Caribbean Health and Sustainability through Cuban Model

Abstract

Over the years, health in the Caribbean has been affected by economic instability and lack of resources. Thus, making sustainability of our Caribbean nations extremely challenging. Cuba’s ideology after the revolution of 1959 focuses on the idea that healthcare should be accessible to all. It provides free healthcare to its citizens and delivers health care around the world. The late Fidel Castro often referred to Cuban physicians as an “army of white coats” in solidarity, providing healthcare to less fortunate countries around the world. Despite its political embargo, Cuba expanded its bioengineering research and eradicated infectious diseases that continue to cause illness and affect several countries today. Among them poliomyelitis was eradicated in Cuba in 1962, neonatal tetanus and diphtheria in the 1970s, and most recently measles, pertussis, mumps, and rubella in the 1990s. As a medical student in Cuba, I saw firsthand how Cuba conducted malaria screening with its international students. A practice that protected international students and Cuban citizens alike. The Cuban Medical system is directed by the Ministry of Public Health. It consists of primary, secondary, and tertiary care levels. Primary care starts at the primary care clinics, or consultorios, made up of one family doctor and one nurse. This medical team provides patient care to approximately 1,000 to 1,500 patients. They see patients in the clinic in the morning hours while the afternoons are dedicated to house visits, pedagogical responsibilities, administrative duties, or epidemiological work. The focus of the epidemiological work is to target issues that affect their surrounding community. For example, during the dengue epidemic of 2007, the afternoon duties for primary care clinics included conducting home surveys to control the spreading of the mosquito and educating families on prevention. The family nurse andphysician programwas established in Cuba in 1984. This primary care team is the center of Cuba’s medicine. They are trained to have an integrated approach to patient care and see their patients as psychosocial beings affected by their immediate environment. This general integrated approach to patient care has resulted in Cuba’s decreased number of emergency room visits, lower rates of hospitalizations, improved family planning, low infant mortality rates, and an overall increase in health literacy in the island. Community is such an integral part of the Cuban healthcare system that the family clinic is often composed of a two-story buildingwhere the clinic is on the first floor and the physician resides on the second floor. This allows the doctor to live in the community he or she works in, while being fully accessible to community members all the time. Secondary care occurs through the implementation of the larger polyclinics, which offer more specialized services to members of multiple primary care clinics in each municipality. These are community