Interview: Enrique Beldarraín Chaple on the Cuban Health System and Medical Internationalism










Dr Enrique Beldarraín Chaple

In this episode of our interview series, our host Claire Galesne talks to Dr Enrique Beldarraín Chaple, Chief of the research department at the Cuban National Information Centre of Sciences and professor of Public Health and History of Medicine.

Listen in, as Chaple gives insight into why he became a doctor, explains the Cuban health system, and talks about Cuban medical cooperation with other countries.

Find a short transcription of the interview below or listen to the full one here:

Galesne: I would like to start by asking you why you decided to become a doctor.

Chaple: Thank you for this interview opportunity, and I would like to say that I am very happy to stay in Berlin and at this institute. I don’t know when I decided to be a doctor; maybe it was in my childhood, maybe because of familial influence, because my father was a doctor. He was an important oncologist in Cuba and I was quite often with him during the day. Sometimes I went with him to his medical office at the Institute of Oncology. It was a process that I cannot identify the beginning of, but I think it was when I was a child.

Galesne: What brought you then to study Public Health and History of Medicine?

Chaple: All my life, I’ve loved history; general history, Cuban history, the war history. When I was working in medicine I began to think about and began to understand the historical evolution of our science, and began to read about the first doctors such as Galeno, Hippocrates, and the ones after until today. I decided that I love it. In Cuba, there is a social services program that the university graduates have to attend for three years. In my period of social service, I was working as a general physician in the community, but in the area where I worked, a municipal center of epidemiology opened up. At this moment, there weren’t any physicians working in that center, so they chose me. In that moment, I did not know anything about epidemiology except for what I remembered from the first year of university. I needed to start studying epidemiology by myself to be able to work in that field, and I began to love epidemiology. Since that moment – maybe in 1986 – I love epidemiology. It is for me an excellent field of work. It is a possibility to help many people at once because we specialize in the control of any disease in the community, so it is better for me than having individual patients.

Galesne: A lot of people do not know about the Cuban health system. I’ve read in your article that Cuba has limited resources, but despite that, it has a great health system with universal and free health care coverage. So could you tell us more about how the Cuban health system functions?

Chaple: The Cuban health system is an important issue in Cuba because it has developed so much since 1959, when the revolution started. The president had the idea to better public health. In Cuba, it was a war at that time, and the process of developing the condition of health services already started. We had many economic problems, historically – not only now because, you know, that we didn’t have good relations with the United States of America and this produces an economic problem because America had a law that prohibited Cuba from buying anything in America. Later the law was modified and prohibited Cuba from buying any American products in another country as well. At that moment, for example, the Cuban health system could not buy any equipment from Sweden if this equipment had any pieces from America – even if only a chip.

But this issue actually allowed for the development of Cuban engineering in health, for example. A big part of Cuban engineering had to find their own solution to our medical problems – regarding equipment – and sometimes we bought equipment in Europe but at the time we could not replace even little parts that needed to be changed periodically because of the new law, so our engineers had to innovate. Of course, it was not like the original, maybe it was not pretty, but it solved the problem. And it was the backbone of our pharmaceutical industry because we could not buy medicine outside of Cuba, could not buy biotech products, and was forced to develop all that in Cuba. We have, for example, an excellent factory on biotechnology products, vaccines, and many other products of biotechnology.

Galesne: So Cuba has now its own biotechnology industry and produces medicine. Do you also export drugs or exports or equipment to other countries?

Chaple: Not exactly. For example, now there is a famous product to cure diabetic foot ulcer many diabetes patients have on their feet. Cuba developed a substance called Heberprot-P, which is the only medicine in the world that solves this problem. A lot of countries are interested in buying that. Some countries in Europe are developing clinical trials for this product. It is also the possibility to export another good factory of monoclonal antibodies for cancer treatment, and some countries like Brazil are buying products of that. China is also interested in those products.

Galesne: I’ve read in one of your articles that Cuba has developed cooperations in the field of health by sending medical teams to Africa or South America. Can you tell us more about what Cuban medical internationalism exactly is?

Chapel: Cuban medical international characteristic is very old. It began in 1963 with the cooperation with Algeria. In 1963, Algeria became independent of France. The new government asked Cuba for medical cooperation because the physicians there were French and they left the country with Algerian independence movement. They had only a few physicians working there and Cuba sent the first equipment to them to start the collaboration, along with nurses and physicians. From that moment the international collaboration started.

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