A Dream Come True: Cuba’s Free Medical School
By Kayce T. Ataiyero

HAVANA – Ever since she was five years old, Chasiti Falls has known two things: She wanted to be a doctor and she wanted to travel the world. But dreams aren't free in America. They often require money and resources – things that Falls didn't have.

"I always had that aspiration that I was gonna go somewhere and it just led me," Falls said. "You follow the yellow brick road and you see the wizard at the end."

As fate would have it, Falls' wizard showed up a year ago on a street corner in her hometown of Atlanta. A man pulled her over and handed her a flyer on the Medical School Scholarship Program at the Latin American School of Medical Sciences in Cuba. It was just the ticket the 30-something mother of one needed to change her life. Suddenly, a woman who had never set foot outside the United States found herself 90-miles offshore in Havana, with her American dream being underwritten by the Cuban government.

"I wanted the best so I came to Cuba. And it was free," Falls said, in explaining why she chose to attend the medical school. "Because I am a parent and have to pay rent and keep the lights on, living free with a bunk mate is heaven to me. I could be at home struggling."

Falls is one of 92 American students – more than half of them black – who are enrolled in the scholarship program. Started by Cuban President Fidel Castro in 2000, the program offers low-income students a free medical school education in Cuba. In exchange, the students must agree to go back to the United States to provide much needed health care in underserved communities.

The students receive tuition, books, room and board for six years. They are also provided Spanish language immersion courses, if necessary. All of the instruction at the school is conducted in Spanish.

Rev. Lucius Walker, executive director of the Interreligious Foundation for Community Organization, the New York-based group that facilitates the program stateside, said students are given the rare opportunity to learn from world-renowned doctors for free. Walker said the program is working to address a critical need in the black community, which is seeing an increasing number of health care providers leave. Currently, only about six percent of U.S. doctors are black.

"Healthcare in the U.S. is generally recognized right now as being in disarray. Cuba has developed a system that has transcended those problems and our students benefit by studying in the culture and come back and help fill the gaps," Walker said. "We see it as a tremendous opportunity to help provide quality medical care in the communities that are most at risk."

The program will graduate its first American students this summer, with the expectation that these students will take U.S. medical licensing exams and apply for entry into a residency program when they return to the states. They will have to adapt their Cuban medical education – which emphasizes medicine sans machines – to the U.S. model, which focuses more on using technology in treatment and diagnosis.

Despite the differences in the philosophy of medicine between the United States and Cuba, school officials are confident that students will be prepared for what lies ahead.

"There is little question about the quality of the education they receive. The primary difference is that Cuba teaches the quality practice of medicine and the U.S. teaches to the test," Walker said. "The U.S. students should perform better on the tests but that doesn’t make them better doctors."

The students will also face challenges created by the U.S. blockade, including overcoming misconceptions about Cuba's medical education.

"We are sure there will be individuals, professional as they may be, who have not been able to work their way through the impact of having” Americans study medicine in Cuba, Walker said.

In addition to gaining acceptance in the U.S. medical community, there are political factors affecting the program. In 2004, he Bush administration tightened regulations on travel to Cuba, a move that threatened to force the students to come back home. With the help of the Congressional Black Caucus, the students obtained a special license that allowed them to legally study at the medical school.

Rep. Barbara Lee, (D-Calif.), a caucus member who came to the program's aid, said she thought it was wrong for the Bush administration to disrupt the students' education.

"In the African American and Latino communities, there is a dearth of health care and medical school is so expensive. Students of little money can't get in," she said. "Why would you hurt these students in the middle of their studies because of political ideology?"

Though the relationship between their home and host countries is dicey, the students say the value of the education they are receiving is worth straddling the line. But some said they worry about what will happen to the program after Castro dies.

"I keep praying that the program survives Castro,” said second year student Michael Woods, 24, of Chicago. He believes Cuba will remain committed to the program even after control of this country’s government passes from Castro to someone else.

And it seems Woods has every reason to be confident.

Medical school rector Juan Carrizo Estevez said the program is an extension of the government's mission to spread humanitarianism worldwide through medicine. Currently, more than 150,000 Cuban-trained doctors are at work in more than 180 countries.

"We are doing a revolution inside our revolution to have a better medical system," Carrizo said. "In our country, we have forged a social contract with medicine, a concept we can only find here in Cuba."

In fact, one of the cornerstones of Cuba's foreign policy is its medical diplomacy. More than 39,000 Cubans provide technical assistance to more than 80 countries. The vast majority of those workers, 75 percent, do medical work in 69 countries, including 42 in Africa.

Cuba has also sent doctors all over the world to countries in times of crisis, including to Pakistan to help earthquake victims in 2005. The Cuban government offered to send 1,100 doctors to the United States after Hurricane Katrina decimated the Gulf Coast in August 2005. But, according to Yilian Jimenez Esposito, Cuba’s vice foreign minister for International Cooperation, the American government never responded to Cuba's offer of help.

Cuba views such “outreach as medical diplomacy which helps developing countries struggling without human and financial resources and build the nation's relationships with neighbors throughout the world," she said.

Despite the U.S. blockade, this outreach has been extended to the American students who have been given the opportunity to learn from some of the world's finest medical professionals.

To take advantage of this opportunity, the American students have to share a dorm room with 18 people, get by on a daily diet of beans and rice, cabbage and occasionally some chicken, take cold showers, sleep in small beds, and have limited access to television or the Internet.

But the biggest adjustment for Leon Daniels, 30, of Oakland was the language.

"Everything was in Spanish. All the Spanish courses were in Spanish. There was no English. The Spanish was fast, quick. It was hard to catch the words. I felt completely and totally lost," he said. "And then by the grace of God, it started clicking."

Daniels said he is most grateful for the opportunity the school has given him to learn medicine from the grassroots, an education he said he could not have received in the United States.

"It's the difference between someone who knows how to bake a cake from scratch and someone who is making it from a box and how much better, richer the cake is from scratch. It's the same with medicine," he said.

"Coming here, learning that type of medicine, and with the financial situation that I had and learning from some of the best doctors in the world, I don't know how I could have passed this opportunity up. The conditions, the food, the situation, it's a small price to pay."

Falls agrees. She said it's worth it to stay up all night studying – the only time it is quiet in her room. Though the school is challenging, she said the benefits far outweigh the negatives.

"It is something I would recommend to other students, but you have to be ready for it. It is not a walk in the park," she said. "But it is worth it."