Home.
So today I attended the meeting (see my work blog), reviewed a journal article and then hit the streets. I haven’t done much walking since I got here, and I thought it reasonable to get some exercise, so I figured that I would walk down the Malecon, to Havana Neuvo and the on to Havana Viejo. The Malecon is the seawall that borders the Florida Straight. It is very windy, and usually has waves washing up from the North, splashing over the Malecon and onto the highway. It is a popular spot to stroll, an excellent spot to sit with your girlfriend or w
ife (but not at the same time) and an interesting place to walk, since, if you are not careful, large waves can get you wet as you walk along. First, I headed west, to inspect by daylight the US Interest Section in Cuba (or which we spoke last night). It is impressive- both the building and the amount of time an energy that the the Cuban governement has but into “suppressing” its message. The “Jose Marti with Child” image is also powerful.
high rent district. There, is was the Havana I remembered. Old, overcrowded building in ill repair, with makeshift fixes holding them together. People carrying bags of rice home on their backs. Neighborhoods that needed work. Even in those places, however, there were spots of renovation and hope- a building under reparations, a new paint job. Something that gave you hope.
ing. Things looked pretty prosperous, near the National Theatre and the Capitol (pretty buiding). I turned East, toward Old Havana. A few images:
So on the workblog, you have already heard that this was the day of our talk, which went well, and generated lots of interest from the folks who heard it. Ironically, you may be reading this after I have returned home-turns out that the hotel is out of Wireless Cards and doesn’t know when they will get them in again. So, I will save things to the hard drive and upload them when I return.
checkpoint along the way. I sat on the bus with Valerie and struck up a conversation with a student from Virginia, an enthusiastic African-American woman who was really enjoying her experience so far in this environment. She told us that students really had little access to Havana; some trips, but most of their off campus activities were focused in a small town just west of campus. Their curriculum included a substantial bit of work in the social sciences- history, English, literature, political economy (a concept rarely mentioned in the US) and physical education (mandatory), and focuses on creating doctors with social engagement. That on top of the same s
ciences and skill based learning that we use. No wonder it takes 6 years. The campus is big and new- we were greeted by representative of each “delegation” in costume and flag, and ushered into an auditorium for video and speeches, with singing and dancing and a reception in the hall in which they display the gifts sent by the various family to the school in thanks for the free medical education. The underlying theme of all of their education is that the practice medicine is a social good, and that the practictioner is obliged to bring that “good” back to their roots, to the community from which they came. They claim a very high rate of success in placing doctors in underserved communities, although it is early and it will be interesting to see if the doctors stay “down on the farm” once they have seen the wonders of the city.
Great idea; I wish that we could have dispensed with protocol, and visited some classes and laboratories. In this time and place, however, that is not the way in which it is done.After the tour, I met up with a group of folks in the lobby to got out eating . We ended up in La Torre, a restaurant high atop a tower, French and expensive ($30 for dinner, the most I have paid yet), with spectacular views of the city and fort. Our guide was was Rob Huish, a Canadian, who has been studying the development of ELAM and has visiting Cuba 16 times in the last 7 years, for up to 5 months at a time. He told us the story of the US Interest Section Scroll, blasting FOX news at the people and blocked by 100 flagpoles, arock concert stage and the statue of Jose Marti saving the children in response to Elian, 
and the Miami 5, imprisoned for espionage because they were spying on anti-Castro groups on US soil (the spying was there- but the target was not the US government- is that espionage?), and even the building in which we were eating (built 30 stories high without the benefit of a crane and considered to be an ugly marvel of civil engineering, but formerly occupied by nests of vultures) . Great dinner, great conversation, great views (and a really nice Chilean shiraz).
Yesterday, I woke to the sound of the ocean (my window looks out at the Malecon and the Straits of Florida), and wrote for a long time- hence all of the posts yesterday. Today, we present- I stayed up late honing our talk into a 10 minute work of polished beauty, and then watched a bit of season 3 Buffy before going to sleep (vampire Willow is indeed awesome) Today’s post will be a bit shorter, as we present in 2 hours. But I wanted to get something out there.
implementing the vision of socially accountable medical schools was complex in our capitalist environment, and that we probably would have to move in baby steps in the US to achieve his vision. He also expressed dissatifaction with the COPC model in practice, and discussed his meeting long ago with the Karps (the folks who invented the idea). He has found it difficult to “stick to the method” of analysis that first proposed, and sees a role for the differing expertise of the MD and the MPH skill sets in caring for individuals and populations. Fun lunch. The oral presentations in the afternoon were interesting: I had trouble following the ones in Spanish, and the ones in English largely seemed to be works in progress, interesting work, but no real data presented to support it. Perhaps today will be more data driven (of course, our talk is more descriptive as well, so a least we will fit in well).
Bob and Linda were going to Chinatown for dinner, and, since I couldn’t locate Valerie, that seemed a reasonable thing to do. The idea came from 2 others they had met, Vaugn and Helen, from Miami and Washington, who were presenting some work on teaching Genetics-oriented family history. The ride to Chinatown was long and complicated, and the Chinatown here looks a lot different than what I envisioned- not at all like San Francisco or New York. Narrow streets, few lights, no signage. But the “Lotus Flower” restaurant lived up to its billing, serving Cantonese food with a Cuban flair. We had a nice sangria with dinner, and good conversation about the
upcoming inauguration before piling back the the Cab to go to Moro Castle at night for the 9 PM cannon firing, a tradition that goes back to Colonial times. The cannon called the people into the fort before the closing of the city walls, and also afforded an incredible view of the city at night. Well worth the visit.
We arrived and cleared customs with little fanfare. The drive in showed a fewer billboards and fewer old cars than I remember- I think that some of those cars from the 1950s are finally giving up the ghost despite the tender loving care that they have received over all of these years. Billboards have been replaced by murals- slogans and pictures painted onto the walls, extolling the revolution and all of its works, exhorting the people to work harder and conserve. The buildings on the outside of town are in disrepair; the quality and upkeep increased dramatically as we got closer to the center of the city. Our hotel is gorgeous; the Nacional is an old hotel, with lots of wood and a gorgeous back yard with a view of the Malecon. Not shabby at all. More to follow
So Sunday was arrival day. We got to the hotel at about 10:30 in the morning. I was sort of exhausted when I wrote the above, since I spent the night in Miami airport awaiting the 4 AM wake up call at the airport and hadn’t slept in 24 hours on arrival. My room was not yet available, so I registered for the conference, and sat out on the “backyard”, an enormous greensward with comfy chairs overlooking the ocean. Changed money: they had suggested that we bring Canadian Dollars or Euros as the Cuban government extracts an extra tax on the conversion of US Dollars to Convertible Pesos (the currency of the tourist), which in the Communist tradition, is different than the money of the locals. So, figuring in fees and stuff, 1 CUC is worth about $1.26 at present, the way I did it. Chatted with a couple from North Carolina who had found the secret to online access at 8 CUC / hr via the business office. I resolved to do that daily, and hopefully I will continue to do so. Wrote the above paragraph and then got tired and hungry, The folks from NC had been here doing research for the last 4 days, and they recommended a pizza place in Vedado, so off I went in pursuit of pizza.
Things appeared to be in better repair, to some extant, than they were last time I was here. I have yet to spot a wooden park bench. Coppellia (the ice cream place) still has a huge line of locals waiting in front of it. I am told that foreigners get to cut to the front of the line, which is probably enough “privilege” that I won’t do it. The architecture is still gorgeous, whether in ruin or newly repaired. Many of the homes are still divided into multiple apartments. Laundry still hangs on otherwise classy looking balconies. Old cars have now become the byword of Havana, and it was unusual to see a car with fewer than 6 riders- people here share rides. I haven’t spotted a “camel” bus yet, and the Metrobus fleet has a bunch of relatively modern looking “double” buses. People were out walking on Sunday afternoon. Nancy, an epidemiologist from NEOUCOM with who we shared a ride on the way in, noticed few children on the road on the 
way in; I found them all wandering around down the Malecon, laughing and playing clapping games and flirting (the 13 and 14 y/o kids in particular) and making fun of each other. Cubans seem to be very upbeat folk, at least on a Sunday afternoon when the sun is shining. Many pedicabs- all trying to get me to take a ride to a house somewhere where I could get “comida typica”, a typical Cuban meal. Apparently many Cubans have converted their homes into restaurants, as a way of augmenting income.
that I will write about the opening in the other blog, but there were a lot of people there, and we did have a lovely flute interlude by Nunca Gonzales Nunez, an audio clip of which may embedded here, if I can figure out how to do it. Afterward, we wandered to a Restaurant called El Conejito, which really did had a lot of rabbit on the menu. We ate with two intensivists from Pennsylvania, who were here because a friend from Swaziland invited them to come, (and then couldn’t make it themselves). I had a pork dish with ice cream for dessert , beer and Café Cubano, for about CUC 12 ($15), which was good but not great, and went home happy and sleep. Took lots of pictures today. Not sure how that will go tomorrow.
