Today we visited a community Polyclinic and met with Dr. Orlanier and Dr. Ana Geisa. They talked about the Health Care system in Cuba, gave us a tour of their facility and answered all of our questions. Health care in Cuba is national and socialized which means all citizens of Cuba have access to free health care. The health care facilities are orgainized into a heirarchical system. At the lowest level are the family doctors (we would call primary care physicians). Each doctor is assigned a geographic area to service. They are to meet all of the individuals that reside in this area making sure they have physicals, vaccinations, a minimum of 1 X-ray per year etc. They meet with their patients in their clinics and in their homes. Their most important job is establishing a relationship with their patients and providing education. They teach their patients about diseases and how to live a healthy life. If the doctor decides a patient needs more advanced care, they send the patient to a Polyclinic. The Polyclinic is also designed to provide health care to a particular geographic area. The Polyclinic we visited to today was responsible for a 1 kilometer squared mile. This area housed 18 family doctors and each family doctor was responsible for the health care of 1200-1800 patients. The Polyclinic has multiple types of health care providers including dentists, physicians, specialists, and sociologists. They also perform blood labs, x-rays, rehabilitation services, prenatal care, and alternative medicine approaches. If the patient has a more serious illness they will then be forwarded to the hospital for more advanced care. We were assured that all medical treatment was provided free of charge, which also includes elective procedures like invitro fertilization, breast augmentations, and gender reassignment surgeries. We questioned whether their was enough medicine for all the patients. We were assured that their was. We asked if the government pressures the physicians to limit costly tests and treatments. Again, we were assured that they do not. I find this hard to believe. The facilities, while adequately equipped were quite old, dirty and in a state of disrepair. The pharmacy at the clinic had very limited drug supplies. If I had to make a guess, I would say they probably do what they can with what they have. If you are having an elective procedure, you may have to wait years. Each patient’s treatment is probably based on need, and some individuals may have to wait a considerable amount of time for a procedure while more urgent cases take precedence. We heard numerous times that Cuba is a poor country and resources are limited. As you can see we asked many questions and learned a lot. I do believe we were given the whole story. The doctors, however, were incredibly nice. The picture below is of our group with Drs. Olanier and Geisa.
After our visit to the Polyclinic we had another exceptional lunch at the paladar La Moraleja. The food here in Cuba without a doubt is some of the best I have ever had.
In the afternoon we visited a different Polyclinic to learn about the Cuban Medical System’s Complementary and Alternative medicine program. We met with Dr Amarilys and she described how alternative medical approaches can be used in concert with traditional medical approaches to enhance medical treatment. She described how some individuals do not tolerate certain medications and how alternative approaches can be used as a valid alternative. She assured us that patient participation in these programs was strictly voluntary and in some situations would only be attempted if the patient had adequate training beforehand. The alternative approaches used included meditation, acupuncture, teas and herbs, and aromatherapy. She talked about how the Cuban health care community did a large national study to compare the effectiveness of traditional to untraditional medical treatments, and that the results of these have been published in national medical journals. Dr Amarilys also stated that alternative medical approaches are no more costly than traditional approaches and in many instances can be provided at a much lower cost and not be associated with unfavorable side effects. At this point, I have to admit that I became somewhat frustrated with my lack of access to technology. My first instinct was to google this research to verify her statements, but I could not. I am amazed at how rapidly I have adapted to the notion that at any moment I can access information about any topic I choose, and also how much I miss that ability while here in Cuba.
Later in the afternoon we went back to the Farmer’s market for more shopping. I enjoyed watching everyone watch soccer. Today is the first day of World Cup soccer and while at the market Brazil was playing Croatia. Everyone, and I mean everyone, was watching soccer, and when Brazil scored you could not only hear that cheers from the market but from all over the city.
Tonight we had dinner on our own and some of the students went to have dance lessons to learn how to Salsa, Son, and Rumba. I did not. I found that I had danced enough in the jungle.