Last month, I joined 40 young organizers and cultural workers to travel to Cuba to deliver vital humanitarian aid, dialogue with the Cuban people, and learn how they have been able to survive in the face of a brutal blockade imposed by the US for over six decades.
The current moment is one of acute crisis for Cuba. Trump’s additional fuel blockade had then prevented a single drop of oil from reaching the island for over three months, forcing the nation to ration fuel to keep vital services running and jeopardizing health, education, transportation, and every facet of Cuban life. But the things I experienced have made me even more convinced of the resilience of the Cuban people, and the capacity of the systems they have built to survive in the face of genocidal US policies.
Exposing the U.S. system’s cruelty
I have been working in healthcare for three years in the U.S., first as a nursing assistant and now as a registered nurse. I work in an emergency department, which, as is the case for most EDs in the US, often serves to fill the gap for gross deficiencies in primary care and other sectors.
We see people in advanced stages of disease and infection who never got the care that would have kept them from getting so sick. We see unhoused people who come in seeking admission just to escape the streets and have a hot meal. We see patients who have fallen through the cracks without proper or efficient care because of broken systems — doctors and nurses stretched way too thin, communication failures, inability to pay, fear of ambulance charges. And we see a single hospital visit send people into financial ruin.
These are systemic failures that every health professional in the US could easily identify, but that can seem impossible to solve. And they are — at least in a capitalist system in which healthcare is a means for profit rather than to meet human needs. In Cuba, I saw with my own eyes what is possible in a system where healthcare is a human right, a government responsibility, and a national priority.
Prioritizing health under blockade
An old saying goes, “an ounce of prevention is worth a pound of cure.” A system that truly values human health prioritizes prevention and early intervention.
In Cuba, each neighborhood has a clinic, with a family doctor and nurse team dedicated to serving that community, who often live in the community themselves. In addition to regular primary care visits and walk-ins, the doctor and nurse do home visits, in which they are able to assess the conditions that impact the residents’ health. And all of this is free! With a system like this, epidemics can be detected and contained more efficiently, chronic conditions are better controlled, and elderly and vulnerable community members are less likely to fall through the cracks.
Cuban people who require specialty care or have more complex medical issues are referred to local polyclinics, and then up to high level tertiary hospitals as necessary. Women with high risk pregnancies are referred to community maternity homes, where they receive daily prenatal care in a home-like setting. And throughout all of these processes, care is coordinated alongside one’s family doctor. Oftentimes, the family doctor will travel to the hospital to see you and coordinate care with the specialists there!
This is possible because Cuba has more doctors per capita than anywhere else in the world, largely because education is free! Meanwhile, the US is facing a major physician shortage, and new doctors with extraordinary student debt are increasingly less likely to go into primary care, in which they are paid less, overworked, and undervalued.
Education and ingenuity is the backbone
Medical education in Cuba not only trains doctors to practice medicine, but to be proactive agents of change in their community — equipped with the knowledge to cure disease, but also with the tools to make the social and political interventions that prevent disease in the first place. Family doctors and nurses work with local mass organizations, such as the Committees in Defense of the Revolution, and government institutions to address issues impacting the health of their regions.
Learning about this scope of practice amazed me. In fact, one of the reasons I chose to become a nurse, rather than any other health profession, was because of how nursing school incorporates education about social determinants of health: safe housing, education, access to nutritious food, income, environmental conditions, and community context. But what good does this education do if nurses are not given the channels or resources to address these factors? What good does it do in a system that refuses to meet people’s needs and knowingly creates conditions that compromise health?
Cuban healthcare workers must come up with creative solutions to overcome the additional challenges imposed by the blockade — lack of access to first-line medications, inability to obtain parts to fix diagnostic equipment, running short-staffed because the fuel blockade means workers can’t commute to the hospital. And yet, even without the advanced technology and equipment that is the standard in the US, they effectively diagnose and treat incredibly complex conditions. As one Cuban doctor told us, “80% of problems can be figured out simply by talking to people.”
Socialism is the future!
Cuba gave me the ability to imagine working in a healthcare system in which nurse- and doctor-driven solutions were actually supported by the state. Caring for people is hard work, but in the US it is made even harder by deliberate short staffing to maximize profit margins, insurance battles, and policies and processes that center shareholders and bottom-lines over patient care.
At a time when the plague of “burnout” has reached crisis levels among healthcare workers in the US, I talked to Cuban nurses who had never heard of such a thing. Because they are working to serve and care for people in a system actually designed with that same goal. That is the type of system that works, even in the face of a blockade. And now that I’ve seen it with my own eyes, I have to tell everyone back home — every burnt out coworker, every frustrated patient.
The people of the U.S. deserve a system that actually works for us, and the Cuban people deserve to run theirs without a genocidal blockade. We can’t settle for this; we have to fight for better. Our health depends on it.
