UMass group to study public health in Cuba

@dustyc123

AMHERST — When University of Massachusetts sophomore Madison Billingsley steps on an airplane early next month, it will be one of her first visits to a foreign country. And to make matters more interesting, the trip will be to a country that only a limited number of Americans get to experience — Cuba.

Billingsley’s trip is part of a new UMass Amherst pilot program that will take 15 students this fall to the Caribbean island, which has a socialized health care system, to study how its public health approach differs significantly from the U.S. system. Those lessons will come at a time of great debate about the United States’ own health care system and how it affects public health outcomes.

“I’m really interested to see how their health care system works in comparison with ours,” Billingsley said.

The new program is a collaboration between the university’s School of Public Health and Health Sciences and its international programs office, and will feature classes from UMass faculty on topics like “Cancer and the environment,” “Global public health policy” and “Reproductive justice.” Students will also take a Spanish class for health care professionals with faculty from the trip’s Cuban host institution, La Universidad de La Habana.

Marjorie Aelion, dean of the School of Public Health and Health Sciences, said the program stemmed from the same big question that has long fueled study-abroad trips: “What can we provide to our students that has more impact than just experience in the classroom?”

Cuba’s public health system, Aelion said, differs greatly from the United States in many ways, one of them being the attention paid to preventive care. Hands-on experience juxtaposing that system with our own, she said, is a valuable experience for health care professionals in the making.

“Many decades ago, Cuba took a public health and prevention outlook to its care of the population’s well-being,” Aelion said, mentioning the country’s relatively low infant mortality rate and high life expectancy. “I think it just has so many pieces of how a low- or limited-resource country has been able to achieve public health.”

Despite the country’s economic challenges, exacerbated in no small part by a stifling U.S. embargo on the island, Cuba’s health system has produced impressive outcomes. A government-run system that’s universal and free for all, Cuba’s National Health System has produced high doctor-to-patient and dentist-to-patient ratios, almost universal vaccinations, a strong primary care network and some of the world’s lowest HIV/AIDS infection rates, among other successes.

Mainstream knowledge of Cuba’s heath care system exploded after Michael Moore’s 2007 documentary “Sicko,” in which he took several rescue workers sickened in the 9/11 attacks to Cuba for quality medical care at a top-rate hospital. But Cuba’s health care system has long interested public health and health policy experts, who see it as an example of an integrated approach resulting in positive health outcomes.

Aelion said that in addition to big questions about health policy, there are also smaller lessons to be learned from observing another country’s way of addressing public health, as she realized on her own trip to Cuba in 2011.

When she was there as part of a delegation with the American Public Health Association, she remembers visiting a kindergarten, where students’ had their own cubbies, similar to the ones her own children had in the United States. The difference, she said, was that the Cuban school included a toothbrush and washcloth in each child’s cubby, providing them easy access to, and education about, basic dental care.

“That’s just a different viewpoint in how to approach people’s health and well-being, and I hope the students, now that it’s a little more open, will have an opportunity to see a little more than I was able to see,” she said of the upcoming trip.

Of course, inherent in discussions about Cuba are the political tensions that underlie the country’s relationship with the United States. Aelion said, however, that a long-standing frosty diplomatic relationship shouldn’t affect experts’ ability to compare and contrast the successes and failures of both countries’ systems.

“Really, in public health, it’s putting politics like that aside,” she said. In doing so, academics and professionals can see Cuba’s successes and failures, and what lessons they can teach other countries.

Kalpen Trivedi, the executive director of the university’s international programs office, said politics also make some elements of travel to Cuba tricky.

“It’s not always possible to make direct payments in Cuba, for example,” he said. Day-to-day logistics and agendas also have to be approved by Cuban authorities. “There’s just a lot more i’s to dot and t’s to cross in taking a program to Cuba as opposed to another destination.”

That extra headache, however, is well worth it, he said.

In addition to $20,000 in grant money from the Association of International Educators’ Marlene M. Johnson Innovation Challenge, the trip will also receive money from UMass Amherst program fees and scholarships to help lower students’ expenses. The total cost of the program — around $13,000 for 18 credits and a full semester of room, board and accommodations — is meant to cost around the same as a regular semester of tuition at the university, Aelion said.

Trivedi said that financial assistance is part of the university’s commitment to making sure that students with high financial needs can have access to study-abroad programs.

For Billingsley, that experience will provide her an opportunity to practice her rusty Spanish, and to deepen her interest and expertise in a field she has only just chosen to pursue.

“I kind of figured I wouldn’t get an opportunity like this again,” she said.

Dusty Christensen can be reached at dchristensen@gazettenet.com.