Cuba is an island nation where the leadership takes pride in providing medical care and education to everyone, regardless of age, race or cognitive level (Brice 2008,). However, although the universality of medical care and education in Cuba is not in question, reports and impressions differ about the prevalence of Intellectual and Developmental Disability vary substantially.
In 2007, Lantigua Cruz, Lemus Valdes, and Marcheco Teruel described the work and findings of the Cuban Medical Genetics Network, the lead body charged with the prevention of genetic disorders on the island. A key activity was the identification of all inhabitants with a developmental disorder, which led to the detection of mental retardation in 1.25% of the population. Since every person in Cuba is connected to medical care, the report concluded that all cases of mental retardation had been identified.
The work of Brice (2008) stands in contrast with this conclusion. Brice questions the reported prevalence of IDD by Cuban sources as an underestimate, and applies the 2-3% figure commonly used in international clinical literature. He adds that limited quality of protein and calories in children's diets, combined with less access to medication and stress of economic problems, create conditions that are ripe for more, not less, cognitive delays.
Both articles acknowledge the presence of IDD in Cuba, and both must be interpreted with caution. Brice (2008) correctly asserts that Cuba has prevented access to their records by international scientists who could confirm or dispute the findings. However, Brice's conclusions are speculative and rely on hypothetical extrapolations that may not apply to an island with a genetic pool that has remained stable over many years because travel has been highly restricted. Lantigua Cruz, Lemus Valdes, and Marcheco Teruel (2007) address the limited genetic diversity, and note the exportation of disabled individuals en mass during the brief 1980 Cuban exodus to the U.S., when a number of Cubans with disabilities left Cuba, thereby further reducing the potential genetic pool with disabilities in the island. Nevertheless, the Cuban prevalence figures must also be interpreted with caution, since the government vets all scientific work and has the power to impact what is ultimately published.
In summary, Cuba may be a location where mental retardation is lower than in other countries. If this is true, it affords an extraordinary opportunity to examine the nature/nurture question, since Cuba is, undeniably, a country of limited resources for its citizens. An accurate assessment of the prevalence of IDD, however, may have to wait until the leadership of the island and of other countries reach amicable agreements that allow doors to fully open for researchers in this field.
References
services in Cuba. Revista Cubana de Genetica Comunitaria, 1( 1), 5-9.
Brice, A. E. (2008). Comparative Policy Brief: status of intellectual disabilities in the
Republic of Cuba. Journal of Policy and Practice in Intellectual Disabilities, 5( 2),
118-121.
Great follow-up: subsequent research conducted in a house-by-house assessment, revealed enough kids with IDD who were kept at home to increase the percentage to levels comparable to other international estimates. This suggests that Cuban families, like families all over the world, struggle with the acceptance of their loved ones with IDD and with their integration into the mainstream of their communities.
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