Tanya Rosa de la Cuevas Hill is a specialist in comprehensive medicine and she runs a neighborhood clinic in Old Havana in Cuba. Along with her nurse, she looks after 334 families who live in the surrounding streets.
“Being a family doctor, I love it,” she says. “The first mission we have is to prevent illness. That’s the wonderful thing about my job. Prevention of diseases, prevention of accidents, that’s what I like best”.
Cuban healthcare system is one of the best in the world. This developing country is the world champion of Preventive Medicine and has become a world-class medical powerhouse. The country has a record unmatched in dealing with chronic and infectious diseases with amazingly limited resources. Cubans hardly die of infectious diseases because of a hugely successful vaccination program, so people live longer.
Cuban healthcare system which can be traced back to the 1960s with the creation of the Rural Medical Service which enlisted 750 doctors committed to revitalizing healthcare networks for the poor and those far from urban centers, is strongly and effectively focused on preventative, primary and community healthcare. The country also combines western medicine with traditional medicine.
Cuban healthcare system developed from more than 50 years of economic sanctions and embargo by the United State. During this period, Cuba was not allowed access to trade, technology, new research findings, modern equipment or foreign drugs. The embargo held down the economy of the country and government spending. This forced Cubans to look inward to develop a local, cheap but very effective health system using available resource.
Prevention is Better than Cure
Rather than spending money (which they don’t have) and energy fighting diseases and problems with expensive clinical services once someone is already sick, they came up with a cheaper approach by designing a mechanism for defeating the cause of disease and treating it fundamentally before it becomes complex.
They built a system that is based on cheap preventive techniques and focused on nutrition, hygiene, vaccination, traditional cultures, western, natural and alternative medicine. This is in direct contrast to western system. Western system focuses on curative medicine, uses costly diagnostic and treatment techniques as the first approach and is contemptuous of natural and alternative approaches.
Unlike western system, Cuban system is not a one-size-fits-all but rather offer locally-tailored solutions that are based on the needs of the communities served, as such Cuban medical schools remain steadily focused on primary healthcare, with family medicine required as the first residency for all physicians. Doctors are mandated to live in the community they serve.
One of the pillars of Cuban healthcare system is vaccination. Vaccination rates in Cuba are among the highest in the world. Cuba has eradicated diseases that include (with date eradicated): polio (1962), malaria (1967), neonatal tetanus (1972), diphtheria (1979), congenital rubella syndrome (1989), post-mumps meningitis (1989), measles (1993), rubella (1995) and TB meningitis (1997).
As a result of the strict economic embargo, Cuba developed its own pharmaceutical industry and now not only manufactures most of the medications in its basic pharmacopoeia, but also fuels an export industry.
Resources have been invested in developing biotechnology expertise to become competitive with advanced countries. Cuban biochemists have produced a number of new alternative medicines.
Unlike western countries Cuba invest on prevention-focused researches instead of disease-focused researches and in 2005 became the first country to eliminate the transfusion of HIV from mother to child – a huge achievement in preventive medicine.
Another aspect of Cuban health system is its health education programs. Health education is a major and mandatory part school curriculum. Children begin studying the multiple uses of medicinal plants in primary school, learning to grow and tend their own plots of aloe, chamomile, and mint, and later they conduct scientific studies about their uses. Radio and Television programs instruct people on how to relieve common stomach upset and headaches by pressing key points.
Cuba Healthcare System Vs Western Healthcare System
Despite limited resources and economic constrains, Cuban healthcare system is not only effective medically but economically efficient. For instance, despite spending $817 on healthcare per capita in 2014, which is less than world average ($1,059), the amount spent by the United States ($9,403), Canada ($5,719) and Europe ($4,135 ) respectively in that same year, Cuba remarkable Life-Expectancy (76-81 years) is on par with the United States and Europe and Infant Mortality rates (5 per 1000 birth) is lower than that of the U.S. and on par or lower than many developed nations.
“At the same time when New York City (roughly the same population as Cuba) had 43,000 cases of AIDS, Cuba had only 200 AIDS patients.”
Taken together, these factors together lead the World Health Organization to call Cuba’s approach a model to be repeated and mimicked by other low-income countries to create highly-effective healthcare systems despite limited resources.
African Countries Can Learn from Cuba
Currently, no African country spends up to what Cuba spends on health per capita. In 2014, Sub-Sahara Africa spent an average of $98 per capita. The highest amount spent in the continent is $570 by South Africa. With such meagre spending African countries should focus on cheaper and effective medicine. They should copy the Cuban healthcare system and modify it to fit their social and political system.
Africans societies are largely communal as such African governments should adopt community medicine and encourage the practice of family medicine. This will make it easier to merge traditional and western medicine for cheap and effective healthcare delivery. Medical students should be made to study the traditional diagnosis and treatments methods of local medicine men in their communities.
The continent will should focus more on preventive medicine, which has been proved to be cheaper than curative medicine. African government should make immunization compulsory for every child as vaccination is part of preventive medicine Cuba used to eradicate many chronic and infectious diseases.
There should be more state-sponsored awareness on immunization, good hygiene, nutrition and first aid treatments. Adopting the system may require a modification the country’s educational system and requires increased investment in literacy and health education. it should be noted that Cuba’s high literacy and education rates (99.7%) helped to promote and support the national priority on medical care especially for children.
Adopting the healthcare system will require African governments to focus on training more family doctors, and other professionals e.g. public and community healthcare professionals. They will also be required to focus more on health education and improve the use of vaccines instead of expensive diagnostic and treatment methods which they can barely afford.