Global Community Health Education: Perspectivas Cubanas

By Coughlin, Jesse | Nursing Education Perspectives, May-June 2005 | Go to article overview
Save to active project

Global Community Health Education: Perspectivas Cubanas

Coughlin, Jesse, Nursing Education Perspectives

CUBA IS A COUNTRY OF CONTRADICTIONS. The beautiful tropical scenery contrasts with abject poverty and a decaying infrastructure. The Cuban people, vibrant and gregarious, are confined by a restrictive socialist regime and their despondent economic status. IN A PLACE WHERE EVERY DAILY TASK IS EQUATED WITH LA LUCHA (THE STRUGGLE). HOW IS IT POSSIBLE THAT CUBA HAS ONE OF THE BEST PRIMARY HEALTH CARE MODELS IN THE WORLD? Despite a lack of resources, Cuba's system of free and equal access for all citizens demonstrates its value in the shadow of the United States, just 90 miles to the north.

One of the crowning achievements of the 1959 Cuban Revolution, the Cuban health system changed in a relatively short period of time from a fragmented, urban, and elite-driven system into a high quality, preventive-care-oriented system that guarantees access to all (1). The embargo placed on Cuba by the United States for more than 40 years has had numerous effects on Cuba's economy. The current dynamic of the US-Cuban relationship not only negatively affects Cuba's ability to prosper and care for its citizens, but also prevents American citizens from benefiting from the many aspects of culture that Cuba has to offer.

The travel ban that exists as part of the embargo restricts Americans from visiting Cuba. Moreover, under the Trading with the Enemy Act of 1917, it is illegal to spend American money in Cuba, which further restricts travel. Specific licenses granted by the US Treasury Department do allow for travel by members of certain disciplines--science, education, and journalism, for example--but recently, many exchanges have not been allowed because US policies have become more restrictive.

I was able to travel to Cuba in June and July 2004 as part of a program that held one of these licenses prior to the recent tightening of the embargo. Medical Education in Cooperation with Cuba, an exchange program based at Emory University in Atlanta, Georgia, has facilitated global education over the last 10 years by providing students of various health disciplines with a variety of courses of study in Cuba. I participated in a medical school elective focusing on public health, a one-month program highlighting primary care in Cuba. Traveling to both urban sites in Havana and rural areas in the Villa Clara province, I was able to experience firsthand a distinct manner of health care delivery.

In Santa Clara, capital of the Villa Clara province and home to the Che Guevara memorial, I witnessed one of Cuba's most impressive examples of primary/preventive care. The Consultorio Medico de la Familia (CMF), or family doctor's office, is a cornerstone of the Cuban health system. Designed to serve approximately 50 families, nearly every neighborhood in Cuba has a CMF. The primary functions of these facilities include well visits, maternal-newborn care, home visits, long-term case management, and referral services for more complicated health issues. Each CMF employs a doctor-nurse team that provides basic care to the immediate community. There is no appointment book; patients simply arrive with their problems and are seen on a first-come, first-served basis.

The intimacy of this setting is apparent in the manner in which the doctor-nurse team interacts with patients. Not only do they personally know each patient, they also live in the same neighborhood. In fact, the doctor's house is usually directly above or adjacent to the office. This creates an ideal environment for carrying out primary care in a country where preventive medicine is the gold standard.

Witnessing maternal care strategies in Cuba was a highlight of my trip. In addition to regular visits to the CMF, pregnant women are given extra rations both during pregnancy and the postnatal period. (All Cubans have ration cards available to them.) A visit to the Crezca la Vida (Let Life Grow) facility in Ranchuelo, Villa Clara, demonstrated health promotion strategies involving education as well as intervention.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
Loading One moment ...
Project items
Cite this article

Cited article

Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited article

Global Community Health Education: Perspectivas Cubanas


Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

While we understand printed pages are helpful to our users, this limitation is necessary to help protect our publishers' copyrighted material and prevent its unlawful distribution. We are sorry for any inconvenience.
Full screen

matching results for page

Cited passage

Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.

Are you sure you want to delete this highlight?