A very educational and fun day! We began with a panel discussion at La Casa de la Amistad (The Friendship House) with three experts on IDD, Dr. Cristóbal Martínez, Dra. Ovidia Rodriguez, and Dra. Sonia Guerra Iglesias.
Here is what I learned:
Dr. Cristóbal - He explained the philosophy of Cuban medical services: prevention first! Risks factors are focused on 3 areas, prenatal, pregnancy and postnatal. All pregnant women are expected (required?) to get medical care and are counseled on no smoking or drinking during pregnancy. This care is managed by the primary physician, a neighborhood doctor to which 120 - 150 neighborhood families are assigned. Those family docs also are the front line of defense for identifying DD very early. The primary has teams of colleagues to whom s/he can refer. Interesting fact: medical school is free, but paper is so expensive that textbook aren't sold so that they don't run out for students. Cuba has 204 child psychiatrists for a population of 11 million, and all physicians are routinely educated in DD. Maternity leave is a year, fully paid and breastfeeding only (including no water to drink) is urged for the first 6 months.
Dr. Ovidia, autism expert - autism assessment and diagnosis follow the same criteria in the U.S. As for causes, the vaccine matter is a non-issue in Cuba. On the other hand, intestinal permeability and candidia are considered major concerns. Gluten and casein-free diets are often prescribed and red meat is eliminated to avoid the build up of purines. Anti-convulsants are used routinely with or without a positive EEG. For behavior severe behavior problems, a small amount of Haldol or Risperidol may be used.But most notably, Dr. Ovidia hypothesizes that the fast rise in autism may be influenced by TV watching and the effects of electromagnetic waves from TV. She was passionate about this position. I would be interesting to see if she has some research to support her suspicions.
Dr. Sonia - had little time left, but graced us with a little preview of tomorrow's school visits, and gave us perhaps the best quote of the day, special education is a labor of love, based in science. She also stated that he incidence of IDD in Cuba is 1.25%, and philosophically the approach to sexuality in people with IDD is that they grow up, love and live as adults, so nothing should limit their sexual expression. Very progressive.
Our afternoon started in ICAP, the Cuban Institute of Friendship with the People and was an educational session of Cuba's view of the embargo--political, but informational. We learned Cuba's position on the Cuban Five, heard Danny Glover and the Rev. Lucius Walker, explaining Cuba's offer to educate Anglo medical students for free, in exchange for their service in under-served areas in the U.S. Interesting concept with curious political complexities. We heard that Cuba is beginning to encourage free enterprise and even may look at travel out of the country for citizens who can make money to bring back to the island. More complexities which left us wondering how opening those doors would change Cuba. How can the current government philosophy survive with such openness and a taste of good life???
Ahh...then we went to Old Habana, a heartbreakingly beautiful area, rich with history and crumbling everywhere. Restorations are underway but with limited materials, the job looks impossible. History, Hemmingway, flowers, art, El Malecon, so much in one day, and so much ahead.
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