SEMINAR INTERNATIONAL LEARNING EXCHANGE PROGRAMME - RSA/ CUBA MEDICAL TRAINING PROGRAMME - MILE

SEMINAR
INTERNATIONAL LEARNING EXCHANGE
          PROGRAMME
 RSA/ CUBA MEDICAL TRAINING PROGRAMME

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OUTLINE
1. Background on international learning exchange programme

2. Key programmes/focus areas, targets and costs

3. Partnerships and key stakeholders

4. Successes and challenges

5. Awareness and outreach programmes

6. Key lessons learnt and impact of the programme on service delivery

7. Outlook: 2017-2020 Plans, Actions and Way-forward

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1. BACKGROUND ON INTERNATIONAL LEARNING EXCHANGE PROGRAMME

•    This programme was conceived in the mid-1990`s as an attempt to address the
     serious challenges in the production of medical doctors in South Africa.
•    The late Presidents of South Africa and Cuba, former President Nelson Mandela
     and former President Fidel Castro, respectively concluded a co-operative
     agreement to realize the concept.
•    The collaboration in the health field between South Africa and Cuba enabled
     South Africa to recruit doctors from Cuba whilst also sending young aspirant
     doctors/students from poor communities for Medical Training in Cuban
     universities for 6 years.
•    KZN is amongst the 08 Provinces participating in the country.
•    Participating Province covers all the costs , management and administration of the
     Programme

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2. KEY PROGRAMMES/FOCUS AREAS, TARGETS

Key Programmes/Focus Areas                  Targets
• South Africa(KZN Health) started          • Target –Must be less than 25
   sending students to Cuba in 1998            years of age before 31 December
• Sending          young         aspirant      of the year of recruitment.
   doctors/students        from     poor
   communities for medical training in
                                            • Youth from KZN poor household
   Cuban universities.                         and, Expanded Programme from
• Recruit doctors from Cuba- Our               2012, affording parents who
   Province has benefited from the             could not get space locally
   Cuban programme with 33 doctors.            formed part of the programme
• Cuban doctors started arriving in the        (ETP) by paying for tuition while
   province from 1996, 1997, 1998 and          department pay for the rest of
   2000 and are still in service               costs.

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COSTS
The Department covers the ff costs :    The Department covers the ff costs :
Before departure to Cuba:               When student are in Cuba:
 Visas                                 • Tuition
 Translation of documents to           • Accommodation
   Spanish
 Flight Tickets                        • Meals
 Tracksuits, golf shirts, lab coats,   • Stipend
   stationery ( backpack,               • Stationery
   stethoscopes , BP Machine            • Medical Insurance
 Orientation 3 days                    • Flights (to commence studies,
   accommodation at Hotel prior to
   Departure                               every 2years vacation ,
                                           bereavements, illness, pregnant
 Transporting of students from
   home to Orientation and Airport         students, suspension and any
                                           other where reason for student
                                           to return prematurely)
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3. PARTNERSHIPS AND KEY STAKEHOLDERS
• Cuban Government as the collaborating partner in the public medical schools
• Department of International Relations and Cooperation(DIRCO) for diplomatic
  relations and protocol
• National Department of Health (NDoH) as the coordinating office and signatory
  to the agreement and policy matters
• Cuban Embassy in Pretoria for translation and legalisation and VISA issuance
• SA Embassy in Cuba for the reception of officials and students
• Department of Home Affairs for Passports issuance
• Department of Basic Education for verification by Umalusi
• South African Police Services (SAPS) for police clearance
• Hospitals/ NHLS for medical testing and psychological assessment of students
• Travel Agency for flight and accommodation bookings

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CHALLENGES
• Rand / Dollar exchange Rate fluctuation affects all costs including flights
• Failure to adapt to Cuba due to challenges such as culture, socio economic,
   language ,climatic conditions such as high humidity levels, short winter season,
   etc.
• Pregnancy / impregnating and High levels of alcohol consumption
• International travelling affects some students during travel
• Loss of travel documents
• 6 hours time difference affects communication
• Political system in terms of the RSA Bill of Rights, patriotism, etc.
• Drop outs due to certain ailments not adequately curable in Cuba such as TB.
NB: These challenges are addressed through national coordinators meetings,
student engagement during holidays or delegation visits to CUBA.

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4. SUCCESSES
•   There are 117 doctors from KZN, out of 590 doctors Nationally , who have qualified since
    1998 who have been trained since the inception of the programme.
•   This translates to 20% of the National consortium of doctors trained in Cuba who have
    since qualified
•   13 students – graduated on the 14th July 2017.
•   About 262 students are returning from Cuba in July 2018 to do final year in SA.
•   Currently there are 728 KZN students in Cuba and it’s the biggest number by the
    province.
•   93 of these doctors are still employed in public health facilities in the Province
•   All students funded by the Department entered into Contractual Agreement with the
    Department
•   Improvement on the Primary Health Care approach to service delivery which is in line
    with PHC reengineering AND Universal Health Coverage.
•   Cuba trained doctors are being appointed as CEO’s of the CHC’s.

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PICTURES

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5. AWARENESS AND OUTREACH PROGRAMMES
• Career Exhibitions
• Media
• Roadshows especially in 2012 due
  to expansion Programme
• School visits information sharing

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6. KEY LESSONS LEARNT AND IMPACT OF THE PROGRAMME ON SERVICE
                               DELIVERY
Key lessons learnt                                       Impact of the programme on service delivery
• Tedious exercise recruiting and managing large         •   Cuba Programme has improved the Socio-
  groups of students – need careful and timeous              economic conditions of households.
  planning                                               •   The Department has prioritized appointment of
• Willingness to work outside normal hours                   Cuban Trained doctors to head CHCs.
• Need to think holistically and be innovative as        •   This decision is yielding good results as the
  challenges are unique in each incident                     CHC’s are well positioned for the community
• Expectations to play different roles in dealing with       integration whereby doctors are also playing a
  students as some report their personal problems            critical role in understanding community
  or challenges that have nothing to do with                 dynamics/Social profile and other development
  academics.                                                 strategies such as Operation Sukuma Sakhe
• Learnt to compromise to find common ground             •   Doctors are able to conduct home visits and visit
  when dealing with stakeholders                             community centres such as schools where the
• Be adapting and put oneself in other persons               primary health care services are rendered.
  shoes                                                  •   Training of doctors using the Primary Health
• Some of the students backgrounds forces you to             Care model is ideal for the Province since it is
  play counselling role.                                     community centred and promote access to
                                                             health care services at a local level.
• Without the political will and support,
  international programme is even more difficult –       •   Cuba trained doctors are easily retained in rural
  regular reports are discussed at Cabinet meetings          hospitals

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7. Outlook: 2017-2020 Plans, Actions and Way-forward
(I) Short Term                     (II) Medium Term
• 2015 Department reduced intake   • Review once all big groups (i.e. 2012,
   for Cuba                             2013 and 2014) have returned to SA
                                   • Expansion of teaching platform in
• 2016 no students were sent
                                        partnership with UKZN
• 2017 not students will be sent
                                   (III) Long –Term
                                   • Reduce intake of students trained
                                        abroad
                                   • Bringing Cuba model of training to
                                        KZN

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CONCLUSSION

We value team work and appreciate support we
received from Senior Management and Political
                 Leadership.

                  Gracias!

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