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When I arrive, Orlando Sanchez, just two years out of University of Havana medical school, is placing tiny acupuncture seeds in the ear of a middle-aged woman. He's practicing the ancient art of auriculotherapy. His patient is being treated for post-menopausal problems, he says. On the opposite wall hangs a symbol of the tao, which is not only an unself-conscious declaration of his faith in traditional Chinese medicine, but also a symbol of the remarkable 180-degree turn Cuba has taken back to centuries-old healing techniques.

Sanchez says his parents were part of Cuba's pre-revolutionary botanical culture. He recalls that his career interest in medicine was ignited during his Cuban army service, when he was befriended by a medical school dropout who taught him tai chi and Qigong (traditional Chinese practices that aim to harmonize body energy).

He doesn't see a conflict between natural and conventional medicine: "We are trying to develop some sort of synthesis," he says, "the best of natural and conventional medicines -- to heal without damaging the patient." The clinic is aggressively promoting self-healing techniques by holding free classes in yoga, tai chi and stress management, even teaching school children acupuncture points.

Without any prompting from me he notes the problem with my leg, and I leave the clinic impressed with the Cuban health-care system's openness to experimentation and innovation.

Patients treated with natural medicine (acupuncture, homeopathy, herbal remedies) have more than doubled since 1996 to about 3,000,000 in 1998, according to Leoncio Padron, director of traditional and natural medicine for the Ministry of Public Health. Tough economic times forced the government to slash health-care expenditures to about half of what it devoted back in 1979.

However, Cuba has more doctors now than in 1979. "Health care is better now because we can do more with less," he said in an interview. Even if the embargo abruptly ended, he adds, Cuba would continue paying attention to natural medicine in the interests of developing "medical science." Medical consultations, hospital visits and surgery are free of charge in Cuba's public system.

The revolution in Cuban health care has not gone unnoticed by Cuba's neighbors to the North. Marta Perez, director of natural and traditional medicine for the Ministry of Public Health in Havana Province, told a dozen visiting health professionals from the United States last fall that the Cuban government promotes natural medicine because it's sustainable and cost-effective. "The special period has been a great teacher for Cuba," she said, "because in the midst of this difficult situation we had to find a way to fight back."

In 1992 the government set up organizational responsibility within the ministry for natural medicine, and a resolution was introduced that sanctioned herbal medicines and infusions made from plants, acupuncture and related techniques, as well as homeopathy and thermotherapy (sulfur baths and mineral mud baths).

Adding all such treatments to a system that was completely allopathic (conventional) hasn't been easy, Perez said. "We defended all of these treatments, saying we needed to have a wide range of treatment options." She added, "We looked mainly for techniques that we could defend scientifically." Pyramid power was not among them, she quipped. The practice of laying on of hands might work, she said, "but its scientific basis can't be measured and it can't be standardized."

Says an official of the Ministry of Public Health: "For Cuba's common illnesses -- skin problems, fungal infections, parasites and especially bronchial diseases -- green medicine usually works at least as well as the drugs, without the side effects."

Rita Beretervide, a doctor in her mid-30s, is a specialist in family medicine in the Havana suburb of Santos Suarez. Her salary is 500 Cuban pesos a month (about $24). A 1986 graduate of the University of Havana, she was trained in the old school before natural medicine started making a comeback. But last year she joined dozens of other doctors attending weekly neighborhood clinics on natural medicine. She now says she's comfortable prescribing herbal medicines and believes in their effectiveness.

A few blocks away customers gather at the counter of an open-air pharmacy carved out of the ground floor of a crumbling apartment building. A large sign lists the most popular herbal remedies. Pharmacists there report that the most common ailment among people over 50 in the neighborhood is hypertension, which can be treated with an herbal medicine derived from sugar cane, called cana santa, which costs the equivalent of 4 cents.

Not everybody, of course, is singing the praises of medicine verde. A Cuban women whose skin problems didn't respond to herbal treatment said, "Frankly, I don't believe in green medicine. If it really worked, the doctors in the United States and other rich countries would be using it too. We only use it here because there's nothing else."

But natural medicine has gained a strong foothold in Cuba, propelled by economic necessity, unopposed by the medical establishment and with deep roots in the culture. In her briefing to the visiting U.S. health professionals, Perez related an anecdote: The vice minister of public health for Cuba came down with a large and ugly lesion on his mouth. He was told the best natural medicine treatment was a combination of aloe vera, rosemary and a special herbal cream. "Within three days it was healed," she said, "and now no one can say a bad word to him about natural medicine."

OK, but I'm having trouble resolving the discrepancy of Cubans' raging because they can't afford to buy aspirins (one bottle costs about one-tenth the average monthly salary) in a health system capable of embracing natural medicine techniques with such alacrity.

These and other unresolved contradictions of life in Havana hang in the air as I climb aboard the Cubana flight back to Toronto two days later. I'm worried because the leg infection is looking scary again. I think I got overconfident and forgot Enrequito's advice to stay off the leg for a couple of days.

Back in Toronto I visit the outpatient department at East York General Hospital and get an antibiotic prescription; I'm willing to sacrifice my belief in natural medicine for a quick fix. I have options unavailable to my Cuban friends, even if their public health care is showing an openness and resilience to be envied by neighbors to the north.
salon.com | Jan. 26, 2000

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