December 8, 2006
Hippocrates Meets Fidel, and Even U.S. Students Enroll
By MARC LACEY
HAVANA, Dec. 7 — Anatomy is a part of medical education everywhere. Biochemistry, too. But a course in Cuban history?
The Latin American School of Medical Sciences, on a sprawling former naval base on the outskirts of this capital, teaches its students medicine Cuban style. That means poking at cadavers, peering into aging microscopes and discussing the revolution that brought Fidel Castro to power 48 years ago.
Cuban-trained doctors must be able not only to diagnose an ulcer and treat hypertension but also to expound on the principles put forward by “el comandante.”
It was President Castro himself who in the late 1990s came up with the idea for this place, which gives potential doctors from throughout the Americas and Africa not just the A B C’s of medicine but also the basic philosophy behind offering good health care to the struggling masses.
The Cuban government offers full scholarships to poor students from abroad, and many, including 90 or so Americans, have jumped at the chance of a free medical education, even with a bit of Communist theory thrown in.
“They are completing the dreams of our comandante,” said the dean, Dr. Juan D. Carrizo Estévez. “As he said, they are true missionaries, true apostles of health.”
It is a strong personal desire to practice medicine that drives the students here more than any affinity for Mr. Castro. Those from the United States in particular insist that they want to become doctors, not politicians. They recoil at the notion that they are propaganda tools for Cuba, as critics suggest.
“They ask no one to be political — it’s your choice,” said Jamar Williams, 27, of Brooklyn, a graduate of the State University of New York at Albany. “Many students decide to be political. They go to rallies and read political books. But you can lie low.”
Still, the Cuban authorities are eager to show off this school as a sign of the country’s compassion and its standing in the world. And some students cannot help responding to the sympathetic portrayal of Mr. Castro, whom the United States government tars as a dictator who suppresses his people.
“In my country many see Fidel Castro as a bad leader,” said Rolando Bonilla, 23, a Panamanian who is in his second year of the six-year program. “My view has changed. I now know what he represents for this country. I identify with him.”
Fátima Flores, 20, of Mexico sympathized with Mr. Castro’s government even before she was accepted for the program. “When we become doctors we can spread his influence,” she said. “Medicine is not just something scientific. It’s a way of serving the public. Look at Che.”
Che Guevara was an Argentine medical doctor before he became a revolutionary who fought alongside Mr. Castro in the rugged reaches of eastern Cuba and then lost his life in Bolivia while further spreading the cause.
Tahirah Benyard, 27, a first-year student from Newark, said it was Cuba’s offer to send doctors to New Orleans after Hurricane Katrina, which was rejected by the Bush administration, that prompted her to take a look at medical education in Cuba.
“I saw my people dying,” she said. “There was no one willing to help. The government was saying everything is going to be fine.”
She said she had been rejected by several American medical schools but could not have afforded their high costs anyway. Like other students from the United States, she was screened for the Cuba program by Pastors for Peace, a New York organization opposed to Washington’s trade embargo against the island.
Ms. Benyard hopes that one day she will be able to practice in poor neighborhoods back home. Whether her education, which is decidedly low tech, is up to American standards remains to be seen, although Cedric Edwards, the first American student to graduate, last year, passed his medical boards in the United States.
If she makes it, Ms. Benyard will become one of a small pool of African-American doctors. Only about 6 percent of practicing physicians are members of minority groups, says the Association of American Medical Colleges, which recently began its own program to increase the number of minority medical students.
Even before they were accepted into Cuba’s program, most of the Americans here said they had misgivings about the health care system in their own country. There is too much of a focus on the bottom line, they said, and not enough compassion for the poor.
“Democracy is a great principle,” said Mr. Williams, who wears long dreadlocks pulled back behind his head. “The idea that people can speak for themselves and govern themselves is a great concept. But people must be educated, and in order to be educated, people need health.”
The education the students are receiving here extends outside the classroom.
“I’ve learned to become a minimalist,” Mr. Williams said. “I don’t necessarily need my iPod, all my gadgets and gizmos, to survive.”
There are also fewer food options. The menu can be described as rice and beans and more rice and beans. Living conditions are more rugged in other respects as well. The electricity goes out frequently. Internet access is limited. Toilet paper and soap are rationed. Sometimes the water taps are dry.
Then there is the issue of personal space.
“Being in a room with 18 girls, it teaches you patience,” said Ms. Benyard, who was used to her one-bedroom apartment back home and described her current living conditions as like a military barracks.
Other students cited the American government’s embargo as their biggest frustration. The blockade, which is what the Cuban government and many of the American students call it, means no care packages, no visits from Mom and Dad, and the threat that their government might penalize them for coming here.
Last year Washington ordered the students home, but the decision was reversed after protests from the Congressional Black Caucus, which supports the program.
One topic that does not come up in classes is the specific ailment that put Mr. Castro in the hospital, forced him to cede power to his brother Raúl and has kept him out of the public eye since late July. His diagnosis, like so much else in Cuba, is a state secret.
Copyright 2006 The New York Times Company