When I arrived, I found several international ELAM graduates (http://elamedicosinternacionalistas.wordpress.com), including 7 United States graduates (http://www.michaelmoore.com/words/mike-friends-blog/cuban-trained-us-docs-complete-haiti-mission), and a number of Haitian medical students working alongside the Cuban doctors. We were stationed at a field hospital set up by the Henry Reeve Brigade of Cuban doctors on January 28th in a small central park of Croix des Bouquet, just outside Puerto Prince. Together we served displaced earthquake victims and patients suffering from inadequate health care services.

In the first six months the hospital was established, we addressed the needs of more than 70,312 patients; 53,588 at the hospital and 16,723 in the field. We performed a total of 2,506 operations on-site, with 786 major surgeries; including emergency caesarean sections, ectopic pregnancies, thyroidectomy, hernias, hydroceles, hysterectomies of uterine fibroids, orthopedic surgeries and more. We assisted 116 natural births. We diagnosed 3,533 patients with our on-site laboratory and diagnostics center. We saw 3,192 patients for x-rays and ultrasounds. We treated 8,778 patients with physical therapy, and we hospitalized 2,053 patients on-site (Information provided by the Henry Reeve Brigade of Croix des Bouquet Statistical Report, June 2010).

When you stepped out of the hospitals and into the streets the only question that came to mind had to be, “where is the aid?” It was obvious, even six months after the earthquake that little progress had been made, with little to no evidence of monetary support. Hundreds of thousands of people were still living displaced in make-shift tent cities. The city still resembled a disaster zone with buildings teetering above cracked foundations, while corpses remain beneath the rubble. The doctors seemed to be the only relief effort making a difference.

The Cuban doctors were accomplishing more than what the international community was willing to recognize. Croix des Bouquet was just one of several field hospitals established by the Henry Reeve Brigade to serve communities in and around Puerto Prince free of charge. CNN even had to apologize after interviewing one of the Cuban doctors and crediting him as Spaniard. Fortunately, Cuban doctors aren’t looking for recognition; they are out to save lives and continue to do so all over the world.

The Henry Reeve Brigade has since moved on to other emergencies, like the fires plaguing Russia. Other Cuban doctors have replaced them to continue serving the Haitian community free of charge. Brazil and Cuba have signed a trilateral accord with the Haitian Health Minister to establish three hospitals staffed by Cuban doctors located in communities surrounding Puerto Prince where health services are limited to non-existent. Cuba has been dedicated to sending doctors to Haiti for 11 years. Amidst the unfortunate circumstances of the earthquake, they continue to fulfill their commitment to the Haitian community by sending doctors. With the success of the students working alongside the doctors, they now have plans to send more students in the years to come.

Note: Article written by Joanna Mae Souers. Photograph titled, “Joanna Mae Souers on Wound Care” was taken by Cuban photographer, Juvenal Balán. The other photographs were taken by Joanna Mae Souers.

David Lundquist, President and CEO of Kingston Hospital, of upstate New York, made efforts to organize supplies to donate to the students of the Latin American School of Medicine in Havana Cuba.  Supplies included masks, gloves, scrubs, and several other useful items that the students can use during their time in Cuba.  Because of the U.S. embargo against Cuba, supplies are limited and students are expected to bring their own.  It is very helpful when hospitals can help students out by donating supplies to alleviate them from these costs.

Kingston is where I grew up, and it is wonderful to get such positive support from local hospitals.  Many health care professionals don’t know about the program to study medicine in Cuba, but when they hear about the opportunity, in spite of political propaganda, they think it’s great and they look forward to anything they can do to support the students.  Cuba is well renowned for their public health care and international relief efforts, but what is little known is that there are over 100 U.S. students studying medicine in Cuba for free, with one catch, the promise to return to the U.S. upon graduation and practice in underserved communities.  Is that really a catch?  This is a gift from the Cuban government to the American people.

I want to thank Kingston Hospital for their generous donation and I want to encourage other hospitals to donate what they can.  If you would like to make a donation of medical supplies or books to the students of ELAM, please contact IFCO & Pastors for Peace via their website www.ifconews.org.

Thank you Kingston Hospital for your support!

[Editor's note: For more information about this program, readers should visit prior postings on this topic.]

Dr. Nelson Gonzalez on Rounds

The Hospital is Our Classroom; The Patient is Our Professor

As third year students at the Latin American School of Medicine the hospital is our classroom and the patients are our professors. We spend our days practicing patient histories and physical exams to tune and then retune our clinical skills.  Students from the U.S. and several Latin American countries rotate at Hospital Salvador Allende in central Havana.   Students from all over the world can be found at teaching hospitals all across Cuba.

Our first semester focuses on clinical medicine, physical exams, and the relationship built between the doctor and the patient.   This is where we step out of the classroom and into the “operating” room as they might say; where medicine starts with “hello.”  From the minute your patient walks in the door, you are required to take notes on what signs and symptoms they might reveal to help you develop a good differential diagnosis.

Currently, I am at the Antonio Guiteras Unit of Internal Medicine run by Dr. Nelson Gonzales, a Specialist in Internal Medicine.  Every day we are tested on our knowledge of the pathological alterations in the physical exam. We see patients, go on rounds and learn first-hand how a patient is received, examined, diagnosed and treated throughout their stay.

I find our exposure to patients and first-hand clinical experience a essential counterpart to our classroom knowledge.  We are constantly applying our skills and seeing new clinical cases.  Recently we were addressing cases of dengue fever to control and quarantine a small outbreak in Havana and now we are focusing primarily on cases of suspected H1N1 influenza in adults with compromised health status.

If that isn’t enough patient exposure, fear not, we are on a weekly rotation at the hospital’s walk-in clinic where we see “walk-in” cases and learn from doctors making quick, accurate diagnostic calls.  Some of these cases are automatically hospitalized if they come in with severe health conditions requiring admission to the intensive care unit or those who present public health risks and need to be quarantined.  Examples of cases quarantined are those who present fever from areas endemic to dengue or present symptoms of an upper respiratory infection and pertain to one of the three risk groups of H1N1: pregnant women, children and/or patients with respiratory illnesses.

Medical Student Souers

I look forward to my third year at the Latin American School of Medicine in Havana, Cuba, where we learn to practice medicine on the bases of altruism, honor and sacrifice as a commitment to society.  It is the patient that teaches us medicine; it is the hospital that sets the stage.   Dr. Nelson Gonzales profoundly states that he is not such an altruistic being just based on character, but because of his formation as a doctor in Cuba.

Dr. Luther Castillo is a dear friend of mine… he is doing amazing things as a doctor in Honduras, and now that the world has turned it’s back, he’s trying to shed light on the situation…

He asked us to thank all of you for defending the lives of Hondurans threatened by the coup. He is spending some hours most nights attending to wounded or to families housed in temporary shelters throughout Tegucigalpa. He moves around, doesn’t sleep in one place. The streets after dark, he says, are “completely militarized”.

He reports that the defacto government is attempting to stop demonstrations and continued strikes by teachers and others, selectively targeting their leaders using a growing “hit list” of names that include his own. He says the attacks are being carried out by the army or by “criminals-for-hire”, reminiscent of the death squads of the 1980s. Three grassroots and labor leaders have been assassinated in the last few days alone.

Dr. Castillo has two main concerns:

ONE: the international press blackout on Honduras, with virtually all media either shut down or expelled. “We can’t let silence win; we need your voices,” he said.

TWO: the fate of the only Garifuna Hospital in Honduras, now without government support. Located in Ciriboya, the hospital is staffed by the group of young Garifuna doctors who founded it, working with volunteer Cuban physicians. Dr. Castillo reports they are down to their last supplies and medicines for 20,000 people living in the surrounding indigenous communities, settlements with no lights or running water.

“These are the poorest of the poor, the invisible poor. They are the real victims of the coup,” Dr. Castillo told MEDICC.

TAKE ACTION NOW!

Urge the US government to act: If you haven’t contacted the White House, the State Department or your Congressional representatives, DO SO NOW. Press them to use the US government’s influence to guarantee respect for the lives of Dr. Castillo, his colleagues and all those protesting the coup, and to ensure the return of Honduras’ elected government. State Department: 202-647-4000 or 1-800-877-8339. White House: Comments: 202-456-1111, Switchboard: 202-456-1414

Contact your Senators here: www.senate.gov/general/contact_information/senators_cfm.cfm

Contact your Congresspeople here:

https://writerep.house.gov/writerep/welcome.shtml

Keep Honduras in the public eye: Circulate this alert widely. GO ON THE WEB: use your blogs, listservs and networks to get the word out. Write a letter to the editor of your local newspaper.

There are also several Facebook groups that you can also join/post on:

http://www.facebook.com/group.php?gid=96870380185

http://www.facebook.com/group.php?gid=102246697300

http://www.facebook.com/againstcoup?ref=s

http://www.facebook.com/group.php?gid=95487307148

If you are a health worker or professional: ask your union, society or organization to post this alert and issue a public statement defending the rights and lives of your colleagues in Honduras.

Donate to the Garifuna Hospital: Global Links in Pittsburgh, Pennsylvania, has sent several containers of equipment and supplies already.  They will make your donation count for more.  Log on to: www.globallinks.org

Donate to MEDICC’s program to support the Garifuna medical students and graduates of the Latin American Medical School.

For more information and actions you can take, go to:

Latin America Working Group– www.lawg.org

Center for Democracy in the Americas www.democracyinamericas.org

Here is more information you can use:

Since 1999, Luther Castillo has directed the Luaga Hatuadi Waduheñu Foundation (“For the Health of our People” in Garifuna), dedicated to bringing vital health services to isolated indigenous coastal communities. After his 2005 graduation from the Latin American Medical School in Havana, Dr. Castillo returned to the Honduran coast, where he led the Foundation’s construction of Honduras’ first Garifuna Rural Hospital, now serving some 20,000 in the surrounding communities.

The hospital opened in December 2007, a few months after Dr. Castillo was named “Honduran Doctor of the Year” by Rotary International’s Tegucigalpa chapter. “Thank you for inspiring me,” said California Lieutenant Governor John Garamendi, speaking at the hospital’s opening ceremony.

The hospital and its community health outreach are supported by a number of U.S. and other international organizations, including the Sacramento, California Central Labor Council, Global Links, The Birthing Project, and MEDICC.  Several US medical schools also have cooperative arrangements with the Garifuna hospital, including Johns Hopkins, Emory, Charles Drew and University of California (SF).

Just weeks before the coup, Dr. Castillo was named director of International Cooperation in the Honduran Foreign Ministry.

Dr. Castillo is featured in ¡Salud! (www.saludthefilm.net), a documentary film that received the Council on Foundations Henry Hampton Award for Excellence in Film & Digital Media (USA).

MEDICC (Medical Education Cooperation with Cuba), www.medicc.org, is a US non-governmental organization working to enhance cooperation among the U.S., Cuban and global health communities aimed at better health outcomes.

–
Joanna Mae Souers
Escuela LatinoAmericana de Medicina
Carretera Panamericana
KM 3,5
Santa Fe, Playa
Ciudad de la Habana, CUBA
CP 19108

Here is the latest update from from Joanna Mae Souers, one of the US students studying medicine on scholarship in Cuba:

June 2009

Today there are 148 American students studying medicine at the Latin American School of Medicine in Havana.  They study within Cuba’s world-renowned system of universal health care.  Despite Cuba being a “poor” country, the World Health Organization (WHO) ranks the Cuban system among the top 10 in the world.  They study thanks to a scholarship provided within the same system of humanitarian medical  solidarity that has placed more than 21,000 Cuban doctors in poor third-world countries.

The 148 students originate from some of America’s poorest and most medically under-served communities. After graduating they plan, in line with the encouragement of the Cuban Government and our own Congressional Black Caucus, to serve the very same under-served communities from which they came.

As students attending ELAM we, have been given an opportunity to do something that has never been done before. On July 26, 2009, 12 American students from ELAM will board an RV for a road-trip of the Southwestern United States. Together we will spend two weeks as humble guests visiting Native American reservations, neighboring communities, hospitals and colleges to spread the word about our medical school opportunity and foster an exchange of information between all participating groups.

As we approach the one month mark in our countdown to departure we are motivated, poised, and excited about the road ahead us.  We are busy preparing for the exchange; writing up the material we hope to present, learning about the different communities we plan to visit and organizing our curriculum of exchange with guidance from our community liaisons.  So far we hope to visit with the following communities and organizations:

• The Oakland Health Fair, California
• Bay Area Native American Health Center, California
• California Consortium for Urban Health
• La Clinica de la Raza, Oakland, California
• California City College
• University of California at Berkley
• Fresno Clinic, California
• Fresno City College, California
• Los Angeles Indian Health Services, California
• Arizona Indian Health Services
• Windowrock, Arizona
• Gallup, New Mexico
• One Hope Clinic, Albuquerque, New Mexico
• Acoma Pueblo, New Mexico
• Pueblo Indian Cultural Center, New Mexico
• Pajarito Mesa, South Valley, New Mexico
• Santo Domingo Pueblo, New Mexico
• Shiprock, New Mexico

As students, we want to thank the following individuals and organizations for all of their support and guidance during the process of organizing this exchange.

• IFCO Pastors for Peace
• Native American Health Center (Martin Waukazoo)
• Office for Community Health, UNM Health Sciences Center (Dr. Art Kaufman & Dr. Julie Sierra)
• Center for Native American Health, UNM (Dr. Gayle Chacon)
• SWOP (Robby Rodriguez & Louise Head)
• Native Health Initiative (Dr. Anthony Fleg)
• Dr. Stephen Dahmer
• The Office of Congresswoman Barbara Lee

We extend a special thank you to all of our donors and supporters for making this exchange possible, and we want to encourage further support.  We are just short of meeting our proposed budget and we hope to make that happen to make this tour possible!  We need your support, please check out our link (http://www.medicc.org/ns/index.php?s=30&p=4) and donate now!

Visit our website www.saludswexchange.org for more information on the exchange!

sent in by Joanna Mae Souers
Escuela LatinoAmericana de Medicina
Carretera Panamericana
KM 3,5
Santa Fe, Playa
Ciudad de la Habana, CUBA
CP 19108

We recently received the following letter from Joanna Mae Souers, one of the US students studying medicine at the Latin American Medical School (ELAM) in Havana:

It is my pleasure to introduce to you a project we have been working on since December.

Inspired by the MEDICC Conference, we put our minds together to manifest the ¡Salud! Southwest Tour:

July 28th, 2009, 12 American students from the Escuela Latinoamericana de Medicina (ELAM – Latin American School of Medicine) in Havana, Cuba will board a Recreational Vehicle (RV) for two weeks to travel across the Southwest region of the United States visiting a number of tribal settlements of American Indian Nations, community colleges and universities.

While at the various sites the students will share their personal experiences of what it’s like to study at ELAM while promoting the availability of full scholarships for students, volunteer their services while learning about some of the more significant health concerns affecting American Indian populations and to build personal and professional relationships with health care practitioners and members of Native American communities.

These 12 students are among the 104 Americans on full scholarships currently studying medicine in Cuba alongside their peers from 27 different countries across the world. They represent not only some of the brightest and most courageous medical school students this country has to offer, but also originate from some of the toughest and poorest communities in the U.S. The settlements they plan to visit represent one example of the type of historically underserved communities where all the U.S. ELAM students have pledged to work upon graduation.

We are seeking funding support and medical donations that will provide the substance with which lifelong alliances will be built between future American physicians dedicated to underserved communities and our national predecessors.

For those interested in making a donation please visit the MEDICC Website (http://www.medicc.org/ns/index.php?s=30&p=4), or under ¨programs¨you´ll find ¨ELAM Students Southwest Tour¨ or email our communications director, Tasha Rassuli, at saludswtour@gmail.com or directly at tjrassuli@gmail.com

posted by: Matt Anderson, MD

J.M. Souers and V. Lezcano at the Institute of Genetic Engineering and Biotechnology

Joanna Mae Souers, a US student studying at the Latin American Medical School (ELAM) in Havana, has sent us this update on her studies. For additional information on the ELAM program you can other posting at this link:

January 2009

Every year, at the beginning of second semester, second-year students of the Latin American School of Medicine (Project ELAM), are responsible for choosing an elective course. 108 courses are offered on a variety of themes including, Microbiology, Pathology, Anatomy, Histology, History, Geography, Math, Medicine and Culture, etc.

Some of the courses I found more interesting include: “Clinical Microbiology and Infectious Pediatrics,” at the Pediatric Hospital of Central Havana, “Bacterial Diagnosis of Respiratory Illnesses,” at Hospital Calixto Garcia, and “The Practice and Theory Behind Sexually Transmitted Diseases” at the Ramon Gonzalez Coro Hospital of Gyno-obstretics. Some other students may have chosen “Preventative Detection of Cervical Cancer Associated with STDs,” “Acupuncture,” “Obesity Treatment,” “Effects of Electrical Current on the Human Body,” “Nanotechnology,” or even “Religions of African Origin and Health Care.”

After course selections were listed, I was pleased to be placed in “Preparation of Histological Slides for Morfophysiology,” a course in the theoretical and practical techniques of preparing and mounting histology slides. The course included several classes in the basic preparation of slides using different preservation, coloration and mounting techniques and a trip to the Herber Biotech Institute of Genetic Engineering and Biotechnology here in Havana, Cuba.

At the institute, doctors and technicians analyze trials to develop new vaccines, methods of diagnosis and new pharmaceuticals every year. We met with Dr. Viviana Falcon Cama, the director of the Electron Microscope Laboratory, who gave us an introductory overview of the institute and a history of the microscope.

Students practicing their technique with the ultramicrometer

After the introduction we were shown the step-by-step the process of preparing slides from samples of rat cerebrum infected with dengue fever. The samples were prepared using immunotechnological techniques to tag traces of dengue virus with gold particles to identify infected samples with the electron microscope.

We started the process with preserving the prepared sample tissue in resin, processed the resin imbedded samples using an ultramicrometer and finished the process mounting the samples on thin copper discs. After the preparation process we viewed our samples with the electron microscope.
The course was a success. It was a phenomenal experience and my first opportunity to manipulate an electron microscope. I was fascinated by the work they are accomplishing at the institute and amazed at the technology and tools available for research. Most people believe Cuba is suffering from a lack of resources. Though the embargo has greatly affected their ability to do business with many countries, they work hard to stay on the cutting edge of medical research and education.

written by Joanna Mae Souers

posted by Matt Anderson, MD

November 30th 2008, commenced the 4-day conference, “Medical Education for the 21st Century: Teaching for Health Equity,” at the National Hotel of Cuba.  The conference brought together health professionals, educators, administrators and researchers from around the world to exchange the latest in socially “accountable” health education.

The opening night included an inaugural address by Dr. Roberto Gonzalez, the Vice Minister of Public Health in Cuba, and a lecture by Dr. Charles Boelen, an international consultant on health care and ex-coordinator of the World Health Organization’s (WHO) Program for Human Resources.

The turnout was impressive with 230 presenters from 29 different countries including Cuba, the Philippines, the United States, Canada, Belgium, Honduras, Chile, Ethiopia, Columbia, Iran, Egypt, Ecuador, Argentina, South Africa, Mexico, Brazil, Spain, Great Britain, Greece, Germany, Ecuador, Belgium, Switzerland, Puerto Rico, Hungary, Tanzania, Australia, Pakistan, and New Zealand.

I was amazed that 54 of the 230 presenters came from the United States, representing a plethora of institutions including the American Association of Medical Colleges (AAMC), UCSF-UC Berkley, Albert Einstein College of Medicine, Boston University, The Jay Weiss Center for Social Medicine and Health Equity of the Leonard Miller School of Medicine, George Washington University, the University of Wisconsin, and the list goes on.

As representative students of the Latin American School of Medicine (ELAM), we were very pleased to be invited as guests of the non-profit organization, MEDICC (Medical Education Cooperation with Cuba).  MEDICC, one of the many sponsors, has worked closely with Cuba over the years to bring awareness to the international community the highly qualified human resources they have developed to meet the needs of the Cuban people and others around the world.

It was a wonderful opportunity for students to meet and share their experience with health care educators from around the world.  Educators were mostly impressed with the student’s humanistic ideals and their well-established set stride ahead of the curve on Social Health Care.

Most of the U.S. students chose the Latin American School of Medicine not only as their first choice, but they chose it as their only choice for the program’s social, humanistic and altruistic ideals embedded in its history and carried out in its curriculum.

As a student of the Latin American School of Medicine, I am proud to represent Cuba’s thought provoking, innovative ways of approaching health education in the 21st Century.  It was amazing to see so many people come together to share their ideas and show an interest in our experience.  I hope that people will be further inspired to mark their experience with positive thinking and practical change.

Joanna Mae Souers
Escuela LatinoAmericana de Medicina
Carretera Panamericana
KM 3,5
Santa Fe, Playa
Ciudad de la Habana, CUBA
CP 19108
jsouers@gmail.com <mailto:jsouers@gmail.com>

Ms. Souers shared with us two reports that the US students have prepared about their work.  This is the first:

On October 30th ELAM students, alumni, school and government officials were present for the Opening Ceremony for the First International Alumni Conference of Project ELAM here in Havana, Cuba.  Dr. Jose Miguel Barruelos Millar, Fidel Castro’s personal doctor during the Revolution and one of ELAM’s founders, was among the speakers.  Over the course of the conference, students, alumni and professors attended lectures, presentations and roundtable discussion on various themes, including human rights, student movements, indigenous movements, gender issues, alumni relations and healthcare brigades.

Students and alumni, discussing healthcare brigades, debated and defined the future formation, participation and integration of projects such as the Brigada Estudantil de Salud (Student Brigade for Healthcare, BES) and the Federación Internacional de Salud (International Federation of Health, FIS).

Since the First Student Congress of Project ELAM in 2001, students have organized chapters of BES to participate in community service projects during their summer vacations.  Stemming back even further, FIS was defined in 1999 to be the association of Project ELAM graduates working for medical brigades worldwide.  Students and alumni have agreed to strengthen relations between BES and FIS by working together in the collaboration of such projects.

On November 1st, alumni and students of FIS/BES, respectively, presented to the ELAM community on the outcome, social impact and scientific results of their work.  On this day, Joanna Mae Souers, graduate of Cornell University, 2nd year medical student, and BES representative for the U.S. Delegation, presented the U.S. BES proposal for 2009.

The US delegation is currently in the process of organizing and forming brigades to work in communities during the coming months of July and August.  It is our goal to organize students working in brigades to collaborate with doctors, local professionals and community leaders, in order to learn more about their communities, the problems that plague them and the potential solutions that could improve U.S. healthcare and strengthen these students as future healthcare providers.

The overall impact of the conference was quite astounding, as it successfully brought students and alumni together from all over the world to show their support for one another.  It was a true milestone for Project ELAM.  We hope that in the upcoming conferences we get representation from the US physicians that have recently graduated from the Project ELAM.

If you have any questions or are interested in supporting this line of work you are welcome to contact Ramon Alejandro Bernal or Joanna Mae Souers, representatives of the U.S. Delegation.

Contact information:

Escuela Latinoamericana de Medicina
Carretera Panamericana Km 3 ½
Santa Fé, Playa
Ciudad Habana, Cuba
C.P. 19108

Email:  Ramon Alejandro Bernal  alex238209@yahoo.com
Joanna Mae Souers  jsouers@gmail.com <mailto:jsouers@gmail.com>

posted by Matt Anderson, MD