- Come in!
Pesquisas en Baracoa para detectar síndromes febriles y respiratorios
Deborah and Richard cross the threshold, but stay at a safe distance.
- Sorry to bother you, this is going to be very quick. We are medicine students doing a health survey.
- What's the address of the house?
- Building 12, apartment D, Turey.
- Tell me the name of the people who live in the house.
- Ricardo Gamboa
- How old is Ricardo?
- Ah, I'm old-fashioned now! 81!
- What other person?
- Orfelina Noa Argüelles.
- How old is Orfelina?
- 77.
- Anyone else?
- Yes. Lidia Rosa Gamboa Noa.
- How old is she?
- 53 years old. And Elexey Sanchez Gamboa.
- How old is Elexey?
- 32. There's one missing: Alexa Sanchez Ruiz. She's nine years old.
- Does anyone in the house have a fever, cough, a cold...
- No, no. I'm an invalid. That's all.
- Does anyone suffer from any disease?
Although Ricardo has answered every question promptly, this time Orfelina comes first:
- No, he had an ischemia, but he ended up pretty good. I haven't had a cold in four or five years.
The voices have drawn other family members into the room. The students take advantage of the moment to start a health talk.
Similar scenes are repeated simultaneously, or with little time difference, in dozens of homes in the Turey neighborhood. The active research being carried out here by students from the Baracoa Medical Sciences school is part of the actions to prevent and contain the spread in the country of the Sars Cov-2 coronavirus, which is the cause of the disease that is currently keeping the whole world on edge.
Deployment on the ground
Professor Noris Nicot Terrero explains to me what's going on around here.
"This activity consists of an investigation to detect feverish syndromes and catarrhal manifestations.
The students work in pairs. There are two teachers in charge of each team of ten or twelve students. The research covers, in this case, all the areas served by the Fermín Valdés Domínguez polyclinic, of El Turey, from Bajada de La Marina to La Aceitera. But the same actions are also carried out in other health areas of the municipality.
The fieldwork began last Thursday, and continues this week. We work from eight in the morning to two in the afternoon, including a report at midday.
At midday we revisit the houses that were closed in the morning because their inhabitants were working or on other business. If we still do not visit them, there is a group that took the initiative to do so after five o'clock in the afternoon, which is the time when people leave their workplace.
Although the investigations have been going on for a few days, the preparation began much earlier. We trained the students about the new virus, what it is, the symptoms of the disease it causes, and how to conduct health talks to the population, as well as protective measures to avoid any contagion.
This was also stated by Dr. Leonardo Antonio Galano Machado, Director of the Medical Sciences School in Cuba's First City.
"It was done in two stages, first in the preliminary phase, and now, recently, when we received indications to carry out active research".
They know what they have to do
We have already seen Cuban doctors face dangers and adversities of all kinds when the lives of people anywhere in the world are at stake, but if they are very young, and perhaps a little inexperienced, then people are doubtful. Dr. Leonardo clarifies:
"Our students have the role of researchers, they don't interact with the patients, they simply identify cases of respiratory diseases and report them to the health authorities for their consequent evaluation, so the risk of contagion, if there were any positive to Covid-19 among, is considered very low".
Professor Noris adds "of course, we have foreseen that the students will protect themselves", something reinforced by the director of the school where the future health professionals of the municipality are trained.
"In addition to the use of the facemasks we gave them, we have explained that they must stay at more than one meter away when questioning people, avoid unnecessary touching of objects and surfaces, wash their hands frequently with soap and water, use sodium hypochlorite or hydro-alcoholic substances, do not use their hands near their faces, or touch their mouths, nostrils and eyes, and above all, extreme these safety measures when there is someone in their physical environment with respiratory manifestations such as coughing, sneezing, fever, etc".
The lesson seems to have been well learned, judging by what several students repeated to me when I asked the usual question, and by what I myself observed in their behaviour.
"There hasn't been a single case of contagion, not now, nor in any of the investigations that have been carried out before in the territory", assures Leonardo. It must be that, as Noris told me, "the students know what to do because they have done it before".
Neither the first nor the last time
The new coronavirus is not the only "aggressor" that has put the health system of the territory on alert.
"When dengue fever broke out, we did an active investigation, looking for suspicious cases in each family and guiding the measures that should be taken," says Deborah Ysabel Legrá Pelier, a third-year medicine student.
Her colleague, Yalena Gómez Borges, adds: "This is not the first time we have done this work. We do it from the first year of the career and until we graduate, even after we are workers we continue doing it. That's how it was when there were dengue and zika outbreaks, now with the coronavirus, and we will do it in all the situations that come our way”.
Integrated Community Work (TCI), explains to me the director of Baracoa´s Medical University, is an academic activity foreseen in the curriculum of the careers of the health profile in Cuba. It is planned for one week in each semester and is organized according to the epidemiological and health needs of the territory.
"Now, taking into account that one of the characteristics of our health system is preventive work, under the principles of family medicine that does not expect the sick person to go to the doctor, but rather to reach people through primary care in order to make an early diagnosis and avoid the transmission of diseases, it has been decided to carry out research with students of medical sciences to detect respiratory conditions that could be associated with the new coronavirus, and to activate the health system for evaluation".
In Baracoa, the surveys are being conducted by students in their third, fourth and fifth years of the medical school and in their fourth year of the dentistry career.
"We think that this activity, besides its formative character, exemplifies to the people the role that our students assume as future professionals in training and raises the prestige of the sector".
This is what we are trained for: to save lives
"Right now we are in this social work", says Yalena", which is an open taks. For us it's not compulsory, but it does represent a moral commitment because we are medicine students, future doctors, and that's what we are trained for: to save lives, to prevent, to prepare the population".
Deborah agrees with her. "I think it is very important that this type of activity, in direct contact with the population, is present in the training of a future doctor because this way people can have confidence in us, and we, in turn, contribute to collective health by advising them how to act in situations like this".
Richard Llácer Leyva is convinced too. "In our training as future professionals we learn that direct contact between doctor and patient is essential; helping those who need it is part of the principles we are taught.
The Cuban health system is characterized by maintaining control over any epidemiological situation and this, in particular, requires our willingness to help register all possible cases of affected people and thus prevent the spread of the disease".
Concerned about us
Trust, love and respect are feelings that these young people have earned with their attitude. Yanela has experienced it firsthand: "People call us, they tell us: come in. The reception has been very good.
Orfelina explains this with simplicity when I ask her what she thought of the visit to her home.
- It is very good, very good, because this way one knows how to do things, do you understand? We have to wash our hands well and not let anyone get close to kiss us.
Her husband Ricardo points out other reasons:
- We're very happy that a health visit came here. It is very good that you are here to see how we are doing. We feel protected, we know you're worried about us.
Our state is in charge of watching over the health of all the people, had said Virgen Mena Mosqueda, another researcher at El Turey, in an interview with a colleague. What she and her colleagues are doing confirms it. But it would not be possible, right now, without them.