A national commitment to community health has been the hallmark of Cuba’s health system for the past five decades, and one that has fascinated Dr. Robert Winn, associate vice president for community-based practice at the University of Illinois Hospital and Health Sciences System.
He thinks his Cuban colleagues could have the key to improving the health of people in some of Chicago’s most impoverished neighborhoods.
“Not only do they actually try to educate their patients about medicine, but they really educate their patients in the context of having the community take care of one another,” said Winn. “There’s a sense of social capital where they think that a part of healthcare is not just the delivery of the medicine, but it’s also the active participation of the community in their own health.”
Community involvement was one of the key insights he gained after UI Health recently hosted officials from the Cuban Ministry of Health.
The two organizations are launching a two-year initiative aimed at sharing best practices in providing community-based care. The goal is to reduce infant mortality rates, as well as improve maternal health and cancer screening.
Cuba, which offers universal healthcare, has one of the lowest infant mortality rates in the world with an estimated 4.5 deaths for every 1,000 live birth in 2016. The U.S., on the other hand, has one of the highest infant mortality rates among wealthy nations, at 5.8 deaths for every 1,000, ranking just behind Bosnia and Herzegovina.
Cuban doctors are considered extraordinarily competent despite using outdated equipment and medical treatments and lacking financial support.
“We have taken one step toward opening a door,” said Dr. Jose Armando Arronte Villamarin, chief of primary health for Cuba’s Las Tunas province, via an interpreter. “And the possibilities it can open up through this bilateral cooperation could be unimaginable.”
Last year, the World Health Organization announced that Cuba had become the first nation in the world to eliminate the transmission of HIV and syphilis from pregnant mothers to their children. The WHO said it was “an important step towards having an AIDS-free generation.”
A second, larger delegation from Cuba will visit Chicago in the spring for a stay lasting three to six months.
The Obama administration’s efforts to renew diplomatic relations with Cuba is in part to have the two cultures learn more from each other.
“It is not just a matter of what we can bring to Cuba, it’s also a matter of what Cuba can bring to us,” said Sen. Dick Durbin (D-Ill.) during a town hall meeting held at UI Health on Friday. “What they can bring to us is decades of public health service with dramatically positive results.”
The Obama administration on Thursday stopped a decades-old policy that allowed Cubans automatic entry into the U.S. They now must undergo the same naturalization process as other foreign nationals. The move also put an end to the Cuban Medical Professional Parole Program, which allowed access to Cuban medical personnel conscripted by the Cuban government to work or study in another country. The Cuban government said the program reduced its number of healthcare workers.
It is unclear what stance a Trump administration will take toward Cuba. If President-elect Donald Trump decides to reverse the current U.S. policy toward Cuba, it could hinder UI Health’s initiative. Winn said he wasn’t concerned given the humanitarian nature of the initiative.
“I don’t really think that in my mind even with a new administration that there would be any fault being found in the context of partners working together to benefit health,” Winn said.
Loosened restrictions could allow Cuba’s state-run vaccine industry to ship more of their high-quality products to the U.S., where they could be distributed to underserved populations at cheaper prices than American vaccines.
Steven Ross Johnson, Modern Healthcare
January 17, 2017