An Acupuncturist’s Visit to Cuba

This article first appeared in The American Acupuncturist, Volume XXIII, Winter 2000. I am reprinting it here because Cuba is a country we will wish we had studied closer as we enter the post-peak-oil era. Cuba has already been through the changes we are just barely starting to feel the effects of, and their solutions were far more brave and creative than most other countries who have found themselves suddenly lacking resources.

Despite huge shortages in medical supplies due to the U.S. embargo, Cuba has one of the most advanced medical systems in Latin America-and a strong commitment to providing free medical care not just to its own people, but to poverty stricken areas around the world.

In recent years, a second revolution has taken root in the fertile soil of the first: “Natural and Traditional Medicine”-from acupuncture to homeopathy to music therapy-is now offered in clinics and hospitals alongside conventional therapies, and Cuban patients pay the same amount for open heart surgery as they do for an acupuncture treatment: absolutely nothing. I traveled to Cuba in November, 1999 to research this phenomenon, and returned with a great love for this small country.

Contrary to what we often read in U.S. publications, life in today’s Cuba has many benefits for its citizens, and it shows up clearly in health statistics. These statistics are a reasonable marker for quality of life, for as we know the health of a person reflects not just medical care, but also stress levels, nutrition, lack or presence of community support, and other influences. Since the 1959 socialist revolution, the average life expectancy has increased from 55 years to 76 years (which is the same as the U.S. average). Before the revolution their infant mortality rate was 80 per 1000 live births, now it is 6.4, lower than the current U.S. figures, and substantially lower than the current 13.7 for African-American children born in the United States. Cuba has one doctor for every 270 inhabitants-one of the highest ratios in the world. In addition, there are some 1,450 Cuban doctors providing free health care in Africa, Latin America, and the Caribbean. And Castro recently inaugurated a free medical school in Havana, limited to foreign students from Latin America and the Caribbean who are too poor to attend elsewhere.

I was very lucky to have been given, literally the night before I left, the name of a woman who directed me to the clinics I visited. Sonia Baez, extremely intelligent, warm, and overworked, has been deeply involved in the Cuban revolution since her student days, and now has one limb in virtually very sector of Cuba’s health care system. She works as a go between with Chinese suppliers, arranging for shipments of raw materials used to make pharmaceutical drugs. She arranges for foreign visitors to visit clinics, herb farms, and innovative state-run organic farms. Baez also practices acupressure and healing touch at a community-health research project called the Laboratorio de Estudios de Salud in Havana, which was the first place I visited.

I met with an earnest and soft-spoken acupuncturist at the Laboratorio named Lazaro Hernandez. When my Spanish failed in acupuncture terminology, our conversation occasionally lapsed into Chinese, which I studied in college, and he speaks and reads well enough to gather information from textbooks. It was an odd and wonderful feeling to be talking with a stranger in Spanish, and when one of us said “San Yin Jiao” or “Qi Hai” there was a whole world of implied meaning that didn’t need to be further explained. The Laboratorio was opened six years ago, and started offering acupuncture to the community right away. “At first people were very suspicious of acupuncture,” Hernandez explained, “but eventually we had lines forming outside as people waited for a treatment. Hospitals refer patients here, and people also come by themselves for all kinds of problems.”

At the time of my visit, they were preparing to launch a new preventive health project. A tuina training was in session as we walked through the building, and Hernandez showed me where, starting in January, they would be teaching tai chi and breathing exercises to the community, as well as nutrition, and health-food cooking classes. Of the 32 people who work at the Laboratorio, 11 are working specifically on this project. These 11 come from a variety of professions-family doctors, surgeons, psychologists, and even an architect and a historian-many of them holding full-time jobs elsewhere. There is a concept in Cuba of ‘Lending of Services’ which makes this sort of project possible. “We are trying to involve the whole community in this project,” Hernandez said, “we are making contacts with the local school, vegetable markets, etc., so everyone will be working together. Ultimately we’d even like to open a health-food restaurant here, and use it as a teaching resource.”

All the clinics and pharmacies I visited were short of supplies. The 40-year U.S. embargo has meant that all supplies must be shipped, expensively, from far away, or if nearer, from poorly equipped neighbors like Mexico. The recent tightening of the embargo, in an attempt to drag down the Cuban system at its weakest moment (when it lost nearly 80 percent of its imports due to the collapse of its biggest supporter, the Soviet Union) included such pressures on the international community as denying entry to the U.S. to any ship that had called in Cuba in the past six months, and pressure on large foreign pharmaceutical companies such as Bayer Aspirin, to stop selling to Cuba or else not be permitted access to the U.S. market. It is a testament to the Cuban spirit that they have responded to these lacks with a spirit of innovation-such as becoming leaders in the field of organic agriculture when they lost access to chemical fertilizers and pesticides. Although acupuncture was already being used in military hospitals in Cuba more than 20 years ago, the lack of medical supplies has no doubt contributed to Cuba’s interest in alternative health care. O.M.S. and Crane Herb Company had both donated acupuncture supplies for me to bring to the clinics I was visiting. When I presented Hernandez with about 20 boxes of needles, and five boxes of moxa poles, it nearly sent him over the edge. “It’s like an angel has come!” he said. “In January, when we start the project, it is our coldest season, and people come in with many cold-related complaints, but we didn’t know where we were going to get any moxa, since at the moment, we have almost none.”

I asked Hernandez what other supplies were most needed at his clinic-and he heaved a big sigh. “Books.” he said, without needing time to think. He picked up a textbook on tuina, in Chinese, and flipped through it. “We don’t get much, and everything we get is in Chinese. I can read it, very slowly, but it takes so long, and there is information that we can’t find in these books. We could use textbooks in English, which we all learn in school.”

Another wonderful clinic I visited was in Matanzas, a city about two hours outside of Havana. The clinic, which opened in 1994and was one of the first to use an integrative approach to treatment, now has 57 people working there-most of them physicians who have an additional degree in Natural and Traditional Medicine. The large cement building was actually a jail from the pre-revolution Batista regime. “Prisoners were beaten and tortured here under Batista, and now.. .” said Gladys Rodriguez, who was showing me around, as she swept her hand down a long brown-and-yellow hallway filled with benches and doorways. Each doorway had a sign sticking out: ‘Tai Chi,’ ‘Acupuncture,’ ‘Psychotherapy,’ ‘Homeopathy,’ the list of good things went on and on.

I spent the afternoon meeting with a group of acupuncturists, one of whom, Dr. Lazara Blanco, had been practicing for 23 years. She was an acupuncture anesthesiologist, and said they routinely do many surgeries with no drugs whatsoever-for example thyroid surgery, mastectomies, and uterine fibroids. In addition to classic T.C.M., Acupuncturists at this clinic also use laser therapy, and point injection therapy-inserting microdoses of B-vitamins into acupuncture points.

During much of the day, the hallways are filled with patients, many of whom are brought in from the countryside on Red Cross buses in the morning, and returned to their small towns later in the afternoon. Every day after school, the clinic runs children’s educational programs. Small groups of 10, 11 and 12 year olds come one afternoon a week (100 children in all) to study herbal medicine, nutrition, sex education, tai chi, painting, poetry and music. There is also a group of 12 children with Down’s syndrome who come to the clinic three days a week for therapy and classes.

My week in Cuba was utterly unlike any other place I have visited. It was strangely relaxing to be in a place where there was virtually no advertising. Time seemed to stretch out while I was there, and I was able to accomplish more in a week than I would have in two or three weeks elsewhere. I realized later: there were no distractions. Life in Cuba is very much about working and maintaining friendships-in other words, it is about people. I was surprised that, despite my U.S. citizenship, I was welcomed by everyone I met, literally, with hugs and kisses.

The Cuban experiment is a rich, untapped resource for those of us interested in simplifying and deepening our lives and our commitment to our work. Please feel free to contact me if you would like further information about professional travel to Cuba, or wish to make donations of books or supplies.

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