes at the national level, but it has been extremely effective at the individual level as well since each neighborhood doctor has a precise history of each residentās medical history and general health.
Cuba has also offered their medical expertise and labor force to aid foreign countries in times of need. Their disaster relief team, formed after hurricane Katrina, is tailored to be site specific and educational. After the Pakistani earthquake, Cuban doctors sent a team of 50% women doctors due to the particularities of Islam, stayed for six months, and subsequently offered Pakistani medical students a free education in Cuba. Basically if youāre hungry, theyāll feed you and teach you how to fish.
This description has been abridged to an almost unacceptable extent based on how much credit the Cuban medical system deserves, but itās probably enough to make my U.S. friends read and weep. When I went to the hospitals here, they opened up packets of brown paper cardboard that contained sterilized-on-site instruments and gauze. I saw the glass bottle IVās. And once when I asked for a band aide, they had none. Itās amazing to me what this country has accomplished with so few resources and zero help from itās northern neighbor. Every Cuban Iāve spoken with is proud of the medical system here (not without a few complains and suggestions, mind you), and for good reason. It works, and it works extremely well.
Thanks to the amazing Conner Gorry for the information she provided for this post!