Beyond Borders: Cuba Embraces Visiting Nursing Students
2,000 miles away in Havana, Cuba, our UCLA nursing students are plunged in a disparate landscape of vibrantly colored buildings, Caribbean music, vintage cars reminiscent of the 1960s “low-riders”, and an exceptional health care system.
Dr. Maria Elena Ruiz, adjunct associate professor, first traveled to Cuba with a prestigious group of delegates selected by the American Public Health Association in 2012. Impressed by Cuba’s health care system, Ruiz developed an academic travel program to Cuba in 2013.
One of the main things this program teaches students, Ruiz said, is there’s a world outside surviving and excelling without the advanced technology students are accustomed to.
What the students learn throughout their week-long visit is that despite being a developing socialist country, Cuba boasts a nearly identical life expectancy to the United States, almost 100% immunization rate, newly developed medications, some of the world’s lowest percentage of vaccine-preventable disease, and a highly accessible primary care system in which teams of doctors and nurses knock on patient’s doors for regular check-ups. Although they spend nearly 15 times less than the United States on health care per capita, Cuba’s health care system was lauded as internationally exemplary by Margaret Chan, former general director of the World Health Organization.
“We live in a high income, high technology country, and yet we experience health care gaps and increasing health disparities,” Ruiz said. “I want students to appreciate how health care is provided in other countries, and I hope when they work in underserved areas, they don’t feel that they have to rely on technology, as their skills, communication styles, empathy, and ability to assess will guide their diagnosis and ultimately their relationships with patients and communities.”
During a visit to a consultorio (neighborhood clinic) and the polyclinic, the comprehensive community health center for each neighborhood, students learn about the Cuban health model. Doctors and nurses are required to reside in the community that they work in and are responsible for the families within the geographic location. As a result, health care providers develop close relationships with the families in their care.
Maria Del Ruth, MSN ‘15, who visited in 2014, said patients in Cuba are called by their names, not just referred to as a number. “Nurses and family doctors know the people from infancy on,” she added.
Primary care doctors can assess not only their client’s physical health risks but also psychological health needs. “I think by knowing our patients from a comprehensive standpoint, including psychosocially, we can educate and normalize the use of mental health services that are beneficial to the patient,” APRN students Lindsey Zamarripa and Ikwinder Bhurjee, wrote in their 2017 travel blog.
Despite a severe lack of equipment and technology (oxygen tanks, beds, and IV equipment from the 1970s being used in the clinics), Cuba’s system compensates in its training of health care staff and its focus on prevention and health promotion over treatment.
“They make do with so little, but they are able to accomplish so much,” added Jacqueline Marroquin, MSN ‘15, now a Family Nurse Practitioner.