Nurse managers seek to learn from Cubans

ELLSWORTH – At first glance, Hancock County and Cuba seem to have little more in common than the Atlantic lapping their shores.

But Kathy Veilleux, vice president of clinical services at Mount Desert Island Hospital in Bar Harbor, and Jeanne Fortier, vice president of nursing at Maine Coast Memorial Hospital in Ellsworth, believe that lessons from Cuba’s socialized medical system may allow them to improve the quality of health care in coastal Maine.

Veilleux and Fortier are among 30 American nursing executives who will travel to Cuba early next year to observe the island nation’s distinctive health care system through the People to People Ambassadors Program, a 44-year-old organization founded to fight the Cold War through international exchanges.

Already, the two women have abandoned typical American preconceptions of weary refugees traveling aboard tiny rafts, or the lush tropical paradise of the nation’s pre-Revolutionary heyday in the 1930s.

“You think of the pictures of people in ragged clothing, coming off boats, but the Cuban health system is not Third World, it’s quite modern,” said Veilleux. “They have universal health coverage – all the kids are immunized, all the women are getting prenatal care.”

In her research, Veilleux learned that Cubans have a strikingly low infant mortality rate, near 100-percent vaccination rates and an AIDS education and management program praised by the World Health Organization as “exemplary.” She said this was primarily due to restriction of individual choice, which prevents patients from rejecting medical treatments.

Physicians and nurses make the choices for their patients, and the results are astounding.

But where this societal welfare bisects personal liberty is unclear. The AIDS program included an extensive education effort, but also government-sponsored mass testing and a forced quarantine for those infected with the virus.

Veilleux is particularly interested in seeing how Cuban hospitals that cannot acquire American-made drugs because of the trade embargo integrate alternative therapies, such as herbal medicine, into the management of long-term illnesses such as heart disease and cancer.

“Fifty percent of the pharmaceuticals that we take for granted are unavailable in Cuba, so they use other treatments,” she said. “We’re such a drug-dependent society. People are on so many drugs, there are so many interactions, that in many ways they’re sicker on medication.”

A rural clinic that the delegation will visit en route to the northern city of Cienfuegos is also highly anticipated by the women.

“At a rural hospital, you’re closer to the reality,” Veilleux said. “You’re not buffered from patients by a huge building with segregated meeting rooms.”

Initially, the women feared that People to People’s highly structured, nonpolitical tour might not give them an accurate view of Cuba. A majority of the eight-day trip is concentrated in wealthy resort cities. The delegates will be flown directly from city to city, visiting tourist destinations such as Havana, Cienfuegos and Varadero rather than exploring the agricultural countryside.

Despite the limitations, Fortier and Veilleux are hopeful that they will be able to talk with Cuban nurses and hospital administrators, discussing – if unofficially – the impact of the U.S. embargo on Cuba’s health care system.

The most important thing to bring home from Cuba will be e-mail addresses and budding friendships, they said. An ongoing discussion of similar problems and differing strategies in the two nations will be priceless, Fortier said.

“There are some things you can’t embargo,” Veilleux said. “We can learn from each other and share ideas.”

Fortier and Veilleux are currently canvassing the region to raise $5,000 each for their journey. Donations may be sent to the Nurse Ambassadors Donation Fund, account No. 1437003 at Union Trust Bank.