Although a poor country, Cuba has health outcomes rivalling much wealthier countries. For example, life expectancy is 77 for men and 81 for women. This is almost as high as in Sheffield (76.7 for men and 82.5 for women in 2013-15).
With social enterprise bursary funding, Sheffield medical student Rachel Hallam, recently spent nine weeks in Cuba, and observed the primary care, rehabilitation and radiology services there.
Social enterprise lies somewhere between charity and business, profitable yet socially conscious. In medicine, it works for the good of patients, while creating enough surplus to feed back into development and innovation in health.
In the face of an on-going trade embargo, the Cuban government reportedly earns $8 billion a year from the professional services carried out by its doctors and nurses overseas and the thousands of international students it trains every year.
This money feeds into a system that is universally accessible, planned and free to all Cuban nationals.
In primary care, I observed clinics and accompanied home visits. The health team were familiar with the lives of patients and their families so had a good idea of the community and any issues that were likely to arise there.
The clinic’s rehabilitation centre offers a range of therapies including physiotherapy, occupational therapy, natural medicine, acupuncture, podiatry, massage and electro-therapies.
This impressive department seemed well-integrated with healthcare provision, but such a thing would never be seen in the UK because of the lack of evidence base, funds and respect for complementary medicine’s ability to help people to recover and cope with their illnesses.
In Cuba it makes sense when a lack of access to various medications makes western medicine more difficult to practise effectively, while natural medicines are cheap.
In radiology I learned many things, including screening processes that stop finite technological resources from being overstretched and resourceful ways in which waste products can be recycled. For example, radiographs were melted down to harvest and sell the silver.
Staff had well-developed ultrasound skills, enabling the widespread use of this low-tech alternative to CT and MRI imaging when these facilities are not available.
You cannot help but notice in Cuba that many patients are concerned about their health.
Doctors would commonly tell patients off for coming in just because they wanted to know their blood pressure. I found this to be a contrast to many people in the UK, where health professionals are constantly trying to get people more proactive in taking regular blood pressure.
At a time when political pressures are squeezing health budgets in the UK, Cuba is certainly a country to take inspiration from for their many ingenious methods and structures to make universal healthcare continually affordable and accessible.