Valuable insights gained after working in Cuban Health System
06 December 2006
Una Lynch, a lecturer at the School of Nursing and Midwifery at Queen’s University Belfast, had the experience of a lifetime, thanks to completing a form she had initially binned. Luckily, Una took a second look at the ‘Lecturers Into Industry’ leaflet and decided to apply for a work-based placement funded by the European Union’s PEACE II programme. Her choice of location? Cuba.
The knowledge-based transfer initiative, funded by the European Union’s PEACE II programme through PROTEUS, aims to give academics in higher education the opportunity to upgrade and familiarise themselves with current practices and developments, as well as identifying areas of graduate skills deficits.
A few months later, Una took off to a country, for which she declares to have had “... a bit of an itch”. Her 12-week residency, provided invaluable insights into the unique way in which the Cubans operate their health system. “The country has received a lot of negative publicity over the years,” she says, “but there is always another side. For many, inside and outside Cuba, health has become emblematic of the revolution. Public health is a major driver for policy and there is a real sense of solidarity with the poorest people within Cuba and throughout the world.“In comparison with its gross national product, its public health indicators are level with the richest countries. Infant mortality is at the same level as here – an astonishing 5.8 per 1,000. It is probably fairer to compare Cuba with other developing countries - for example, the infant mortality rate in Ghana is ten times higher.
“There is a strong focus on health and the things that keep people well - family, environment, diet, living conditions. Pregnant women and children are unbelievably well cared for and there is intensive care for women, right through pregnancy, from conception to birth.” During her placement, Una met academics and practitioners from Cuba and many other countries and formed strong professional alliances and friendships. As well as staying in Havana, she spent a week each in Guantanamo, Sancti Spiritus, Cienfuegos and la Isla de la Juventud.
“It was inspirational to see how the system works in these remote areas,” she says. “Guantanamo is one of the most isolated places in the country, yet it has the same services as in Havana. “Here, we get bogged down with narrow interpretations of clinical governance and accountability. The Cubans believe that every citizen has a right to quality services, regardless of where they live. They rotate the doctors between places to maintain their expertise. All doctors and nurses have a teaching responsibility and must demonstrate that their knowledge and skills are up to date.” Now Una is back in Belfast, transcribing hours of taped interviews and collating the information into her doctorate thesis. “I have come back with a sense that we must start to think differently about the way we do things. We are great at seeing what needs to be done - then finding reasons for not doing it. In Cuba, they identify the need and develop innovative ways of ensuring they get there. “It was a stroke of luck that I didn’t bin that leaflet. The experience of Cuba has left a mark on me that will never be erased.”