In the wake of this month's Republican electoral shakeup in Congress, talk of lifting the U.S. travel ban to Communist Cuba is pretty much off the table. But President Barack Obama still has the executive power to ease the amount of red tape faced by U.S. medical researchers who can travel to the island.
For some, such a move might awaken fears of radical socialism, but others say when it comes to issues like the spread of tropical and infectious disease from global warming, increased collaboration with a neighbor is just good medicine.
“I think because of climate change, because some of these infectious diseases are coming through in epic forms, collaboration between all countries is more needed than ever,” said Gail A. Reed, the International Director of MEDICC, an American non-profit organization working to enhance global health cooperation with Cuba.
Hepatitis, chikungunya, bird flu and H1N1 are all diseases that concern U.S. epidemiologists. But dengue fever, the most common of mosquito-born illnesses, is one of the biggest. This summer, the Centers for Disease Control reported that five percent of residents in Key West, Fla. had been exposed to the deadly virus.
Dengue was eradicated in the United States in the 1940s, with just a few cases creeping across the U.S.-Mexico border in the 1980s. It is endemic to most of the Caribbean, but not to Cuba. In fact, strong research and preventative measures have won Havana’s Pedro Kouri Cuban Tropical Medicine Institute special status as a World Health Organization Collaborating Center for Dengue Study and Control.
“In that sense, U.S. scientists are very interested in collaborating with Cuba because they have a history of investigations and successful research not only into the impact but the viral origins,” Reed said.
That interest dates to before the 1959 Cuban Revolution that brought Fidel Castro to power. In 1889, the American Public Health Association requested that the United States government annex Cuba from Spain to protect Americans from Yellow Fever.
Panic over the disease helped fuel the 1898 Spanish American War, says Pedro Orduñez, a Cuban doctor who has published extensively on U.S.-Cuba medical research in both Washington and Havana.
“Health in Cuba is the icon of the revolution,” noted Orduñez, explaining that Cuba’s invention of a broad-based primary care system helped it assert its sovereign identity.
That faltered during the 1991 collapse of the Soviet Union, Cuba’s main economic backer. Thousands of Cuban rafters set sail for Florida, and many of the Cubans who remained began to suffer epidemics such as optic neuropathy, a temporary blindness associated with certain nutritional deficiencies.
As a result, the U.S. government loosened some U.S. travel and trade restrictions on humanitarian aid. That, in turn, pried open collaborative doors a little further, allowing new organizations such as MEDICC to create U.S.-Cuba medical exchanges. In 2001, Cuba offered full-ride scholarships for up to 500 U.S. students at its Latin American Medical School, and the U.S. government obliged.
Dr. Sitembile Sales, a 2010 U.S. graduate of the Latin American Medical School in Havana, is grateful both nations allowed her to access the Cuban government’s medical scholarship. She says it gave her invaluable training for crises and epidemics anywhere. During her third year of medicine, she was thrown onto 24-hour hospital rounds for two dengue fever epidemics.
“There were meetings with our professors saying this is war, we have an attack … there’s no room for mistakes,” she told Discovery News. “The good thing is that people never dropped like flies because we never let them get to that point.”
Obstacles still abound. Sales needed a special student license to travel to Cuba, and a general license that allows American professionals to conduct research there is not as general as it sounds.
Researchers must scrutinize every aspect of their trip to make sure their spending and collaborative habits do not infringe upon U.S. sanctions. That means knowing what research equipment they can carry without a separate license, how much money they can spend in country and on what, how their work will be disseminated later, and under what specific contexts they can collaborate with or learn from the Cuban people.
For example, researchers have to ask for a different license if they plan to attend a Cuba-sponsored science conference or workshop, and in Cuba, most events are government run. Obtaining a U.S. license for conferences or research equipment involves mounds of paperwork and an answer can take months. Interest groups say these factors slow down the process of participating in projects that would otherwise prove to be a quick and efficient way of obtaining important medical data or learning new methods for curbing an epidemic.
Earlier this year, the U.S. Congress had seriously discussed a full lifting of the travel ban, but Cuban-American Congressmen expressed concerns about Americans fueling a tourism industry run by the Cuban government. Now researchers say more Republicans in Congress will further stifle that possibility, but note that Obama could still ease the licensing needed for more extensive medical research.
To gauge the likelihood of that possibility, Discovery News reached out to the White House, as well as to Cuban American Congressmen Ileana Ros-Lehtinen, R-Fla., Robert Menendez, D-N.J., Lincoln Diaz-Balart, R-Fla. and Albio Sires, D-N.J. None responded.
Jorge Bolaños, the Chief of Mission for the Cuban Interests Section in Washington, did offer Discovery News some thoughts following a lecture he gave at nearby Howard University.
“We have no objection to any cooperation,” he said, adding that his country was very proud of its ability to stave off epidemics through preventative strategies in spite of serious economic and material deficiencies.
“If I’m waiting to get the flu shot, and if I don’t go there (to the clinic) for the flu shot, they will go to my house… When you don’t go to see the doctor, you suffer the tyranny of the doctor,” he joked.