The fourth day of our trip was unique because we had a scheduled evening activity, which was to visit a group referred to as the Committee for the Defense of the Revolution (CDR). We didn’t know much about the CDR, but our tour guide thought it would be best to allow the group to introduce themselves and tell us about their purpose. Arriving to the meeting location proved to be quite challenging. The sun had already set and the streets of the neighborhood were dark without any lights or street signs. A member of the group, on a moped, had to intersect our bus and guide us to the final meeting location.
When we arrived the first thing that stood out was a group of young school girls, who were in their uniforms standing in a straight line, holding Cuban flags and a paper in their hand. The president of the organization introduced herself and mentioned that the girls were waiting to read us a poem. The poem that they read was related to the significance of the revolution and the momentous and influential role of Fidel Castro in Cuba’s revolution. Once the young girls had finished the president addressed our group and told us the purpose of their group and introduced some of the members. We met a physician, a public health university professor, as well as entire families. The girls and young boys in attendance then proceeded to give each one of us Cuban flags and posters as a souvenir of our meeting. We returned the favor and provided them with small gifts such as: school supplies, candy, and small toys that as a group we had gathered and brought as a token of our appreciation.
The children and adults present all seemed really glad and appreciative of not only the gifts, but of our presence. The feeling that night was one of joy, respect, and admiration. One of the young boys that we got to meet was so excited to meet us that he proposed we danced to one of his favorite songs. As a dance and music lover I couldn’t resist his offer. Moved by our presence and our gestures one of the mother’s who spoke English thanked us in detail and welcomed us to come again.
Overall, I learned that the CDR is a group of women, men, and young adults that unite in each community to defend their way of living and ultimately support the revolution. The major focus of the group is to promote social welfare and to encourage their members to participate in community events. The specific neighborhood group that we visited had made the most blood donations and therefore was the one chosen to represent the CDR for their exemplary work.
MATERNITY HOME VISIT
As we have learned during our time in Cuba, health maintenance is seen as a public duty. The same applies to pregnant women in Cuba. They are screened early in pregnancy to prevent and assess for potential complications at the consultorio level by the family physician and nurse. If the woman is at risk for or has pre-existing co-morbidities, she can be referred to a maternity home. The maternity home houses and cares for pregnant women who need special monitoring. There are 138 maternity homes in Cuba. Diagnoses range but are not limited to uncontrolled diabetes, gestational diabetes, multiple gestational pregnancy, nutritional deficiencies, and pre-eclampsia. One of the main goals of the maternity homes is to reduce low birth weight and infant prematurity.
The women referred to the maternity home live there until delivery, at which point they are transferred to a maternity hospital; they are fed a balanced diet, are provided education for their situation, their families are able to visit at any time, however the women are not allowed to leave the facility. Services accessible at the maternity home are social and dietary services, dentistry, ultrasound, laboratory, acupuncture, a gym, beauty salon, and a library. This raises a question. How would American women respond to this type of treatment plan? When the maternity home nurse was asked about patient compliance, her answer was “we don’t have that in Cuba, if they have to come, they have to come. They do what the doctor recommends.”
The women in the home that we visited during our stay appeared content. One shared that she was expecting twins and that she was happy to stay in the maternity home for the safety of her children.
LATIN AMERICAN SCHOOL OF MEDICINE
The ultimate experience of the Cuban Healthcare system and the free education! In Cuba the Latin American School of Medicine (ELAM) was created in 1998 as a comprehensive health program and a project of solidarity among the Latin American countries. Although the project began toward the end of 1998 the first students besides the native Cuban residents did not arrive until February of 1999 from Nicaragua and Guatemala. The school of medicine was converted from a military school to provide for victims of the hurricanes in Central America. A full inauguration followed in November of that same year with special attendees Fidel Castro and the King and Queen of Spain. ELAM now provides education for over 110 countries including students from the United States. 28,000 doctors have graduated from this school of medicine, and 145 of those students were US students who are now working for the underserved population in the US. The physicians are trained to work in the community and are placed in community settings to broaden their perspectives about preventative care in the community. The prominent Healthcare system of Cuba relies on the education of future Cuban doctors. They take pride in their medical training emphasizing on the value of the human life, healing touch, active listening, alleviating pain, and saving lives. From the beginning of their training cuban medical students are expected to become general and primary care physicians (PCP) in order to meet the needs of their communities. By doing so they emphasize on primary prevention and health maintenance in order to avoid acute hospitalizations and the growth of chronic conditions. Once their PCP training is completed then they are given the opportunity to pursue other specialties.