Social Welfare in Cuba: Michigan Social Workers Take Trip of a Lifetime

NASW group outside of famous Cuban artist José Fuster’s “Fusterlandia” Playa, Havanna. (Back L-R: Terry Kupers, David Matisoff, Tom Powell, Audrey Matisoff, JP van Woerden, Esta Kaftan, Brad Bender, David Manville, Michele Smith, Faye Askew-King. Middle: Christine Boender, Karen Hague, Julie Frick, Katherine Brandon, Amircal “Cal” Salermo, Chuck Kieffer, Cheri Dickinson. Front: Marjorie Ziefert, Jackie Knight, Terry Manville, Harriet Charney, Lela Squitieri, Lynn Rosenfield, Judy Stone, Yvette Colon, Esperanza Luzbert, Peppy Rosenthal)

"This was definitely the most educational and informative continuing education activity that I have ever experienced. The presenters and topics were very thorough and the diversity of agencies that were visited helped to give a holistic picture of how the Cuban health/social care system works. It was very beneficial to learn how a community based approach can be effective in dealing with multiple issues and can be very preventative." -2016 Cuba Trip Attendee

We are not communists, we are socialists. Communism is an ideology; socialism is a form of government.

On October 31, 2015 a group of 27 individuals comprising of mostly social workers and their partners from Michigan, Minnesota, New York, New Jersey, California, and Ireland embarked on an eight day social welfare educational research tour in Cuba. NASW-Michigan Chapter coordinated this trip to better understand Cuba’s perspective on social welfare issues and how they relate to the work being conducted by social worker’s within the United States.

This was the second Cuba trip organized by NASW-Michigan in the last three years in partnership with Eco Cuba Network. Even with some of the sanctions against Cuba recently lifted, it is still difficult for Americans to travel to the historic island nation.  There are 12 categories the United States has mandated citizens fulfill in order to be granted travel to Cuba; our trip fulfilled the “educational activity” requirement. As part of the educational activities component, we had a robust and intentional itinerary where we visited a number of agencies, ranging from the National Center for Sex Education and Research (CENESEX), the Union of Cuban Jurists (UNJC), with members of the Association of Family and Civil Law, to a Community Mental Health Center. Through agency visits, cultural events, and lectures from our guides the Cuban lifespan of social services was covered. We had the opportunity to interact with official policy makers, directors of programs, and a variety of practitioners with a range of social work and other disciplinary training. There were also a number of cultural activities that allowed for us to engage with Cuban citizens in formal and informal settings as we learned about the history and culture of the country.

One important thing our travelers learned early on in the trip was to keep an open mind and disconnect from common U.S. misconceptions about Cuba. For example, affirmative action was implemented in order to increase the number of men being admitted into medical school. Men were struggling to enter medical school due to insufficient math test scores compared to women. This was contrary to the United States, where women struggle with achieving high scores in math - one of many reasons there is a low number of women represented in the STEM professions. At one of the local agency visits the group was told, “When everyone has equal opportunity at conception, women do better in math.” Gender equality is one of many areas in which Cuba thrives.

One social worker stated that "This was truly an exceptional experience and it was sometimes hard to describe all of what I took in to my family and friends in the US.  I certainly had some misconceptions and many of these were nullified.  I left feeling that this country needs the embargo lifted and needs help from the US but also am concerned how this will potentially change what Cubans know and love.  I felt extremely safe there.  And I will admit that I was happy to NOT have to use their antiquated medical system – a system that Cubans are used to, but would scare me.  It was a fabulous learning experience and worth every penny and Cuc." 

There were other surprising significant achievements that conflicted with what Americans have been told to believe about this socialist country. Cuba has one of the highest life expectancies in the world, and one of the lowest infant mortality rates in the world. They also became the first country in the world to receive validation from the World Health Organization that it had eliminated mother-to-child transmission of HIV and syphilis. Women are also well represented in government throughout the country.  While only about 20% of the United States Congress is comprised of female representation, nearly half of all seats in Cuba’s parliament are held by women.

One of the biggest overarching takeaways from the trip was being challenged with a perspective on government and social welfare that is counter to what social workers have been taught and experience in the U.S.. Tania Causse, Head of International Relations Group at CENESEX, explained that “Cuba’s democracy is different. The U.S. does not get our democracy. It’s not perfect but it works. Here, they think we all agree with our party. We don’t. We are fighters. We discuss and discuss until consensus. The people feel that they are heard. Our people wouldn’t stand for our voice not to be heard. We are educated and wouldn’t stand for it.” U.S. citizens are welcomed and embraced by Cubans, but one of the first points made is that Cuba is not communist, they are socialist; communism is an ideology, while socialism is a form of government.

Our visits to agencies allowed us to witness how the Cuban governmental policies have been carried out. The overall observation was that Cuban people are happy, healthy, educated, and proud people. The basic needs and necessities of the population are met, so while some Cubans may be hungry, they are not starving.

While we may not fully agree with some of Cuba’s practices, it is important to be put in situations that challenge our ideas and beliefs in a way that questions and enhances our own practices. This sparks the creativity and critical thinking skills and abilities necessary to overcome the numerous local and global crises that we are plagued with. I can affirm to the testament that was spoken, “There is no secret recipe. The solution is community based.” The model that works for Cuba is centered around the collective, and not the individual.  

The group heard at the Center for Sociological and Psychological Investigation Serves (CiPS), “Our main richness is our people.” They were able to witness this first hand with the health care system: everyone sees a doctor twice a year, and from that visit patients are placed in one of five levels to receive the appropriate care needed. Another visit was a trip to a Maternity House, where, in every community, pregnant women are sent to receive 24-hour nurse and doctor care if they have hypertension. When care is low cost and/or free it is more accessible for all people to seek the care they need to prevent health conditions from growing into larger, more expensive and time consuming relief.

Multiple times the group was told by Cubans that their country is not perfect. Cubans acknowledge their problems and assert they are working to improve. This realism and understanding of the issues that are at play remind us that we always have room for improvement and need to strive for continued excellence. Cuba has fought many battles to maintain the political system they believe in. In doing so, Cubans have faced a variety of obstacles that have made them admirably resilient. The exchange of ideas and practices from both the U.S. and Cuba needs to continue in order to bridge the gaps in improving the quality of life of our citizens and countries.

~Brad Bender

A huge thanks to Majorie Ziefert, our trip organizer, for the hours of time put in to planning and executing such an amazing trip. Marjorie also organized the 2013 NASW-Michigan trip to Cuba. To read about that trip click here.

Additionally, a special thanks to our in-country guides: Michelle Frank, Amircal “Cal” Salermo and Esperanza Luzbert – our guides/translators guides, and our bus driver who kept us safe while traveling. We asked a plethora of detailed questions that were patiently translated and answered with sincerity. Because of our guides were we able to learn and explore Cuban social welfare and culture in a manner that most might not otherwise be exposed to. Thank you to all of our agency sites who hosted us with open arms (and many cups of coffee)!

• "The trip was personally and professionally inspiring and rewarding. Extremely well organized and provided a broad spectrum of experiences and opportunities for cross cultural exchange."
• "I really appreciated the intense immersion in the social welfare policies & practices in Cuba.  Our guides were outstanding & added greatly to understanding both the macro & micro perspectives of Cuban values, history & the resulting community based delivery model.  Very inspiring & educational.  Thanks to all who worked so hard to make this continuing education course such a meaningful experience!"
• "This was an eye-opening experience that challenged me to analyze the U.S. context for intervention models, service delivery, and formal and informal care systems. I am still processing my experience and have begun to share what I learned with my students and colleagues. Thank you!"
• "Enormous amount of information. Fabulous experience. Lots of information."
• "This was an absolutely amazing experience. Learned so much about Cuban history, culture, structure."
• "I think this was an incredible experience to learn and witness Cuba’s community based holistic approach which in effect serves as a prevention model for many of the social issues we struggle with in the US. This integrated model seems to build in protective factors and provide early identification of any merging social issues experienced by families. I was also impressed that they now recognize the need to create a master’s prepared social worker curriculum and degree program to more effectively address more complex social issues. I was inspired by their approach and think there is much that we can learn from them that can be adapted both on the micro and macro levels of social work practice in the US. I’d like to learn more about how policy decisions are made."
• "This seminar was an amazing experience and provided a wealth of information about social work in Cuba on both micro and macro levels. I enjoyed the opportunity to learn about different systems directly from the people and organizations. I would recommend this course to any social worker and would definitely participate in this program again. The coordinators did an excellent job."
• "I learned so much at every presentation. It was obvious that there was a great deal of time, energy and collaboration both in the US and with folks in Cuba .Marjorie and Chuck and Michelle were amazing. The places we visited and the people that we met were well prepared for us. Although I was tired and somewhat limited I enjoyed and learned so much. "
• "So much learning took placed as rode the bus!!we had the ability to learn so much from our guides on the bus and the interaction within the group was amazing. It was a trip I had wanted to make for a very longtime and am so happy I had the opportunity. Very happy that we did it."

Photo Captions: (Starting second from the top)

• Walking in front of the Basilica Menor de San Francisco de Asis in Old Havana
• Visiting a local hospital or “Policlinico” in Matanzas
• The NASW-Michigan group meeting with Odalys Gonzales Juban, President of the Cuban Society of Social Workers in Health
• Receiving a history and cultural lesson of the Plaza de Armas in Old Havana