Let’s Talk About Cuba

By: Emma Berry

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The word of the day is “Cuba.” With the restoration of Cuban-American relations, Cuba is re-entering the U.S. media stream in no small way. In the past month, America has been excited about the re-establishment of the embassies, enraptured by the U.S.-Cuba showing in the Gold Cup quarterfinals and abuzz with discussion of President Obama’s foreign goals for our neighbors to the South. We talk about what America can do for Cuba, but what are we not talking about? After over half a century of silence, what is still unheard?

Healthcare is a universal necessity that affects quality of life, both mentally and physically. The conversation it sparks bridges cultural gaps and unites even conflicting nations under a common goal.

World Health Organization (WHO) director-general Dr. Margaret Chan called the elimination of the transmission of a virus one of the “greatest public health achievements possible.” Now, Cuba has done just that. The island nation has a history of successful disease interventions: Medicines for diabetic foot ulcers, lung cancer and hepatitis B. It developed a meningococcal vaccine more than 20 years before America did. And, in early July, the WHO announced that Cuba had effectively eliminated mother-to-child HIV transmission, a massive stepping stone towards an HIV-free generation. With 1.2 million Americans infected with the virus and an estimated 12 percent unaware that they are ill, this is a topic the U.S. should be talking about. But we’re not.

As Ebola ravaged nations in West Africa last year, international providers traveled to the region to lend a healing hand. America sent 65 health workers to Liberia. Cuba sent 165. Cuba, whose cultural approach to medicine teaches a sense of responsibility to help people in need, simply asks students of Havana’s Latin American Medical School (ELAM) to work in underserved world communities in exchange for their education.

Cassandra Curbelo, an American ELAM student, said that the school teaches students to “better understand what patients’ lives are like.” As America strives to achieve equal access to healthcare and transition to patient-centered care, this is a topic the U.S. should be talking about. But we’re not.

So why isn’t it a topic of discussion?

Healthcare isn’t sexy. The top social media influencers in the healthcare space are not celebrities or glamorous public figures. They are educational institutions, renowned doctors and top tier news outlets. When social media users discuss Cuba on Twitter, they aren’t talking about HIV or Ebola- they are talking about soccer, travel and Obama.

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Healthcare doesn’t have the “wow” factor that many other high-profile topics have in today’s media landscape. What it does have, however, is need. The world needs healthcare; it needs access, treatment and resources. Healthcare deserves to be talked about so that it can continue to be improved.

America has a population of over 300 million people, a GDP per capita of over $50,000 and spends 17.6 percent of its total GDP on healthcare – more than any other nation. Cuba is home to just 11 million people, only slightly larger than New York City. It has a GDP per capita of about $10,000. For every $20 that the U.S. spends per capita on health, Cuba only spends about $1.

But we have comparable age structures and life expectancies. Birth rates in both countries are significantly lower than the world average. Infant mortality rates are even closer – Cuba has the 33rd lowest rate and the U.S. has the 34th.

To put that into perspective, New Jersey, one of America’s wealthiest and healthiest states, has a comparable population size to Cuba and spends over $1,000 more per capita on healthcare than the U.S. national average. Yet, the health outcomes are surprisingly similar. New Jersey’s life expectancy is only three years longer than Cuba’s and its infant mortality rate, in the lowest 15% of America, is still higher than the Caribbean country’s.

When it comes to public health, Cuba and the United States have a great deal in common despite our socioeconomic differences.

The question now becomes: What can we stand to learn from Cuba and what, in turn, can Cuba learn from us?

America’s public perception of Cuban relations is historically negative, but this new relationship provides both countries with an opportunity to collaborate for the first time since 1961. Collaboration, however, requires an open flow of both communication and information.

Regardless of personal or political beliefs, Cuba’s healthcare system is something we should be talking about because improving the quality, safety and effectiveness of the global healthcare structure is beneficial to all. Maybe we can learn from Cuba’s low-cost public health system and maybe they can learn something from our emerging health tech revolution.

As President Obama strives to foster a sense of friendship with Cuba, it is important to remember that this means an open dialogue between both nations. America needs to continue to discuss Cuba in order to understand what that friendship will mean for our country, exchange ideas on what healthcare can and should be and recognize opportunities to learn. After over half a century of silence, we can’t afford to sacrifice more.

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