For each of the past four years, up to four residents at Yale-New Haven Hospital have spent six weeks studying health care in Cuba. Those rotations are unlike other foreign rotations that take residents to more than a dozen countries, said Michele Barry, M.D., HS ’77, co-director of the Yale/Johnson & Johnson Physician Scholars in International Health program, which sends 40 Yale residents abroad each year.
“It’s a little bit different than our other rotations in underserved areas, where they desperately need doctors,” Barry said. Cuba has no shortage of physicians and Barry sends residents to Cuba, she said, to observe the Cuban approach to primary care. “They have a physician assigned to an entire neighborhood. The physician takes ownership of the neighborhood’s health and does outreach in a way that we have never been very effective at,” Barry said.
That exposure to Cuban health care practices is no longer possible because of new restrictions on travel to Cuba that the U.S. Department of the Treasury put into effect on June 30. Among other limits on travel by American citizens, students must stay in Cuba for at least 10 weeks, too long for hospital residents, Barry said.
The rotations in Cuba were organized through Medical Education Cooperation with Cuba (MEDICC), a nonprofit organization that has sent almost 900 students from more than 100 medical, nursing and public health schools to Cuba since 1997. “These regulations will make it very difficult for health sciences students to study in Cuba, since most academic institutions do not have the resources to organize a course of 10 weeks,” said MEDICC’s director, Diane Appelbaum, R.N., M.S.
The new guidelines, she said, restrict MEDICC in several ways. For one, it’s not an academic institution, the only entity now allowed to send faculty, staff or students to Cuba. The new guidelines also require that students wishing to study in Cuba must do so as part of accredited courses in the institution in which they are enrolled, rather than under the auspices of other organizations or programs. And the courses MEDICC offers in Cuba only last between two and six weeks.
For most of Fidel Castro’s reign, which began in 1959, the United States has restricted travel by U.S. citizens to Cuba. Typically only scholars, journalists and Cuban-Americans with relatives on the island have been allowed to travel there. The latest restrictions are based on recommendations by the Commission for Assistance to a Free Cuba, which President Bush created last fall to find ways to move Cuba toward democracy. The new rules do not affect graduate students pursuing independent research.
Barry sees a political motive for the new rules—a desire to garner support from conservative Cuban exiles in Florida in the presidential election. And she believes the restrictions are counterproductive. “I only see good things coming out of the exchange,” Barry said. I do not think a country like the United States should foster censorship and thus prevent an exchange of ideas and cultures which could effectively promulgate democracy in Cuba.”