Although Cuba lies less than 100 miles from the United States, we Americans tend to know far less about the island nation than about almost any other country in our hemisphere. Only since 2014 has the United States begun to allow its citizens to travel directly to Cuba and has opened official diplomatic relations, although direct trade still remains blocked.
Cuba’s health care system has been touted as providing universal access to primary care services, whose goals are promoting health and preventing disease as well as providing free medical education to a veritable army of health care workers. Less well known are the quality and standards of their surgical services.
Thirty U.S. surgeons recently spent a week in Havana to learn about Cuban health care. Participants on the trip responded to an invitation from the American College of Surgeons, although we funded the trip ourselves. We met with physicians at every level of the health care system, from primary care physicians, medical school faculty, trauma surgeons, general/oncologic surgeons, minimally invasive surgeons, officers in the Cuban Surgery Society, ministers of health, and representatives of the Cuban Institute for Friendship with the Peoples.
Although the Cuban government is a centralized, one-party state that follows the Marxist-Leninist ideology, every individual with whom we met answered our many questions with apparent candor. Perhaps our easy rapport was based to some degree on our common profession and our shared commitment to patient care. Although they were clearly proud of the quality of their free education and medical care, they were also quick to admit the shortcomings in their system: widespread poverty, shortages of food and advanced pharmaceuticals, and old medical facilities. We were not restricted in any way from moving around Havana or speaking with anyone, although our free time was admittedly limited because our busy schedule was crammed with at least two visits per day with the groups listed above.