Social Welfare in Cuba: A Holistic View of Human and Environmental Sustainability
Study tour offered by the NASW – New York State Chapter
November 4 – 12, 2017
Tour leader: Marjorie Ziefert, LMSW, ACSW
Professor Emeritus, Eastern Michigan University, School of Social Work
This workshop is being offered for 40 Continuing Education Hours
Cuba has an International reputation as the third world country with the model health care system. Statistics disseminated by the United Nations puts it among the leading countries in the world in health and educational outcomes for its citizens. Despite economic hardship and economic isolation, Cuba has demonstrated that a citizenry can enjoy health care and education as human rights, even with few resources. This 9-day study trip takes a first-hand look at Cuba’s healthcare system and its powerful impact on social welfare in Cuba. Participants will have the opportunity to examine the holistic system of care which achieves such positive health outcomes for its people. We will be visiting with policy and practice organizations and agencies in Havana and rural surrounding area to observe and interact with staff with the goals of understanding the Cuban healthcare system and how it benefits the Cuban population.
This program will engage participants with professional social workers, community workers, and citizens in observation and dialogue about the Cuban social service system and the historical, socio-political context within which it has developed and functions. Nine days of emersion into the Cuban culture, engaging with Cuban people, and visiting a variety of agencies and organizations where we will learn about a wide range of services at the micro and macro levels will provide participants with a substantive understanding of the Cuban social welfare system and the role social workers play in that system. The timing of this trip allows for participants to take a critical look at the consequences of changes in US/Cuban relations and Cuban economic reforms on the social welfare system’s impact on the Cuban people.
Throughout the trip Participants will have both formal and informal times to meet with the Cuban practitioners who participate in our program. We meet with them at their agencies, observe them at work, and invite them to share a meal with us to continue informal discussions about their work and lives to examine the process of planned social change, policy development, and practice implementation in Cuba. Our air-conditioned bus serves as a traveling classroom as we move around the city and countryside enjoying lively conversation about what we have been seeing and doing.
Visits will be made to the following organizations as they can be arranged and others will be added and substituted as need be depending on schedule and unique interests of the participants who enroll in the program.
· * Walking tour of Old Havana, with a community planner, focusing on Community Arts and Development Projects, including a visit to “Arte Corte” a model community development project which includes educational, entrepreneurial, service, and social components, which enhance the social and economic development of the community.
· * Meeting with Marc Frank author of Cuban Revelations and Reuters journalist in Cuba to provide an overview of Cuban political history and context for current social welfare planning and policy.
· * Panel presentation at the Antonio Nunez Jimenez Foundation for Nature and Humanity – “Sustainable Community Development and Social Welfare”
· * Tronces grassroots community development project – visit to community where arts are being used for community organizing and development among residents to solve community problems and strengthen community.
· * Payasos Terapeuticos (therapeutic clowns) –demonstration of use of this modality for intervention with children.
· * Dance performance and lessons – history, roots and evolution of Cuban music and dance as a way of understanding Cuban social history.
· * Visit to a farmers market to initiate a discussion of food security in Cuba and learn about herbs and other foods used for healing in Afro-Cuban culture
· * Visit to the Center for Psychological and Sociological Research (CIPS), a center for research, education, and clinical work with communities. A panel of researchers will share their research model of community engagement and describe several of their projects related to their mission which includes families in community, the change process within people and communities, and social structure and inequality.
· * Visit to the National Center for Sex Education and Research (CENESEX), which is funded by the Ministry of Public Health. This organization, headed by Mariella Castro, daughter of Raul Castro, President of Cuba, engages in activities to enhance sexual health from a public as well as clinical perspective. They have organized Nationally for LGBT rights and have been the spearhead for major cultural as well as legal change regarding LGBT issues. They have also been instrumental in changing policy and laws regarding domestic violence and child abuse. They operate both from a macro and micro level.
· Attend “La Colmenita” (Little Bees) Children’s Theater Troupe performance and discussion. * La Colmenita is both Nationally and Internationally known as a model for providing children, without “gifted” talent in theater arts, an opportunity to learn creativity, cooperation, and discipline. Children with special needs are integrated into this normalized environment as a therapeutic tool. They perform musical plays as children’s theater in their communities and serve the participants as well.
· * Visit to the Union of Cuban Jurists (UNJC) where Association of Family and Civil Law representatives will discuss legal rights of families, women and children in Cuba. They are working on the new Family Code addressing anew issues of divorce, and child welfare in child testimony. They will discuss their educational and advocacy role in the passage of family focused laws..
· * Visit Guanabacoa Community Mental Health Center which serves as a day hospital for chronically mentally ill adults and outpatient treatment for the same population. Meet with the staff to discuss their treatment approaches and their connection back to the community health provider for their patients.
· * Visits to health settings that are a part of the health care structure. The Consultario is the neighborhood family clinic, which provides family care to a specific neighborhood or community, depending on the size of the population. The family doctor and nurse will talk about community based medical care and primary and secondary prevention efforts.
· * Visit a Policlinic, which serves as a regional specialty center with services referred by the family doctor. Everything from X-ray and lab testing to psychological testing and specialty treatment are provided here. Meet with the Director at the Policlinic. The visits to the three medical locations provided a full spectrum look at the structure of the Cuban medical system that includes a strong social component to both “cause and cure”.
· * Committee to Defend the Revolution (CDR) that is neighborhood and community based and serves as a social service support agency, a Neighborhood Watch, and a resource in each community for everything from street cleaning to personal support for community members, in need.
· * Visit the home and studio of artist Jose Fuster who lives in the community of Jalmanitas where the community is decorated with art tiles that Fuster has created with the help of local neighbors, as a part of a community revitalization project. The themes of Fuster’s work are connected to cultural and political identity.
· * Visit to Comesgendra Hogar de Ancianos, a home and day center for seniors. Provides an opportunity to talk with Seniors and staff about the planning for and care of elders in Cuba.
· * Presentation and meeting with Odalys Gonzalez Juban, President of the Cuban Society of Social Workers in Health.
· * Saturday Artisans Market where local artists display and sell their works and children’s art stations are set up for children in the community who are encouraged to participate in artistic projects.
· * Farewell dinner with our group to include presenters from the various visits during the 9 days in Cuba to participate in closing discussion about learning and take ways from the trip.
1. Participants will be able to describe Cuba’s model of community based, holistic health and education, prevention, and intervention strategies and asses which components have applicability to practice in the US.
2. Participants will be able to explain the context for human service delivery in Cuba including the cultural, political, social, and organizational mandate for services.
3. Participants will learn about how human services are integrated into the healthcare system in Cuba so that social issues are defined as and treated as consequential health issues.
4. Participants will examine how the NASW Code of Ethics applies to social work in Cuba and the relevance of cultural context to the application of the ethical principles.
5. Participants will gain an understanding of theories, methods, and strategies used by Cuban social workers in addressing issues in a variety of practice settings
6. Participants will learn how homeopathic, indigenous, and natural medicines are used in Cuba to address chronic medical and psychiatric issues and how social workers are engaged with these practitioners.
7. Participants will learn from the perspective of Cuban people and professionals, the impact of both change in US policy towards Cuba and of Cuban economic reforms.
1. David Strug (2006). Community‐‐oriented Social Work in Cuba: Government
Response to Emerging Social Problems, Social Work Education, 25:7, 749-76
2. David Backwith and Greg Mantle (2009). Inequities in health and community-oriented social work: Lessons from Cuba? International Social Work, 52:499
3. Strug, D. L., & González Jubán, O. (2010). Social work and healthcare. In S. E. Mason, D. L. Strug, & J. Beder (Eds.), Community Health Care in Cuba (pp. 13–23). Chicago, IL: Lyceum Books.
4. Johnson, Candace. (Fall 2008-Winter 2009). Women, Policy Development, and the Evolving Health Frame in Cuba. Canadian Woman Studies, 27:63
5. Strug, David (2013) Social Work in Cuba. In Encyclopedia of Social Work, accessed online. National Association of Social Workers and Oxford University Press USA, 2013.
Program Format and CE Credits
During this immersion program Participants are accompanied by the Program Leader who is a US social worker who has been visiting Cuba and studying the social welfare system for the past 5 years. We are also accompanied by the Eco Cuba Network Representative (our host in Cuba), in Cuba who is a U.S. born, practicing child psychiatrist with excellent cross-cultural knowledge of human services practices in the US and Cuba, and our guide and interpreter who also does much explaining and interpreting culture in Cuba. Times between visits are spent in dialogue about issues such as ethical practices in Cuba, which we are both hearing about and observing, cross cultural relevance of the Code of Ethics and alternative ethical frameworks, as well as conversation about socialism, practice modalities, and lessons that we could bring home. Agency and organization staff that we meet with in formal sessions are invited to accompany us to meals so that our discussions can continue in more informal times and settings.
Relevant learning for social workers happens throughout this trip. Observing families interacting on the street or children playing in the park are instructive and give one a very real sense of the differences in family structure, relationships between people, and hierarchy in Cuban society. The visits described above each take about 2 hours of formal “classroom” time which allows this program to provide 40 CE credits for the 9 days in Cuba.
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