American medical students getting free schooling

[Tovarish 0]

Why Cuba's training American doctors

Quote[/b] ]HAVANA -- With his mastery of Cuban slang, love of guavas and chess in the parque central, Cedric Edwards could easily pass for a Habanero. Only his name gives him away.

The young man from New Orleans is about to make medical -- and political -- history.

This month, he will become the first American doctor to graduate from the Latin American School of Medicine (known by its Spanish acronym ELAM), a school that is exclusively for foreigners and is free.

"I'm not trying to make a political statement. I just wanted to become a doctor," says Mr. Edwards, 32, with the dazed look of someone who has just finished a 24-hour on-call shift at Havana's Salvador Allende Hospital, where he spent much of the night treating patients with cardiac failure, diabetes and leg ulcers.

"It feels good, but it's a little scary at the same time to be the test case. Sure, I'm worried there could be political repercussions in the U.S.," says Mr. Edwards, who has avoided interviews until now. "But people are misinformed about Cuba, and as they learn more about the medical system, they will see its high standards."

The Cuban government opened ELAM in 1998, in a former naval academy 20 kilometres east of Havana, as part of an assistance program for countries struck by Hurricane Mitch. The idea was to train doctors to treat the poor of the Americas and Africa.

Today, 8,000 fully funded scholarship students from 27 countries are enrolled in the Spanish-language program, including 88 Americans. The U.S. economic embargo, in place since 1961, prohibits Americans from travelling to the Caribbean island and the medical students have won a hard-fought exception.

Their presence in Cuba is a political victory for Fidel Castro, the Cuban ruler, who loves to invite them to demonstrations and to his televised round tables, making the most of the irony of a small island nation subsidizing the education of poor students from a superpower that for years has engaged in economic warfare against Cuba.

Yet, at least some of the American students say they take a pass on such political theatre. They prefer to see the school as an opportunity to fulfill a dream that would be out of their reach in the United States, where the price tag for medical school is as much as $200,000 (U.S.).

"I focus on my studies. At the same time, when you see the U.S. blockade from this side, you see how stupid it is. A bunch of old men with grudges," says Toussaint Reynolds, a New York native who gave up his Dodge Intrepid, his television and his brand-name clothing to come here and study to become an emergency-room physician. He hopes to graduate in two years and do an internship in a hospital in Harlem or the Bronx. "I think we are getting the last laugh," he says.

Mr. Edwards, who, like Mr. Reynolds, avoids political events, credits ELAM with "literally saving my medical career." Distressed by one low grade and a mounting debt, he dropped out of Louisiana State University medical school in midstream, a decision he later regretted.

Whether the program is "a cunning move by one of the world's great chess players or an extraordinary gesture of civic generosity or a bit of both" -- as a December, 2004, article in the New England Journal of Medicine put it -- it is definitely helping black and Hispanic Americans enter a profession traditionally closed to them.

The article notes that while 25 per cent of the U.S. population is black, Hispanic or native American, only 6.1 per cent of the country's doctors have this background. Many poor Americans also do not have access to medical insurance.

The New York-based Interreligious Foundation for Community Organization recruits American students for the 500 spots at the school. While the number of applicants falls far short, a spokesman said more and more states have begun to express interest in the program. To qualify, students must have completed two years of pre-medical courses, be from poor communities and commit to returning to practise in those communities.

To be sure, the program is not for Hilton-hoppers. At the ELAM campus, students eat a beans-and-rice diet, are not allowed to leave during the week without a special pass, and nobody, including family members, may visit their dorms, for reasons not well explained by ELAM officials.

Mr. Edwards has endured mosquitoes, limited Internet access, and the absence of hot water, toilet seats, Snickers bars and Pepsi. When he goes back to New Orleans for his annual visit, he returns with a suitcase filled with Neutrogena soap, Mennen deodorant, waxed dental floss, cologne and boxes of gummi bears and Winterfresh chewing gum -- luxuries not often seen on stores shelves here.

Yet he has also developed a fondness for local pleasures: tropical fruit drinks, mesmerizing son and casino dance music and Cuba's unique patient-oriented system of care. He even married a fellow student from Equatorial Guinea in a civil ceremony, celebrating with a small reception and a Cuban layered wedding cake.

Cuba's sophisticated and public medical system is one of the revolution's most notable successes. The country has one of the lowest infant-mortality rate in the Americas and twice as many physicians per capita as the United States, with a long tradition of sending doctors to work in developing countries in Africa and Latin America.

The Cuban medical system focuses on preventive medicine and viewing patients as human beings instead of clients, as several earnest first-year students explain.

The country gets around the shortage of medications and high-tech equipment by relying on traditional diagnostic techniques. Mr. Edwards says there is a greater use of the stethoscope, vaginal exams to determine pregnancy and plastic cups with a suction device to detect fetal heartbeat.

"Cuba really challenges the way we think about health care and health-care services. They approach it as a human right, whereas other places approach it as a business," says Robert Huish, a PhD student from Simon Fraser University and a scholar with the Trudeau Foundation who is doing his thesis on the ELAM program.

"My question is, how much will the training, which reflects the needs of the Cuban society, fit in with the needs of other societies?"

Mr. Huish will track the progress of this year's first graduating class. Eliud Rivas, a 24-year-old Guatemalan who comes from a family of peasant farmers with nine children, is thrilled with the opportunity to become a doctor.

"I never dreamed I would be able to go to university, let alone medical school," says Mr. Rivas, a first-year student who plans to return to a job in Guatamala's public-health ministry.

While he describes himself as apolitical, Mr. Edwards says he is against the U.S. blockade, and supports Cuba's recent crackdown on democracy advocates, which has been criticized by human-rights groups.

But he insists he is most concerned about landing a residency in internal medicine at a U.S. hospital. (He has already passed his U.S. equivalency exams.) He would also love to practise in Canada, a country with public medicare similar to Cuba's, he says. "Canada has no blockade or political motivation to demonize the country," he said. "It's still strange to me, why would a small country like Cuba want to pay for me to come here?"

For the moment, ELAM is not open to low-income Canadian students looking for scholarships in the Caribbean. But Dr. Gillian Jiménez, with Cuba's Ministry of Foreign Affairs, is not opposed to the idea: "If we had an application from Canada, we would evaluate it. The program could be opened to include Canadians."

This is the second in a series of articles exploring Cuba's transition from its Soviet-bloc past.

In other news, the U.S. is still refusing to sell aspirin to the evil commies.

[breaker44 0]

Go to Canada for yer drugs. It's cheaper anyway.

-Breaker Out

[Supah 0]

I think this is a good initiative. Especially for poorer countries ... that americans have to use this program too because they are to poor to get an education ..... something to reflect on for americans and their leaders. I think under this current administration this devide between rich and poor will only get wider.

[simba 0]

aren't you cuban Tovarish, don't you have first hand info about what cubans think about cuba ?

I think that even if there aren't lots of consumption products as in europe or u.s , Cuba remains a nice place to live , and their are defintively doing a good job despite the embargo.

for those who don't know, Oliver Stone has made a documentary about Castro, it's available in dvd in english (maybe spanish too) really interesting, castro seems perfectly comfortable to talk about wathever you want.

Don't you think , american that's this embargo should be cancelled, because it doesn't serve any fair purpose??

[Ares1978 0]

Don't you think , american that's this embargo should be cancelled, because it doesn't serve any fair purpose??

It should have been cancelled a long time ago.

[harley 3 1185 0]

The embargo makes absolutely no sense, because we know which country's out of control companies will rush in to sell their wares to the Cubans.

The problem is that both the Democrat and Republican parties are committed to acting in the interest of all those Cuban emigres who have set up shop over the last 40 years in Miami, with their own brand of "Barrio".

The Cuban exiles seem to think of themselves as the "Real Cuba", and therefore would scream for ever and ever if the U.S. Government bypassed them and dealt with Castro.

That this embargo has caused suffering in Cuba, there is no doubt - that Cuba can achieve such a high level of healthcare with so much medical equipment barred to it is very impressive, as well as political dynamite. Washington really should start to review its Cuba policy sometime soon.

[SFWanabe 0]

Go to Canada for yer drugs. It's cheaper anyway.

-Breaker Out

Free heath care too I hear.

[Tovarish 0]

aren't you cuban Tovarish, don't you have first hand info about what cubans think about cuba ?

I think that even if there aren't lots of consumption products as in europe or u.s , Cuba remains a nice place to live , and their are defintively doing a good job despite the embargo.

for those who don't know, Oliver Stone has made a documentary about Castro, it's available in dvd in english (maybe spanish too) really interesting, castro seems perfectly comfortable to talk about wathever you want.

Don't you think , american that's this embargo should be cancelled, because it doesn't serve any fair purpose??

Yes, my whole point with this thread is how ridiculous the embargo is, and how this particular situation is especially ironic - the only superpower in the world is benefitting from a tiny island nation in that people who would like to become doctors but would not be able afford it in the U.S, are getting completely free medical school there, yet the U.S. refuses to sell the most basic medicines to this country, and any company that does will have a hard time selling to the U.S. I knew about this school but the fact that Americans attend it is especially news to me.

This article also compares Canada's health system to Cuba's...from personal experience, I can tell you, there is still a big difference. When I was 5 I was diagnosed with scoliosis, and from then on until I left the country I had physiotherapy twice a week. Once I came to Canada however, I was told it would not bother me till I was in my 50's, so I should "not worry about it till then". On the other hand, I remember once after a fight I needed a few stiches to my lip, and the hospital was short on painkillers, so getting the damn lip fixed hurt more than getting it busted up in the first place.