Cuba: Teaching the world about containing Ebola

Havana took up the challenge by hosting a special Summit on Ebola with its regional partners and global health authorities on October 20.

By Conner Gorry, Havana

October 24, 2014 -- Guardian Professional -- West Africa needs what Cuba has: a well-trained, coordinated healthcare system. Anything less and Ebola wins.

Guatemala, Pakistan, Indonesia, Haiti. Four different nations that share a common experience: in the past decade, they were all struck by natural disasters which overwhelmed their under-staffed and under-funded public health systems. Into the rubble, flooding and chaos of these distinct cultures and contexts, Cuba dispatched a specialised disaster and epidemic control team to support local health providers. It was a story of unprecedented medical solidarity by a developing country which few media outlets picked up – until now.

The Henry Reeve Brigade, as it’s known, was established in 2005 by more than 1500 Cuban health professionals trained in disaster medicine and infectious disease containment; built on 40 years of medical aid experience, the volunteer team was outfitted with essential medicines and equipment and prepared to deploy to US regions ravaged by Hurricane Katrina (the offer was rejected by the Bush administration). Today, Cuba’s Henry Reeve Brigade is the largest medical team on the ground in west Africa battling Ebola.

The small island nation has pledged 461 doctors and nurses to provide care in Sierra Leone, Guinea and Liberia, the largest single-country offer of healthcare workers to date. While United Nations Secretary-General Ban Ki-moon decried the pallid aid commitment from around the globe calling for “a 20-fold resource mobilisation and at least a 20-fold surge in assistance” Cuba already had 165 of these specially-trained healthcare workers on the ground in Sierra Leone. Each of these volunteers, chosen from a pool of 15,000 candidates who stepped forward to serve in west Africa, has extensive disaster response experience.

Nevertheless, preparation for this mission required additional, rigorous training at Havana’s Pedro Kourí Institute of Tropical Medicine with biosecurity experts from the United States and the Pan American Health Organisation. This rapid mobilisation of sorely-needed health professionals begs the question: how can a poor developing country spare qualified, experienced doctors and nurses?

By pursuing a robust medical education strategy, coupled with a preventive, community-based approach, Cuba, a country of just 11.2 million inhabitants, has achieved a health picture on par with the world’s most developed nations. This didn’t happen overnight. Rather, Cuba’s admirable health report card results from decades of honing a strategy designed specifically for a resource-scarce setting.

By locating primary care doctors in neighbourhoods and emphasising disease prevention, the health system – which is universal and free at the primary, secondary and tertiary levels – makes care accessible and keeps people as healthy as possible, as long as possible, saving resources for more expensive treatments and interventions in the process.

But prevention and health promotion by community-based healthcare workers are only part of the story. Cuba’s policies and practices, both at home and abroad (currently more than 50,000 Cuban health professionals are serving in 66 countries) are built on several principles proven effective in resource-scarce settings.

First, coordinating health policies at the local, regional, and national levels is essential; this is particularly important where infectious diseases are concerned since uniform protocols are integral to containment.

Next, health initiatives must be cross-sectoral and based on integrated messages and actions. A fragmented, uncoordinated response by and among different agencies can prove dangerous and even deadly. This was tragically illustrated by the death of Thomas Eric Duncan in Dallas and the US Centers for Disease Control allowing a nurse who has Ebola to travel on a commercial flight.

Finally, infectious disease outbreaks must be addressed quickly – easier said than done in poor settings, where public health systems are already strained or collapsing already.

The Ebola outbreak snaps the need for Cuba’s approach into sharp relief: only a coordinated response, provided by well-trained and well-equipped primary healthcare professionals will contain this – and future – epidemics. Indeed, policymakers such as World Health Organisation’s Margaret Chan and US secretary of state John Kerry have lauded the Cuban response, underscoring the importance of collaboration as the only solution to this global health crisis.

Forging this solution, however, requires harnessing the political will across borders and agencies to marshal resources and know-how. Havana took up the challenge by hosting a special Summit on Ebola with its regional partners and global health authorities on October 20. Noticeably absent were US health representatives; if we’re to construct a comprehensive, integrated, and effective global response, all resources and experiences must be coordinated and brought to bear, regardless of political differences. Anything less and Ebola wins.

[Conner Gorry is senior editor of Medicc Review. Follow @ConnerGo on Twitter.]

Submitted by Anonymous (not verified) on Thu, 10/30/2014 - 05:49


I think Cuba has sent an awesome example for other nations when it comes to sending large number of medical crew in the time of the need. These days when the Western nations are really cautious about sending their doctors and nurse, I think Cuba has shown the world its charitable side by sending medical teams.

I am glad that Cuba has found the strength and means to combat this terrible virus. At the present time it is generally the task of the world - all countries.

It is refreshing to see warm acknowledgement of what Cuba is doing to assist people of other nations despite the mean-minded and inhumane US blockade which President Obama promised to have removed.

I have visited Cuba and it is a poor country, but the people are very proud of both their health and education systems. Every Cuban citizen has free education from kindergarten to university and there is full health cover "from the cradle to the tomb".

Cuba has been a very good international citizen compared with many of those that complain about it. Cuba has beenvery helpful to many Latin American countries by providing medical and dental staff to work for long periods of time.

In addition, Cuba, for some years now, has had 300 medical and nursing staff in the independent Republic of Timor-Leste. Cuba has also reserved places for 300 Timorese medical students in Cuban medical schools.

Since being involved in Timor-Leste, the Cuban health workers observed the high levels of illiteracy in the nation. They informed their government and now there are Cuban literacy teachers also working there in a program similar to the "Si, Yo puedo" (Yes I can) literacy program that the Castro Government established after the 1959 Cuban Revolution to address illiteracy there.

In August this year, I visited Timor-Leste with my wife and the East Timorese informed me that Cuba is funding a medical faculty at the Universidade Nasional de Timor Lorosae.

The Timorese were very grateful to the Cubans for this generosity – especially as its doctors are trained to believe that their role is to serve the ordinary people, not to enrich themselves.

There will be many who try to demonise Cuba for these efforts and question the motives of its leaders. No government is perfect and the Cuban government is no exception. Wouldn’t it be wonderful, though, if the US, a nation that has caused many wars since World War 2, overthrown many elected governments and replaced them with ruthless dictators and purloined resources from other nations, actually took a leaf out of Cuba’s book?

Let’s call on the US to stop its mindless persecution of Cuba and creating wars and havoc in our world.

As they say in many Latin American countries: NO BLOQUEO!

Andrew (Andy) Alcock
Information Officer
Australia East Timor Friendship Association (South Australia)
PO Box 240

Submitted by Satish Ratna (not verified) on Sun, 11/02/2014 - 03:14


I think Cuba has shown the world its charitable side by sending medical teams. and providing there services and making an awareness among the people.