from the desk of Annette Walker

from the desk of Annette Walker

Tuesday, October 6, 2015

Darian Zubia - Colorado native is student at Cuba's International Medical School
              African-American Leaders Play Key Role in U.S. Admissions
                                                      by Annette Walker

     Darian Zubia never thought that his interest in improving health care for poor and working-class people would take him to Cuba.  However, his concept of health care conflicts with some practices in the United States.
     "Medical care here is based on the curative model and less on the broad context of how to treat human beings," he said.  "On the contrary, Cuba operates on the preventive model and incorporates social consciousness with science."
     A second year student at Cuba's International Medical School (ELAM), Zubia is a Colorado native and his family has lived in Ft. Lupton, Denver and Mexico.  Upon graduation from high school in Lafayette, Colorado he studied at Colorado State University in Ft. Collins, but received his Bachelor's Degree from Duke University in North Carolina.
     "Cuba's focus is primary health care," he said.  "'I've noticed that many U.S. medical students do not wish to become primary care health physicians.  Rather, they want to become specialists, and often the reasons have nothing to do with health or research," he continued.
     "When most medical students here graduate, they owe about $300,000 in education loans.  As medical specialists they will get higher salaries and pay raises, which they need to pay back their debts incurred in medical school"
     In Cuba education is free at all levels.
     Zubia believes that the chronic diseases plaguing many poor and working-class people in the United States can be addressed through better primary health care.  Many poor neighborhoods lack health clinics or doctors' offices.
     "Medical care here is tied-up with money" he said.  "On the contrary, Cuba's health care system functions with non-monetary incentives."
     The essence of Cuba's national health system lies in the neighborhood health clinics.  Depending on their size, they serve from 150 to 500 people.  Many medical staff, including doctors, reside in the same neighborhoods where they work.  
     Health care, along with education, is one of the achievements of the Cuban Revolution.  One of the best examples is the dramatic change in infant mortality.  In 1959 Cuba's rate was 39 per 1000 live births.  Today it is 4.2 per 1000 live births which is among the lowest in the world.  That is lower than the United States which is 6.9 per 1000.
     Ironically, the infant mortality rate in Colorado's African-American population is 14.9 per 1000 or three times higher than Cuba.
     Cuba has developed a world-class biotechnology and pharmaceutical industry that has become an important source of well-needed foreign exchange.
      Cuba has developed four therapeutic cancer vaccines that are exported to 26 countries (not yet to this country due to U.S. trade embargo imposed 50 years ago).  Cuban scientists have also developed a medicine that cures diabetic foot ulcers, and this, too is exported.  
     Other vaccines against various viral and bacterial pathogens, including meningitis are sold internationally.  In addition, medical research scientists from Canada, China and Spain participate in joint ventures with Cuba.
     On June 30 the World Health Organization (WHO) declared Cuba the first country in the world to eliminate the transmission of HIV and syphilis from mother-to-child.
     In 2012 the United Nations Children's Fund (UNICEF) announced that Cuba is the only Latin American and Caribbean country without child malnutrition.
     In 2009 the United Nations Development Program (UNDP) indicated that despite the fact that Cuba is a poor nation and has been subjected to THE U.S. economic and trade embargo, its achievements in health and education are outstanding.
     WHO has recommended that the island's public health system be considered "a model for the world”, especially for developing nations.

                                        Medical Internationalism

     Cuba's International Medical School (ELAM) is part of the government's concept of "internationalism", or assisting nations in need.  Since 1960 Cuban health professionals have served in over 103 countries, including 35 African nations.
     In 2013 Brazil requested that Cuba send 800 doctors and other medical professionals to assist in rural areas.  Cuba has complied.
     In 2005 Cuba offered to send medical and other personnel to Louisiana and the Gulf coast to assist with Hurricane Katrina, but President George W. Bush and the State Department rejected the offer.
     In 1998 Hurricanes Mitch and George devastated some Caribbean and Central American nations.  Cuba sent medical personnel to assist and they noticed the general dearth of hospitals, clinics and health professionals, especially in rural areas.
     The Cuban government resolved to help by allowing students to go to Cuba for medical training.  In 1999 ELAM was established and initially all of the students were Latin American.  That has changed.
     "There are approximately 1300 African students at ELAM," said Zubia.  I have classmates from Angola, Chad, South Africa, the Sudan and South Sudan as well as the Caribbean, Asia, the Middle East and other countries.
     A spirit of social justice is intrinsic in ELAM's curriculum and the basic concept is that foreign students will return to their countries of origin and work in areas lacking medical services and trained personnel.
     In 2000 a U.S. Congressional Black Caucus delegation visited Cuba to meet with Fidel Castro and the Ministry of Public Health about ELAM.  Representative Bennie Thompson, a Democrat from Mississippi, was concerned about the shortage of doctors in his state as well as the high cost of medical education.
     Cuba agreed to accept some scholarship students from the United States.  The State Department classified the program as a "cultural exchange" to get around U.S. restrictions on travel and extensive stays on the island.
     Ten U.S. students entered in the Spring 2001.  By 2014 there were a total of 134 U.S. graduates of ELAM of which 64 are African-American and 38 are Latinos.  The United States does accept ELAM as an accredited medical institution and graduates are practicing doctors or in residency.  Currently, there are 92 U.S. students enrolled, or which 49 are African-American and 28 Latinos.
     U.S. students must apply to ELAM through IFCO (Interreligious Foundation for Community Organizations), a multi-issue national ecumenical agency headquartered in New York City.
     IFCO was founded by Rev. Lucius Walker, an African-American Baptist pastor who also founded Pastors for Peace.  Both organizations dedicate some work to international issues, among them active opposition to the U.S. economic embargo against Cuba.
     While in Colorado over the summer Darian Zubia made presentations at the University of Colorado medical program at the Anschutz campus as well as the Mercury Café in the historic Five Points area.  He also recorded an interview at KGNU radio for a series on global health to be broadcast later this year.
     "When I complete medical school, I will either work in Colorado or the Southwest, or maybe somewhere near the Mexican border.  
     (This article originally appeared in the October 2015 issue of the Denver Urban Spectrum)