MEDICAL STUDENTS WARM TO STUDIES IN CUBA

Caribbean nation puts Chinese on road to success

After Kou Shunchao arrived in 2006 in Havana, Cuba's capital, at age 19, he became one of the first Chinese to pursue medical studies in Cuba.

Kou, from Qinghai province, would spend the next 13 years - almost half his life - in the Caribbean island nation.

More than 3,000 Chinese students from 12 central and western provinces have studied in the country with a Cuban government scholarship. They have since gone on to become doctors and nurses back home.

"I chose the project because of the financial aid given by the government. I can also learn Spanish as well as medicine, my major," the 32-year-old said of his decision to study in Cuba. Financial concerns were also a key motivation for most of the Chinese students taking part in the program.

Li Siya from Xi'an, capital of Shaanxi province, did some research and found that Cuba is strong in the fields of biopharmaceutical technology, ophthalmic clinical practice and clinical medicine.

She planned to apply to Northwest University of Political Science and Law in her home city after taking the national college entrance examination in 2009, but changed her mind when she saw information about the Cuban program in a local newspaper.

"My mother is a doctor. She believes it is an honor to be a doctor or a nurse ... Moreover, we don't need to pay tuition, so I finally decided to join the program," Li said.

The Chinese all grew up after the launch of the reform and opening-up policy in 1978. They were shocked when they witnessed the embargoes placed on Cuba by the United States, but all have had heart-warming experiences while studying on the island.

"Although Cubans suffer from a critical shortage of supplies, I am deeply touched by their simple and sincere interpersonal relationships," said Kou, who expects to earn his PhD this year.

"Teachers and local doctors have low salaries, but most of them are devoted to their jobs."

During one day of Kou's six-year internship, he was responsible for health checks and setting up medical records for a new patient.

"The process required lots of time and there was a shortage of disposable sterilized gloves at the time. I asked the director if I could do the work after lunch, since the college canteen was going to stop serving in half an hour," Kou said.

"The director agreed, but when I came back from the canteen, he had already done the job for me, and explained the whole process in detail. Later, I found he had eaten his lunch of rice and soup in the rest room."

When Li arrived in Havana 10 years ago, most daily products, such as eggs, meat and potatoes, could not be traded freely.

"At the very beginning, we used to complain about the food in the canteen. But when we did health screening in local people's homes, we suddenly recognized that the Cuban government had tried its best to provide a quality life for us," Li said. "And most Cubans I have met are very friendly and helpful."

Li has spent her time studying healthcare in Havana. In January last year, the 28-year-old began her postgraduate studies at the Central Institute of Ophthalmology Ramon Pando Ferrer in the city as a medical resident. After graduation, she will specialize in general ophthalmology.

Li remembers clearly her teacher's opening remark in her first class at the School of Santiago Figueroa, where students spend the first year learning Spanish. The teacher said, "I am 26 years old this year, and I am excited to have so many children (referring to the students) all of a sudden." Li said all the students burst into laughter on hearing this.

Li was among the last group of students to enroll in the program. The scholarship, which started in 2006, was suspended after 2009 due to the Cuban government's financial difficulties, but many students stayed in the country to further their studies.

Zhou Can, from Guiyang, capital of Guizhou province, began her studies in Cuba in 2008. She returned to China after seven years and became a doctor at a hospital in her home city.

"I often miss my time in Cuba, even though the living conditions there are not so good," she said.

"I was deeply impressed by Cuban people's gratitude for life and their outlook. They long to see the rest of the world, and they cherish each day, whether they are rich or poor."

After working for three years as a doctor in Guiyang, Zhou said her most direct impression is that China, with its large population, cannot emulate Cuba's free healthcare system. Chinese doctors face a great deal of pressure due to the large number of patients, she said.

"Sometimes we even have to run to the restroom. And in China, the relationship between doctors and patients is not so harmonious as it is in Cuba. A lack of preliminary medical knowledge usually makes communication between doctors and patients more difficult in China."

Zhou left the Guiyang hospital last year to pursue further studies in Spain, while Kou, who is president of the Chinese student union in Cuba, is applying for an internship at the World Health Organization.

Kou's research for his doctorate is on atherosclerosis, a condition in which the inside of an artery narrows dues to a buildup of plaque, a topic highly relevant in both Cuba and China, due to their fast-growing aging populations.

"I am thinking about finding a job in Beijing later, hoping my strengths in both medicine and Spanish can give me a competitive edge," Kou said. "But maybe I need more time to familiarize myself with the medical system and process at home."

Li is also thinking about becoming a doctor at home after finishing postgraduate studies in Cuba. "But if my country needs me to work in Cuba, I will never refuse," she added. "There are many practices we can learn from Cuba."

The State-run healthcare system has earned Cuba praise over the years. Despite scarce resources and a less-developed economy, the country has one of the world's lowest infant mortality rates - just slightly below that of the United States. Industry statistics show that its life expectancy is 77.5 years, one of the world's highest. The nation has 30,000 family doctors and 500 local clinics, and every Cuban sees a doctor at least once a year.

Cuba is one of the few countries to offer its citizens free healthcare treatment and services. Although not wealthy or economically developed, the country spends half of the national budget on healthcare and education.

Chinese students enrolled in the program have also benefited from Cuba's free medical system.

Kou said a Chinese student, Zhou Kai, had a heart attack during his studies in Cuba. After Zhou's parents gave their approval, he underwent surgery at a local hospital. All the medical treatment, including rehabilitation, was free.

"All of us enjoy the same treatment as Cuban citizens, and our institution does its best to look after us," Kou added.

He believes that early emphasis on community-based primary care and prevention is the key to success.

"China should really learn from that," Kou said. "Promoting health knowledge and treating common illnesses in communities is an efficient method, with minimum cost."

The Cuban healthcare system starts at community level, where each neighborhood has a clinic with a doctor and a nurse. These doctor-nurse teams spend each morning in their neighborhood office seeing patients, and every afternoon they visit people based on need.

"That's why Cubans love to have some small talk with doctors, as they take them as their friends. There are not that many patients in hospitals as quite a number of them have received timely treatment in the community where they live," Kou said.

Every Cuban is assigned a health number and has an annual care plan developed for them based on their level of risk. As a result, most illnesses can be detected or prevented at an early stage.

Li said: "For instance, a number of patients come to the ophthalmology department for regular half-year examinations by appointment for dilated pupils. Although China has a very high instance of myopia, only a few people recognize the necessity for such periodic checks.

"Although the medical equipment and treatment in China is much better than what we have in Cuba, medical students have fewer chances to practice," Li said. "And this is one of the major strengths of studying medicine in Cuba."

What impressed Li the most was her experience in helping to deliver a baby when she served as an intern at a local hospital during her fourth year of learning gynecology and obstetrics.

"My teacher was beside me to tell me what to do next, but I was so nervous and was sweating," she said. "I even found my legs shaking and I burst into tears when I finally held the baby. This was the first time I felt the great joy brought by studying healthcare. I am now more determined to further pursue my studies and am glad I decided to learn medicine in Cuba."

When Li began her studies at the Central Institute of Ophthalmology Ramon Pando Ferrer, the lecturer taught students how to use delicate devices.

"The lecturer even loaned me her research materials, written notes and e-books, which makes me feel we are in a big family," Li said.

For Xu Shicheng, a researcher with the Latin America Institute of the Chinese Academy of Social Sciences, there are many "successful experiences" that China can learn from the Cuban healthcare system.

But the Caribbean country also faces challenges. The US embargo resulted in a lack of essential drugs, and no new medical facilities. The government faced a huge financial burden in providing a free healthcare system, and as private hospitals are not allowed, a reduced level of competition has led to low efficiency in public ones.

Gail Reed, founder of Medical Education Cooperation with Cuba, a nonprofit organization, was quoted by Tampa Bay Times, a Florida newspaper, as saying, "You can get a heart transplant (in Cuba) but might have to bring your own sheets to the hospital."

huyuanyuan@chinadaily.com.cn

(China Daily 02/22/2019 page2)