The Healing Power of Culture

On the airplane there was no first class.  The flight attendant came on the loud speaker and politely told us that we were about to be sprayed with insecticide, but that it was "environmentally friendly and did not contain DDT."  Thirty minutes later, my colleagues and I were in Habana, Cuba.  We rode in a rusty Volkswagen van to the hotel; the solstice moon illuminated the streets.  

We traveled to Cuba from Seattle, as a group of five overly optimistic natural medicine students, with dreams of revolutionizing health care at home.  We set out to see the integration of the Cuban health care system with urban gardens and to discover a model that we could bring back home with us -- a sustainable model of preventative, community-based natural medicine.  I imagined Cuba as a utopia, with lush green gardens outside of every clinic, where doctors would go outside and harvest herbs necessary to treat their patients.  I imagined urban space teeming with vegetable gardens, meeting the nutrient needs of the neighborhood.  

I didn't find what I expected or a tangible way to bring acupuncture and organic broccoli into the lives of everyone in the United States.  Instead, I was blown away by Cuba's big heart.  The joy and unselfishness I experienced from the Cuban people will shape my life and career in the years to come.

The most important piece of information I came away from this experience with is that the Cuban community-based culture is preventative medicine.  The day-to-day way people live in Cuba creates health and vitality in the individual and the community.  The lives of Cuban people are filled with love, dance, simple food, art, music, socializing with neighbors and a generally stress-free, slow paced life.  I noticed that despite their economic status, as a whole, the Cuban people are happy and healthy.  This is a stark contrast to the United States where we have so much wealth, but suffer from high levels of stress and discontent.  

Health and education are main priorities for the Cuban government, with 40% of each municipality's budget dedicated to medicine and schools.  In 1959, at the time of the Revolution, many doctors fled Cuba and only two medical schools remained.  The life expectancy was 60 years, the infant mortality rate was 65 per 1000 live births and communicable diseases and parasites were increasing.  Creating a system of free, universal health care that is available in every town became a top priority in the Fidel Castro government.  By 2008, there were 72,000 Cuban doctors, which equates to one doctor per 153 people.  This is the best doctor patient ratio in the world.  The life expectancy is now comparable to developed countries with men expected to live 76 years and women 78.  The infant mortality rate is 5.7 per 1000 live births.  There are 498 polyclinics that offer natural health modalities spread throughout Cuba's 169 municipalities.  

Beyond statistics, Cuba's health care system displays generosity to populations that might otherwise be marginalized, despite limited resources.  I was particularly amazed by how Cuba takes care of their elderly by providing assisted living facilities, food, exercise and social programs (crafts, gardening and educational programs) to anybody who needs or wants them.  The facilities are staffed with medical professionals, family doctors, dentists, hair-dressers, teachers, etc. and provide full support to people as they age.  The senior citizen homes we visited provided the best example of urban agriculture integrated with health care.  The homes had gardens of vegetables and medicinal herbs where the residents could work as well as receive herbal remedies from the on-site pharmacist.  

Since the Special Period and unable to import petrochemicals (except for the insecticide we were sprayed with on the plane), Cubans have returned to a traditional form of agriculture that is local and organic.  Habana has 30,000 hectares devoted to urban agriculture which is far more than any city in the US.  All of the urban gardens in Habana seemed to be set up in the same way, growing the same crops, and using the same plants (oregano, neem and marigold) for pest control.  So, it is apparent that communism runs through the system of community gardens, but we also visited a larger urban farm that was run in a cooperative (and dare I say democratic) way.

I came away with a sense that the Cuban government has good intentions as far as promoting sustainable agriculture and providing land for community farms; however, resources are lacking and access to healthy food seems to be an issue that the national government is only beginning to address.  It is a challenge for families to get fruits and vegetables, especially if there isn't a garden in their neighborhood, because produce is not provided by the monthly government rations and is quite expensive for the average Cuban.

The question remains, what can we take from the Cuban experience and apply at home?  The Cuban culture is based on community, so a health care system that is based in community works well.  The US does not have a culture rooted in community so I am unsure Cuba's model would work here, especially from a government mandated perspective.  But from a grassroots level, community clinics can work to meet the needs of local populations throughout the US.  I plan on having my nutrition practice based on my small biodynamic farm, creating a connection between the community, their food and the land.  Traveling to Cuba has solidified these goals and showed me that health is as much about having access to many modalities of medicine and healthy food as it is about cultivating joy in one's life and community.