Public health care

If we had a better national health infrastructure, we would have been able to handle the coronavirus disease 2019 or covid-19 epidemic a lot better. But several administrations, including the current one, have not given importance to improving the quality of our health infrastructure.

And that’s a pity. The poor health of our people is a drag to our economic growth. Unhealthy people can’t be economically productive. Children not given proper health care from the start struggle to survive the rest of their lives.

It is said that in many parts of the country, people live and die without seeing the shadow of a modern doctor.

For a while, I thought Duterte would be different when he talked about the Cuban system. I thought change was coming.

One of the first things Duterte did was to send his first health secretary to Cuba to study their much-acclaimed health care system. Ours is a perverted version of the expensive American system which leaves many of our people without good health care.

Duterte’s health secretary went to Cuba, she returned to Manila and was soon replaced. We have no idea what she learned there and it doesn’t seem the Filipino people will benefit from the investment in her trip.

That’s too bad because our public health care system is very much broken for most Filipinos. The wealthy go to Singapore or Hongkong for healthcare. The rest of us deal with a pay-as-you go system. That may work for employed upper middle-class people, but it leaves everyone else with whatever the public system has.

A doctor friend urged me to google an episode in Dr Sanjay Gupta’s CNN health program on Cuba’s health care system. I found out it is nothing fancy, but it keeps Cubans healthy.

Dr. Gupta reports that “despite being one of the poorest countries, Cuba has a relatively strong health system… a lot of the focus is on prevention. That’s because it’s easier to prevent disease and cheaper than to treat them. We should be doing the same thing, and with more feeling.

“So there are screening programs starting at a young age for vision and for hearing. There’s also a very robust vaccination program. But keeping track of 11 million on the Caribbean’s largest island often requires a personal touch.”

Dr Gupta reports that Cuba’s health system has a network of polyclinics responsible for the surrounding neighborhood. The doctor in charge of the one Dr Gupta visited told him she covers 1,100 to 1,500 people.

In the morning the doctor sees patients in the clinic. Then in the afternoon she heads out to make house calls.

The US trade embargo has limited access to resources, even medications. The neighborhood clinic only has the bare essentials – an old Chinese-made scale, a cabinet with medication organized into plastic cups, a single bed.

If the patient needs other kinds of medications and assistance, they go to the secondary institutions, which are the hospitals, where they can find other drugs they might need.

Dr. Gupta observed that “on average Cubans have a long lifespan, nearly 80 years. The focus on preventive health care has contributed to that. It also means a growing aging population. Diseases like Alzheimer’s are becoming more common.

“Along with a focus on preventive care, Cuba also places a heavy emphasis on prenatal care for babies and their mothers, boasting one of the lowest infant mortality rates in the region… the World Health Organization validated the Cuban health system a few years ago, calling it, quote, ‘A model for the world.’”

Dr. Gupta also noted that Cuba managed to develop some impressive innovations because of necessity arising from the trade embargo. Much of that happens at the Center for Molecular Immunology.

Cuban researchers have made their own vaccines for everything from hepatitis to meningitis. They are producing more than 70 percent of the medication they need. We should work towards that level of self-sufficiency. We have the expertise, it is just a matter of wanting to do it.

One vaccine, in particular, has caught the attention of countries all over the world, including the United States. The vaccine is for lung cancer, and it’s called CimaVax. It is now undergoing clinical trials internationally.

Dr. Gupta qualifies that the word “vaccine” is actually a bit misleading. “In its current form, it does not prevent disease like a traditional vaccine, but rather keeps diagnosed tumors in check by inhibiting their growth. It’s a form of immunotherapy, harnessing the power of the body’s own immune system.”

Cubans get this cancer treatment completely free.

They also have this medical school that takes people from impoverished areas, trains them to be doctors, and then sends them back home to provide medical care. Since it opened in 1999 it has trained 25,000 doctors from all over the world in 84 countries, including the United States.

Studying in this medical school is free. In fact, the students receive a small stipend to attend the six-year program. The only agreement they make is that they return to their home country and serve impoverished communities in need of medical care. Our late great Dr Juan Flavier, our doctor to the barrios, will love that.

This university was founded in 1999 because they realized they cannot always send Cuban medical teams on medical missions to other countries.

Cuba sent hundreds of health care workers to West Africa to fight Ebola. Recently, some 50 Cuban doctors went to Italy to help with the covid epidemic. This was the first time a European country used Cuban doctors to deal with a situation of such magnitude.

Duterte’s instincts about Cuba’s socialized medicine are correct, but he didn’t follow through.

Of course, our medical community will rise up in arms at the mention of socialized medicine. But something like Cuba’s would be more meaningful for our people than our current one.

Maybe the next president will have more guts to fix our broken health care system.

Boo Chanco’s e-mail address is [email protected]. Follow him on Twitter @boochanco