By Susan Kepecs | Special to The Capital Times
Cuba is not paradise. But Fidel Castro’s health care system racks up some wins in the “Battle of Ideas,” a Madison-based medical aid delegation learned this month.
The Battle of Ideas, a national solidarity and service campaign now in its fifth year, holds up Cuba’s socially oriented, government-funded programs - especially health care and education - as models against President Bush’s versions.
On a damp January night, the 11-member Wisconsin Medical Project group met at the office of Dr. Bernie Micke, a UW Health family practitioner, to stuff huge rolling suitcases with items like Tylenol, Immodium, ostomy supplies, sutures and stethoscopes.
A week later, packing personal luggage and the donation bags, we flew to Toronto and then to Havana. The nonprofit Wisconsin Medical Project, directed by Micke, is one of the few programs in the state still licensed by the U.S. government to travel to Cuba.
From Havana, through the windows of a modern bus, we watched royal palm country give way to drought-ridden cattle ranches and eventually to the nighttime lights of Camaguey, Madison’s sister city.
There, Paquito Lopez and his Camaguey office of the national Cuban Institute for Friendship with People threw us a welcome dinner. Thanks to Lopez and his staff, who facilitated all of our endeavors, we packed two weeks’ worth of activities into six days.
We began with an orientation by a woman named Lupe, a liaison between the state visitors program and the Department of Public Health.
Cuba’s health care system is built on a pyramid, she said. At the base are family practitioners - in Camaguey, there is one per 120 families.
That’s compared to one primary care provider per 1,700 patients in the United States, according to a March 2004 Wisconsin Hospital Association and Wisconsin Medical Society study.
At this level, neighborhood-based family practitioners administer immunizations, prenatal care and other routine preventive measures.
The next level in diagnosis and treatment is the polyclinic. The aim at both levels is to intervene before a hospitalization is required.
We visited the newly refurbished Jose Marti Polyclinic, which occupies a former nunnery built in 1870. Two tiers of rooms surround an airy patio. People sat in clean, open-air hallways, waiting for appointments.
Camaguey has nine polyclinics distributed across the 300,000-inhabitant city. Jose Marti serves about 38,500.
“Everything’s new,” Lupe said. “And the restoration always respects the building’s architecture.”
Marti provides medical attention, lab work and emergency services for more than 400 patients daily.
Clinics run the gamut - we peeked into doors marked gynecology, allergies, psychotherapy, dermatology, STDs, optometry, ultrasound, family planning, X-rays, acupuncture, massage, physical therapy, herbal medicine and emergency room.
The polyclinic has limited rehab facilities, but Camaguey also has a provincial office of the Cuban Association for Limited Motor Skills, which we visited.
In a dilapidated little suite of pink and green rooms with plain desks, old typewriters, vases of plastic flowers and little painted landscapes, a staffer served us tiny cups of sweet Cuban coffee and slices of cake.
The association used to get help from a U.S. humanitarian aid group, but the latter lost its license to travel to Cuba under a recent round of Bush administration restrictions.
“We have 400 patients of all ages, all bed-ridden,” said Kenya Concepcion Perera, the association’s vice director. “Amputees with no wheelchairs. When people come to us, they think the world has ended. We help them climb back up.”
Some of the agency’s success cases compete in the paralympics in Cuba and internationally. But the association, a non-governmental organization, is usually last in the Cuban health care system’s international donations line.
“We need wheelchairs, crutches, canes, anything,” Perera said. “We have patients who wait and hope.”
They hoped the Wisconsin Medical Project could help. But the only designated recipient is Camaguey’s Eduardo Agramonte Pediatric Hospital.
Last October, Micke shipped out a 40-foot container filled with medical equipment and wheelchairs to Agramonte, which is the main children’s hospital in eastern Cuba.
Micke did not receive any receipt, however, and part of our mission was to follow up.
At Agramonte we met Nancy Raton, technical vice director, who assured us that after winding its way from the Port of Havana to the Camaguey Provincial Health Commission, the container from Wisconsin had indeed arrived.
Some supplies - hospital robes, lancets - had already been distributed. The wheelchairs were still in the warehouse.
The Agramonte Pediatrico, in the midst of a major renovation, is building toward a 430-bed capacity, with 250 beds currently in service. A rotating staff of 280 nurses yields a ratio of one to three nurses per 15 children, according to Raton.
In the hospital, a young boy in a baseball cap who has diabetes and psychiatric problems attached himself to our tour. A little girl hobbled on homemade, wood-slat crutches. Nurses in a dark room held up X-rays for parents to see. We visited the oncology ward, and hematology, where Cuban researchers are making headway on cures for blood cancers.
We passed a big, open intensive care unit with cracked, cream-colored tiles and metal bedsteads that resembled a Depression-era New York charity ward. Through a window we saw a little boy on a respirator. He had had a tracheotomy, Raton said.
A woman leaned over him. A nurse held up a baby boy for us to see - the patient’s brother? He waved and grinned, showing two front teeth.
“The Cuban government buys defibrillators, heart monitors and other equipment for the ICU from Europe and China,” Raton said. “But antibiotics donated by the Wisconsin Medical Project keep these kids alive.”
The medical tours were exhausting. But at night, those who had the strength to keep going enjoyed the events of Camaguey’s annual Culture Week, or danced and sipped rum at La Casa de la Trova, an outdoor nightclub.
Camaguey isn’t paradise. But it’s one of those places where Madisonians feel at home.