Science and diplomacy: Cuba
When considering options for improving diplomatic relationships between conflicted countries, one of the most political-neutral methods to re-establish ties is through science and medicine. As scientists, we are well versed in launching collaborations without any thought to political regimes or tension.
Scientists speak a common language, with a goal of dissecting the intricacies of nature and how it impacts mankind. We are typically altruistic and passionate individuals who wish to simply advance our understanding of the world and ultimately improve human lives. In essence, scientists make the perfect team to send into a politically sensitive situation to diffuse tension and regain trust.
A case in point is Cuba. Over the past year, the United States made several strides in in repairing a relationship that has been broken for 57 years, beginning with an announcement by President Obama on Dec. 17, 2014 that the U.S. government would begin working towards lifting embargoes.
This past month, we celebrated the official opening of the American embassy in Havana and the Cuban embassy in Washington, D.C. The resolution of this conflict certainly will not occur overnight; instead, it will require baby steps towards regaining trust and confidence between the two sides.
Necessity spurs invention
The U.S. Department of State decided early on in this process to consider sending a scientific delegation to Cuba to begin to diffuse the tension. This summer, I was afforded the opportunity to be a member of this scientific delegation—a multidisciplinary eight-member team with representatives from the US government, non-profit organizations, and academia.
While I initially thought this would simply be an amazing opportunity to see a country that has been forbidden to us Americans for so long, I completely underestimated the magnitude of our mission and being confronted with the emotional consequence of embargoes and their severe impact on the general Cuban population.
First, I would like to begin by saying how completely impressed I was of the resiliency and intellect of our Cuban counterparts throughout the entire visit. I kept reflecting on the saying, “necessity is the mother of invention,” as we were continually presented with their ability to overcome obstacles using extremely limited resources.
For example, of the 11 childhood immunizations recommended by the World Health Organization, Cuba locally produces eight of them. Another case in point was the need for cost-effective diagnostics for dengue virus, which is endemic throughout the country.
Scientists at the Pedro Kouri Tropical Medicine Institute developed an ELISA that required one tenth of the reagents otherwise needed, providing substantial cost savings. Another impressive observation was their integrated and comprehensive health care system and medical education throughout the country.
There are seven doctors for every 1,000 citizens, with one primary care physician assigned to approximately 130 people. In comparison, the US has one primary care physician for every 700 people. Every citizen in Cuba has free access to health care, and there is a strong sense of national pride that they have strategically placed family medicine physicians in every community to comprehensively serve the health needs of the people.
I am confident that this infrastructure allowed Cuba to be the first country to successfully eliminate mother to child transmission of HIV this year.
Technology, communication lags
For each accomplishment presented, there was a sense of well-earned pride among the Cuban scientists. These accomplishments were typically followed by their humble admission of extreme difficulty in being able to do more. The main impediment to their progress besides resources was communication.
In Cuba, there is no high-speed broadband internet access available to quickly research publications or scientific methods. At most, internet connections and email are highly restricted and equivalent in speed to dial up. As scientists, exchange of information is vital to our research progress, and it was almost impossible to fathom the lack of connectivity between Cuba and the outside scientific community.
If the embargo is lifted in the future, it will be interesting to see what occurs with the expansion of internet access and influx of information from the outside world. I can only presume that the new freedom to information will result in exponential expansion of their scientific performance, as well as a guaranteed shift in thinking from the social and political perspective.
When I left Cuba, the easiest way I could communicate my experience and induced emotions was this: Imagine a young man who constantly defies his father, and because of his behavior, the father decides to cut him off completely, severing the family tie. The young man goes on to have children, and passes that anger towards his father to those children, making them believe their suffering is because of him. The grandfather goes on to teach his other children and their grandchildren how defiant and dangerous that one son became. Generations continue, with those same messages carried down, until 57 years later, when the distant family members realize what happened way back then should not affect their need and desire to reunite with their family now.
Our meetings, while initially were formal and a little tense, felt like family coming together again. By the end of the week, we were all relaxed and laughing, and it truly felt like a reunion. For the sake of the people of Cuba, I look forward to witnessing the rekindling and healing of the relationship between our two countries, and I am delighted to help move this progress in whatever capacity I am capable.
-By Kristy Murray, DVM, Ph.D., is associate professor of Pediatrics and associate vice-chair for research at Baylor College of Medicine and Texas Children’s Hospital, where she also directs the Laboratory of Vector-borne and Zoonotic diseases. She also serves as the assistant dean for Faculty and Educational Development at Baylor’s National School of Tropical Medicine.
