In Cuba, a free medical education leads to a lifetime of benefits
Autumn 2015
“For once, if you are poor, female, or from an indigenous population you have a distinct advantage… an ethic that makes this medical school unique.” Margaret Chan, WHO
Students don’t just graduate with medical degrees, but also leave with a lifetime commitment to public service. Connor Gory reports on Havana’s Latin American School of Medicine
Lilian Nuñez grew up in a refugee settlement in Nicaragua; once the civil war ended in her native El Salvador, she returned home to begin life from scratch. Luther Castillo hails from far-flung San Pedro de Tocamacho on the Atlantic Coast of Honduras, a hardscrabble town with no running water or electricity and from where he walked three hours every day to school. Patrick Dely is the youngest of eight children from the central Haitian town of St Michel L’Attalaye, where deforestation, child labour and dying of preventable diseases define daily life.
Today, Dr Nuñez is the director of the Oscar Arnulfo Romero Specialised Community Family Health Unit in Bajo Lempa, El Salvador; Dr Castillo is Director of the Garifuna Community Hospital of Honduras, which he co-founded and helped build with the local community; and Dr Dely is Head Coordinator of the Haitian Field Epidemiology Training Program of Haiti’s Ministry of Public Health and Population and Founder-Director of the St Michel L’Attalaye Health Clinic.
Each of these young physicians got their medical degrees from Cuba’s Latin American Medical School – for free.
ELAM, as the school is known, is a groundbreaking, socially-accountable institution which has graduated more than 23,000 doctors like these since its inauguration on the outskirts of Havana in 1999. The concept was born in the wake of Hurricanes Mitch and Georges, which killed 30,000 people and left 2.5 million homeless throughout Central America and the Caribbean. These back-to-back disasters – much like the current Ebola outbreak in West Africa – exposed public health systems in or close to total collapse, due in part to a critical shortage of human resources.
Cuba responded by founding ELAM, a medical school with a mission: students, recruited from the world’s most remote and vulnerable communities, receive full six-year scholarships in return for their pledge to work in similarly underserved areas upon graduation. To date, physicians from 83 countries and more than 100 ethnic groups have made good on that pledge, helping to make ELAM one of the biggest, most diverse schools on the planet. Upon visiting in 2009, WHO Director-General Margaret Chan declared: “For once, if you are poor, female, or from an indigenous population you have a distinct advantage… an ethic that makes this medical school unique.”
A global reach
Patients from the Brazilian Amazon to the Saharan Desert – many of whom may never have seen a doctor before – are being treated by graduates of this unique medical school.
The same goes for vulnerable populations in Oakland, Brooklyn, Albuquerque and other US cities: hundreds of young people from across the United States have also taken the ELAM pledge and are practicing the community-based medicine they learned in Cuba. Philadelphia’s Veronica Flake (Class of 2015) says: “I wanted to learn a holistic, comprehensive approach to medicine and Cuban doctors are renowned for that. My goal is to work with low-income and immigrant communities, so it made sense to study in Cuba. I also wanted to be immersed in an international setting.”
This international component is ever-present and translates into a strong public service commitment. Following the 2010 earthquake in Haiti, for example, nearly 300 ELAM graduates stepped forward to serve in Cuba’s Henry Reeve Brigade, the island’s specialised team trained in disaster medicine and epidemics. These young physicians served in Haiti for six months, providing post-quake care and staying through the subsequent cholera outbreak.
According to Dr Joanna Souers, an ELAM graduate from New York who served in Haiti during this time, “We learn to work with minimal resources and to take a team approach. The strong emphasis on public health in Cuba prepares doctors to address epidemiological outbreaks, while carrying out culturally sensitive community outreach, contact tracing and working cooperatively with local authorities and community leaders.”
Most recently, hundreds of these ELAM graduates volunteered to work alongside their Cuban counterparts fighting Ebola – an outbreak that required at least 20,000 trained health workers to treat and contain it.
In a letter to the Pan American Health Organisation dated 18 September 2014, Dr Waldino Casteñeda, (Class of 2008), representative of the Federation of Colombian ELAM Graduates, stated:
“Helping vulnerable populations wherever in the world they’re found is part of the humanist training we receive at ELAM. Given our experiences working in Haiti and Chile in 2010 after earthquakes there, we are ready to offer our help to the countries of West Africa affected by Ebola.”
Whether epidemic, natural disaster, or desperately-needed primary care for the one billion people worldwide who have never seen a doctor, a Cuban-trained physician is ready for service.
This article originally appeared in at www.latincorrespondent.com
