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tv   Vital Signs with Dr. Sanjay Gupta  CNN  November 26, 2016 11:30am-12:01pm PST

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"vital signs" starts right now. > cuba is roughly 90 miles off the coast florida but it feels a world away, the old cars, architecture, music. it is the sights and sounds of havana. this is "vital signs." i'm dr. sanjay gupta. despite being one of the poorest countries, cuba has a relatively strong health care system, a lot of focus on prevention. their screening program for vision and hearing and also a very robust vaccination program. keeping track of 11 million people on the caribbean's
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largest island often requires a personal touch. this is a family doctor's clinic in havana, they are known as poly clinics and the primary care facilities of cuban health care. dr. marta runs this clinic and is responsible for the surrounding neighborhood. >> how many patients do you care for? 1100 to 1500 people. >> what is the most common things you see here? >> narrator: the diseases we see more off noun are high blood pressure, diabetes, heart disease, as ma and chronic object struck tough tiff pulmonary diseases.
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>> she sees patients in the morning and heads out in the afternoon to make house calls. we will be heading out with her. let's first take a step back. a pivotal moment in cuba's history came on january 1st, 1959 when fidel castro overthrows u.s. backed president bautista. the culmination of the cube ban revolution, ending one dictatorship and starting another. two years later, january, 1961, cuba and the united states end diplomatic relations. cuba turns to the soviet union for economic support but sees its economy crash when the soviet union collapses in the early 1990s. with the u.s. embargo still in place and a centralized soviet style economy, cuba struggles. for its free government run health care system, that means a need to keep costs low. preventing disease, as i said, is cheaper than treating it.
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so cuba focuses intensely on prevent tiff care. the u.s. trade embar also means limited access to resources, even medications. in this clinic, you can see how bare it is. just essentials here. an old chinese made skacale, a cabinet with medication organized in plastic cups and a single bed. >> sometimes you hear it is difficult to get medications. is that true? have you found that? >> translator: well, you know, we are a country which has been relocated. the number of medications as we can import are not as much as needed and we have those that are essential in the local offices. remember, this is a primary health assistance office. we focus on health prevention and promotion. if the patient needs other kinds of medication and assistance, they will go to the secondary
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institutions, which are the hospitals, where they can find other drug that is are needed by the patients at the time. >> time for house calls. the first patient is a baby boy. to our surprise, we take a left out of the clinic and then straight up the stairwell. >> so literally next door to where the office is is the first patient of the afternoon, a little baby is what we are hearing. are you worried about anything or just a routine visit? >> translator: we plan field visits. we see them once a month in the office and once a month in the field. if the child is ill, we come more often until we discharge them. >> dr. day hejesus talks to nol
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mother about everything from his diet to his motor skills. >> translator: this is the heightnd the weight curve we record. this measures the baby evolution as a percentile. here we have the foods with information to the families and what has to be eaten month by month. here are the vaccines that reflect a follow-up of the child's development. >> translator: >> so the baby is healthy? >> translator: very, very healthy. >> a clean bill of health and it is time for the next patient. this is a bit of an unusual sight. you see a doctor and a nurse walking down the sidewalk making house calls in this neighborhood. a few minutes later, we arrive at the home fof a woman sufferig from alzheimer's dementia.
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>> she has her caretaker and she is here until her daughter comes home from work. >> how off down see her? >> translator: almost every day. >> on average, cubans have a long life span, nearly 80 years. the focus on preventative health care has contributed to that. it means a growing, aging population. diseases like alzheimer's are becoming more common. along with a focus on preventative care, cuba places a heavy emphasis on prenatal care for babies and their mothers, boasting one of the lowest infant mortality rate. these numbers are coming from the cuban government. we can't independently confirm them. they validated the m health system calling it a model for the world. making the rounds. you can tell this is a personal
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doctor/patient relationship. she knows her patients and this neighborhood. it is a unique system that does seem to be working. for cuba, a country cut off from the united states for so many years, finding these unique solutions has led to some impressive innovations. next, we are headed to a research center. developing their own vaccines, including one for lung cancer.
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according to the world health organization, the united states spends twice as much on health as cuba.
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with fewer resources and lack of access, they have had to improvise through innovation. much of that happens here at the center for molecular immu immuneology. >> does it make it so you can make these drugs that get extorted to other countries. >> yes. >> in this research center, they have made their own vaccines for everything from hepatitis to meningitis. >> we are using more than 70% of the medication we need for our population. >> there is one vaccine in particular that has caught the attention of countries all over the world, include the united states. the vaccine is for lung cancer. it is called cimavax. >> lung cancer is a disease here. it means we have more patients with lung cancer each year.
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in the same period of time, the same amount of patients die from this cause. >> is it the lifestyle of pollution, smoking, cigars? >> in cuba, it is lots of smoking because we produce tobacco. >> reporter: this man was 77 years old, a smoker all his life starting at age 7, saying he smoked as much as a box of cigars every day. in 2007, he was diagnosed with lung cancer. >> when they told youed lung cancer, were you surprised? >> yes, yes. it was like a house fell on top of me. it hit me really hard. thanks to the help that i have had from my doctors, specially the doctor here, she gave me the treatment, chemotherapy, and then invited me to the clinical
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trials with the vaccines. >> reporter: the critical distinction about this treatment is that the word vaccine is a bit misleading. it does not prevent disease like a traditional vaccine but rather keeping diagnosed tumors in check by inhibiting their growth. it is a form of immunotherapy harvesting the power of the body's immune system. >> this is completely free? >> yes, in cuba, it is completely free. >> others are participating in clinical trials including japan and europe. it shows patients younger than 60 lived on average 11 months longer than those that did not receive it. it is expected to start fda clinical trials in the united states later this year. it is all part of the newly formed health collaboration between the united states and cuba signed a week before our visit to havana. after 54 years, the united states and cuba normalized diplomatic relations last july. not all contact had been cut off
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before that. in fact, outside havana, there is this medical school with a unique mission. take people from impoverished areas and train them to be doctors and send them back home to provide medical care. sips it opened in 1999, it has trained 25,000 doctors from all over the world and 85,000 countries from around the world include the united states. >> reporter: one of the biggest draws of the latin-american medical school is the cost. there isn't any cost. it is free. the students receive a small stipend to attend the six-year program. the only agreement they make is that they return to their home country and serve impoverished communities in need of medical care. that's the other important thing to realize. cuba pays for this training, the docts don't actually stay in ba. >> how many of you are from the united states?
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>> reporter: most all of you. >> how many of you had ever visited cuba before coming to medical school here? just two of you. how many plan on going back to the united states after finishing your school? all of you. i spent tsome time with many students from the united states. they don't pay to come to school here and when they are done, they are going to go back to the united states. what does cuba get out of that relationship? >> translator: this university was founded in 1999, because of several problems that occurred in central america related to hurricanes mitch and george. sending cuban medical teams couldn't be the definite solution. >> reporter: the idea of medical diplomacy has been a running theme in fidel crass stro's cuba. cuban doctors off goen on medical missions to other countries and they sent hundreds to west africa to fight ebola.
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they have exported doctors for other latin-american countries in exchange for badly-needed oil and hard currency which has led to a shortage of experienced doctors in their own country some xlap. i left the latin-american medical school impressed by these students who took such a huge leap of faith to come to a country most of them had never even visited to study medicine in a foreign language and give a true commitment to this style of health care. next, we take a ride for a classic tour of this historic city.
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according to the world bank, life expect tennessee here in cuba is 80 years old, one of the highest in the world. the united states is 79 years old. brazil is 75 years old. a lot of that likely has to do with what they don't eat here but also with what they do eat. the vegetable markets like the one you are looking at here weren't available some ten years ago. even today, to buy cucumbers, for example, two cucumbers would cost more than a day's salary for the average cube ban. the cost of living is a common theme we heard from nearly everyone we spoke to. many look to a second job to supplement their state salaries which average $20 to $25 a month. for doctors, a bit higher, roughly $50 to $60 a month. some doctors and nurses occasionally taking supplies to resell on the black market or patients bringing gifts to appointments to ensure access to those limited supplies.
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as much as things may be improving here, there is still a long way to go with people looking crease theto increase t income, tourism appears promising as the united states and cuba further improve diplomatic relations, that means more tourists and the first things they want is a tour of the city in a classic american car. several drivers had other jobs, some were chefs, some were engineers and a few of the fellow drivers were, in fact, doctors. we didn't find any full-time doctors that were also part-time drivers that day. so i hitched a ride with roe dofl foe, a 43--year-old cuban who has been driving these cars for 20 years. >> nice to meet you. >> nice to meet you too. >> what kind of a car is this? >> '53 chevy. you want to go in front or sit with you. >> what kind of car is this? >> '53 chevrolet. >> safe? >> yes, of course.
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>> let's go. >> as far as careers in cuba go, this is a pretty good career. you make good money doing this? >> yes, of course. >> it costs us $25 to rent this car for about an hour. in one hour, rodolfo makes as much as the average state salary for a month. >> how is the health care system here? >> very good. in my opinion, it is very, very, very good. it is free for everyone. it is free. >> what's the worst thing about the health care system? >> the system is very good. the problem is with, for example, for the medicine, don't get to everyone in cuba.
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the american embargo, you know that. it is sent to another country, everything for the cuban citizen. >> on our drive, we passed cuba's revolution square. >> this is revolution square. >> reporter: a >> and the american embassy with the flag flying high out in front. a recent edition here in havana. >> in front, we have the american embassy and the flag sghch. >> that make you happy to see the flag go up. >> many they look at, oh, my god, the american embassy. that is possible in cuba. yes, it is possible. after 50 years. >> cuba, people live a long time in cuba.
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the life expectancy, 70 years oyears -- 80 years old here. inhe united states, 79. why do you think? >> in my opinion, that's happened maybe because we live more quieter, more free in our spirits. the cuban is free. cue base the best country to live. no violence, no crime in the street, very, very loud person we have in this country, no crime and violence. for example, in cuba, you can see a child in the street playing in 6:00 in the afternoon to 12:00 midnight and no happen nothing.
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>> no worries. >> nothing. very, very safe country for living. maybe that is the one reason between the many one where cuban people are living better, are living more fine. >> what other reasons do you think? >> for example, the food in cuba is nature. >> natural? >> yes. >> that's good. the americans use so many chemicals in their food. not only in america, around the world. >> i think you are right. how about fixing the car if it has problems? >> myself. >> you fix it yourself? >> you are a mechanic. >> so-so. in cuba, when you are talking about the cuban people, you can see and when you get hurt, somebody tell me we are music
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and crazy, because we make everything. >> as we drive around this beautiful and fascinating place, i can't help but think about what these classic cars represent. r rodolfo's 1963 chevrolet has original parts but a few added on, thanks from ingenuity from a so-so mechanic and a tremendous amount of pride. cuba is doing more with less and has been for decades. a country on the bridge of change with potentially a lot to gain and a lot to offer. [vo] quickbooks introduces jeanette.
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and find the plan that's right for you. ♪ 3:00 eastern, i'm pamela brown in for poppy harlow on this saturday. you are live in the "cnn newsroom." we begin with the death of fidel castro at age 90. to some, a revolutionary hero, the father of modern cuba. to others, a brutal tyrant that ruled with an iron fifty. when he took over power, he released white doves signaling a new era. 57 years later, his death is triggering two very different types of powerful reactions. some are shedding tears o


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