by Jean Rabovsky
In November 2010 a delegation from APHA traveled to Cuba to learn about that nation's public health system. During an interval of less then one week, more than 70 participants representing a broad spectrum of health-related backgrounds met with Cuban public health officials and visited many facilities devoted to specific public health programs. Among these facilities and programs were primary care clinics (polyclinics), maternity homes, elder care, HIV/AIDS prevention, public health information/communication technology, vaccine production, ophthalmology and oncology. A program providing treatment to child victims of the 1986 Chernobyl explosion highlights Cuba’s sense of internationalism and the provision of health services to people in need throughout the world. A major hallmark of the Cuban public health approach is health promotion/prevention and access to health care by all people throughout the country. Notable outcomes of the Cuban public health system include significant reductions in infant/childhood mortality and increased life expectancy statistics.
Although many facilities were visited, some public health issues, such as the relationships between occupational and/or environmental exposures, were not explored. The contribution of workers to the development of Cuba is acknowledged by the nation, as demonstrated by a prominently placed plaque honoring early 20th century Chinese railroad workers. Current occupational health/safety issues that are of concern include truck driver/taxi driver safety due to use of aging vehicles, exposures during cigar manufacturing, and industrial safety during nickel extraction/refining. Exposures that occur during such activities include respirable size particulate matter, diesel exhaust, tobacco smoke and nickel, which also affect the general population.
In conclusion, the delegation learned a great deal about the public health system during this short visit, including the public health approaches and accomplishments of this nation. Hopefully future travel to Cuba will include discussions about the impact of occupational/environmental exposures on health status. The next delegation will travel to Cuba in May of this year. More information can be found at: http://professionalsabroad.org/overview?program=apha&overview=apha.