Cuba’s Minister of Health on achieving zero mother-to-child HIV and syphilis transmission and the benefits of ending the embargo

Cuba becomes the first country to eliminate mother-to-child transmission of HIV and syphilis

By Bridget DeSimone, Burness Communications 

Moments before President Barack Obama made the official announcement that the U.S. and Cuba will reopen their respective embassies this month, Cuba’s Minister of Health shared his thoughts about what the normalization of relations would mean for health care.

“We believe in sharing what we have, and this normalization will allow us to exchange experiences and knowledge and construct projects that respond to problems we have in both countries,” said Dr. Roberto Morales. “It will also help people better understand the reality of the Cuban health system, which is free, accessible, regional, and doesn’t discriminate against anyone, no matter the color of their skin or their political beliefs.”

Dr. Morales spoke yesterday at the National Press Club in Washington, DC, just one day after the World Health Organization announcement that Cuba became the first country to eliminate mother-to-child transmission of HIV and syphilis. Morales outlined Cuba’s work to eliminate the diseases and the overall success of Cuba’s health care system which led to these achievements. Programs to combat syphilis that were ramped up the 1970’s led to the island nation’s success in effectively eliminating the disease. Morales said that the annual rate of congenital syphilis has remained between zero and 0.04 percent for births, below the original criteria set by the WHO.

Morales explained that Cuba began the request for WHO validation in 2013. An independent, international expert panel including WHO, UNAIDS, PAHO, UNICEF, and others visited Cuba in March 2015 to validate progress toward the elimination of mother-to-child transmission of HIV and syphilis. Besides visiting health centers and laboratories, the team also certified that services were provided in accordance with human rights principles.

Cuba has among the lowest rates of HIV infection globally. Morales said the annual rate of mother-to-child transmission of HIV has been at or below 2% during the last three years.

Morales also fielded questions about the impact of the 54-year US embargo against the island nation. “The effect of the economic, financial and commercial embargo against Cuba has cost us more than 60 billion dollars,” he said. “What we can’t calculate is the pain and suffering it has also caused. We hope that it can be lifted so that we can acquire the technologies that we currently can’t buy, that the Cuban people really need.”

Morales touted the high quality of the Cuban universal health coverage and public health system despite limited resources. He said that after the Cuban revolution in 1959, nearly half of island’s doctors fled to the United States. But he credited the government with prioritizing the health of the Cuban people through its investment in providing free health care for all, free medical education, and free treatments and free medication for all residents. He spoke of the nation’s booming biotech and pharmaceutical industry and of Cuba’s success in developing hundreds of medications and more than a dozen life-saving vaccines.

Cuba’s life expectancy – about 78.5 years, according to Morales – rivals that of the United States. The United Nations ranks Cuba’s HIV rate as the lowest in the Americas, and its infant mortality rate is much lower than that of the United States.

Morales said that currently 50,000 Cuban collaborators, including 25,000 doctors, provide their services in about 70 countries worldwide, and expressed hope that more countries would be able to collaborate with the island nation and follow its lead in improving health outcomes for all people.

Cuban doctor in Liberia: “I’m just an ordinary guy.”


By Dr. Ronald Hernández


Dr. Ronald Hernández in Liberia.

Dr. Ronald Hernández (left) and colleague on arrival in Liberia.

Our words were “spoken” via Facebook, which for several weeks has hosted e pictures and comments from this doctor who might do well as a journalist himself one day….

Here is the story…

Hello. I hope we can meet. Till then, take care of yourself.

Ronald: Hello. I’m here!

Hello again. I wanted to ask you a few questions, not only because the work you do is amazing but also because you’ve become the face of the group of our health professionals fighting Ebola in Africa. At least on Facebook there are Cubans searching for you to get information on how things are going over there. By the way, I am a journalist for the “Venceremos” local paper, and also a blogger in Guantánamo Province.

Ronald: I don’t think of myself as the face of our group of the Cuban collaborators…in fact, in many of the pictures I post, you see their faces, not mine. I try to keep it like that, so most of the time I’m the one taking the photos. And what I do like is keeping people updated on what’s going on in Liberia.

There’s a lot of misinformation about what’s going on here. Also, it’s a real boost to receive thanks from friends and relatives who I’m about to provide news about.

Exactly. That’s why I wanted to interview you. Is it possible?

Ronald: Sure, you’re already doing it!

So, here’s the first question. Who are you? Where were you born? What did you study? How old are you? What’s your job in Cuba?

Ronald: I’m just an ordinary 45-years-old Cuban guy. I’m a specialist in family medicine. I have two children, three brothers. My parents are still alive, thank God. I am from Banes in the province of Holguin but I’ve always worked in Sagua de Tánamo. Right now, I live in Las Tunas Province and I work in the primary care section of the provincial health department.

I was born in Tacajo on May 4, 1969. I went to s school like any Cuban and graduated from medical school in Holguin in 1992.

I worked as a family doctor for two years as part of the Plan Turquino in Sagua (a program for rural and mountainous areas —Eds.) Three years later, I finished my residency in family medicine. Since then I’ve also headed teams at different levels, in Cuba and in both stints I did abroad: in Honduras and Venezuela.

Are you a leader of the team in Liberia?

Ronald: Here, I’m just a doctor.

Do you hold a degree in epidemiology? Do you have any experience in epidemiological situations requiring such a high level of care and training?

Ronald: I was the deputy director and director of the Municipal Hygiene Unit in Sagua over four years. I’ve taken courses in tropical diseases, medical emergencies and management.
As for experience, I’ve worked in emergencies involving cholera, dengue, malaria and TB. But nothing like Ebola.

How did you make it into the brigade? What was that process? I guess you know that some media are saying it was ‘mandatory’, that you were forced to go…

Ronald: Our disposition to go was the first thing required. Over here, we are just a portion of the ones who wanted to come. There were many more getting ready to do so. But there weren’t enough spaces, which frustrated a lot of the ones left behind. There is nothing ‘mandatory’ about it. I offered to come from the start. My boss didn’t let me go in the first group but I got lucky and he let me come in the second one.

I just said ‘Yes’. I filled out the form and made it to Havana with the rest of the doctors from Las Tunas for a month of training. Then we left for Africa. A lot was explained to us in Cuba before we left.

Did anybody drop out at the last minute?

Ronald: We all had to have a thorough medical check-up—tests of all kinds at the Hermanos Ameijeiras Hospital, and some people turned out not fit to go. The only dropouts in my group were due to medical conditions, by decision of the medical commission.

Rumor has it that you were told that if you got infected with Ebola you couldn’t return to Cuba in five years and in case of death, your bodies wouldn’t be brought back home. Is that true?

10838225_812770345431539_7909124340872962672_oRonald: Look, the fact is that a cadaver infected with Ebola is the most contagious element. Contact with cadavers explains many of the deaths here, too. But, first of all, we’re not going to die here. And second of all, if that were ‘my destiny’, then my body shouldn’t be transported back home to infect you all. That’s the way I think.

My apologies for talking about death. I know a doctor always works surrounded by it, but this time you have it closer than ever. Aren’t you afraid?

Ronald: No, I’m not. For over three months, I’ve been conscientiously preparing myself. Besides, there are situations that remind me that I’m a health professional and I must act as one and save lives. Yesterday, in the ward of confirmed Ebola cases, there was a 10-year-old girl who had lost her entire family to Ebola… and I mean the whole family… looking at her makes you feel like crying. But our job is not to cry; our job is to save her. That’s what we came here for.

That’s hard…

Ronald: Living it is harder, a lot harder…

It must be heartbreaking to see the Ebola patients…

Ronald: It’s the hardest thing…and I’ve seen quite a few. First, the fever, the headache, muscle and joint pains; abdominal pain, diarrhea, vomiting, dehydration and bleeding at every possible level.

Nobody doubts the Cubans’ courage. But taking a look at the images, the number of deaths… many people here on the island look up to you but at the same time think you’re all ‘crazy’… in a good sense… but ‘crazy’ after all.

Ronald: We are crazy–about doing our job. Thinking we’re not going to do it? Now that would be really crazy…

I think people think that way because they wouldn’t have done what you all did, were they in your place. In the beginning you said you were just an ordinary guy but, actually an ordinary person wouldn’t go to another country to save lives putting his own at risk.

Ronald: There’s nothing extraordinary about it. We’re common and ordinary people who’ve been educated based on principles of humanism, altruism and internationalism. That’s our ‘destiny,’ and to fulfill it, we have to do it right.

How did your family take it?

Ronald: Hard. At the beginning it was a mess, no one understood my decision, especially my youngest boy. Then little by little, they grew used to the idea and now they’re more accepting. However, my mom’s birthday was last week and they couldn’t even make a cake for her: she said there’ll be no party until I get back home.

J: I guess that cake will deserve a Guinness Record Award by then…

Ronald: That’s right, maybe so.

How often do you communicate with your family and how does it go when you do?

Ronald: Through email, several times a day. We exchange messages and I call them on the phone. No problems in that sense.

Do you feel safe?

Ronald: Very safe. We have good living conditions, nutrition and protection gear.

What is the work like that you do in Liberia?

Ronald: I already shared that on Facebook, so I’ll copy the text from there and paste it here, not to abuse my fingers that are already hurting, since I’m writing on a cell phone…

It goes like this:

To answer questions I’ve received from a number of people, I’ll explain how the biosafety procedures work, essential for maintaining the good health of all personnel working here. First, the suits are impermeable. As you can see, they cover the whole body including the head that gets covered with a hood that it is part of the suit. We wear rubber boots, masks, glasses and two pairs of gloves.

In between patients we must wash our hands with hypochlorite at 0.5% and change the gloves. We always work in pairs or trios, making sure that each others’ suits are perfectly fit. Not one bit of the skin can be exposed.

The hospitalization of patients is subdivided into three groups: suspected, presumed and confirmed cases. The rounds start with patient one and continue until all have been seen. The flux is always in one direction; there is no coming back to the previous case.

During rounds, there is no use of personal items of any sort, not even pens. Everything is written on an information board: treatments, vital signs, temperature and pulse.10830088_812774718764435_3183339605326629285_o

The most important thing is choosing a suit with the accurate size. And the greatest danger comes when you take off the suit, which might be contaminated with fluids or vomit from the patients.

On our way out, we get help from the epidemiologists. They are the soul of this mission. They guide us through all the steps for taking off the suits. They also give us psychological support, because after wearing the suit for two hours straight, we’re anxious to take it off and drink water, but we have to keep calm.

First, we get showered with hypochlorite at 0.5% all over the body and then slowly, we start shedding our protection…washing our hands… Anyway, it is a long, complicated and highly professional process that keeps problems from arising.

Another thing–if someone is working in the “red area” [where confirmed cases are hospitalized//Eds.] and starts feeling bad, becomes too thirsty or requires relief from a physiological need, the work stops right there and then, and the person is guided outside by their partner. After this is done, the person then gets supplied with oral rehydration salts and water.

We have set times to rest. The work is carried out in six-hour shifts, but we work in the “red area” for only two hours.

I hope this answers your question.

From a cell phone? My apologies. Just two more questions. How were you received by people in Liberia? Have you received encouragement through social networks? What do they say, the people who contact you?

Ronald: These are almost two questions… hahhaha. We never thought we would be received with so much public affection. The people who work with us every day are even speaking some Spanish. Every now and then, they tell us how grateful they that we’re here. It’s become like a second home to us.

Well… two questions, three questions… I know you have spent just a short time there, but I’m sure you already dream about coming back to the things you love. Your return to Cuba–because I’m sure you’ll come back–how do you imagine it?

Ronald: When I get back to Cuba, the first thing I want to do is see my family. Then, have a nice Cuban meal and then go back to work, which is my thing.

If you ever decide to leave medicine, you’d sure do well in journalism. You write well and clearly… anyway, thanks so much for sharing with me some of your Sunday time.

Ronald: A pleasure, my friend… and thanks but I would rather stay doing my thing.  Abrazos to all.

Trading white coats for Ebola protection suits: Cuban volunteers gear up to fight Ebola

Pierre M. LaRaméeBy Pierre M. LaRamée PhD and Gail ReedGail Reed MS in Havana

Dr. Jorge Pérez, director of Havana’s Pedro Kourí Tropical Medicine Institute, provided an update to a MEDICC group in Havana on preparations for Cuban medical volunteers to leave for West Africa in the next few days, providing critically needed medical assistance to African countries impacted by the Ebola epidemic.

Dr. Jorge Pérez--The first Cuban Ebola team will leave for Africa within days.

Dr. Jorge Pérez

The first team of the 461 health professionals will be dispatched to Freetown, Sierra Leone, and later to Liberia and Guinea if requested of those governments and the World Health Organization (WHO), he said. The Cubans will be working under the umbrella of the WHO, whose Director Margaret Chan has said that trained human resources are the missing link in the fight against Ebola, and has praised Cuba for sending the largest contingent of any country. The epidemic has already taken 3,000 lives and infected more than 6,500 people.
Dr. Pérez noted that 15,000 Cuban health workers have volunteered to go from which the 461 candidates have been initially selected, based on their prior experience in treating patients in epidemic and disaster situations. He strongly emphasized the voluntary nature of their commitment and described the rigorous training being received to master new state-of- the-art sanitary procedures, including the correct use of protective suits and the proper handling of patients as well as medical waste.

Suiting Up To Tackle Ebola

Suiting up in Havana for Ebola in Africa( Photo: Courtesy of Tropical Medicine Institute, Havana)

MEDICC CEO Pierre LaRamée and MEDICC Research Director Gail Reed had the opportunity to visit the mock field hospital set up on the grounds of the Institute, where they examined the layout of the tent-wards and briefly experienced the extreme conditions under which these volunteers will be toiling. Even without the suits, the tents are unbearably hot under the intense tropical sun. Part of the training has involved limiting the permissible suit-wearing shifts to a maximum of three hours.

Dr. Pérez declared prevention as “the most important measure”, and emphasized that the Cuban health workers have received extensive training from Cuban professors and foreign experts from WHO and the Pan American Health Organization (PAHO). He said “we will cooperate with professionals from any country, including the United States.” In fact, the preparations already involve three US specialists contracted by PAHO as well as one each from Italy and Brazil.

Cuba’s track record of offering disaster responders to other countries dates back six decades, to the brigade sent to post-earthquake Chile in 1960. Most recently, medical personnel has been dispatched to the Caribbean and Central America (1998 Hurricanes George and Mitch), Pakistan (2005 earthquake) and Haiti (2010 earthquake). The island’s ongoing international medical cooperation is carried out with personnel staffing public health facilities in underserved areas in in 66 countries, and also includes training nearly 25,000 doctors from over 120 countries since 2005, graduates of Havana’s Latin American Medical School.

MEDICC's Dr. Pierre LaRamée inside mock field hospital in Havana

MEDICC’s Dr. Pierre LaRamée inside mock field hospital in Havana

Emphasizing the urgency and severity of the crisis to the Security Council, UN Secretary-General Ban Ki-moon declared, “The Ebola crisis has evolved into a complex emergency, with significant political, social, economic,
humanitarian and security dimensions. The suffering and spillover effects in the region and beyond demand the attention of the entire world. Ebola matters to us all. The outbreak is the largest the world has ever seen. The number of cases is doubling every three weeks.”

Dr. Pérez told the MEDICC group—in Cuba on a People-to-People educational exchange—that the first measures taken back in March were designed to protect the island nation’s own population. He said that as early as last March, his Institute began training local personnel working at Cuban ports of entry on how to look for Ebola symptoms, and began preparing an isolation ward at the Institute’s hospital.

Tropical Medicine Institute Ebola Trainer Dr. Madelín Garcés with Volunteers copy

Tropical Medicine Institute Ebola Trainer Dr. Madelín Garcés with Volunteers

No cases of Ebola have entered the country thus far, he said. The first case to enter the USA on a passenger plane was reported yesterday in the USA, a patient now being treated in Dallas after a flight from Liberia.

Residency Match Day

Residency Match Congratulations


On Friday, March 21st results of the National Resident Matching Program (NRMP) were released. MEDICC extends a hearty congratulations to the nine ELAM graduates who matched to residency programs in Family Medicine, Internal Medicine and Pediatrics this year. We’ve listed the graduates who wanted to share their good news publicly below. Please join us in sending them all a big ¡FELICIDADES!

Akua Brown (2011) – Internal Medicine, Wyckoff Heights Medical Center, Brooklyn, NY
Nadra Crawford (2012) – Family Medicine, Contra Costa Regional Medical Center, Martinez, CA
Desta Ellis (2009) – Family Medicine, Kaweah Delta Health District, Visalia, CA
Jessica Standish (2012) – Family Medicine, Glendale, Adventist Medical Center, Glendale, CA
Jonas Telson (2013) – Family Medicine, Mid-Hudson Family Practice Residency, Kingston, NY
Janice Verbosky (2012) – Pediatrics, Woodhull Medical & Mental Health Center, Brooklyn, NY
Medina Vernon (2012) – Internal Medicine, Woodhull Medical & Mental Health Center, Brooklyn, NY


US Health Researchers Look to Cuba for Better Outcomes


US Health Researchers look to Cuba for Better Outcomes: Team welcomed by Cuban Officials

By Joseph Vargas 

For many Americans, Cuba is perceived as a forbidden island associated with Soviet era revolutionary leaders mixed with distant memories of cold war politics that culminated in the Cuban missile crises of the 1960’s.  Although the country maintains its Communist ideology, Cuba has evolved from a bourgeois playground in the 1950’s to a vibrant and emerging developing Caribbean nation that has some of the region’s best health and disaster programs.

Eleven health care professionals were selected to be part of a research team to examine Cuba’s distinguished public health and advanced emergency disaster infrastructure. For most of the teams researchers, including HCA Health Promotion Division’s Joe Vargas, it was their second Cuban visit since their initial research visit in 2010. The 2-week research study was composed of a variety of health care individuals including emergency physician assistants, nurses, a pharmacist, a research scientist, public health officials, a firefighter, paramedics, and a medical equipment designer.

The trip was arranged through MEDICC, an Oakland-based non-profit organization that works to enhance cooperation among the Unites States, Cuban and global health communities to understand and learn how to foster better health outcomes.  They also served as the groups official academic advisors throughout the visit arranging meetings with Cuban officials at Hospitals, Clinics, Public Health Ministry, Red Cross, National Ambulance Service, Meteorological Institute, schools and community organizations.

Since the United States has not had diplomatic relations with Cuba and an embargo since the 1960’s, travel to Cuba is restricted to select permitted individuals.  Fortunately, this group was allowed special permission visas under the US Treasury Department general license for professional research that includes full-time health related professionals conducting research in Cuba.

Polyclinics: Cuba’s answer to community health

The research group followed a Cuban government approved itinerary that was rigorous and nonstop, covering three main cities on the island nation; Habana, Santa Clara, and Cienfuegos. The trip initiated with field visits to Havana’s unique and efficient public health clinics termed Polyclinics. The strategically placed clinics serve as a hub for the neighborhood that include a doctor/nurse team that live in the community and an accredited research and teaching center for medical, nursing and allied health science students. In addition to providing primary care at their office, the doctor/nurse team make visits to the homes of their patients to conduct health audits and home care visits. Secondary care is provided at the Polyclinic facility where there are specialists that include lab, x-ray, physical and occupational therapy, dental, acupuncture and other services not offered in the neighborhood medical office. Tertiary care is provided at larger hospitals in larger cities, like Havana, where surgery and other more specialized treatments are conducted including transplants.

Vargas 3

The polyclinics are responsible for about 80- 130 families in their catchment area. One unique requirement is that Polyclinics are required to continually monitor and routinely conduct a health assessment of the neighborhood population they are responsible for and transform the service offered by the clinic, based on these needs. As it was explained to the US researchers, if the data or health picture of the community indicates that there is an increase in a health issue like smoking, then services like cessation counseling sessions would be increased a few days a week. Likewise, if there is an increase in a communicable disease in the community, then extra campaigns, monitoring and education would be directed expeditiously within the community to deter further cases. Polyclinic officials commented that because of their lack of financial ability to purchase costly medical equipment and supplies, Cuba medical personnel rely intensely on primary prevention efforts because they understand this to be the most cost-effective alternative to prevent future medical complications.  A quick look at Cuba’s health indicators are a reflection of the strong preventive primary-care structure enacted for the last 40 years. Many of these numbers surpass or are equal to industrialized countries in the world. According to WHO, Cuba has one of the world’s highest life expectancies at 77 years (WHO, 2008).

Public Health’s Neighborhood Participatory Model

The research team was fortunate to be able to visit the National School of Public Health and talk with Cuban medical professionals about the Cuban Public Health system and their vast disaster experiences working in austere environments. Cuba has a history of sending large numbers of medical teams internationally that are affected by disasters including recent missions to Pakistan, Haiti, Chile, Peru and Indonesia. The two countries were able to exchange viewpoints of best practices in managing medical care and disaster preparedness to vulnerable populations. Both international teams agreed that preparedness must be viewed and embraced by the local people as a community wide effort, ensuring that everyone works collaboratively due to limited availability of health and emergency services during disasters. The US research team expressed particular interest in the success of the community participatory model where every Cuban whether young or old plays an essential role in their community’s health and quality of life. The team was able to see this in practice through their participation in a neighborhood meeting. At the core of these weekly meetings held in front of the elected neighborhood leaders residence is an opportunity for all residents to share any of their community concerns. Most importantly any residential issue from concerns of senior transportation to unsafe street lighting can be identified by any resident young or old and resolved through the neighborhood leader process.


Universal Health Care: A Cuban Right

A prominent yet important lesson researchers had to comprehend was the repeated reference to universal health and the Cuban Constitution throughout the visit.  This is in reference to article 50 of the Cuban Constitution that stipulates that all Cubans are entitled to receive free medical care and to have their health protected.  It also details the government to provide medical and hospital care free of charge, including dental care, prophylactic services and access to specialized centers.  Other key and impressive components of the Constitution embrace preventive care, specifying that the State shall develop plans for health education, programs for periodic medical examinations, immunization and other preventive measures.

International Conference

The research team was also invited to attend the 2nd Annual Health and Disaster Conference in Habana, Cuba. The international conference consisted of workshops in mental health, risk-communication, international cooperation, communicable diseases and vulnerable populations. Workshop presenters included experts from Ecuador, Argentina, Chile, Mexico and Great Britain. As invited guest, the US delegation was invited to provide an impromptu presentation related to US disasters. The conference provided a unique opportunity for the US researchers to share earthquake preparedness plans for California’s high-risk fault areas. Conference attendees were captivated once they were introduced to the risk-reduction models and emergency procedures that the team has experience with. Most of the US team are also members of Disaster Medical Assistant Teams(D-MAT) in California and have responded to numerous national and international disasters. Several foreign press were present including Radio Habana and Cuban television to interview team members and spotlight the research visit and the findings of the US group. 


Early Disaster Training in Schools


One of the most memorable visits was to Orlando Pantoja elementary school outside of Havana. Upon the arrival of the team the whole student body participated in a welcoming friendship song waving their uniform scarves from the balconies of the three story school building. To show their enthusiastic understanding of their disaster training, students from 3rd grade gave an impressive demonstration of first aid skills that included applying splints, neck collars and CPR. Faculty were equally proud to demonstrate that the lesson plans Vargas8include emergency and disaster preparedness as early as the first grade due to Cuba’s geographical exposure to numerous tropical storms. Random conversations and interviews with children throughout Cuba confirmed the children’s thorough command of these critical preparedness skills and knowledge. The group learned that this early institutionalization of disaster preparedness is extremely effective and reflected in data that indicates smaller numbers of fatalities related to major tropical storms in Cuba compared to other industrial countries with more financial resources.

To finalize the research visit, the group toured several medical facilities including a hospital, ambulance headquarters, emergency dispatch facilities, Red Cross, and meteorological institute.  At these facilities, the research team was able to get an inside account of Cuba’s robust primary prevention focused medical system and understand it’s critical ties to civil defense teams, meteorological and information sharing systems.

After their return to the US, the research team is currently processing information for submission to academic journals for publication and scheduling presentations to share their experiences in Cuba to interested organizations.


World Health Organization,The World Health Report 2008: Primary Health Care Now More Than Ever. Geneva, 2008.

MD Pipeline to Community Service—One Student’s Dream

Fourth-year medical student Sarah Hernandez’s ultimate goal is to serve as a family physician in her hometown in Sacramento, California. Re-opening a medical clinic at a neighborhood center— where she and her family have volunteered and received services from—is her dream.  The eldest of three children from a single-parent household, she learned early in life the values of giving back to the community. 

Sarah explained, “I have committed to working in solidarity to create sustainable systems and programs tailored to heal damage suffered from environmental, social, political, and economic health determinants in my community, or wherever there is a need for my services.  I believe that health is a human-right to a harmonious well-being (spiritually, biologically, psychologically, and sociolSarah Hernandezogically) that is achieved on a personal and community level.”

A full scholarship to the Latin American Medical School (ELAM) in Havana offered Sarah a path to becoming a physician.  As a non-traditional medical student, she may not have had this opportunity to train as a doctor.  At ELAM she is receiving a medical education that emphasizes integration of clinical knowledge and skills with public health.  However, Sarah and other US ELAM graduates face formidable obstacles returning home, including their status as foreign medical graduates, extreme financial burdens, and unfamiliarity with residency placement procedures and the workings of fragmented US health care delivery.

Through MEDICC’s MD Pipeline to Community Service program, she has received support in the form of mentors, fellowships for medical exam preparatory courses, and summer placements in US medical facilities.  Through a Kaiser Permanente Community Benefit grant, Sarah and 14 other US ELAM students were matched with healthcare sites throughout Northern California in the summer of 2012 to gain critical US clinical experience. At her observership at Kaiser Permanente San Francisco, she spent a month in rotations, shadowing physicians, practicing note taking and presenting, and working through the differences between the Cuban and US healthcare system, such as style of oral presentations and electronic records systems.

Sarah remarked, “There are a lot of things to learn, but it pushes me to work harder and find those niches where I can apply my excellent Cuban medical education with my US clinical training…exposure to a US clinical setting is essential to my training and possible residency placements.”

MEDICC’s investment in medical students such as Sarah will result in a more diverse physician workforce better equipped to meet the needs of underserved communities around the country.  The social commitment; cultural competency; bilingual fluency; and orientation towards preventive, primary and community health care offered by this outstanding group of young physicians-in-training are precisely the attributes needed to tackle the nation’s profound healthcare and health equity challenges.

Cuba Graduates More Doctors for the World: Class of 2011 Includes 19 US Physicians

July 23, 2011, Havana–Following stirring choral offerings ranging from Ave Maria to We Are the World, 19 US medical students were among those awarded their degrees at today’s graduation of physicians, nurses and allied health professions of the Medical University of Havana’s Dr Salvador Allende Health Sciences Faculty.  The new US physicians are among 1396 international medical students graduating this week throughout Cuba who were enrolled in the full-scholarship Latin American Medical School (ELAM) program.  They all completed a bridging course and another two years of basic sciences study at ELAM’s main Havana campus, before fanning out to health sciences faculties across the country for their final four clinical years.

US Graduate Michael Woods

Here in Havana, Allende is one of the faculties celebrating graduations today, 22 countries represented in its Classof 2011, including Cuba and the USA. In his remarks, Allende’s Dean Dr Jorge Jimenez called them “worthy young men and women ready to do battle for health anywhere in the world.”

ELAM Rector Dr Juan Carrizo noted that, since the first ELAM students received their degrees in 2005, the program has graduated over 9900 MDs from the Americas, Africa and Asia. He praised those who made their medical studies possible, including the students themselves, their parents and professors, and former President Fidel Castro whose idea founded the ELAM program. “We owe ourselves to our vocation,” he reminded the graduates in closing, “to see people as patients, never clients, and to apply our knowledge, skills and commitment to help them.”  Dr Carrizo was among various speakers who paid tribute to the late Rev. Lucius Walker, director of the Inter-Religious Foundation for Community Organization (IFCO)/Pastors for Peace, whose work was vital to the US contingent of students, calling him a “courageous man of principles.”

MEDICC International Director Gail Reed was a guest at the graduation. She explained that MEDICC provides the ELAM program with latest-edition textbooks and carries out cooperation projects with students from Haiti, Honduras and the USA. MEDICC supports US graduates’ transition into medical practice through the MD Pipeline to Community Service, which awards fellowships to defray the costs of US board exams and preparatory courses, provides students and graduates with US physician mentors, coordinates clinical opportunities for students in US public hospitals and community health centers, and conducts outreach about ELAM to US residency programs. “Our heartiest congratulations go to these wonderful young people from across the United States,” she said. “And we want to let them know how much they are needed back home, where health disparities continue to plague our communities along lines of race, gender and income.”