Cuba’s relentless focus on preventative medicine is the foundation on which they have been able build an enviable reputation as one of leaders in the world regarding health care for its people. To underscore this position is the fact that in 2015, the World Health Organisation (WHO) recognised Cuba as the first country in the world to eliminate HIV transmission from mother to child. Additionally, with an infant mortality rate of 4.0 per 1000 live birth places the country of among the lowest in the world.
These were some of the remarks made by Her Excellency Ines Fors Fernandez, Cuban Ambassador to Jamaica, as she addressed the 3rd annual White Coat Ceremony of the Caribbean School of Medical Sciences Jamaica (CSMSJ) held in the lecture hall of the institution, which is located at 15 Braemar Avenue, Sunday January 27, 2019.
A total of seven students received their White Coats.
In a wide ranging address the Cuban ambassador spoke of the fact that despite extremely limited resources and the impact of a 57-year old economic blockade imposed by the United States of America, Cuba has managed to guarantee access care for all segments of the population and obtaining results similar to those of the so-called first world countries.
The Cuban diplomat further explained that one of the central reason for her country’s medical success was related to a program which revolutionize health care, ‘ The most far reaching curricular reform to date was initiated in early 1980’s which was the direct result of a new launched Family Doctor and Nurse program, that following its pilot in 1983 in Havana and a national roll-out a year later, achieved a 98% coverage by the doctor and nurse health teams, in all neighbourhoods throughout the country by 1999’.
Each team was responsible for the health care of 120-150 families in their geographic area .In practice this means morning visits by the patients to the office and afternoon house calls for the team interspersed with health promotion activities. Family doctors in a given community were clustered around a local polyclinic, serving between 20,000-40,000 citizens, relying on it for referrals, to specialists, laboratory and diagnostic services and other organizational support. The family doctor and nurse teams were also posted in schools, large factories, in homes for the seniors, on board ships and other settings.
Ambassador Fernandez pointed to the 3 main pillars on which medical education and training was built in Cuba and they included:
1. The scaling up of physicians training to meet the needs of the wider population
2. The recruitment and training of scientifically prepared and socially committed students
3. The matching of competencies, knowledge base and scope of responsibilities to the concrete health needs of the Cuban population and the other countries where these future physicians will serve.
She exhorted the new white coat inductees to be guided by principles of loyalty to profession, respect for well-being and humanity, aiding general welfare and community, spirit of cooperation and practice with conscience and dignity.
In highlighting the growth of the 3-year old institution consultant surgeon and dean of the CSMSJ Dr Neville Graham, spoke of the access to the loan facilities of the Student Loan Bureau by the students as one of the important achievements since the previous induction ceremony in 2018. The forging of relationship with both local and international institutions to include, University of Technology Dental School, University of Havana Institute of Superior Medical Sciences and Hermanos Almedia Hospital in Havana , where a cohort of students are currently involve in clinical rotation in areas related Radiology, Orthopaedics, Urology and Ear Nose and Throat(ENT),Oregon State Medical School for a similar clinical rotation program and with Morgans Funeral Home for cadavers to aid students in the area of pathology training. CAAM for preparing students for their examinations.Addittionaly advanced discussions have been held with the University of the West Indies (UWI) medical school regarding collaboration in areas related to clinical rotation and other areas aimed at strengthening student offering by both institutions. Meetings have also been held with the Royal College of Physicians in the UK with a view to a collaborating in the streaming of classes, conferences and other scientific discourses which will benefit both institutions. A major thrust has also been made within the diaspora and on the African continent for students especially from the sub-Saharan region.
The White Coat Ceremony is rite of passage that welcomes new medical students into the medical profession, which bounds them by the same professional commitment that binds all physicians. The ceremony joins the symbol of the white coat with the virtues of altruism, responsibility, duty honour respect and compassion.
The CSMSJ instituted the white coat ceremony as a means of reinforcing to its medical students to always do their best.