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Healthcare In Cuba by Patrick McCarty

The building was easy to spot from the street. On the front wall a clean, large sign proudly proclaimed "Che Guevara." Officially known as CIMTAN (Clinica Integral Medicina Tradicional Asiatica Y Natural) which means Traditional Asian and Natural Integrated Medical Clinic. A crowd gathered to greet us even before we had gotten out of the car. An entourage of patients and doctors were lined up with pleasant smiles on their bright faces. We the foreign guests had arrived and all were ready for a big day. The fact that it was a special celebration day, Día de la Mujer - Women's Day, only made the event even more significant. I was traveling with a special woman, Mary Morgan, widow of beloved Dr. Benjamin Spock. Mary's poise and grace mingled with a presence of her husband. Family-oriented Cubans were acutely aware that she had only recently lost her husband. Today was a very special day indeed. Women's day and a visit by the wife of one of Cuba's dearest friends, a friend especially of children.

"Bienvenidos", welcomes were showered upon us as our hands were pumped excitedly. Pausing to appreciate the welcome we received from the patients, we were introduced to Dr. Armando and the staff.

One of America's closest neighbors has been actively integrating western and eastern medicine. I had the opportunity to journey to the island nation of Cuba to visit and teach at their medical institutions.

Clinic "Che Guevara"

At traditional clinic "Che Guevara," as the name implies, Asian and traditional therapies are dispensed. I felt like I had returned to the Asian medical hospitals where I had studied in China. Clean, sparse rooms with treatment beds filled the area making the most out of limited space. Meridian and acupoint charts adorned the almost bare walls. Except for the frequent posters of Che and Fidel we could have been in China. Patient treatment consists of acupuncture, moxibustion, cupping, Tui Na (shiatsu-like massage). Western physical therapy and the use of Cuban herbs, homeopathy and Bach Flower essences are also used. Nothing fancy here, only economical and effective treatment.

Traditional Asian medicine has been around for over 5,000 years in the Orient but is relatively recent in the Western hemisphere. With the Cuban revolution of 1959 and the subsequent United States blockade of the island nation, Cuba has not had access to western medicines nor medical supplies. Later speaking with a pediatric surgeon I was told that most of the medical equipment was originally American because of the close ties Cuba had with the U.S. before 1959. Maintaining essential hospital equipment and getting replacement parts has been all but impossible. For obvious reasons a less technical and expensive modality of medical treatment needed to be explored. The Asian model fit the bill and for more then a decade Asian medical clinics have been established as part of accepted medicine. The Cuban people have responded positively to this once foreign method of treatment with acceptance.

Professional Staff

Tomás Armando Alvarez Diaz. M.D. is chief physician at "Che Guevara." The clinic is staffed by about a dozen doctors (M.D.s) and several nurses. It is a teaching hospital with first year residential medical students. All of the clinicians at the Asian clinics are allopathic physicians. They have graduated from a six year medical school. This is followed with specialization in traditional Asian medicine for another four years of training. The small clinic sees approximately one hundred patients daily. Dr. Alvarez received his Asian medical training in North Korea. Dr. Armando Alvarez is also President of Bioenergetic and Naturalist Medicine-Cuban Science Society. He is soft-spoken, humble, and extremely gracious. On meeting he was a bit disappointed with me because he thought that I would speak Chinese because of my studies in China. He really wanted an opportunity to practice his Chinese. (How he spoke Chinese while studying in North Korea I never figured out.) The only Chinese I learned to speak while in Shanghai was, "does it hurt? and how much does it cost?" not exactly your average conversation dialogue.

Today's Cuban Diet

I asked about the role of food and diet in the clinic. I was told that discussion about diet is a tricky proposition in Cuba. (I didn't tell him that even to mention the word diet by a regular physician is unheard of in the United States.) He confided to me that if the doctors tell their patients to stop drinking milk or eating meat it may be interpreted that the government does not have milk or meat to give them and that is the reason for the recommendation. This was the case not so long ago. The people of Cuba have had many hardships. In the past because of widespread food shortages one must be tactful when talking about food, especially about cutting out any hard to get favorite food items like meats, eggs, and milk.

I queried him further about the components of the current Cuban diet. He replied:

Feeding Infants

Here are the highlights of national dietary recommendations for youngsters that I gathered from several sources. For infants the use of cow's milk is not recommended until a minimum of six months. Then it is recommended like any other food. But not more than one liter of milk per day because of the possibility of creating anemia. Breast feeding is strongly recommended for a minimum of four to six months and in the countryside it is commonly continued for up to one year. This one-year recommendation concurs with Dr. Spock. After one year, the child receives fruit juice. However, no citrus juice is recommended because it may cause dermatitis. (With reference to adults because of the intense sunshine we asked about the incidence of skin cancer. We were told that it is not a problem. There are only a few cases reported.)

Each municipality has a natural clinic similar to the one that we visited. Clinic "Che Guevara" received the award as the best traditional clinic in Havana for the year 1998.

Hope For the Future

The people of the Cuban government have integrated Asian and Western medicines into a holistic package that apparently works well. For two days I had the opportunity to formally lecture to over one hundred physicians and hospital directors at the Cuban Institute for Vaccines. (This institute has perfected vaccines for meningitis and other deadly illnesses.) When I asked the participants what topic was most important to them they resoundingly responded they wanted to know about food and diet and its role in health and healing. Included in the audience were officials of the Ministry of Public Health as well as surgeons of the National Cancer Institute. They genuinely seemed to want practical nutritional information that could be added to their medical system. Five years ago Dr. Spock visited Cuba and repeatedly emphasized the importance of diet and life-style in his good health. At that time he credited macrobiotics and shiatsu with enhancing his healthy state as well as his quality of life. He was so convinced of its value that when the seventh edition of his famous book, Baby and Childcare was released this year, he specifically dictated what to feed babies, choosing to eschew meat and dairy products, he favored grains, beans, vegetables and fruit. Cuban physicians saw and listened to Dr. Spock. Now they wanted the same information that this learned activist had spoken of earlier. They wanted macrobiotics.

Open Hearts

The openness of the Cuban people to new dietary information will be tested in the years to come. As Cuba continues to meet its food needs with an expanding organic garden system (the raised bed method) and imported food stuffs, and as greater variety and choices of food grows, they will be faced with the dilemma that most developed countries have also faced in the twentieth century. Most countries see health deteriorate as junk food increases. As more meat, dairy products and refined foods become available and people have the economic means to purchase these items, you will see an increase in the rates of heart disease, cancer, diabetes, obesity, and osteoporosis. This is a worldwide phenomena. In a strange way scarcity has been a friend to the Cuban people's health. Unless people heed this new direction that the medical community is heading in, they may be doomed to repeat the mistakes of others. Recently a Cuban American friend told me his aunt from Cuba was permitted to leave Havana and visit her family in the U.S. for three months. In those months she gained sixty-five pounds. To me she represents a future tendency for fellow Cubans. Happily, the Cuban spirit is open and joyful. Given education and opportunity, I'm convinced the majority will choose a healthy path.

End of Article.

 

Patrick McCarty accompanied Mary Morgan (widow of Dr. Benjamin Spock) on a visit to Cuba from March 7-21, 1999. They visited pediatric and traditional Asian-style hospitals and monitored the distribution of humanitarian aid provided by Disarm Education Fund. On this trip the organization distributed 25,000 pounds of medical supplies valued at $ 8.8 million.

Mr. McCarty and Ms. Morgan lectured to over one hundred physicians and government officials in Havana, including staff of the Ministry of Public Health, Ministry of Traditional Medicine, and National Cancer Institute

Inside Clinic "Che Guevara" in Havana, Cuba. From left: Patrick McCarty and Dr. Armando Alvarez (director of clinic). April 1999

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