Browsing by Author "Werle C"

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    The gift of health: Cuban medical cooperation in Kiribati
    (2023) Werle C; McLennan S; Leslie H
    Since 2006, 33 I-Kiribati students have undertaken medical education in Cuba and returned home as doctors, but little is known about how they translate the Cuban preventive model of care to medical practice in the Pacific context. The research addresses this gap through qualitative fieldwork in South Tarawa and reveals that the assimilation of Cuban-trained doctors into medical practice is complicated by challenges related to clinical skills, language and contextual knowledge. These challenges have been successfully addressed with the development of the Kiribati Internship Training Programme but a misalignment between the prevention-focussed medicine taught in Cuba, and the curative orientation of the Kiribati health system and internship programme remains a concern, and the graduates’ knowledge and experience of primary and preventative care is not yet well utilised. This paper argues that the challenge now is to ensure that the knowledge and skills gained by the Cuban graduates at all steps of this journey are utilised in order to bring better health outcomes for the people of Kiribati.
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    “We are the ones who will have to make the change”: Cuban health cooperation and the integration of Cuban medical graduates into practice in the Pacific (article)
    (3/05/2023) McLennan S; Werle C
    BACKGROUND: This paper responds to Asante et al. (in Hum Resour Health, 2014), providing an updated picture of the impacts of Cuban medical training in the Pacific region based on research carried out in 2019-2021, which focused on the experiences of Pacific Island doctors trained in Cuba and their integration into practice in their home countries. METHODS: The research focussed on two case studies-Solomon Islands and Kiribati. Study methods for this research included multi-sited ethnographic methods and semi-structured interviews as well as qualitative analysis of policy documents, reports, and media sources. RESULTS: The Cuban health assistance programme has had a significant impact on the medical workforce in the Pacific region increasing the number of doctors employed by Pacific Ministries of Health between 2012 and 2019. Qualitatively, there have been some notable improvements in the medical workforce and health delivery over this period. However, the integration of the Cuban-trained doctors into practise has been challenging, with criticisms of their clinical, procedural and communication skills, and the need for the rapid development of bridging and internship training programmes (ITPs) which were inadequately planned for at the outset of the programme. CONCLUSIONS: The Cuban programme in the Pacific is an important model of development assistance for health in the region. While Cuba's offer of scholarships was the trigger for a range of positive outcomes, the success of the programme has relied on input from a range of actors including support from other governments and institutions, and much hard work by the graduates themselves, often in the face of considerable criticism. Key impacts of the programme to date include the raw increase in the number of doctors and the development of the ITPs and career pathways for the graduates, although this has also led to the reorientation of Cuban graduates from preventative to curative health. There is considerable potential for these graduates to contribute to improved health outcomes across the region, particularly if their primary and preventative health care skills are utilised.
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    “We are the ones who will have to make the change”: Cuban health cooperation and the integration of Cuban medical graduates into practice in the Pacific (preprint)
    (Biomed Central Ltd, 2023-05-03) McLennan S; Werle C
    Background: This paper responds to Asante et al (2014), providing an updated picture of the impacts of Cuban medical training in the Pacific region based on research carried out in 2019-2021, which focused on the experiences of Pacific Island doctors trained in Cuba and their integration into practice in their home countries. Methods: The research focussed on two case studies – the Solomon Islands and Kiribati. Study methods for this research included multi-sited ethnographic methods and semi-structured interviews as well as qualitative analysis of policy documents, reports, and media sources. Results: The Cuban programme has had a significant impact on the medical workforce in the region increasing the number of doctors employed by Pacific Ministries of Health between 2012 and 2019. Qualitatively, there have been some notable improvements in health delivery over this period. However, the integration of the Cuban-trained doctors into practise has been challenging, with criticisms of their clinical, procedural and communication skills, and the need for the rapid development of bridging and internship training programmes (ITPs)which were inadequately planned for at the outset of the programme. Conclusions: The Cuban programme in the Pacific is an important model of development assistance for health in the region. While Cuba’s offer of scholarships was the trigger for a range of positive outcomes, the success of the programme has relied on input from a range of actors including support from other governments and institutions, and much hard work by the graduates themselves, often in the face of conservable criticism. Key impacts of the programme to date include the raw increase in the number of doctors and the development of the ITPs and career pathways for the graduates, although this has also led to the reorientation of Cuban graduates from preventative to curative health. There is considerable potential for these graduates to contribute to improved health outcomes across the region, particularly if their primary and preventative health care skills are utilised.