ELAM in 2010.

• Author: Fitz, Don
• Position: Thinking Politically - Escuela Latinoamericana de Medicina

"ELAM is the revolution realized," says Ketia Brown, a 30 year old third year medical student in Havana from California. The Latin American School of Medicine, ELAM (Escuela Latinoamericana de Medicina) is the 11 year old medical school in Santa Fe, Playa, a 90 minute bus ride from Havana, Cuba. (1) With their educational costs covered by the Cuban government, students focus on returning as doctors to underserved communities in their countries.

Cassandra Cusack Curbelo, a second year Cuban-American student, believes that "There is no experience like thousands coming together with the same idea of medicine. It feels like we are not separated into two continents, but we are one people who share a common history of struggle. This is what ELAM opens our eyes to." (2)

International medicine: A revolutionary dream

Che Guevara also had a vision in 1960, the year after the Cuban revolution. After observing that many graduating doctors did not want to serve in rural areas, he imagined training campesinos to themselves become doctors so they could run "immediately and with unreserved enthusiasm to help their brothers." (3) That year, Cuba sent medical teams to Chile to help after a major earthquake. (4) Cuba's first health contract resulted in its sending a medical brigade to Algeria in 1963. (5)

When Hurricanes Mitch and Georges devastated the Caribbean Islands and Central America in 1998, Cuba sent doctors and paramedics. Fidel Castro then proposed expanding Cuba's new Comprehensive Health Program (Programa Integral de Salud) by creating ELAM, which began in 1999.

Castro's ability to inspire changes should not be underestimated. I met Exa Gonzalez, a sixth year ELAM student, on a plane to Havana in December, 2009. In high school she studied art and film in Baja California, Mexico. As a teenager, she made two trips to Cuba with her parents, members of the Workers Party (Partido de Trabajo, PT). During her second trip, in 2001, Fidel described ELAM to the PT delegation, which inspired Exa to change her studies to medicine. She entered ELAM in 2002, when she was 19 years old, and spent her first year in pre-med, studying biology, chemistry and physics. (6)

Cuba's Programa Integral de Salud expanded dramatically in 2003, when the Venezuelan Medical Federation attempted to obstruct efforts by President Hugo Chavez to provide health care to underserved communities. Collaboration between Cuba and Venezuela resulted in the Barrio Adentro (Inside the Community) program which brought 10,000 Cuban doctors in less than a year. (3)

When Katrina slammed New Orleans in August 2005, Castro mobilized hundreds of ELAM graduates and Cuban doctors to help. US President George W. Bush refused to even consider the gesture of good will. A friend told me that it must have been a publicity stunt by Castro, since he knew that Bush would not accept. I replied that, given the breadth and depth of Cuban medical aid to countries in Latin America, the Caribbean and Africa, it would have been an insult by Cuba to ignore the plight of a US city near its shores. The high number of primary care doctors in Cuba makes it possible to move quickly after disasters like Katrina.

Ever since Hurricane Georges in 1998, Cuba has assigned hundreds of doctors to its neighbor, Haiti. Cuba has also been training Haitian doctors since the doors of ELAM first opened in 1999. The only requirement is that when they graduate, Haitians agree to return home to take the place of Cuban doctors (rather than defecting to plush jobs in the US or Europe). (7)

Haiti is merely the most recent example of the enormity of Cuba's international medical work. According to ELAM's website, there are 52,000 Cuban medical workers currently offering their services in 92 countries. (5) This means that Cuba has more doctors working overseas than either the World Health Organization or the combined efforts of the G-8 nations. Thus, "by 2008, Cuban medical staff were caring for over 70 million people in the world." Additionally, almost 2 million people outside of Cuba owe their "lives to the availability of Cuban medical services." [4, pp. 3, 169, 112]

BES

A revolution can only be successful when the new generation takes over from the old. When thousands of students come together because of their dedication to helping others at a school that was built to allow them to fulfill their goals, the ground is fertile for students to take over the leadership of the struggle.

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After the third class graduation at ELAM, the Student Congress proposed creating the opportunity to work on specific projects during summer vacation months. The faculty approved and students began designing projects designated as Brigadas Estudiantiles por la Salud (BES, Student Health Brigades) that would take them to clinics in New Orleans, California, the US Southwest and impoverished urban and rural communities of South and Central America.

The Yaa Asantewaa Brigade (YAB), whose key organizers include Omavi Bailey and Ketia Brown, is illustrative of how BES projects function. (8) YAB is the group that will carry out the "African Medical Corp--Ghana Project." It was designed by the Organization of African Doctors (OAD), a group of African and African-American medical students. Founded in 2009 on the ELAM campus, OAD adopted the mission of developing "programs, projects and institutions with the objective of producing an organized, politically conscious and socially-responsible medical body able to meet the needs of African people suffering from health related issues throughout the African world. OAD is composed of 160 students, interns, and residents trained in Cuba currently representing over 35 countries." [8, p 2]

Currently, the "brain drain" of African doctors getting jobs in Europe or the US leaves Ghana with just 1 doctor for every 45,000 residents. Similarly, there are more Ethiopian doctors in Chicago than in Ethiopia. (9) OAD aims to confront the problem head on by strengthening the norm at ELAM that African (and all other) medical students return to serve impoverished communities in their homeland.

The 2010 phase of the Ghana Proposal plans to begin with ELAM students traveling to Ghana to meet with...