The Cuban doctor programme being implemented in KwaZulu-Natal has caught the eye of doctors in the UK. KZN Health MEC Dr Sibongiseni Dhlomo recently returned from London where he was invited to speak about the provincial Cuban doctor programme.Dhlomo, a number of South African academics, as well as two South African doctors who trained in Cuba were invited by the Imperial College of London to give feedback about the programme and its success in the province.The two-day meeting on April 24 and 25 was attended by members of the UK’s Public Health department, Cuba’s UK embassy, the UK Foreign and Commonwealth Office and academics from the London School of hygiene and tropical medicine.In an exclusive interview with The Witness in the wake of the event, Dhlomo said London’s public health system was interested in the way the programme was run in KZN. He had learnt while at the meeting that some London doctors spend a year in Cuba and came back to a good deal of praise. He said while places such as London were ahead of South Africa in terms of technology and research, they were experiencing difficulties in the approach to universal health.He said in KZN they have learnt a great deal from the Cuban model.He said following the Cuban example the intention is to screen and categorise the public into four groups — healthy citizens who are least costly to the country, those on medication for various illnesses, those classified as “high risk” due to certain behaviour such as drug and alcohol abuse and finally, disabled citizens.He said the aim is to push as many people as possible into the first category. This can be done by processing patients early and preventing illnesses instead of treating them at hospitals when they were already sick.“Cuba focuses on primary health care,” said Dhlomo. “They focus on going into the communities and screening the people. There is no TB, no HIV and few women dying in child birth in Cuba,” he said.“This is because Cuba looks at the risk factors and stops them before they become a problem.”Dhlomo admitted there were some challenges with the programme, such as reintegrating South African doctors who had trained in Cuba back into the country’s hospital-centric system.“Doctors such as myself are trained to treat people in hospitals, whereas Cuban-trained doctors go into the community and prevent people from getting sick and going to hospitals.”Another issue the Cuban-trained doctors faced was that they were not being “fully utilised” once they were back in the country. He said the Cuban primary health care model is being applied in the Umzinyathi (Dundee) district in KZN and appears to be paying off.Dhlomo added that the Cuban doctor programme is strong in KZN.Dhlomo said that they had “absolutely amazing feedback” from the UK meeting. Members of the UK health system had offered to set up a programme that would help support the South African Cuban-trained doctors in their transition from a primary health system to working in a hospital-centric country. “They were interested in the programme and they want to learn from us and expose the UK to this programme,” he said. “The purpose of primary health care is not to wait until someone is sick to treat them. We want to remodel the health system to wipe disease out from the beginning.”UK watching SA to aid research University of Cape Town professor Steve Reid, who was present at the meeting, said although the programme was not directly applicable to the UK, they were interested in the programme from a research point of view.He said London wanted to support South Africa’s Human Sciences Research Council and its research on the programme.He added that he had noticed Cuban-trained doctors were struggling to adapt once they were back in the country, but once they had adapted they became “highly resilient”.Reid said there was not enough information yet to reach firm conclusions, but it appeared the programme was working well.DHLOMO FACTOIDS• Dhlomo was imprisoned on Robben Island for six years before being released in 1991.• Dhlomo had just received his doctorate in medicine when he was arrested on Christmas day in 1985. While in prison, he had a job peeling vegetables and earned R1 a month.