Following a fascinating, fact-finding visit to health care facilities in Cuba with three colleagues, Ilene Zuckerman, PharmD, PhD, professor and department chair at the University of Maryland , UM,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 the 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 affect 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, (pictured) who heads the School of Pharmacy's Department of Pharmaceutical Health Services Research, says, "We have a concern for older people 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 there is that their family structure is different than it is here; they don't have nursing homes, or they are very rare," she says. "You bring [old family members] into your home like they did in my grandparents' generation."
Joining Zuckerman and Cornman were Debra Wertheimer, MD, director of hospice and palliative care at the Veterans Affairs 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 there 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 a healthcare 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., arranged a meeting for the Americans with health care leaders.
The travelers learned that Cuban citizens have to pay a basic minimum for medications. "Then we wondered how they reached out to reach 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. "Wherever you go there is health care. People looked well cared for, such as in a provincial rural province where they traveled called Pinar del Rio.
They also visited the Research Center in Longevity, Ageing and Health in Havana and the 750-bed Havana Hospital, the largest and most prestigious teaching hospital in Cuba, according to its website. Zuckerman observes, "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 the University of Maryland Medical Center hospital for example," says Cornman, "But it seemed to me that the integrity and the training and the 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."