A Cuban Delegation

I had the privilege of leading a group of U.S. delegates on a People to People trip to Cuba. The goals of the trip were to learn about the Cuban culture and their health care system and outcomes, with particular emphasis on women’s health and the role nurses play within the system. Our group of delegates was made up of nurses, physicians, psychiatrists and a judge, representing clinical practice, education, research and legislation. The depth and breadth of what we experienced and learnt far exceeds the time we spent in Cuba. Prior to our trip, we reviewed articles written by Cubans and non-Cubans, and during our trip, we listened to and absorbed knowledge from Cuban leaders, physicians, nurses, politicians and guides. We witnessed firsthand the different levels of health care that make Cuba successful in increasing life expectancy, eliminating HIV, decreasing maternal and infant mortality rates and decreasing amputations due to diabetes. This particular blog will reflect on the group’s shared impressions and learning experiences. Here are a few shared insights from our group:

• The hallmarks of the entire Cuban political system are focusing on free education for everyone (mandatory until 9^th grade), preventative health care and insuring gender equity in all systems.
  
• Three levels of health care at community, province and specialty hospitals based on individual needs, guarantee access, prevention and better health outcomes.
  
• Cuba spent 10% of their GDP on health, as compared to 17% for the U.S., and both countries have similar life expectancy (78 years) and infant and maternal morbidity and mortality rates.
  
• Cubans have a very strong sense of identity tied to their country and a great deal of demonstrated pride in their achievements in spite of limited resources.
  
• Everyone we met was excited and hopeful about a more normalized, reciprocal relationship with the U.S.
  
• Health diplomacy, sending doctors and nurses to work in other countries, is used as a means to establish solidarity, to promote good will, to generate revenues for the country, and when needed, to help other countries as humanitarian gestures.
  
• Cuban family nurses and physicians live in the neighborhoods they serve and personally know most of their patients. They assess individual risk levels, they increase compliance and they promote self-care. Together, health care professionals and patients are responsible for health care.
  
• Intersectional collaboration and integrated services are values shared by all.

I am grateful to the members of the delegation who traveled with me, experts and leaders in their own fields, engaged and totally present throughout our adventure.