C U B A

 Havana.  November 13, 2009

10TH ANNIVERSARY OF THE LATIN AMERICAN SCHOOL OF MEDICINE

Creators of a more humane world

“…Allow me to dream. Only after half a century of struggle am I absolutely sure that nobody could say of Cuba’s dreams what Calderón de la Barca affirmed: “all life is but a dream, and dreams are dreams” –Fidel, in 2005, during the first ELAM graduation

José A. de la Osa

TEN years ago a former military installation – the Granma Naval Academy – was converted, in an action of solidarity on the part of a little country criminally besieged and blockaded by a contemporary Goliath, into a Latin American medical university, with the idea that thousands of disadvantaged young people could make a reality of their dreams, subsequently to promote health, prevent disease, cure and save the lives of thousands of their own of their own compatriots in need.

In order to have a palpable sense of that historic event I talked at that time with Nora Karina of Guatemala, Lesver Miguel of Nicaragua, Nelson Menocal of Honduras and many more of that huge group of young people from our America who began that journey into the future.

I was deeply impressed by the story of a petite and communicative young woman, Igni Estrada Moncada, with vivid memories of poverty, doubtless similar to those of many students studying free of charge at the Latin American School of Medicine, and who received her doctor’s degree, as confirmed by the University’s General Secretariat, during the first ELAM graduation in 2005.

I remember that Igni said she liked the rain but, paradoxically, suffered when she heard it falling, because a few steps away from her home in Ilopango municipality, El Salvador, many people were living in corrugated shacks, “and then I think that the children will be getting wet inside their own homes, getting sick, and the people who most need it are the ones who receive the least medical attention.”

And she asked: “What doctor living in Colonia Escalón (a nearby area where wealthy people live) is going to go and attend to a community living ion such poverty?

“I’ve come to Cuba in response to your solidarity, to train in order to serve people in need with out any distinction of class.”

Sometimes she felt afraid, she explained, that the humane and social vision that she felt so deeply could be diverted from its source even if she had had the possibility of being educated in a capitalist country, “and I would come to be impregnated with the philosophy – as I’ve seen – that you take a sick child (to hospital) and if you don’t have the money to pay, you simply don’t get attended to, and that happened to me with one of my little brothers when he was only one day old.”

Studying for this humane career in Cuba, she concluded by saying, “I know that I couldn’t change those ideas, because I am surrounded by doctors who think the same as I do: that, as doctors, we have to be where the people need us.”

The student selection process for entry into ELAM is undertaken in their own countries of origin, fundamentally in response to a Cuban proposal that they should be young people with a vocation for Medicine and with scant or no possibilities of training for this university career in their places of origin.

THE IDEA EMERGES

From the heart of City of Havana, driving toward the west of the capital along Fifth Avenue, you come to the Panamericana highway. Some 25 kilometers further on, at the very limit of the two Havana provinces, lies ELAM, notable for its structure and rural setting and, in the academic sphere, for the integration of its teaching, investigative and welfare components in the education-learning process.

The idea of an Comprehensive Health Program (of free medical aid for the region and other continents) and a Latin American School of Medicine (as the sustainable part of that aid) was born in 1998 after the passing of two hurricanes that inflicted much damage in the Caribbean and Central America, giving rise to a large number of victims and incalculable material damage.

On November 15, 1999, during the 9th Ibero-American Summit of Heads of State in Havana, Fidel officially announced the ELAM project, “as a simple symbol of what, united, we can achieve,” and which aspires to be, he said, “a modest contribution from Cuba to the unity and integration of the peoples that we are representing here.”

He stated that material of a political nature would not be imparted, as is the case with young Cubans in all university centers. “They will learn the history of our hemisphere, especially that of Latin America and the Caribbean… Anyone is free to profess his or her religion, whatever it might be. And he noted: “The most important thing will have to be their total dedication to the most noble and humane of the professions: to saving lives and to preserving health. More than doctors, they will be the jealous guardians of the most precious of human beings, the apostles and creators of a more humane world.

“Doctors prepared to work there where they are needed, in the most remote corners of the world where others are not prepared to set foot. These are the doctors that will be trained in this School.”

“Your example, as the dearly loved young people already studying in this School,” stated Fidel, “will awake consciences and will be followed by the professionals who, in high numbers and with excellent quality, have formed the universities of Latin America. Saving millions of lives, offering secure and optimal healthcare to the 511 million inhabitants of Latin America and the Caribbean, can only be the task of hundreds of thousands of doctors who, in their vast majority, are already technically trained for that.

ACADEMIC TRAINING

Doctor Midalys Castilla Martínez, deputy teaching rector of ELAM, says that the training principles in the School are the same as those implemented with Cuban students, and the same rigorous study plan. In this academic sphere the integration of teaching, investigative and welfare components in the educational-learning process favor the comprehensive training level that these students have to reach on their courses.

Another essential objective of this program is associated with the values that should characterize a medical professional: humanism, solidarity, professional ethics and internationalism, fundamental aspects of the work that will transform them into human beings capable of aiding social and community changes, expressed in improved health indicators, quality of life and well-being, and the ELAM project’s principal goal as a contribution to greater social equality.

The educational training model of these students establishes a direct link with scenarios in which they will undertake their professional work. From the first of the six years of the course, and in their vacation periods, they are inserted in the most remote communities of their countries to take part in promotional and preventative health projects.

This link becomes more intense and diversified as students advance in their courses.

As one example of this integration in the investigative and welfare sphere, a clinical-epidemiological study is being made of kidney disorders among the inhabitants of a remote community in El Salvador, with the participation of ELAM students and graduates, together with specialists from the Nephrology Institute attached to the Cuban Ministry of Public Health and that of El Salvador.

Students complete their courses with a National State Examination, which legally endorses them as professional doctors, in line with regulations established by the Cuban higher education system, and which facilitates the recognition and accreditation of their degrees in their countries of origin.

The teaching deputy rector recognizes that the heterogeneous composition of the ELAM student body in terms of origin and cultural diversity has presented a challenge to the faculty’s professors but, at the same time, is an important pillar in the students’ overall training.