Zuckerman, Colleagues Visit Cuban Health Care Facilities

Team notes how Cubans care for the frail, the elderly, and how societal and political circumstances affects people.

By Steve Berberich
June 14, 2012

Following a fascinating, fact-finding visit to health care facilities in Cuba with three colleagues, Ilene Zuckerman, PharmD, PhD, professor and chair of the Department of Pharmaceutical Health Services Research at the School of Pharmacy, wants to explore how the University of Maryland (UM) can share educational opportunities with students in Maryland and on the island nation.

The government in Cuba is allowing more Americans to travel there. Although the trip by Zuckerman and others was a personal one, it rose from their professional interests in pharmacy and geriatrics.

“Cuba is only 90 miles from our shores and has not been terribly accessible. So, I was very interested in how a society like Cuba cares for the frail, the elderly, and how the societal and political circumstances affects people,” says Reba Cornman, MSW, director of the University of Maryland Geriatrics and Gerontology Education and Research Program in Baltimore.

Unlike in the United States, the Cuban government exclusively runs its national health care system, controlling both the administrative and financial responsibilities for maintaining the health of all of its citizens. There are no private hospitals or clinics in Cuba.

Zuckerman says, “We have a concern for older peopl,e and this concern is shared with health care providers in Cuba. So when Reba had this interest in arranging a trip to Cuba, we joined her.”

Zuckerman was fascinated with the Cuban system. “What is really interesting is that their family structure is different than it is here; they don’t have nursing homes, or they are very rare. You bring [older family members] into your home like they did in my grandparent’s generation.”

Joining Zuckerman and Cornman were Debra Wertheimer, MD, director of hospice and palliative care at the Veterans Administration Maryland Health Care System, and Madeline Feinberg, PharmD, adjunct faculty at the School of Pharmacy.

“It was fascinating to see that connection between the things they do in Cuba that we find interesting and the things we do that they find interesting, while each are doing the same kind of work. It was great to cross that communications barrier because culturally they have different ways of doing things. And old people are in the middle of it and don’t get farmed out,” says Feinberg.

Originally Cornman wanted to join a scheduled health care professional tour called Care of the Elderly, but schedules of the four busy women conflicted. Instead they traveled to Cuba with a Canadian group and Cuban citizen Enrique Garcia-Vega, regional advisor on Healthy Aging at the Pan American Health Organization in Washington, D.C., who arranged a meeting for the Americans with health care leaders at the Research Center on Health, Longevity, and Aging in Havana.

The travelers learned that Cuban citizens have to pay a basic minimum for medications. “Then we wondered how they reached out to elderly people and their caregivers about health issues. The public health education system is widespread. There is also no commercial television, but the government produces extensive medical infomercials on the services available to them, which they feel is an effective way to reach people regarding health concerns,” says Cornman.

She says in Cuba there is a value to the population being educated and having access to health care. “Where ever you go, there is health care. People looked well cared for, such as in a rural province where we traveled called Pinar del Rio.”

They also visited the Research Center in Longevity, Aging and Health in Havana and the 750-bed Havana Hospital, the largest and most prestigious teaching hospital in Cuba, according to its website.

Zuckerman observed, “Their public health is in some ways more advanced than ours in terms of getting to the masses. Their level of high-tech equipment is lagging behind us, though. I was surprised that they seemed to have gotten the health care system down, but we have to remember that what we were seeing is what we were shown.”

Their visit to the hospital was not arranged by the Cuban government but on their own. “The hospital beds and wards were not as modern as those at the University of Maryland Medical Center, for example,” says Cornman, “But it seemed to me that the integrity, training, and knowledge of the providers was right on, especially for older adults, and that is what we were interested in.”

Zuckerman says the group learned that, “The primary problems of aging in Cuba are the primary problems with aging here. You have dementia, cardiac disease, cancer, and stroke. So, in terms of what you can do as a country in addressing those issues … how do you engage patients and families in healthy behaviors, in prevention. I think these are all issues that they address.”