This post is adapted from an article originally published in the February 16 issue of GIH (Grantmakers In Health’s) Bulletin.
This January, some members of Grantmakers In Health’s (GIH’s) board and senior staff visited Havana, Cuba, with MEDICC (Medical Education Cooperation with Cuba), an organization licensed by the US Department of the Treasury to conduct people-to-people trips to Cuba. MEDICC promotes cooperation among the US, Cuban, and global health communities to improve health outcomes and equity.
Photo credit: Archie J. Brown
One objective of our trip was to see in action the Cuban approach to health. Another was to see if there were lessons for US communities. MEDICC arranged meetings for us, over the course of a week, with schoolchildren, seniors, hospital patients, community groups, and families with mentally ill members. We talked to family doctors and nurses and to specialists. We walked down Havana’s scenic, low-crime streets, where a variety of living conditions could be observed. It was an exciting time to be in Cuba, knowing that we were on the cusp of changes in relations between our country and Cuba that will have major consequences for everyday people’s lives.
The effects of the fifty-six-year embargo are immediately evident: food is rationed, medical facilities lack certain supplies, and living quarters can be quite dilapidated. Famously, many cars on the road predate the 1959 embargo. Although eye-catching, they are also major air polluters—and almost everyone in our group felt the effects.
The other side of the story is that while material resources are limited, the social vision is rich and strong. We were particularly struck by the remarkable commitment to public health values, which was consistent across the settings we visited and among the health professionals we talked to. This commitment is the product of Cuba’s decision, in the early 1980s, that its country would become the first in the developing world to cover the health needs of every citizen by focusing on prevention and primary care. One of the most-noted results of this focus is that Cuba now compares favorably with the United States on outcomes like infant mortality and life expectancy, without the wide disparities by race and income that characterize the United States.
The basic building block of the Cuban health care system is the neighborhood consultorio, from which family physician and nurse teams—who also live in the neighborhood—serve up to 1,500 people. Their work is backed up by a social determinants approach to understanding health. We heard repeatedly that “health is a social product,” and it is widely accepted that keeping people healthy involves outreach to the community, and community involvement, as well as the delivery of health care services.
Our week’s visit brought about multiple insights about the US and Cuban health care systems, implications for health philanthropy, and other observations. Board members are in the process of capturing their thoughts, which will be published in a few weeks in the GIH Bulletin and on GrantWatch blog.
Editor’s note about the picture above:
Pictured above are left to right, in the front row: Daniel Garcia, Fatima Angeles of the California Wellness Foundation, Wendy Peñalver, and guest blogger Faith Mitchell of Grantmakers In Health. In the center row is Adriana Estrada. In the back row are Patti Doykos of the Bristol-Myers Squibb Foundation, Billie Hall of the Sunflower Foundation, David Fukuzawa of the Kresge Foundation, Archie Brown, Bruce Chernof of the SCAN Foundation, Georgina Gómez Tabio, Osula Rushing of Grantmakers In Health, and Pierre LaRamée of MEDICC. Octavio Martinez of the Hogg Foundation for Mental Health is missing from the picture.
