The Latin American School of Medicine (ELAM for its Spanish language initials) is a masterpiece of Cuba’s remarkable healthcare system. A conference of ELAM graduates took place in Havana from Nov. 11 to 15; two sets of them attended. The gathering marked the 25th anniversary of ELAM’s founding in 1999.
What happened and what was said reflect Cuba’s healthcare achievements and ELAM’s special contribution. A focus on ELAM demonstrates for us the paradox, cruelty, and injustice of U.S. aggression against a people capable of producing such an unprecedented achievement as ELAM.
To be aware that ELAM exists and that its creation falls within the range of human capacity is to be reassured that, in fact, possibilities do exist other than U.S. war-making, militarization, and complicity in anti-Palestine genocide.
ELAM evolved out of Cuba’s response in 1999 to the ravages of Hurricanes George and Mitch in the Caribbean area and in parts of Central America. Cuban physicians carrying out rescue missions discovered that local healthcare workers were overwhelmed by the catastrophe. Within weeks, Cuba’s political leaders opted to prepare young people to be physicians in their own countries and be ready for future disasters and much more
Soon, prospective medical students were heading to ELAM from hurricane-affected regions. Later they came from throughout Latin America, and eventually from Africa and farther afield, including from the United States. They were motivated by idealism – enrollees dedicate themselves to serving the underserved – and the fact that no personal outlay is required.
Over a quarter-century, ELAM has now prepared 31,180 physicians for service in 120 countries. Some 1,800 medical students from many countries are presently studying there. ELAM provides the first two years of pre-clinical courses at a converted naval base immediately to the west of Havana. Clinical training over the next four years takes place at teaching hospitals throughout Cuba.
On hand, in Havana, 25 years after ELAM’s initiation were more than 300 ELAM graduates and students, plus 250 guests, physicians, and students from 30 countries. The occasion combined the 1st International Congress of ELAM graduates and the 2nd International Assembly of the International Medical Society of Graduates of ELAM (SMI-ELAM).
Organizers assigned the theme “Guardians of life, creators of a better world.” They projected the assembly as “a space for scientific interchange … and a concrete step toward the creation of an international medical and scientific organization whose members [are] ELAM graduates.”
The gathering featured plenary sessions, round tables, panels, and presentations by clinical and research specialists. These took place in Havana’s teaching hospitals and Conventions Center. Topics were: primary health care, medical care during emergencies and natural disasters, postgraduate medical training, and higher education in the medical sciences. Presenters linked medical education, social impact, and international solidarity. Experts from abroad and from international organizations were participating.
Welcoming the delegates, ELAM Rector Yoandra Muro insisted that, “Commander Fidel is here, standing up, fighting with the example he instilled in his children, the graduates of this project of love.” Here, “we have a space for [ELAM] graduates to continue strengthening our kind of work and projecting training programs for the guardians of the present and future.” She identified graduates as “invincible standard-bearers in the field of health, who from their quality preparation are steeped in the work of solidarity.”
Luther Castillo Harry, currently minister of science, technology, and innovation in the Honduran government, graduated from ELAM in 2007. He declared at the conference that, “We are looking at the possibility of building the greatest scientific organization in the world…. Each one of us has to be an ambassador of the Cuban Revolution.” And, “We will only gain the possible, through struggle against the impossible.”
Cuban President Miguel Díaz-Canel sent a message welcoming graduates back to their “second homeland.” He indicated he could not attend the sessions in person because of duties with post-hurricane recovery efforts. Díaz-Canel cited Fidel Castro’s “deep conviction that a better world is possible if we fight tirelessly for that ideal.” He speculated on “Fidel’s happiness had he been able to see you become guardians of the life and health of your people.”
Presiding over a plenary session, Public Health Minister José Ángel Portal Miranda discussed healthcare in Cuba. The report has him outlining a system based on primary care that involves 69 medical specialties and three levels of care. Cuba’s medical network, he explained, consists of 451 polyclinics, 11,315 community health centers, 149 hospitals, and a workforce of 400,000 people. There are eight physicians serving each cohort of 1,000 Cubans – 80,000 in all. Maternity homes and homes for elders are part of the system.
The minister indicated that 40 different faculties or their affiliates are responsible for training physicians; medical sciences are taught in 13 universities. He identified “the development of science and technology as the fundamental pillar of the health system.” Presently 2,767 research projects and 82 clinical trials are underway.
Portal highlighted Cuba’s international medical solidarity, mentioning the Comprehensive Health Program mediated through international missions, the Barrio Adentro program for Venezuela, Operation Miracle (for eye care), and the Henry Reeve Brigades. He cited some 600,000 Cuban health workers having cared for people in more than 160 countries over many years.
Concluding his remarks, he stated, “Out of ELAM have emerged and will emerge galenos who will save humanity from the barbarism. Or, as leader of the Revolution Fidel Castro said – ‘Doctors, not bombs!’” (Claudius Galen was a Greek physician and researcher in the classical era. Spanish speakers often refer to physicians as “galenos.”)
Here is Castro speaking in Buenos Aires in 2003:
“Our country does not drop bombs on other peoples, nor does it send thousands of planes to bomb cities; our country has no nuclear, chemical, or biological weapons. The tens of thousands of scientists and doctors in our country have been educated in the idea of saving lives. It would be absolutely contradictory to their conception to put a scientist or a doctor to produce substances, bacteria, or viruses capable of killing other human beings.”
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