Learning lessons in care from Cuba

Professor Michael Kidd says Australia, like Cuba, should be training more doctors and nurses to contribute to global health care.
Professor Michael Kidd says Australia, like Cuba, should be training more doctors and nurses to contribute to global health care.

“If a developing country like Cuba can train more doctors and nurses than they need so they can contribute to the health care needs of other countries around the world, you have to ask the question – why can’t Australia do the same?”

Flinders University Professor Michael Kidd, Executive Dean of the Faculty of Medicine, Nursing and Health Sciences, has been pondering this very question since his return from Cuba last month.

An esteemed primary health care expert, general practitioner (GP) and President of the World Organization of Family Doctors, Professor Kidd travelled to Cuba to learn more about the country’s delivery of primary health care and doctor training, with a focus on the Medical School of Latin America (Escuela Latinoamericana de Medicina – ELAM).

He said Cuba has 36,000 trained family doctors (GPs) addressing the health care needs for their population of 11 million people, while Australia has just 26,000 GPs for 23 million people.

“In Cuba, in addition to ensuring that everyone has access to well trained teams of doctors and nurses working in primary care, they train a lot more doctors than they actually need so they have capacity to provide support to other countries at times of need,” Professor Kidd said.

“Cuba sent a team of doctors to Haiti during the 2010 earthquake, they were the first to send medical teams to West Africa following the Ebola outbreak and, closer to home, they sent 300 Cuban doctors to meet the needs of the health care people of Timor-Leste and at the same time trained 300 young people from Timor-Leste in Cuba at the Medical School of Latin America to become doctors,” he said.

“In an extraordinary contribution to global health, the Medical School of Latin America has trained 27,000 doctors from 65 countries since 1998.

“While the people of Australia have good access to excellent GPs and primary care nurses, we still have a chronic shortage of doctors and nurses in many rural areas and long term projections show these shortages will worsen over the years ahead.

“We have to source doctors and nurses from other countries to meet our needs when, as a wealthy nation, we should be training more health care professionals than we need and making a net contribution to the rest of the world.

“If a small, developing nation like Cuba can make extraordinary contributions like this to humanity, why can’t Australia?”

Aside from playing a major role in the provision of global health care, Professor Kidd said Cuba has all but perfected the art of personalised family medicine.

“Cuba is one of the best examples of ensuring every member of the community has access to good quality primary health care, delivered by well-trained doctors and nurses.

“Every Cuban, including all people in rural areas, has their own primary health doctor and nurse team.

“These doctor/nurse teams have a list of all people in their community, and they are expected to know the health status of everyone in their community, including who the elderly and housebound people are, and they will go to visit them rather than expecting them to come to their clinics.

“It is a proactive approach to ensure all people, and especially the most vulnerable, are getting access to the health care they need.”

During his trip Professor Kidd visited the Medical School of Latin America which, together with Flinders University, is part of a global movement of socially accountable medical schools dedicated to training medical students to better meet the specific needs of the communities they will serve as doctors.

“The Medical School of Latin America is very similar to Flinders and the work we’re doing in rural South Australia and across the Northern Territory to increase both health care in the region and also build Indigenous health workforce capacity,” Professor Kidd said.

“Flinders’ Northern Territory Medical Program is a great example of socially accountable medicine which is gaining global recognition. It is addressing the shortage of doctors in the NT, working effectively with Aboriginal communities to increase the number of Indigenous medical students and medical graduates, and supporting our medical students to complete their entire medical training in the NT and, after graduation, establish their medical careers in the NT.”

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