US Doctors in Cuba: A Tradition Begins
José Jasán Nieves Cárdenas (Progreso Weekly)
HAVANA TIMES — They look Cuban, suntanned as they are. At first sight, only their unmistakable English accent betrays them, even if typical Cuban sayings are a habitual part of their conversation.
About 250 US citizens have been studying in medical schools and practicing in medical institutions in Cuba since 2000, writing with their presence one of the most revealing pages of fruitful coexistence between the United States and Cuba.
The first doctors who graduated from a program created by the US Congress’ Black Caucus and former President Fidel Castro, and later channeled through the organization Pastors for Peace have already returned to their homeland, while the island’s schools continue to train dozens of new students. Every year, more arrive.
Deep-rooted prejudices and stereotypes have been broken by the interaction. The students’ greatest lesson is the realization that they’re both alike and different.
CASSANDRA
The asphyxiating air of Havana’s Monte Street disappears as we walk up the stairs. In the living room, the young Atuey Fénix plays with his grandmother while a computer plays back old chapters of the Sesame Street series.
It’s the home of Cassandra Cusack Curbelo, a Cuban-American who was given a free scholarship to become a doctor in her mother’s homeland.
“I’m Cuban enough so as not to be an extra-terrestrial here, but American enough to be seen as a crazy lady,” she says, smiling, while she prepares vegetarian hamburgers made with crushed grains for Atuey.
Born in Hialeah but raised in Chicago, Cassandra at age 30 decided to reconsider her job as a public relations specialist in an activist group.
“I wanted to do something sustainable. The knowledge of medicine will never go out of style or become obsolete,” she says. A friend of the family helped her to get on a list of scholarship recipients issued by the Cuban Foreign Ministry to solidarity groups.
Upon arrival in Cuba in 2008, she was placed — as all Americans were — in the Latin American School of Medicine (ELAM) on Baracoa Beach, west of Havana. She did her practice at the Salvador Allende Hospital in Havana’s Cerro municipality which is still known by the name of the Catalonian Virgin of La Covadonga.
“I don’t like elitist medicine, and in the United States almost all doctors are white, from wealthy families, who studied at an early age. They don’t usually do workups, generally don’t listen to you, don’t look at you, don’t touch you and they charge you $100 just to show up,” Cassandra says.
“I love the way doctors here talk. My teachers have been very natural and friendly.”
“The program doesn’t force anyone to do anything,” Cassandra replies when asked if political gestures were expected in exchange for her diploma. It would be neither extraordinary nor infrequent for the health authorities to ask doctors to practice in disadvantaged areas in exchange for the free training. But Cassandra insists that it isn’t so.
“Among us, there are people who are not interested in serving anyone. They say, ‘I’ll leave [Cuba], do my residency, and go on to make money.’ But most of us, we have dreams.
“I want to set up a clinic in New Orleans with my friends. Others have thought about Detroit. We have even thought about setting up a clinic in a poor Third World nation where we can spend our vacations and help the local population a little.”
JOANNA
Those who knew her in Havana remember her for her restless spirit and vocation for service. She was an active and renowned student during her years in Cuba. Therefore, her teachers and friends were not surprised to learn that, upon entering the difficult system of medical specialties in the U.S., Joanna Mae Sauers enlisted as a volunteer to fight Ebola in Africa.
Sauers arrived at the Cooper Hospital in Monrovia, Liberia, and tried to join the Cuban medical brigade that was working there.
“I was interested in working as a volunteer with the Cuban doctors, but they told me that they weren’t accepting any graduates from ELAM, given the circumstances of the epidemic. No doubt, it was their example and my experience in Cuba what inspired me to do that work,” Joanna says.
The idea of joining a Cuban brigade was not new to Joanna, a student of specialists who traveled to places like Pakistan, Angola, Venezuela or Haiti and in some cases accepted native doctors graduated in Cuba as members of their “mission.” Her closeness to Cuba was always there, through her solidarity with the people of the island.
“I heard about the program through a friend and applied for the scholarship through Pastors for Peace,” she says. “There are some basic requirements for admission, such as a payment for the application, an interview and an orientation session.
“First, you must be approved by the organization and then accepted into the program by the school. What they seek primarily are applicants who have a proven dedication to serve the needy.
“Most of the people I knew in the States were surprised when they heard that I was going to Cuba to study. They didn’t know that was possible and were amazed when they learned that the program is a totally free scholarship guaranteed by the Cuban government. They could hardly believe that such an opportunity existed.”
Sauers lived on the ELAM campus from her first to third year but later rented a room near the Covadonga Hospital. Learning the Cuban culture and the values of other friends from Africa, South America and the Caribbean was to her as important an education as the medical training.
“There was nothing better than visiting my friends in the provinces and sharing with them a good home-cooked meal, especially a dish of yucca with mojo, congri rice, fried plantains, salad and roasted pork. My mouth waters just thinking about it!” she says.
Hinges for normalization
Like their compatriots who have graduated or are about to graduate, Cassandra and Joanna are small examples of interaction between two countries with a longtime ideological confrontation. They have lived through coexistence without trauma and demonstrate that it is possible to maintain relations of mutual benefit.
The closed medical system in the U.S. — described by many as endogamous and elitist — has begun to accept graduates from Cuba, as reported by Joanna, one of the most recent 13 U.S. students at ELAM who passed the tests to practice medical specialties in the States.
“To me, it wasn’t particularly difficult to get my residency in the United States,” Joanna says. “I had to get through the USMLE [U.S. Medical License Examination] tests, which require rigorous knowledge. I did all I could to get as much clinical experience in the U.S. as I got in Cuba. That meant spending much of my summer vacations doing observations and clinical rotations in the U.S.
“Many programs of competitive specialties were interested in my application, because the ELAM is renowned through the graduates who returned before I did, and those who know about us and the Cuban medical system value our training quite a lot.”
That positive perception is noticed even in the state of Florida, says Cassandra, who says she has heard of hospitals interested in hiring doctors like her. “I know that Baptist Hospital and Jackson Hospital in Miami are,” she says.
Most of the Americans return home after their sixth year. Since the rapprochement of December 2014 they hope that the US will soon have an embassy in Havana but unsure of the possibility.
“As an American, I’m very cynical and say that as long as nothing is on paper nothing is happening. People can talk all they want but it may only be words,” says Cassandra. “[Cuba] is virgin land in the Caribbean and the wolves are drooling to come in.”
“I think the rapprochement is useful for both countries,” Joanna sums up. “Cuba is an example to the world in terms of top-level medical care and training. The US and much of the rest of the world have a desperate need for primary-care physicians. As graduates of this program, we can provide health services for the needy and share our experience with the rest of the world.”
From this experience a new type of doctor emerges — and a new source of interaction.
It is you that are so biased with your posts.
In Cuba only the elite and tourists can have access to “top class medical attention”. The elite for free and the tourists paying.
The Cuban people suffers shortages of everything – doctors, specialists, medical equipment, medicines, food, bed sheets, … – in the decrepit and regretfully by now corrupt medical system for Cubans.
As far as Ebola goes: MSF – volonteers from the US, UK, France, Belgium, – treated ten times as many Ebola victims as the Cubans “press ganged” and induced with cash by the Castro regime. The Cuban doctors only could function thanks to the medical facilities set up by the US and UK military medical corps – which you call “soldiers” – and US logistics.
I can truthfully say that Fidel Castro is a murderous dictator.
Dictator of the right, dictator of the left, dictator wrong. Remember that.
It is you that are so biased with your posts.
In Cuba only the elite and tourists can have access to “top class medical attention”. The elite for free and the tourists paying.
The Cuban people suffers shortages of everything – doctors, specialists, medical equipment, medicines, food, bed sheets, … – in the decrepit and regretfully by now corrupt medical system for Cubans.
You have no knowledge of Cuban reality or you are just plainly lying for dogmatic reasons.
As far as Ebola goes: MSF – volonteers from the US, UK, France, Belgium, – treated ten times as many Ebola victims as the Cubans “press ganged” and induced with cash by the Castro regime. The Cuban doctors only could function thanks to the medical facilities set up by the US military medical corps – which you call “soldiers” – and US logistics.
You clearly don’t know much about Cuba, let alone Cuban doctors. Most Cuban doctors make less than $100 per month. Most of them, a lot less. When given an opportunity to earn 5 -10 times that amount, is it any wonder that they line up to “volunteer”? Since there is no such thing as ‘private practice ‘ in Cuba, there is pressure from their Castro employers to sign up for missions abroad as medical missions generate the single largest source of revenue to the dictatorship. Have you been to a Cuban hospital? That’s to say a hospital for Cubans. Did you spend the night? There’s nothing first, second or third class about Cuban medical facilities. Combined with scarce medical supplies and overworked and underpaid staffing there’s simply no comparison to the experience Americans have access to. Can you tell me which US hospital asks that you bring your own sheets and toilet paper? As far as your “New World Order” crap, are you nuts? Do you want to live in a world where you are not free to work where you want to work or live where you want to live? Do you want to work in a job that pays a monthly salary that won’t buy a pair of running shoes? If you do, then move to Cuba. Everybody deserves the fair opportunity to “bite of the fruit of the land”. The fact that you don’t understand the difference is your problem. By the way, check your facts regarding ‘volunteerism’ of American medical personnel. And thanks for your concern regarding my “conscience”. Everything is just fine.
Can you truthfully call Castro a dictator? What about Papa Doc of Haiti, Pinochet of Chile, and all the other military dictators America trained in Virginia to suppress the Trade Unionists, so that the multinationals could reap huge profits from the sweat, the tears the lives of the workers? How many persons vanished, disappeared or were murdered by these military juntas, did we hear America utter any outcry? If you heard these outcry, educate me, please? From what time is America interested in the human rights of the working class peoples of the world? The Red Indians who are the original natives of America and who have suffered all kind of indignation as human beings, have oft times described the Americans as “SPEAKING WITH A FORKED TONGUE.” They cannot be trusted. You need to clean up the historical slate of America before you can open your mouth to criticize Cuba and the Castros. Cuba does hold free and fair general elections where the people choose their own candidates. School children, not soldiers, guard the ballot boxes!!
Moses, why are you so bias with your comments? Point me a finger in any part of America where the ordinary person can access top class medical attention as in Cuba? In the Ebola situation, how many US doctors volunteered their services? When an earthquake struck the remotest part of Pakistan did the US doctors volunteered their services to help the inhabitants of the area? While Cuba sent doctors to Africa to fight the Ebola epidemic, America sent troops to protect their interests. American doctors are interested in becoming rich off their patients; the Cuban doctors are interested in the welfare of the patients. This is why Americans travel to Cuba to receive first class treatment at a lower cost and more professional and humane service. Stop being so biased man. You almost sound like a racist or an anti- working class person who wants to keep the working class people of the world in total ignorance, abject poverty, living in squalot and dying from want of good medical attention. Do you have a conscience Moses? Is it alive or dead? If it is dead, resurrect it. The Cuban Revolution is ushering in aq new WORLD ORDER in which the exploitation of man by man, becomes a crime against humanity. Everybody must get a bite of the fruit of the land, not just a privileged few. “EVERYBODY!!!!!!!!!!!”
Again, as pro-Castro propagandist, you confuse “anti-Cuban” with anti-Castro. Those are two different things. Castro is the dictator of Cuba, he isn’t Cuba. Neither Castro was elected in free and fair elections and neither can claim to represent the people of Cuba.
As far as the so-called “achievements” or “positive aspects” of the Castro regime: all were the result not of the good work of the regime but of the 30-35% of GDP the Soviet Union subsidized. To give credit for any of these now defunct achievements to the Castro regime is a lie.
Now, after a return to a “real economy” and only limited subsidies from Venezuela health for Cubans in their part of the apartheid health service and education have crumbled.
The bottom line is that the Castro regime just consumed the economic wealth of Cuba and survived on subsidies. There are no “positive aspects” of the Castro regime unless you feel that using other people’s money to make you look good (for a while) is an achievement.
Re-read my first sentence.
It is amazing to me that, for going on six decades after the Batista-Mafia dictatorship was booted off the island of Cuba, that anti-Cuban propagandists in the U. S. can disparage positive aspects of the Cuban Revolution, such as the one depicted in this article. These are, of course, the same propagandists who sanitize such things as the rape and robbery of the island by the Mafiosi, which fled the revolution to regroup on U. S. soil. Both the World Bank and UNESCO recently praised Cuba for devoting an astounding 12.6% of its GNP to education, with another unique percentage devoted to health care. I’m sure Moses, etc., can also assail that difference to the Batista-Mafia dictatorship, which was designed solely to enrich and empower a few at the expense {and worse if they complained} of the majority. In addition to Cuba giving free medical scholarships to hundreds of poor Americans and thousands of others, the BBC has recently applauded Cuba for its “Operation Miracle,” which has improved or restored eyesight to thousands of poor people free of charge, including flights to Cuba for the procedures. I have criticized Revolutionary Cuba but I realize that Celia Sanchez in the 1950s into the 1980s and Josefina Vidal from 2000 till 2015 have been far superior to Fulgencio Batista and Meyer Lansky as leaders and as human beings. To criticize Revolutionary Cuba for such things as its medical scholarships while pretending that such things as the bombing of Cubana Flight 455 are figments of someone’s imagination is, I believe, much more harmful to the U. S. democracy than it is to Revolutionary Cuba.
Taking nothing away from the medical training that Cuban doctors receive, it is simply not correct to label that training as “top-level”. A long time friend of mine is a Harvard Medical School / Johns Hopkins trained neurosurgeon. Another very good friend of mine is the chief of surgery at Calixto Garcia Hospital in Havana. I introduced these two and they continue to converse and share. Both unabashedly admit that there is no comparison of their respective medical training. Cuban doctors have a solid “Third World” education. The good news is that for most patients in Cuba and in other third world countries this training is more than enough. If the only other choice is no medical care, then obviously Cuban doctors are better than no doctors. But to compare Cuban doctors to their US counterparts is unfair. There is no comparison.
“Cuba is an example to the world in terms of top-level medical care and training” Jo, I think it would be better to say Cuba is an example in fairly equitable and very accessible care. Top-level care medicine is still pretty much relegated to the first world. Maybe your comment would be easier to understand if you explained by what you meant when you said “top level”?
Wonderful article. Thanks!