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Report from Cuba by Robin Williams '04
December 8 2002
I worked in a tropical health institute on a Communist island in the middle of the Caribbean this summer. It sounds a bit surreal, but it is true.
Cuba has always fascinated me because of its 43-year commitment to universal education and health care. Most foreigners do not realize this, but the revolution is still going on. It didn't happen, it is happening.
There is a great depth of misinformation that clouds Americans' perceptions of Cuba. Fidel Castro has undoubtedly been portrayed as a tyrant and human rights violator by the American press and government. This simply isn't true. At least Fidel is no more a tyrant or human rights abuser than the majority of the presidents we have had in the last few decades in the United States.
Without going deeply into Cuban politics and Cuban-American relations, I think they are worth mentioning, as they framed my summer experience. Cubanos are very receptive to their neighbors from the United States and are very adept at separating the American people from the American government. Of course, they, like all people who live in the western hemisphere, consider themselves Americans as well.
I received a big surprise after arriving in Havana. The health institute- El Instituto Pedro Kouri- sent word that I would not be able to stay in the boarding house next to the facility, but would need to find alternative housing. This posed a major challenge. Fortunately one of the women who worked at the Institute let me move in with her family. Beyond a doubt, this was the highlight of my trip.
Maribel lives with her son Xavier (11 years) and her mother who we all call Mama. Maribel and I took the 7:30am worker bus from southern central Havana out to the Institute every morning. The ride was about 35 minutes. I usually stood as women have priorities for seats.
The benefit of living with a family, especially a worker at the Institute, was immense as I was able to basically live like a Cuban for almost all aspects of my daily routine. Maribel and her family were extremely supportive. I took the opportunity to teach English lessons to Xavier every night and sometimes his 15-year-old cousin would join us. I was also privileged to having some of the finest Cuban cooking for dinner. Mama tried to make me gain as much weight as possible.
At the Institute my work was somewhat different from what I had anticipated. Instead of doing community health outreach in the field (like the streets of Havana or rural areas for instance) I was mostly confined to the Institute's facility. This had benefits though as I was often able to see the same patients over the course of several weeks.
The Institute specializes in tropical medicine and infectious disease, and over half of the patients are HIV positive. I gave routine physical exams and interacted with patients in Sala G primarily- one of the five wards for in house patients. My favorite activity with the patients was the creation of a series of photographic portraits. I hope to show this work to American audiences to create awareness of the Cuban health system and patient care.
I also worked with a dermatological surgeon two days a week. On Mondays we would see patients with a variety of skin lesions, ulcers, growths and infections. On Tuesdays we would operate on the patients. This mostly included removing warts, giving and removing stitches and removing other skin growths. About half of the patients were being treated for venereal diseases. All of the patients of course received free medical care and medicine.
I must admit I was very intimidated at the first thought of giving stitches. Cuban operating rooms are not necessarily sanitary (cockroaches could often be spotted) and I had never had such hands-on experiences before. The surgeon was very helpful and trusting and I became better skilled at the procedures as the weeks went by.
I also worked part time in the laboratories. Many patients come to IPK because of parasitic infections. One of the most memorable experiences was working in the parasite lab. I assisted a lab tech in testing samples of feces to identify the types of parasitic invaders present so that treatment could be prescribed most effectively for patients. I must say that this experience has not led me towards a career in parasitology. I also worked in other labs, helping to prepare cultures and solutions to be used for testing bacterial infections.
This was the first time I really began to understand the greater scope of medicine. I clearly saw the connections between lab work, clinical work and patient care. There was an amazing team spirit between all of the sectors of the Institute. I felt privileged to be able to travel back and forth and assist with all of the spheres of medicine that are needed to fully treat a patient.
While at the Institute I had a great opportunity to interact with the other doctors. Some were rather fluent in English, but most had limited proficiency, especially regarding writing skills. Frequently I would help doctors translate letters and applications for grants and other opportunities.
My medical Spanish improved immensely while I was in Cuba. I immediately began to use this new vocabulary upon returning to Princeton as a translator for the maternity classes at the Medical Center at Princeton. Last year I translated in the clinic and after this trip the volunteer coordinator moved me into the maternity class. Every Thursday morning for almost three months now I have translated a three-hour class on labor expectations, breathing techniques, and well baby care.
Overall my experience in Cuba was stunning. I had an amazing time and witnessed a land very few Americans get to visit. Although I think I was able to add to the strength of the Cuban community while I was there, I also think there is more I can do from home as well. In May, Small World coffee shop on Witherspoon Street will host my photography from Cuba. I hope that my photographs will help to give a voice to a community often spoken for and about in a very superficial manner. The Cuban people have a lot to say. Hopefully some of that will come through in my artwork.
I would like to thank the Class of 1995 and the '95 Summer Service Fund for their generous support in helping to make this summer happen. It has been an incredible journey that will stay with me and my friends in Cuba for a long time to come.
Robin Williams '04
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