Review Joan Onnink

Joan Onnink, Medical Advisor

Look behind the scenes of the healthcare in Cuba in 2019; a unique experience

In the first week of March I was allowed to participate in the course”La Atencion Primera de Salud y la Medicina Familiar and Cuba” I had no idea what to expect, but it exceeded my expectations.

The ladies of the Escuela Nacional de Salud Publica had put together a fantastic program for us in which informative talks were interspersed with working visits on location. An interpreter and transportation were also provided. To finish, we were allowed to give a presentation about what we had learned and make a comparison with our own situation.

We get not only in five days a complete picture of the current state of health care in Cuba, we were also taken into account in the concerns and dilemmas that this country is facing.

Good and accessible health care for all residents of Cuba was one of the spearheads of the revolution. Implemented this in the last 50 years. Although due to trade boycotts, the country has to contend with large shortages of raw materials and technological possibilities, the knowledge is at a comparable level with that in Western countries and available resources are deployed as responsibly as possible.

There is a clear vision on health and care, the starting point being that as much as possible in the social domain must be solved in connection with primary care. There is a strong bond between the Policlinicos, community health centers and the district. GP care is highly developed. The home doctor care acts as a ‘spider in the web’ for prevention, identifying social problems, treating patients and referring them to complex treatments. Medicine students who are not only selected for intelligence, but also for social skills start in practice in their first year of study. What I found very special was to see that data were collected at practice level that were epidemiologically analyzed and led to insight into policies for every citizen.

Just as in the Netherlands, the aging of the population is also a concern for Cuba. In recent years, day care centers have been established for the elderly, and if much care is needed that can no longer be delivered at home, there is the possibility of being admitted to a nursing home. The government also encourages the establishment of families and supports this with schemes for pregnant women, and leave schemes for young mothers, their partners and their system post-delivery. To allow families to develop as stable as possible, the participation of fathers in the family is strongly encouraged. During our visit to a specialized oncology center it became clear that, despite (or perhaps thanks to) the limited resources, a lot of energy goes into scientific research and the development of medicines

Ambulatory care for people with mental illness and for people with intellectual disabilities has also been set up at the neighborhood level. Ambulatory treatment and day care are offered combined in the neighborhood.

When you visit the largest psychiatric hospital in the country (2000 beds!) You will think you are back in time a few decades, although we were assured that a lot had already been improved. All in all it was an impressive week where especially the positive energy and attitude of all involved noticed. Despite the lack of many basic means to be able to perform good treatments, buildings with overdue maintenance, the people here work with love for their profession and a lot of attention for fellow human beings. Everyone received us very warmly and hospitably and willingly answered all questions, even though they were sometimes critic.

In short: Recommended 

In addition to this great program, there is of course much more to see in Cuba. Havana is a special city with a lot of historic buildings. The rest of the island has beautiful nature and beaches. And of course there is music everywhere!

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