Except for the people living with the disease, no others have so immersed themselves in Cuba’s world of HIV/AIDS as Dr Jorge Pérez. It is a world of Cuban returnees from Angola’s war against apartheid South Africa, gay and bisexual men, housewives, transactional sex workers, rebellious teenagers, and infected surgeons and scientists—a cultural kaleidoscope reflecting all the faces of AIDS. To more than one international author, he is simply “Cuba’s AIDS doctor.” Speaking to his patients at the Pedro Kourí Tropical Medicine Institute in Havana, it is easy to see why, but also to appreciate the courage, compassion, and persistent search for new knowledge that characterize the Institute’s staff as a whole. Dr Pérez’s story—now told in two books based on his diaries—is not his alone.
MEDICC Review held two interview sessions with Jorge Pérez just days apart at the beginning of April: one before and one after his designation as the new Director of the Tropical Medicine Institute, where he previously served as Deputy Director and Chief of Hospital Services. More than strictly medical matters, the conversation turned to the human dimension of HIV/AIDS, the depth to which it has touched many directly and affected Cuban society as a whole, and the challenges ahead for Cuba’s flagship institution for research and treatment of infectious diseases.
The Abel Santamaría school in Havana had moved since my last visit there in the late 1970s. Once occupying a converted residency in the Miramar section of the city, the school is now in a more modern building with open-air hallways surrounding an inner courtyard. Devoted to visually-impaired children, it is one of Cuba’s 396 schools for special-needs children, which enroll some 40,000 students across the country and employ 15,000 professionals.
But not only the physical plant of this school has changed: added to its original goals— rehabilitation and education—is a third mission indicative of an evolving national policy on the role of special education institutions. In a program begun just two years ago, the Abel Santamaría now prepares its students to eventually transfer to regular public schools. Its faculty work with teachers and classes at the new schools to develop a nurturing, inclusive environment.
Dual specialties in epidemiology and labor medicine, as well as an advanced degree in public health, gave Dr José Blanch expertise on disabilities in Cuba from a population health perspective. However, when he began losing his sight due to a diabetic retinopathy while serving in Africa, he also began a difficult journey that would transform his life and career, giving him new personal and professional perspectives on disability and the potential of disabled persons. Active for the past several years in the National Association of Blind Persons (ANCI, its Spanish acronym), in 2010 Dr Blanch was elected President of the non-governmental organization. He spoke with MEDICC Review about ANCI’s role and challenges in the context of Cuba today.
Niviola Cabrera is from Santa Isabel de las Lajas, a small town in central Cuba with a mystique all its own as the birthplace of the island’s legendary crooner, Benny Moré. Dr Cabrera studied medicine in her home province of Cienfuegos before completing a residency in epidemiology in 1981 and working at the provincial hygiene and epidemiology center. Her move to Havana came with an appointment as Deputy Director for Research at the National Institute for Workers Health; in 1996, she transferred to the Ministry of Public Health’s Science and Technology Division, which she has directed for the last five years.
Most recently, she headed the Cuban organizing committee for the Global Forum for Health Research’s 2009 meeting, Innovating for the Health of All, held in Havana.
Last April, the same week that the World Health Organization (WHO) declared a public health emergency due to influenza A(H1N1), Cuban government and public health authorities met to chart a course for prevention and management of the flu that by year’s end had become pandemic, spreading to some 200 countries. Like disaster response, epidemic-containment strategies […]
Rolando Camacho was born in Pinar del Río-Cuba’s westernmost province and, ironically enough, home to the country’s richest tobacco-producing farmlands. He was about to leave for an engineering scholarship abroad when he accompanied a friend to medical school on the first day of classes in Havana, a bus ride that changed his life. Since completing his oncology residency in 1985, Dr Camacho has served as director of Pinar del Río’s Cancer Control Program, chair of the National Cancer Control Program, director of the National Oncology and Radiobiology Institute (INOR), and today, chair of the National Oncology Group. The Group advises the Ministry of Public Health through its National Cancer Control Unit on questions of cancer control policy, planning and development of human resources for cancer care, structure of services, material resource planning and cancer research. Since 1988, breast cancer has been a particular focus for Dr Camacho’s research, practice and teaching.
MEDICC Review spoke with Dr. Camacho for his views on the problem of cancer in Cuba, and the prospects for more effective control.
Immunologist by training, Dr Fernández Yero began his career in medical technology at the National Center for Scientific Research in Havana, working at the behest of several hospitals to develop the first Cuban alpha-fetoprotein test. It was the 1970s, a time when a single public health system was taking shape in Cuba and many of the main poverty-related social determinants of health had been tackled. “We were looking for technologies of the future,” he says, “to see what we could do that could be applied throughout a national public health system.” Sixteen generations of equipment later, Dr Fernández Yero heads the 21-year-old Immunoassay Center, a leader in the field of medical technology for population health. The road traveled has not been an easy one, lack of resources threatening delays and detours along the way. He shares his thoughts with MEDICC Review on his work, the meaning of appropriate technology and the challenges he foresees ahead.
The year 2005 was a watershed for disaster management worldwide and also in Cuba. Representatives of every continent met in Japan, hammering out the Hyogo Framework for Action (2005-2015), an international blueprint for risk reduction strategies and a guide for developing national platforms. In Cuba, a spate of devastating hurricanes the year before led to a reassessment of how the country was managing disasters, and to the 2005 comprehensive overhaul of national, provincial, and municipal disaster
Pedro Valdés spent his childhood in Chicago, Illinois, USA, where he says his love of science began. After his family returned to Cuba in 1961, he studied medicine, received his PhD in biological sciences, and in 1990 at the age of 40, founded the Cuban Neuroscience Center with a group of young scientists that included his brother Mitchell, now the Center’s Director. Since then, the Center has accumulated an impressive record developing patented neuroimaging diagnostic equipment for national use and export, a nationwide infant screening program for hearing loss, and the Cuban Brain Mapping Project, among other pioneering efforts. The Center’s recruitment of new graduates keeps the median age of its professionals at 28, and its scientists are the island’s most widely published outside of Cuba.
Chronic diseases are Cuba’s number one health problem, causing 90% of all deaths. The top three killers (in order) are: heart disease, cancer and cerebrovascular diseases, which together account for nearly 60% of all deaths.
The guidebooks call Mpumalanga one of the “often overlooked provinces” of South Africa.[1] Northeast of Johannesburg, its grassy hills are just a blur on the highway for foreign visitors heading to the spectacular game reserves of Kruger National Park. They will not often get to Themba Hospital in White River, just 50 miles from the border with Mozambique, serving over three million of Mpumalanga’s overwhelmingly rural population.
The National Immunization Program (NIP) begun in 1962 has considerably reduced the infectious disease burden in Cuba over the years, especially among children. The Ministry of Public Health estimates that some 560,000 children would have contracted these diseases, some with fatal outcomes, had it not been for the aggressive vaccination strategy begun 45 years ago and developed since then.
