Sarah Lawrence College faculty, students and alumnae of the graduate program in Health Advocacy recently returned from a study visit to Cuba where they learned about health care in a country where, they say, the health of the country's citizens is one of two domestic priorities.
Program director Marsha Hurst, HAP student Cathey Bienkowski, who helped organize the visit, and their colleagues were impressed with the comprehensiveness and innovativeness of Cuba's health care system. They were particularly taken with the health advocacy role played by the local family doctor-nurse team, a fixture in every neighborhood. For example, in addition to their primary and preventive care responsibilities, family doctors and nurses provide education, follow-up care for patients with chronic conditions, coordination of in-home medical and nursing services, and they accompany families to specialists and the emergency room when needed. "A lot of advocacy concerns here are part of the system there," explained Hurst.
The visit was particularly good in viewing the interaction between the political and health care systems, said Hurst. In Cuba, health care is all public health. There is no separation between personal health and medical care and public health, not surprising for a country where "everything is about public policy." Bienkowski tells of a neighborhood doctor who went from house to house to be sure families removed hurricane water from their back yards as a preventive measure against Dengue fever.
The Health Advocacy program will use what the group learned to broaden its approach to teaching such topics as policy and history, ethics and advocacy. With an increasing interest in developing international perspectives particularly with regard to access to care, informed consent in research programs, bioethics and community health, new curriculum areas are likely to follow.
Hurst says the Health Advocacy Program is considering bringing together other health care groups who have been to Cuba to compare experiences, organize future trips and in various ways, expand an advocacy network of professionals interested in learning from the Cuban system.