Risks of ICT in Health

Many Cuban doctors and public health professionals are worried about the potential negative side effects of ICT in the health sector. Though many recognize the positives of increasing ICT use in medical facilities, interviewed health professionals outlined some risks that could drastically affect the culture of health in Cuba.

Loss of Jobs

Presently, the Cuban healthcare system is wrought with inefficiencies, each of which creates a government job for someone. According to one source, in order to “digitize” medical records, doctors initially hand-write everything. Someone comes by their office on a daily basis and collects their handwritten notes which are then carried to the nearest Polyclinic. At the Polyclinic, someone else inputs the data into a computer system. After the data is inputted into the system, another person is responsible for cleaning the data and completing the initial analysis. Finally, a doctor with a certificate in biostatistics is responsible for a more complex analysis. Thus, if a doctor were to digitize data while speaking to their patients, two jobs would be eliminated from the healthcare system. Doctors worry that medical technology might create unemployment, a risk that in their eyes, could outweigh the increased efficiency.

Loss of Personal Touch

The Cuban healthcare system prides itself on being extremely holistic. Doctors know their patients from birth, live amongst them, and understand the complexities and nuances of every aspect of their environments that might be affecting their health. Doctors also take a lot of time to speak with their patients to understand their health needs and share accurate information with them. Most Cubans have a fairly robust understanding of personal health issues because their doctors spend so much time educating them about the various health condition they or their family members have.
The doctors interviewed for this project worry that introducing a screen between them and their patient will reduce this level of intimacy. Patients might not feel as connected to their doctors if they are separated by a screen. Despite this concern, there are ways doctors and patients could come together over medical web platforms or text messaging apps that have the potential to further strengthen doctor-patient relationships and trust, complementing the Cuban system.

Photo by Chiara Bercu

Loss of Innovation

One of the biggest causes for concern is the potential loss of innovation that might come with the introduction of ICT in Cuba. Cuba is an innovator in the health space. They discovered the first cure for lung cancer and were recognized by the World Health Organization as being the first country in the world to eliminate mother-to-child transmission of both HIV/AIDS and syphilis.
Cuban doctors innovate and create despite operating within a fairly resource-restricted setting. The amount of money and equipment that is available to health professionals is not comparable to what is poured into research and development in the United States and other developed nations. Cuba has excelled, in part, because they have become experts at adapting to difficult scenarios.
In medical school, doctors begin learning how to think outside of the box and approach health care holistically. During the Zika outbreak of 2016, medical students were the primary implementers of a public health campaign to fumigate people’s homes on a bi-weekly basis and went door-to-door to ask if anyone in the household was experiencing fever. This type of careful attention to detail and deep-seeded knowledge of the functionality of fighting tropical diseases gives Cuban doctors a leg-up against the international community.
During the Ebola crisis of 2015, Cuban doctors were more highly sought after than doctors trained in the U.S. or Europe because of their ability to operate so efficiently with low-resources availability. Cuban doctors have been sent all across the globe on medical missions to act as frontline caregivers during natural disasters and outbreaks of infectious disease because they are especially well-equipped to take on these situations. Cuban trained doctors might no longer become experts in this niche if they become dependant on much of the technology that doctors in developed countries have difficulty functioning without. Additionally, Cuban medical professionals trains hundreds of thousands of doctors from other low-resource countries to become experts in addressing health concerns under similar resource constraints. As a result, Cuba is one of the foremost experts in teaching medicine. Some doctors interviewed expressed concern about the medical school system, which would become less effective if it began incorporating technology that was not available to most of these doctors upon returning to their countries.

Written by: Chiara BercuEdited by: Emily Sylvia