On
Dec. 10, 2007,
my husband and I traveled with a mission team from Oklahoma Volunteers in
Mission
to
Havana
,
Cuba
. As humanitarians, we were issued a license by the
U.S. T
reasury to legally go to
Cuba
. A primary goal of this mission was to assist in the rebuilding of a church in
Pilón
,
Cuba
that was destroyed by Hurricane Dennis in 2005. As a public health professional, I was very interested in observing the public health system in
Cuba
, having read about the country’s public health strategies that have resulted in health indicators comparable to industrialized countries in a country that has an average annual income of around $2,500 per year.
So, what does community health look like in Cuba? I can give you a snapshot from my experience in Pilón, which is a town of about 30,000 located on the southeast coast of the island of Cuba, a 14-hour bus ride from Havana. Our team of 12 stayed at the home of the pastor, so we got a little more insight into Cuban life than a stay at a nearby resort would have afforded us. How many of us would put up with 12 guests plus six family members in a home of less than 1,000 square feet? The home was small but comfortable; the pastor had borrowed bunk beds from the local school for us to sleep on.
Although we drank only bottled water, the home had basic conveniences such as running water, a flush toilet and a telephone! The kitchen included a refrigerator, sink and propane cook stove. We were served very generous meals and observed the butchering of a goat and a pig during our visit. The pig was for a holiday pig roast, and I watched with interest as we waited for a local health inspector to come and check the pig out before it was killed. Our hosts explained his inspection had something to do with flies (I wonder what my sanitarians would think of that). After the health inspsector gave his approval, the pig was slaughtered out in the back yard. During our seven day stay we ate every meal with our hosts, and no one was afflicted with any of the diarrheal illnesses we commonly associate with foreign travel.
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Shari Kinney getting physical activity shoveling sand to mix concrete as she helps with re-building a church in Pilón, Cuba |
We had two interesting experiences with Cuban health care. The first was our interpreter from Havana who had lost a filling in a tooth. After a phone call to the local clinic, the bus driver drove her to the clinic. She was gone about an hour, returning with a new filling. The second instance was during a pick-up basketball game with the Americans when one of our Cuban friends injured his foot. He went to the local clinic/hospital and an hour later returned with a knee high white plaster cast and explained that he had “broken his foot.” However, there was no walking boot or crutches – he fashioned a cast boot out of a tennis shoe and was able to ride his bicycle. We supplied him with some Tylenol for pain. Over-the-counter medication is in very short supply in Cuba.
There were many aspects of this Cuban community that explain their good health. All women have access to prenatal care from their local physician – Cuba has more doctors per capita than virtually any country in the world (reportedly 1:170). The diet in Cuba appeared to be primarily rice and plantains and local fresh produce, with limited meat and dairy products. I especially enjoyed the strong Cuban coffee, which was served espresso style or with hot milk. We also enjoyed flan for dessert. There was little processed food available to the local population; we were able to purchase canned soda, chips and candy bars at tourist stores.
In Pilón there were virtually no automobiles, so most people walked or rode bicycles around town. The home where we stayed was across the street from a children’s park and another park that seemed to be more for adults. There was also a bus station for travel to other communities, and hitch hiking is also very common. All children went to school at no cost and wore identical school uniforms. We were told that everyone had the opportunity for free primary and secondary education, but also advanced education based on test scores, including vocational training. One of our interpreters was a teacher at the local teacher’s college.
Although the standard of living in Cuba was far below what we have in the United States, public health has been made a priority by the government, and every citizen seems to have access to health care.
By Shari Kinney, MS, MPH, RN; Cleveland and McClain County Health Departments, Norman, Okla., and CHPPD Section Policy Chair
sharik@health.ok.gov.