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AAP, Cuba navigate embargoes to bring science to island nation :

July 13, 2016

When visiting Cuba two years ago, Douglas Edelman, M.D., Chapter Affiliate, of New Jersey, expected to see dilapidated conditions. But something else caught him by surprise.

At a large children’s hospital in Havana, Dr. Luis Alberto Solar Salaverri was explaining how Cuba’s medical system works. “He reached into his desk drawer and pulled out the most current journal he was reading,” said Dr. Edelman. “It was from 2002.”

The hospital’s outdated library collection included literature from more than a decade ago and an older copy of the AAP Red Book.

“We spoke of the dearth of educational resources available to physicians in Cuba,” said Dr. Edelman. For pediatricians there, the latest information on emerging diseases like Zika and Ebola was difficult to access. He knew that paying out of pocket for journal subscriptions was not an option for Cuban doctors, whose average salary is around $60 U.S. dollars per month.

Back home, Dr. Edelman set out to find a way to donate some new copies of the AAP Red Book to Cuba. He contacted then New Jersey Chapter President Margaret Fisher, M.D., FAAP, who had served on both the AAP Committee and Section on Infectious Diseases.

Doctors and medical students at this Cuban pediatric hospital now have access to AAP educational materials. Photo courtesy of Douglas Edelman, M.D.Doctors and medical students at this Cuban pediatric hospital now have access to AAP educational materials. Photo courtesy of Douglas Edelman, M.D.


Dr. Fisher said she found Dr. Edelman’s discovery to be “somewhat surprising news, as Cuba in general had been way ahead in public and preventive health.”

“Throughout their training, there’s a very strong emphasis on public health and awareness,” added Dr. Edelman. “One has to acknowledge and admire what they’ve achieved with so few resources.”

Familiar with the Academy’s outreach efforts to bring educational materials to other countries, Dr. Fisher told Dr. Edelman she would reach out to the AAP International Office for help.

“The American Academy of Pediatrics is a well-established source of expertise in children’s health. There is literally no end to the resources available,” she said. “Further, they are continually updated to deal with emerging threats such as Zika virus and electronic cigarettes.”

AAP international and licensing staff and Cuban partners set to work navigating a thick labyrinth of communications and trade laws sealed by the 50-year trade embargo. It took hours of phone calls and emails, made more cumbersome by the need to request advance permissions to make calls and restrictions on data transmission sizes. Spanish-speaking AAP staff aptly translated communications to facilitate the process.

More than two years later, they have secured a cost-effective means to provide Cuba with AAP materials. It is the first international distribution to include all AAP resources: journals, Pediatric Care Online and ebooks.

Zika information was among the first AAP content transmitted to Cuba. The country’s only online medical network, The National Information Center of Medical Sciences/Infomed, shared content across the island via its distribution lists, websites and content portals. Cuba’s pediatricians, faculty and medical students access the medical information via 27 hospitals and 16 medical schools.

Cuban pediatricians also were eager to see the Academy’s neonatology, perinatology, preventive care and oral health information, noted Dr. Mario Nodarse, who works on content dissemination with Infomed pediatric editors, including Fernando Dominguez Dieppa, M.D., Honorary FAAP, and Dr. Roberto Zayas. An AAP training workshop will be held in Cuba this fall.

The information reaches beyond Cuba’s doctors and students to the international medical students studying in Cuba, noted Dr. Nodarse. “By having access to AAP’s educational resources, these professionals will in turn improve the outcomes of children’s health not only in Cuba but also in their native countries.”

Dr. Fisher sees the stronger relationship as a way for the Academy to gain knowledge from Cuban compadres, as well.

“We can learn by finding out how they have managed vaccine hesitancy and how they have ensured government support for health care,” she said. “Cuba has an incredibly strong public health system.”

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