Old-Fashioned Doctoring Keeps Cubans Healthy

["Charles Brown" <CharlesB@xxxxxxxxxxxxxxxxxxxxx>]

http://www.latimes.com/print/health/20010709/t000056343.html

Los Angeles Times
July 9, 2001

Old-Fashioned Doctoring Keeps Cubans Healthy

By SARAH LUNDAY, Special to The Times

    HAVANA--In the office of Dr. Alex Carreras near
downtown Havana, water drips from a patched ceiling, a
window is missing glass and a broken machine for
sterilizing instruments lies idle. The phone
rings constantly as Carreras explains that his only
nurse is out for the week.
    Carreras and the nurse care for 120 families in
the neighborhood.
    Living and working in the community is essential
to understanding patients' needs, he said. Recently,
after a patient said he had stopped
smoking, Carreras was suspicious and went to the
patient's house.
    "I could see the cigarettes on the table," he said
with a shrug.
    Carreras keeps track of the community's health
with handwritten charts, noting basic indicators such
as who has high cholesterol, who has diabetes and who
has a drinking problem. "You know everything,"
he says.
    While Cuban doctors might not actually know
everything about their patients, they come closer than
their counterparts in many areas of the world,
including the United States. Their ability to track
patients' histories, ensuring that children get their
immunizations and that older patients stay active in
the community, has made this country a model
for primary medical care for other impoverished
countries and even areas of the United States.

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