Cuba is the newest training site for a U.S. National Institute for Health (NIH)-funded program that gives U.S. students the opportunity to conduct research in an international setting.
Tulane University student Alejandra Marks spent eight weeks on the island this spring, working with a mentor to study maternity homes and their role in prenatal care. It’s believed to be the first time a U.S. student has conducted research in Cuba as part of an NIH-funded research training program.
This fellowship is an example of what’s possible as the thaw in diplomatic relations between the U.S. and Cuba raising interest in increasing scientific collaboration. Tulane’s School of Public Health and Tropical Medicine has opened a permanent collaboration site in Cuba and intends to send more students there.
The school was awarded an NIH grant to provide minority students with short-term training opportunities outside the U.S. so they can hone their research skills, and explore international health issues and careers. The program is offered by the NIH’s National Institute on Minority Health and Health Disparities (NIMHD).
Cuba’s National School of Public Health is the partner institution. From her base in Havana, Marks worked on a project examining maternity homes in the country and other parts of the world. These residential facilities give care and shelter to pregnant women who have obstetric complications and other risk factors when adequate housing or hospitals are out of reach. Cuba has been using this prenatal care strategy since the 1960s.
Marks helped build the conceptual framework for the U.S.-Cuba collaborative research project. She reviewed literature on prenatal care policies, strategies, and programs as well as articles documenting how maternity homes have improved prenatal care and contributed to better outcomes in Cuba and elsewhere. Marks also got a firsthand look at health care in urban and rural settings by visiting maternity homes, family doctor and nurses’ offices, and polyclinics that provide both general and specialty care.
She says the experience gave her a deeper understanding of how Cuba’s health system reaches out to women who are pregnant, or thinking of having a child, and provides continuity of care throughout their pregnancy.
“Cuba’s case is a complete anomaly among health care systems in Latin America as it is the only country in which poverty is not an indicator of diminished health care access,” observes Marks, who is earning a master’s degree in Latin American studies and aspires to work for the WHO, United Nations or a nongovernmental organization.
Marks will write several papers with her U.S. mentor, Dr. Arachu Castro of Tulane, and her Cuban mentor, Dr. María Cecilia Santana, a former director of maternal and child health in the Ministry of Health and current faculty member with the National School of Public Health.
“Working with my mentor was fascinating, especially on a cultural level,” Marks says of her relationship with Santana. “It opened my eyes to a different system of research methods and styles to those in the U.S.” Marks also notes that while she is bilingual, the training in Cuba strengthened her ability to write in Spanish at an academic level. Two of the three planned papers will be written in Spanish for peer-reviewed journals.
Tulane’s international research training initiative is one of 24 funded by NIMHD’s Minority Health and Health Disparities International Research Training Program (MHIRT). Since 2005, Tulane has given students the opportunity to train on research projects in Peru, Argentina, China and Mexico. The expansion to Cuba came after Tulane got approval from the NIH and the U.S. Departments of State and Treasury. Fogarty staff shepherded the process.
Dr. Castro and Dr. Richard Oberhelman, who direct the MHIRT program for students at Tulane and Xavier Universities in Louisiana, say they hope to develop more research collaborations in Cuba and provide additional training opportunities.
The National Institutes of Health (NIH) is a biomedical research facility based in Bethesda, Maryland. An agency of the United States Department of Health and Human Services, it is the primary agency of the U.S. government responsible for biomedical and health-related research. The NIH both conducts its own scientific research through its Intramural Research Program (IRP) and provides major biomedical research funding to non-NIH research facilities through its Extramural Research Program.
With 1,200 principal investigators and more than 4,000 postdoctoral fellows in basic, translational, and clinical research, the IRP is the largest biomedical research institution in the world, while, as of 2003, the extramural arm provided 28% of biomedical research funding spent annually in the U.S., or about US$26.4 billion.