On 9 May, we had the opportunity to meet two active members of Cuba’s medical brigades, Dr Corria Lopez and anaesthetic nurse Ms Chacon Gonzalez. They were accompanied by the Cuban Ambassador to Belgium, H.E. Yaira Jiménez Roig, and the Head of Mission at the embassy, Juan Carlos Camacho Camero. On this occasion, they reflected on the impressive transformation of the Cuban healthcare system since the Revolution and introduced us to the Cuban medical brigades, a group of volunteer healthcare professionals, trained for emergency situations, who work around the world under the banner of solidarity in the face of disasters.
The transition of Cuba’s healthcare system since 1959 and the Revolution
The key characteristics of the healthcare system have a direct impact on how it is perceived, and also influence how patients are viewed. For Cuba’s healthcare system, free healthcare for all is a fundamental principle guaranteed by the Cuban Constitution. Following the 1959 Revolution, the foundations of this healthcare system were laid, and it was upon these foundations and conditions that Cuba built a strong healthcare system, through the quality of the care it provides, the calibre of its healthcare professionals and the extent of its infrastructure.
Health is now a national priority, and this transition has established a public, universal and free healthcare system, placing patients at the heart of healthcare provision. Whilst the number of doctors has increased a hundredfold, the entire workforce in the health sector has also been strengthened through the creation of a variety of academic training programmes (for doctors, nurses, scientists, teachers, researchers, etc.).
The healthcare revolution has also involved the construction of new hospitals, teaching hospitals, maternity hospitals and other specialist medical centres in every province. There are currently 290 hospitals on the island.
The transformation of the healthcare system also introduced, 35 years ago, a key concept: family medicine, which sets it apart significantly from private healthcare systems. The most notable cornerstone of this concept is disease prevention; this is the principle that must lie at the heart of healthcare professionals’ work, regardless of where they practise. It must be part of a doctor’s character to want to prevent, treat and save lives.
From the very outset of the structural changes to the healthcare system, the commitment to training competent staff to care for and save patients in Cuba has gone hand in hand with a commitment to sending these staff abroad, to safeguard human rights and, more specifically, the right to healthcare for everyone across the globe.
Introduction to the Cuban medical brigades
To be part of these teams, healthcare professionals must be prepared for any emergency situation and understand the direct and indirect consequences these have on those affected. A great deal of training is therefore required to treat this type of patient, which is why the government is calling for healthcare professionals to receive in-depth training to deal with such situations. Members of the teams are recruited on a voluntary basis, but most of Cuba’s medical staff are trained to deal with this sort of situation. This voluntary work also requires a spirit of selflessness and solidarity, as their commitment means they must leave their families, sometimes for long periods, and face difficult conditions.
Ever since the first medical delegation was sent in 1963, the medical brigades and their humanitarian values have been present in a variety of situations. When Ban Ki-moon, former UN Secretary-General, issued an emergency appeal in 2006 to combat Ebola, Cuba’s medical brigades were the first to respond. The same was true in Haiti, following the 2010 earthquake, thousands of healthcare workers stepped up to manage emergency and multi-trauma cases in the immediate aftermath and subsequently remained to tackle the serious epidemiological situation that followed. During the mobilisation in Pakistan in 2005, it took less than 24 hours to dispatch the brigades. This demonstrates their capacity for a rapid response to such disasters. To achieve such a level of performance, their entire community supports them; families, loved ones and neighbours all rally round to ensure that brigade members can set off quickly and with peace of mind. Furthermore, in the event that a healthcare worker called upon to deploy leaves behind someone in need of care, the government takes responsibility for providing the necessary support.
As evidence of the success of the Cuban healthcare system and the work of the medical brigades, one can cite the thousands of missions carried out in 158 countries and the thousands of patients treated. Nevertheless, above all, they wish to receive the recognition they deserve, rather than dwell on the figures, which are reminiscent of a debt.
During the pandemic, the scientific community came together to develop a vaccine; it is currently working on five different vaccines which have enabled the country to achieve a vaccination coverage rate of 92% on the island and which have been supplied to other countries such as Venezuela. However, the WHO has refused to authorise their use and does not recognise their effectiveness, despite the evidence. They are aware that the US wields considerable influence in this matter when it comes to approving the use of the Cuban vaccine for the rest of the world.
A healthcare system that is focused on towards human solidarity
Dr Corria Lopez points out that all doctors share the same goal during their training: to save patients. It is for this reason that the Cuban medical teams are extremely effective and resilient.
The Cuban Ambassador, Yaira Jiménez Roig, states that, following numerous demonstrations of the effectiveness of the Cuban medical brigades, particularly in the face of natural disasters, the proposal to send the brigades to respond to the disaster caused by Hurricane Katrina in the US received no response from the US government.
The response and support provided by the medical teams during the pandemic earned them a nomination for the Nobel Prize. The pandemic has exposed the shortcomings of countries that were thought to have advanced resources and technological capabilities in the field of healthcare. But in reality, when compared with Cuba’s healthcare system – based on free access and solidarity – it is clear that it is these qualities that make for an effective system. For Cuba, the essence of medicine must be human solidarity.
