We were only 90 miles away from the U.S., but it felt like we had crossed the border into a different world and into another era. The entire city of Havana, Cuba had such a romance to it with the stunning views of the European style building facades, the ever-present smell of the fumes coming from the Frankenstein Chevys, and the frequent sound of live music being played in paladares (in-home restaurants) and on street corners displaying the heartbeat of the community. No one could deny the charm of this colorful city and its friendly people. However, while I admired the beauty of the environment and the culture, there was no hiding the deteriorating infrastructure and the obvious need for improved sanitation and living conditions.
Being born and raised in the mostly anti-socialist U.S., there were constant thoughts running through my mind throughout this trip that questioned the ability of the government to provide for its people, especially when I witnessed run-down residences, old men asking for change, and numerous health risks throughout the city. These thoughts were challenged, however, when we were presented with Cuba’s health outcomes, which were surprisingly comparable with, if not better than the U.S.’s health outcomes. I was shocked that, despite the lack of building codes, safety regulations, and sanitation requirements, the government manages to keep the citizens of Cuba relatively healthy with low rates of infant mortality, low rates of HIV/AIDs, and with many common infectious diseases eradicated.
As we visited each clinic, each educational center, each school, it became clear to me that the successes of the Cuban health system can be largely attributed to three differences from the U.S.: The Cuban government’s economical practices based on its limited resources, the focus on primary and secondary prevention and promotion, and the underlying cultural sense of community and solidarity. In Cuba, health care costs are kept at a minimum through the country’s resourceful practices and their upstream solutions to preventing expensive downstream problems. In the U.S., we become so focused on providing the “best” treatments by breaking everything down into specialties that we often lose sight of the bigger picture. Instead of spending on expensive end-of-life treatments that often become futile, Cuba’s government invests in primary and secondary prevention practices, in which health is integrated into everyday life through schools and advertisements, as well as throughout the community. Clinics are easily accessible, and income is not a determinant of the extent or quality of health care one receives. The underlying feeling of shared social responsibility, however, remains to be the biggest difference between Cuba and the U.S., where we tend to value individual rights above all else.
It is evident to me now why the health care system is something that the Cuban people take such great pride in. Although it would be impossible for us to simply “cut and paste” the Cuban health system into our American way of life, I believe the preventative, multidisciplinary approach to care that the Cuban government provides for its people is something worth studying more closely in order to improve the status of our own health system.
While the country itself may not be the wealthiest, there is no doubt that its people are rich in health, in history, and in culture. As I go on to finish nursing school and begin practicing as a nurse, Cuba’s integrative, preventative, and egalitarian approach to health care will always be something I will keep in mind, while the infectious spirit of the Cuban people and their strong sense of community will always remain in my heart.
By Jessica Salamat, MECN Student