CubaPLUS Magazine

Having written and published about medical advances in Cuba over the past five years, I have become knowledgeable about the health care system in Cuba. In Cuba, rather than waiting six months for a brief meeting, you can call your cardiologist or other specialist and he will come by your house at night to share a cup of coffee. Cuba has without argument the best national healthcare system in Latin America, and one of the best in the world. Cuban citizens do not have to pay for medical treatment. A great majority of the population are covered by the Family Doctor Program, whereby they have an easily accessible personal physician in their immediate neighborhood.

Despite a 50-year trade embargo by the United States and the post-Soviet collapse in international support, the Cuban nation has developed a world-class health care system. The average life expectancy is 77.7 years, compared to 81.2 years in Canada, and infant and child mortality rates match Canadian standards. In Cuba, there is one doctor for every 170 people, which is more than twice the per-capita average of many developed countries.

These data were not achieved easily. In the prerevolutionary period before 1959, Cuban medical practice and research were highly influenced by the scientific approach of the U.S. and French schools. With the arrival of the Fidel Castro government, this turned out to be a plus and a minus: Cuban physicians were highly trained and well respected, but nearly half of them left for the United States when the new government set about drastically reforming the health sector. Thus, from 1959 through 1967, the island of six million people lost 3,000 of its 6,300 physicians and found itself with just 16 professors of medicine and a single medical school. The new government defined health and education as social responsibilities of government and individual rights of citizens. Thus began the difficult task of creating a unified national health care system.

In the 1960s, doctors of the new health system took steps to recruit doctors for the Rural Health Service, setting up 50 new rural hospitals; establishing over 160 community clinics in urban areas; and initiating the badly needed national childrenrsquo;s immunization program. Health expeditions were organized in which teams of physicians, nurses, and paramedical personnel traveled to rural areas in order to diagnose, treat, and refer patients for medical care.

In the 1970s, the first investments were made in new general hospitals and pharmaceutical production plants. The community clinic, or polyclinic, model of primary health care was reinforced and expanded, taking on health education, prevention, and environmental monitoring. Maternal-child health, from the start a priority for the new health system, evolved into the first national comprehensive health program.

The 1980s saw the takeoff of the biotechnology industry, which would put Cuba in the forefront of global vaccine research. There was also the introduction of the Family Doctor Program in 1986, which placed doctor-and-nurse teams literally next door to their patients. By the early 90s, over 95% of Cuban families would receive primary medical attention in their own neighborhoods.

In the 1990s, Cubarsquo;s economy shrunk by 35% due to the collapse of the socialist bloc. The cash flow for medicines, equipment, and supplies was heavily reduced, as well as Cubansrsquo; daily caloric intake. As Cuba slowly emerged from the crisis, several other projects to maintain and develop public health were in the works. An example was the 2004 national program for refurbishing the countryrsquo;s 400 and some community polyclinics.

In addition to providing high-quality medical care for its own citizens, Cuba has also been a popular medical tourism destination for more than 40 years. Many patients who travel to Cuba are attracted by the reputation of Cuban doctors, low prices, and warm beaches on which to recuperate. In 2006, Cuba attracted approximately 20,000 medical tourists. This number is foreseen to grow with the increase of visitors to the island.

Granted, there is room for improvement in any system, but I believe in giving credit where credit is due. Healthcare being one of the main challenges facing the world today, Cubarsquo;s achievements cannot go unmentioned.

The countryrsquo;s health system began to share its experience with other developing countries as doctors from Cuba were also sent to assist in poorer nations. Cuba has sent its doctors to many African nations and has established hospitals in other countries. Such is the case in Haiti, where around 1,300 Cuban-trained doctors, both Cuban and foreigners, play an important role in the relief aid after the 2010 earthquake. There were already at least 350 Cuban medical personnel working in Haiti before the earthquake, sent by the Cuban government to provide free care in nearly every Haitian municipality. Cuba also offered to send doctors to the United States to assist in the disaster after Hurricane Katrina.

The Cuban health care system is already helping to improve the quality of life of people suffering from health issues and other crises, and it has proven its success on the world stage. In the near future, I plan to work with Cuban Medical Services in offering medical procedures to North Americans. Together, we can make Cubarsquo;s world class health system available to those who need it most.