When you think of Cuban exports, you probably think, cigars, sugar, and rum. But Cuba exports something of much greater value to third-world countries: doctors. Cuba has trained 23,000 foreign physicians for free at the Latin American School of Medicine near Havana.
In 2001, Cuba opened the school to Americans.
While in Cuba, we met one such American, Samantha Moore of Detroit, in her final year of medical school.
Medical school is no picnic - whether you're in Cuba or the U.S.
The day we met, it was nearly 90 degrees, and Moore had just finished a more than 24-hour shift on her surgery rotation. Yet she appeared cheerful and full of energy.
"There were so many cases last night for surgery alone, so we got swamped," Moore says as she both laughs and sighs. "I was in an operation at 5:00 a.m. this morning. Una appendicites." (Appendicitis in English.)
She takes us on a tour of the main hospital, which seems dated but not that different from U.S. hospitals - except many of the hallways and courtyards are open air. Many other buildings on the sprawling campus are a bit shabby. Some are being reconstructed.
Moore rates her education in Cuba highly. Her textbooks are the same as those in American medical schools. She has a lot of interaction with patients. In her fourth year, her class went door-to-door for several weeks, teaching Havana residents how to protect themselves from dengue and the Zika virus.
She's assisted in many procedures as well.
"I've got to see hip surgeries, knee surgeries.....and I can cast you, I know how to do the casting and everything. It's one of my favorites."
When I look surprised, she says, "It is! I like putting people in casts!" and laughs.
U.S. medical school was out of reach - so the dream was deferred
We sit under the shade of gigantic trees on the campus and I ask Moore to tell me her life story.
Her path to medical school wasn't linear. She got a bachelor's degree in math and computer science at the University of Detroit Mercy, and a masters in computer science at Lawrence Tech. She worked.
"It wasn't that I didn't want to go to medical school," says Moore. "I couldn't afford to go to medical school."
Then, one day, she got a call from her dad, with news. "You can become a doctor if you want to," he said.
Moore's father had read about the Latin American School of Medicine in the Michigan Chronicle. He urged her to apply, and he kept urging her, until she did. "You'll be bilingual," he argued, "and you'll be a doctor. You have nothing to lose and -- it's free!"
With the average medical school debt in the U.S. about $180,000 dollars, free had a good ring to it. She applied, was accepted in the program, and, seven years later, seems to have no regrets.
Not everything in Cuba's health care system is rosy
Moore says the big weakness with Cuba's government-run health care system is financial. There's not enough money to pay doctors, for medicine, for buildings, for tests. That's not surprising, given the Cuban government's limited budget.
And Moore says the U.S. embargo doesn't help. If a hospital in Cuba acquires a U.S.-made MRI or other machine, and it breaks down, it can mean long waits for patients who need tests.
"They eventually find the parts, but it's not something they can fix right away," notes Moore. "Where in the U.S., 'Oh, we need this part, we can special order it, and have it there in the afternoon or the very next day.'"
What's next for Moore
The main goal of the Latin American School of Medicine is training primary care physicians to serve impoverished and underserved people in their home countries.
Moore would like to be a family physician, but says the paperwork and staffing required to run such a practice in the U.S. is daunting; perhaps she'll specialize in internal medicine and work in a clinic or hospital.
"I would like it to do it in Michigan. I really would like to stay in Michigan."
She'll graduate in June. Cuba's top leader Raul Castro is expected to attend the graduation ceremony.
Like all doctors in the U.S., Moore will have to run the gauntlet of passing her exams when she returns to her native country - and then go through the nail-biting process of being matched with a hospital for her residency years.
Meanwhile, medical students from Michigan State University found much to admire and criticize - when they saw Cuba's approach to health care first-hand. We'll have that story later as part of our series, Pure Cuba: Opportunities for Michigan.