cuba health tourism

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Medical Tourism

Cuban medical tourism: proven strategies for attracting patients.

Cuba, an island nation renowned for its rich history, vibrant culture, and picturesque landscapes, is emerging as a new frontier in medical tourism. This article delves into the unique attributes of the Cuban market, highlights the market opportunities, and elucidates strategies for attracting Cuban patients to international healthcare facilities.

Understanding the Cuban Market

Cuba’s healthcare system is among the most developed in Latin America. However, there is a growing demand among Cubans for specialized healthcare services that may not be widely available in Cuba due to economic limitations. Moreover, the diaspora of Cubans living abroad often seek healthcare services in their home country for their relatives.

Understanding the Cuban culture is essential. Cubans value family bonds, community connections, and tend to place a high level of trust in personal recommendations.

Building Trust through Quality and Cultural Sensitivity

It is paramount for healthcare providers to offer quality services that can build trust among Cuban patients. This includes employing culturally sensitive staff, providing patient-centered care, and communicating effectively in Spanish. Engaging with the community through events, partnerships with local organizations, and providing educational content that addresses specific health concerns is also effective.

Global Healthcare Accreditation: A Gateway to Excellence

Healthcare providers who wish to tap into the Cuban market must consider working with Global Healthcare Accreditation (GHA). The GHA helps hospitals and healthcare providers to elevate their services to international standards while ensuring that the cultural aspects and expectations of Cuban patients are met.

Through a Gap Analysis, GHA helps identify areas of improvement that align with the needs and preferences of Cuban patients. GHA’s training and accreditation programs have been employed by top hospitals around the world to ensure that their services not only meet clinical excellence but are also aligned with the patient’s cultural and personal needs.

It is essential for Cuban patients to seek healthcare services from GHA-accredited providers, as these institutions are well-prepared to manage their specific needs. They have undergone rigorous training and accreditation processes to ensure they are culturally competent and capable of delivering excellent patient experiences.

Having an accreditation like GHA also helps in building trust among healthcare consumers. Cuban patients often rely on trust as a deciding factor in choosing an international healthcare provider. This trust can transform patients into living testimonials, who will share their positive experiences with friends and family, further propelling the reputation of the healthcare provider.

Digital Engagement and Tailored Content

Leveraging social media and other digital platforms can help in building connections with the Cuban audience. Creating content that showcases the facility's capabilities, patient testimonials, and culturally sensitive care can be extremely effective.

Collaborating with Medical Tourism Association and Global Healthcare Resources

At the end of the journey, collaboration is key. The Medical Tourism Association is an international organization that can play a crucial role in helping healthcare providers expand their reach. With its vast network and experience in launching initiatives in various regions including Korea, Abu Dhabi, Dubai, Washington DC, Florida, Miami, Las Vegas, Colombia, Costa Rica, and more, the MTA can provide insights and connections that are invaluable.

Moreover, healthcare providers looking to penetrate the Cuban market should consider engaging with Global Healthcare Resources . Global Healthcare Resources specializes in market penetration and has a global network of consumers and buyers. This can be essential for both B2C medical tourist referrals as well as B2B referrals like facilitators, insurance companies, and governments.

Final Thoughts

The Cuban medical tourism market is a realm of potential waiting to be unlocked. Through cultural sensitivity, building trust through quality services, engaging with accreditation bodies like GHA, employing digital platforms, andcollaborating with organizations like the Medical Tourism Association and Global Healthcare Resources, healthcare providers can strategically position themselves to attract and serve Cuban patients effectively.

By integrating these strategies, healthcare providers can not only offer medical excellence but also create a holistic, culturally-resonant experience for Cuban patients. This approach will ensure that the patient journey is not just about medical procedures but encompasses emotional well-being, cultural respect, and ultimately turns Cuban patients into brand ambassadors through word-of-mouth within their tight-knit communities.

In a globalized world, the ability to understand and cater to diverse cultural norms and expectations is not just an added benefit but a necessity. With the right approach, the Cuban market can become a vibrant and sustainable source of growth for international healthcare providers.

Let's remember that the core of medical tourism is care – extending beyond borders to provide healing and comfort to those who seek it. Embracing the heart of the Cuban culture and providing them with the healthcare excellence they seek could create lasting bonds and mutual benefits for all parties involved.

Unveiling the Power of Social Media Marketing in Medical Tourism

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The Medical Tourism Magazine (MTM), known as the “voice” of the medical tourism industry, provides members and key industry experts with the opportunity to share important developments, initiatives, themes, topics and trends that make the medical tourism industry the booming market it is today.

February 2025 Study Medicine in the Republic of Cuba

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History of medical success since 1726

From pioneering yellow fever vaccines to exporting doctors globally, embodying healthcare as a human right.

Best education system in Latin America and the Caribbean

• 96% of Cuban medical students pass the United States Medical Licensing Examination (USMLE) Step 1 on their first attempt.

High-level teaching faculty

The only country on the continent to have a high-level teaching faculty.

Why the University of Medical Sciences of Havana (UCMH)

Medical program’s recognition and accreditation.

• 285 years of medical education experience
• International accreditation by the  International Evaluation and Accreditation Council of the Union of Universities of Latin America and the Caribbean (UDUAL).
• Graduates are eligible to apply to  ECFMG
• Registered in the  World Directory of Medical Schools (World Directory)
• 13 Faculties, 12 medical careers, and extensive list of postgraduate programs
• 82 Polyclinics, 1693 Family Physician’s Office, 28 Maternity Homes, 12 Research Institutes, 51 hospital institutions, 38 pharmacies, 54 Stomatology Clinics and Services, 18 ophthalmology clinics.

University life

• Gain an additional language (Spanish)
• Start your journey by building solid relationships with thousands of international medical students
• Situated in the hear of historical Havana and surrounded by an abundance of nightlife, theaters, restaurants, art galleries.

First-year accommodation

• Fully furnished airconditioned apartments, including international TV channels package
• Wi-Fi services within the compound
• Electrical generators
• Garden snack bar/ BBQ area
• Swimming pools
• Studying areas
• Common laundromat
• Transportation to and from school
• 24/7 security
• Spanish and pre-med tutorial classes (1-2 classes a week. CubaHeal Medical Tourism Inc offers this program

CUBAHEAL’S SERVICES:

Prior to the student’s arrival:.

• Ensuring adequate accommodation. Please visit our  Accommodation facilities page
• Keep constant line of communication with the university’s administration to confirm seat reservation.
• Arranging for airport pickup

Upon the Student’s Arrival:

• Airport pickup
• CubaHeal team.
• local transportation.
• Other aspects relating to and city’s facilities as well as relevant immigration and legal laws that must be adhered to in the Republic of Cuba.
• Establishment of bank
• Issuance of University and government IDs
• Health insurance setup
• Be on standby ready to offer full support for students during medical emergencies
• Stand as a permanent point of reference for the student should a need arises.
• Stand as a permanent point of reference to the student’s relatives overseas should the need arises.

Curriculum organization:  Semester–based except for one-year internship Program Length:  Six years, with the first five made of ten semesters as academic period and one year of rotating internships. Admission requirements:  Approved pre-university level Number of curricular units:  66 Academic degree:   Medical Doctor Accreditation:  Title of Medical Doctor

• The model of the professional or Professional Profile of the decree declared in the curriculum is a general practitioner
• The objective is to graduate general practitioners equipped to practice competently with robust scientific knowledge and provide medical care to pregnant women, adults, adolescents, children, as well as outpatients, families, and hospitalized patients through actions of health prevention, promotion, diagnosis, treatment and rehabilitation in the physical, psychological and social environments. They also perform educational, self-educational, administrative, and research actions alongside environmental health care.
• There are 4 areas of general competencies of the physician: Education, Research Administration, Comprehensive Medical care and Specialty
• The program defines 220 health problems identified and solved according to actions and 224 skills to be developed.
• The program promotes active learning methods, enhances cognitive independence and student protagonist. It offers a superior balance of theory and practice with an emphasis on group activities and activities related to the participation of students in health care processes (education at work). The program does not prioritize theoretical activities in the form of lectures, providing opportunities to students to focus on information research
• The amount of time for independent study and work in the first two years is 4 hours, increasing significantly from the 3 rd  year onwards. On average, self-study hours fluctuate between 15 and 30 hours per week.
• The performance of the day and night shifts from the 3 rd  year onwards with 6 to 8 hours per week as a mandatory minimum in on-call corps, intermediate, and intensive care units including Saturdays and Sundays with a more extended schedule (12 to 24 hours).
• The curriculum establishes extracurricular activities such as Knowledge Meetings, Award Exams, Student Assistantship Movement, Student Scientific Activity, and Special Attention to Student with outstanding academic performance, cultural sports, and recreational activities.
• To graduate, students must pass a National External State Examination, consisting of practice and a theoretical examination that proves the acquisition of the established professional competencies. To take the State Exam, students must have passed through practical and theoretical exams and 5 rotations of the internship.

*Contents of cell, prenatal development and basic tissues. ** Contents of integumentary system and osteomyoarticular system *** Contents of the nervous system **** Contents of endocrine regulation Note: The subject Medical Informatics can be taken in the first or second semester of the first year.

*Contents of blood, hemolymphopoietic system and cardiovascular system. ** Contents of the respiratory, renal and digestive systems. Note: The subject Research Methodology and Statistics can be taken in the first or second semester of this academic year.

Rotating Internship

Study medicine in havana/ cuba, one of the safest, most beautiful cities in the western hemisphere.

Immerse yourself in historical charm and beautiful architecture as you step back in time. Havana was once considered the Queen Jewel of the Colonial empire, and while history has changed, the beauty and charm of this city is still something to behold. The four plazas that make up Old Havana are filled with brilliant architecture built of original but restored stone and seemingly painted by a rainbow. Among these plazas you’ll not only find several unique and fascinating museums, shops, and attractions, but you’ll also be mesmerized by St Christopher’s Cathedral, whose impressive bell towers seem to dominate the area. Located in the Plaza de la Cathedral, this piece of history is rumored to hold remains and relics of Christopher Columbus himself, and is rich in 18th century beauty.

CubaHeal Medical Tourism INC

Customer care services (24h/7), affiliate companies.

• CubaHeal MENA (النسخة العربية)
• CubaHeal Caribbean
• CHMT LA (versión en español)
• EcoCuba PRO (travel agency)

Connect with CubaHeal

© 2007 – 2024 CubaHeal Medical Tourism INC. All rights reserved. by Moustaide

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Health in Cuba

The health system in Cuba is generalized and backed by the most advance techniques, applied by highly qualified staff in an extensive network of hospital institutions of well-known capacity.

Unique proposals to confront diseases like the pigmentary retinopathy or diabetic foot and a complex scheme of vaccination are also among the health options in Cuba. Read More...

Programs and unique procedures lead visitors to a differentiated and responsible treatment that is offered though clinics, optics, drugstores and medical institutions distributed from east to west in Cuba.

The possibility of academic exchanges and the enjoyment of the natural wealth in order to improve the quality of physical and mental life are also other options that boost health tourism in Cuba.

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COVID-19: travel health notice for all travellers

Cuba travel advice

Latest updates: Health –Travel health notice for dengue added.

Last updated: August 26, 2024 11:39 ET

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Safety and security, entry and exit requirements, laws and culture, natural disasters and climate, cuba - exercise a high degree of caution.

Exercise a high degree of caution in Cuba due to shortages of basic necessities including food, medicine and fuel.

Resort areas - Take normal security precautions

• Cayo Largo del Sur
• Cayo Santa Maria
• Guardalavaca

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Petty crime

Petty crime, such as pickpocketing and purse snatching, occurs.

Theft generally occurs in crowded places such as:

• tourist areas
• public buses
• night clubs

It can also occur in isolated areas.

Theft from hotel rooms, particularly in private accommodations ( casas particulares ), and from cars is common.

• Ensure that your personal belongings, including your passport and other travel documents, are secure at all times
• Don’t pack valuables in your checked luggage
• Avoid showing signs of affluence
• Keep electronic devices out of sight
• Carry valid identification at all times
• Keep a digital and a hard copy of your ID and travel documents
• Avoid carrying large amounts of cash
• Never leave belongings unattended in a vehicle, even in the trunk

Violent crime

Incidents of violent crime are not frequent, but assaults may occur. They mainly occur during a burglary or robbery.

• Stay in accommodations with good security
• Keep your windows and doors locked at all times
• If threatened by robbers, don't resist

Credit card and ATM fraud may occur.

Be cautious when using debit or credit cards:

• pay careful attention when your cards are being handled by others
• use ATMs located in well-lit public areas or inside a bank or business
• avoid using card readers with an irregular or unusual feature
• cover the keypad with one hand when entering your PIN
• check for any unauthorized transactions on your account statements

Some businesses may try to charge exorbitant prices, namely taxis and classic car rentals. Disputes about overcharging may lead to violence.

• Always confirm prices before consuming or taking up a service
• Avoid running a tab
• Avoid leaving your credit card with bar or restaurant staff
• Check your bill to make sure it’s exact

Some hustlers specialize in defrauding tourists. Most of them speak some English or French and go out of their way to appear friendly. They may offer to serve as tour guides or to facilitate the purchase of cigars. Some have used violence in their efforts to steal tourists.

Fraudulent tour agents and taxi drivers also operate throughout the country, including at Havana’s international airport. Thefts of luggage from taxi trunks have occurred.

In bars, sex workers, including minors, may be very persistent and intrusive with tourists who refuse their advances. Foreigners, including Canadians, have been the victim of theft after engaging in sexual relations, and some of them have faced child sex accusations.  

• Use reputable tour operators and registered taxis only
• Avoid independent street vendors
• Be wary of strangers who seem too friendly

Overseas fraud

Cuba faces chronic and severe shortages of ‎basic necessities, including:

• bottled water
• public water supply
• hard-currency

Fuel shortages are currently critical and affect a wide range of services. Travelling across the island is extremely challenging. Public transportation services, including taxis, are often disrupted, leaving tourists with few options to travel. Some travellers have been temporarily stranded with a rental car. Intermittent shortages of tap water provided by municipalities happen, including in Havana and in resorts.

Hotels and resorts, that often use generators during power outages, may not be able to maintain their services. Fuel shortages may also affect government services.

Local authorities enforce the rationing of food and medications, which could also affect travellers.

Shortages may lead to disruptions to other essential services. There are often long line-ups at gas stations that have led to altercations.

• Plan accordingly
• Bring some basic necessities with you such as toiletries and medication
• Keep a supply of water, food and fuel on hand
• Make sure you always have access to a complete emergency kit

Power outages

Power outages occur regularly outside of Havana and touristic areas.

Obtaining services during an outage is challenging.

Women’s safety

Women travelling alone may be subject to some forms of sexual harassment

Incidents of sexual assault against Canadian women have occurred, including at beach resorts.

If you’re the victim of a sexual assault, you should report it immediately to the nearest Canadian consulate or embassy and seek medical assistance. You should also report the incident to Cuban authorities and ensure that local police provide you with a Comprobante de Denuncia. This document confirms that a report has been filed.

A criminal investigation will likely not be possible if no formal complaint is made to Cuban authorities before you depart the country.

Police officers may speak only Spanish.

Advice for women travellers

Spiked food and drinks

Snacks, beverages, gum and cigarettes may contain drugs that could put you at risk of sexual assault and robbery.

• Be wary of accepting these items from new acquaintances
• Never leave food or drinks unattended or in the care of strangers

Telecommunications

The telecommunications network in Cuba is poor. Connections are unreliable and may be intermittent.

Some Canadian cell phones may not work, even in large cities. Internet access is limited across the island.

Local authorities control telecommunications. They may block access to mobile phone and Internet in case of civil unrest or before demonstrations.

• Don’t rely on your mobile phone for emergencies, especially outside major cities
• Subscribe to and install a VPN service before leaving Canada
• Avoid travelling alone
• Inform a family member or friend of your itinerary

Online transactions

Online banking or shopping may be challenging in Cuba, if at all possible. Most Cuban websites are unsecure. Many are inaccessible.

Some travellers, who bought their travel package online on a travel website in Canada, found out on arrival in Cuba that their hotel received no reservation or payment.

• Avoid online shopping
• Check with the hotel if they accept online reservations and payments if you plan to book online

Demonstrations

Demonstrations sometimes occur, even if taking part in them may be illegal. Local authorities will break up political demonstrations or gatherings not sanctioned by the government. They may also block access to the Internet, including social media, without notice.

Even peaceful demonstrations can turn violent at any time. They can also lead to disruptions to traffic, public transportation.

• Don’t participate in demonstrations
• Avoid areas where demonstrations and large gatherings are taking place
• Follow the instructions of local authorities
• Monitor local media for information on ongoing demonstrations

Mass gatherings (large-scale events)

Water activities

Rescue services may not be consistent with international standards. Tidal changes can cause powerful currents, and riptides are common. Not all beaches have lifeguards or warning flags to warn of hazardous conditions.

• Never swim alone or after hours
• Don’t swim outside marked areas
• Monitor weather warnings
• Avoid visiting beaches or coastal areas during periods of severe weather warnings
• Don’t dive into unknown water, as hidden rocks or shallow depths can cause serious injury or death
• Consult residents and tour operators for information on possible hazards and safe swimming areas

Tour operators and diving centres may not adhere to international standards.

If you undertake adventure sports, such as diving:

• choose a reputable company that has insurance
• ensure that your travel insurance covers the recreational activities you choose
• don’t use the equipment if you have any doubts about its safety

Recreational boating

If you are planning to go boating:

• know the navigation rules
• make sure life jackets are available for all passengers
• follow safe practices for all water activities such as jet-skiing, water-skiing or fishing
• don’t overload your boat capacity
• carry a VHF marine radio that will generate your position in case of emergency
• be prepared for emergencies

Water safety abroad

Road safety

Road safety standards are poor throughout the country. Accidents causing fatalities are common.

Road conditions

Road conditions are poor throughout the island, with the exception of the Central Highway, which runs west to east across the country. Driving may be dangerous due to:

• poorly maintained roads
• lack of signage
• Inadequate lighting
• roaming livestock
• horse-drawn carts
• pedestrians
• slow-moving traffic

Most Cuban cars are old and in poor condition. They often lack standard safety equipment. Some cars and most bicycles don’t have functioning lights.

Driving habits

Some drivers don’t respect traffic laws. Many of them, driving an electric vehicle for which licence and registration are not required, are inexperienced and unqualified. Drinking and driving is also common.  

If you choose to drive in Cuba:

• do so defensively at all times
• avoid travelling at night
• travel in groups when possible
• never pick up hitchhikers, who have been known to assault drivers

Public transportation

City buses are scarce, overcrowded and poorly maintained. Bus service is not reliable.

Incidents of pickpocketing are frequent.

Tour companies offer good bus service between airports and the all-inclusive resorts. Buses used for organized day trips from hotels are usually in good condition.

Official taxis are generally reliable.

Old-model private vehicles offered as taxis are not equipped with standard safety features. They have no insurance coverage for passengers in case of an accident.

• Use only registered taxis
• Avoid flagging a taxi down on the street
• Never share a taxi with strangers
• Agree on a fare before departure, as taxis are not equipped with meters

The rail network is comprehensive, connecting most of the island, but it’s unreliable and slow. Train service is limited to Cuban nationals only.

Health incidents

The Government of Canada continues to investigate the potential causes of unexplained health incidents reported by some Canadian diplomatic staff and dependents posted to Havana.

There is no evidence that Canadian travellers to Cuba are at risk.

We do not make assessments on the compliance of foreign domestic airlines with international safety standards.

Information about foreign domestic airlines

Every country or territory decides who can enter or exit through its borders. The Government of Canada cannot intervene on your behalf if you do not meet your destination’s entry or exit requirements.

We have obtained the information on this page from the Cuban authorities. It can, however, change at any time.

Verify this information with the  Foreign Representatives in Canada .

Entry requirements vary depending on the type of passport you use for travel.

Before you travel, check with your transportation company about passport requirements. Its rules on passport validity may be more stringent than the country’s entry rules.

Regular Canadian passport

Your passport must be valid for the expected duration of your stay in Cuba.

Passport for official travel

Different entry rules may apply.

Official travel

Passport with “X” gender identifier

While the Government of Canada issues passports with an “X” gender identifier, it cannot guarantee your entry or transit through other countries. You might face entry restrictions in countries that do not recognize the “X” gender identifier. Before you leave, check with the closest foreign representative for your destination.

Other travel documents

Different entry rules may apply when travelling with a temporary passport or an emergency travel document. Before you leave, check with the closest foreign representative for your destination.

Useful links

• Foreign Representatives in Canada
• Canadian passports

Tourist visa: required Family visa: required Business visa: required

Tourist card

Canadian tourists travelling to Cuba need a visa, known as tourist card. The tourist card allows you to stay in Cuba for up to 90 days. The tourist card is generally included in holiday packages provided by tour operators or airlines providing direct flights from Canada. If you go to Cuba on your own or transit via another country, you are responsible for obtaining the tourist card from a Cuban government office in Canada. You may also buy it at some airports in Canada and in the United States.

Length of stay

As a Canadian tourist, you may stay in Cuba for up to 6 months.

However, you must obtain an extension of stay if you intend to stay longer than the initial 90-day period allowed by the standard tourist card.

D’Viajeros traveller information portal  – Government of Cuba

Arrival form

You must provide information on your arrival in Cuba via an online form within 72 hours before entering the country.

Once done, you will receive a QR code by email.

You must show an electronic or printed version of the QR code to authorities upon arrival.

Health insurance

You must show proof of valid health insurance to enter Cuba.

All health insurance policies are recognized in Cuba, except those issued by U.S. insurance companies. However, the Cuban immigration authorities will decide which proof of health insurance is acceptable.

Proof of health insurance may be:

• an insurance policy
• an insurance certificate
• a Canadian provincial health insurance card

If you don’t have proof of health insurance or if the proof you present doesn’t satisfy the Cuban immigration authorities, you may have to obtain health insurance from a Cuban insurance company upon arrival. This insurance may have limited coverage. Local authorities may refuse your entry to the country.

Canadian provincial health care coverage provides very limited coverage outside Canada. It won’t pay for medical bills up-front. It does not include air evacuation, and neither does Cuban health insurance.

Cuban authorities won’t let you leave the country with outstanding medical bills, which are payable by credit card only. You will need to remain in Cuba until all debts are paid.

• Make sure you purchase the best health insurance you can afford
• Ensure the insurance includes medical evacuation and hospital stays

More on Travel insurance

Other entry requirements

Customs officials will ask you to show them:

• a return or onward ticket
• proof of sufficient funds to cover your stay
• proof that you have a place to stay if arriving with “air only” tickets

Dual citizenship

If you’re both a Canadian and Cuban citizen, you must:

• present your valid Cuban passport to the immigration authorities to enter Cuba
• have a valid Canadian passport to return to Canada

If you were born in Cuba, you should contact a Cuban government office in Canada before you leave to ensure compliance with Cuban regulations, regardless of your current citizenship. Failure to do so may result in your being refused entry into Cuba or being detained upon entry.

Canadian permanent residents

You will not be able to leave Cuba if you are a Canadian permanent resident and are without a valid permanent resident card. If your card is lost or stolen, you must contact the Canadian Embassy in Havana to obtain a travel document that will allow you to leave the country. This procedure can take up to 10 working days. Once the document is ready, you'll need to make an appointment with the immigration section of the Canadian Embassy in Havana to collect it before returning to Canada.

Permanent resident travel document: How to apply

Health screening

You may be subjected to a medical screening or interrogation by public health authorities when you enter or exit Cuba, or when reporting for domestic flights.

You may be subject to a mandatory quarantine for medical observation for up to 7 days if local authorities believe that:

• you have come in contact with a suspected carrier of one of these viruses
• you’re arriving from a country with a known epidemic
• Children and travel

Travelling with children

Yellow fever

Learn about potential entry requirements related to yellow fever (vaccines section).

Relevant Travel Health Notices

• Global Measles Notice - 13 March, 2024
• Zika virus: Advice for travellers - 31 August, 2023
• COVID-19 and International Travel - 13 March, 2024
• Oropouche fever in the Americas - 9 August, 2024
• Dengue: Advice for travellers - 26 August, 2024

This section contains information on possible health risks and restrictions regularly found or ongoing in the destination. Follow this advice to lower your risk of becoming ill while travelling. Not all risks are listed below.

Consult a health care professional or visit a travel health clinic preferably 6 weeks before you travel to get personalized health advice and recommendations.

Routine vaccines

Be sure that your  routine vaccinations , as per your province or territory , are up-to-date before travelling, regardless of your destination.

Some of these vaccinations include measles-mumps-rubella (MMR), diphtheria, tetanus, pertussis, polio, varicella (chickenpox), influenza and others.

Pre-travel vaccines and medications

You may be at risk for preventable diseases while travelling in this destination. Talk to a travel health professional about which medications or vaccines may be right for you, based on your destination and itinerary. 

Yellow fever   is a disease caused by a flavivirus from the bite of an infected mosquito.

Travellers get vaccinated either because it is required to enter a country or because it is recommended for their protection.

• There is no risk of yellow fever in this country.

Country Entry Requirement*

• Proof of vaccination is required if you are coming from or have transited through an airport of a country   where yellow fever occurs.

Recommendation

• Vaccination is not recommended.
• Discuss travel plans, activities, and destinations with a health care professional.
• Contact a designated  Yellow Fever Vaccination Centre  well in advance of your trip to arrange for vaccination.

About Yellow Fever

Yellow Fever Vaccination Centres in Canada * It is important to note that  country entry requirements  may not reflect your risk of yellow fever at your destination. It is recommended that you contact the nearest  diplomatic or consular office  of the destination(s) you will be visiting to verify any additional entry requirements.

There is a risk of hepatitis A in this destination. It is a disease of the liver. People can get hepatitis A if they ingest contaminated food or water, eat foods prepared by an infectious person, or if they have close physical contact (such as oral-anal sex) with an infectious person, although casual contact among people does not spread the virus.

Practise  safe food and water precautions and wash your hands often. Vaccination is recommended for all travellers to areas where hepatitis A is present.

 The best way to protect yourself from seasonal influenza (flu) is to get vaccinated every year. Get the flu shot at least 2 weeks before travelling.  

 The flu occurs worldwide. 

•  In the Northern Hemisphere, the flu season usually runs from November to   April.
•  In the Southern Hemisphere, the flu season usually runs between April and   October.
•  In the tropics, there is flu activity year round. 

The flu vaccine available in one hemisphere may only offer partial protection against the flu in the other hemisphere.

The flu virus spreads from person to person when they cough or sneeze or by touching objects and surfaces that have been contaminated with the virus. Clean your hands often and wear a mask if you have a fever or respiratory symptoms.

In this destination, rabies is carried by dogs and some wildlife, including bats. Rabies is a deadly disease that spreads to humans primarily through bites or scratches from an infected animal. While travelling, take precautions , including keeping your distance from animals (including free-roaming dogs), and closely supervising children.

If you are bitten or scratched by an animal while travelling, immediately wash the wound with soap and clean water and see a health care professional. Rabies treatment is often available in this destination. 

Before travel, discuss rabies vaccination with a health care professional. It may be recommended for travellers who are at high risk of exposure (e.g., occupational risk such as veterinarians and wildlife workers, children, adventure travellers and spelunkers, and others in close contact with animals). 

Measles is a highly contagious viral disease. It can spread quickly from person to person by direct contact and through droplets in the air.

Anyone who is not protected against measles is at risk of being infected with it when travelling internationally.

Regardless of where you are going, talk to a health care professional before travelling to make sure you are fully protected against measles.

  Hepatitis B is a risk in every destination. It is a viral liver disease that is easily transmitted from one person to another through exposure to blood and body fluids containing the hepatitis B virus.  Travellers who may be exposed to blood or other bodily fluids (e.g., through sexual contact, medical treatment, sharing needles, tattooing, acupuncture or occupational exposure) are at higher risk of getting hepatitis B.

Hepatitis B vaccination is recommended for all travellers. Prevent hepatitis B infection by practicing safe sex, only using new and sterile drug equipment, and only getting tattoos and piercings in settings that follow public health regulations and standards.

Coronavirus disease (COVID-19) is an infectious viral disease. It can spread from person to person by direct contact and through droplets in the air.

It is recommended that all eligible travellers complete a COVID-19 vaccine series along with any additional recommended doses in Canada before travelling. Evidence shows that vaccines are very effective at preventing severe illness, hospitalization and death from COVID-19. While vaccination provides better protection against serious illness, you may still be at risk of infection from the virus that causes COVID-19. Anyone who has not completed a vaccine series is at increased risk of being infected with the virus that causes COVID-19 and is at greater risk for severe disease when travelling internationally.

Before travelling, verify your destination’s COVID-19 vaccination entry/exit requirements. Regardless of where you are going, talk to a health care professional before travelling to make sure you are adequately protected against COVID-19.

Safe food and water precautions

Many illnesses can be caused by eating food or drinking beverages contaminated by bacteria, parasites, toxins, or viruses, or by swimming or bathing in contaminated water.

• Learn more about food and water precautions to take to avoid getting sick by visiting our eat and drink safely abroad page. Remember: Boil it, cook it, peel it, or leave it!
• Avoid getting water into your eyes, mouth or nose when swimming or participating in activities in freshwater (streams, canals, lakes), particularly after flooding or heavy rain. Water may look clean but could still be polluted or contaminated.
• Avoid inhaling or swallowing water while bathing, showering, or swimming in pools or hot tubs. 

Travellers' diarrhea is the most common illness affecting travellers. It is spread from eating or drinking contaminated food or water.

Risk of developing travellers' diarrhea increases when travelling in regions with poor standards of hygiene and sanitation. Practise safe food and water precautions.

The most important treatment for travellers' diarrhea is rehydration (drinking lots of fluids). Carry oral rehydration salts when travelling.

Typhoid   is a bacterial infection spread by contaminated food or water. Risk is higher among children, travellers going to rural areas, travellers visiting friends and relatives or those travelling for a long period of time.

Travellers visiting regions with a risk of typhoid, especially those exposed to places with poor sanitation, should speak to a health care professional about vaccination.  

Salmonellosis is a common illness among travellers to this country. It can be spread through contaminated food or beverages, such as raw or undercooked poultry and eggs, as well as fruits or vegetables.

Practice safe food and water precautions . This includes only eating food that is properly cooked and still hot when served.

Pregnant women, children under 5 years of age, those over 60 years of age, and those with weakened immune systems are at greater risk of becoming seriously ill.

Most people recover on their own without medical treatment and from proper rehydration (drinking lots of fluids).

• Carry oral rehydration salts when travelling.

Travellers with severe symptoms should consult a health care professional as soon as possible.

Insect bite prevention

Many diseases are spread by the bites of infected insects such as mosquitoes, ticks, fleas or flies. When travelling to areas where infected insects may be present:

• Use insect repellent (bug spray) on exposed skin
• Cover up with light-coloured, loose clothes made of tightly woven materials such as nylon or polyester
• Minimize exposure to insects
• Use mosquito netting when sleeping outdoors or in buildings that are not fully enclosed

To learn more about how you can reduce your risk of infection and disease caused by bites, both at home and abroad, visit our insect bite prevention page.

Find out what types of insects are present where you’re travelling, when they’re most active, and the symptoms of the diseases they spread.

There is a risk of chikungunya in this country. The level of risk may vary by:

The virus that causes chikungunya is spread through the bite of an infected mosquito. It can cause fever and pain in the joints. In some cases, the joint pain can be severe and last for months or years.

Protect yourself from mosquito bites at all times.

Learn more:

Insect bite and pest prevention Chikungunya

• In this country,   dengue  is a risk to travellers. It is a viral disease spread to humans by mosquito bites.
• Dengue can cause flu-like symptoms. In some cases, it can lead to severe dengue, which can be fatal.
• The level of risk of dengue changes seasonally, and varies from year to year. The level of risk also varies between regions in a country and can depend on the elevation in the region.
• Mosquitoes carrying dengue typically bite during the daytime, particularly around sunrise and sunset.
• Protect yourself from mosquito bites . There is no vaccine or medication that protects against dengue.

Zika virus is a risk in this country. 

Zika virus is primarily spread through the bite of an infected mosquito. It can also be sexually transmitted. Zika virus can cause serious birth defects.

During your trip:

• Prevent mosquito bites at all times.
• Use condoms correctly or avoid sexual contact, particularly if you are pregnant.

If you are pregnant or planning a pregnancy, you should discuss the potential risks of travelling to this destination with your health care provider. You may choose to avoid or postpone travel. 

For more information, see Zika virus: Pregnant or planning a pregnancy.

Animal precautions

Some infections, such as rabies and influenza, can be shared between humans and animals. Certain types of activities may increase your chance of contact with animals, such as travelling in rural or forested areas, camping, hiking, and visiting wet markets (places where live animals are slaughtered and sold) or caves.

Travellers are cautioned to avoid contact with animals, including dogs, livestock (pigs, cows), monkeys, snakes, rodents, birds, and bats, and to avoid eating undercooked wild game.

Closely supervise children, as they are more likely to come in contact with animals.

Person-to-person infections

Stay home if you’re sick and practise proper cough and sneeze etiquette , which includes coughing or sneezing into a tissue or the bend of your arm, not your hand. Reduce your risk of colds, the flu and other illnesses by:

•   washing your hands often
• avoiding or limiting the amount of time spent in closed spaces, crowded places, or at large-scale events (concerts, sporting events, rallies)
• avoiding close physical contact with people who may be showing symptoms of illness 

Sexually transmitted infections (STIs) , HIV , and mpox are spread through blood and bodily fluids; use condoms, practise safe sex, and limit your number of sexual partners. Check with your local public health authority pre-travel to determine your eligibility for mpox vaccine.  

Medical services and facilities

Good health care is limited in availability.

The health system is government-owned. The Cuban government operates hospitals and clinics throughout the island.

Medical professionals are generally adequately trained. However, facilities are in poor condition. They lack basic drugs, medical supplies and equipment. Hygiene practices may be inadequate.

Medical services are also available at most hotels and international clinics located in resort areas, where doctors and nurses provide initial emergency medical care reserved for foreigners. Health care provided in those clinics is usually better than services offered in public facilities.

Mental health care facilities are extremely limited. There are no hotlines available for this type of care in the country.

Emergency and ambulance services are limited. Response times may be slow, especially outside tourist areas.

Make sure you get travel insurance that includes coverage for medical evacuation and hospital stays.

Health and safety outside Canada

 Many prescription medications may not be available in Cuba.

If you take prescription medication, you’re responsible for determining their legality in the country.

• Bring enough of your medication with you
• Always keep your medication in the original container
• Pack your medication in your carry-on luggage
• Carry a paper and an electronic copy of your prescriptions

Cuba faces severe medicine shortages, including antibiotics and common pain killers. In addition of your prescription medication, you should also bring your own basic medicine in sufficient quantities to last beyond the length of your intended stay.

Public health authorities implement insect control measures including periodic fumigation and aerial spraying.

• Consult your doctor before traveling to see if the situation could affect you, especially if you suffer from respiratory ailments
• Stay away from a nearby fumigation process

Death abroad

Standards of mortuary services in Cuba differ from those in Canada. Cultural and religious beliefs are not taken into consideration. Autopsies are mandatory.

There is one funeral home and one morgue in the country which cater to foreigners. Both are located in Havana. Only these facilities have the authorization to issue appropriate documentation to accompany human remains. Timelines for the repatriation of human remains are long and costly.

The capacity for refrigeration is limited, as well as the availability of coffins and urns. Embalming materials and techniques are unlike those in Canada. Embalming may not be an option in some circumstances.

Ensure your insurance includes coverage for the repatriation of human remains.

Death Abroad Factsheet

Keep in Mind...

The decision to travel is the sole responsibility of the traveller. The traveller is also responsible for his or her own personal safety.

Be prepared. Do not expect medical services to be the same as in Canada. Pack a   travel health kit , especially if you will be travelling away from major city centres.

You must abide by local laws.

Learn about what you should do and how we can help if you are arrested or detained abroad .

Transfer to a Canadian prison

Canada and Cuba accede the Treaty between the Government of Canada and the Government of the Republic of Cuba on the Serving of Penal Sentences. This enables a Canadian imprisoned in Cuba to request a transfer to a Canadian prison to complete a sentence. The transfer requires the agreement of both Canadian and Cuban authorities. This process can take a long time, and there is no guarantee that the transfer will be approved by either or both sides.

Cuban criminal justice

The criminal justice system in Cuba differs significantly from that in Canada. Charges are not laid until the investigation is complete. If you’re arrested in Cuba, you will likely be detained during the entire period of investigation. You should expect long delays to resolve your case. You will not be allowed to leave the country during this period.

Cuba’s constitution allows the death penalty, but since 2003, the country has effectively had a moratorium on carrying out death sentences.

Investments

Private property rights in Cuba are strictly controlled. Only Cubans and permanent residents can buy a property in Cuba or register a privately owned vehicle. Be wary of strangers or acquaintances offering to purchase these items on your behalf. If you plan on making investments in Cuba, seek legal advice in Canada and Cuba. Do so before making commitments. Related disputes could take time and be costly to resolve.

Penalties for possession, use or trafficking of illegal drugs are severe. Convicted offenders can expect lengthy prison sentences.

• Pack your own luggage and monitor it closely at all times
• Don’t transport other people’s packages, bags or suitcases

Drugs, alcohol and travel

Child sex tourism

It's a serious criminal offence to have sex with minors in Cuba.

Local authorities are actively working to prevent child sex tourism. Tourists, including Canadians, have been convicted of offences related to the corruption of minors aged 16 and under.

Prison sentences for this type of crime range from 7 to 25 years. Release on bail before trial is unlikely.

Child Sex Tourism: It’s a Crime

 To get married in Cuba, you must provide several documents including:

• your birth certificate
• a copy of your passport
• your decree absolute certificate if divorced
• a death certificate for your spouse and a marriage certificate if widowed
• an affidavit of your single status if you have never been married before

All documents must be translated into Spanish, certified, authenticated and legalised by the Embassy of Cuba in Canada.

 Consult the Embassy of Cuba in Canada if you wish to marry in Cuba, including to a Cuban national.

• Foreign diplomatic missions and consulates in Canada
• Marriage overseas factsheet

Drones are prohibited.

They will be confiscated by the authorities upon entry.

Photography

Professional photographers require a visa to work in Cuba. They may also need a permit to import their equipment.

It’s forbidden to photograph, including with drones:

• military and police installations or personnel
• harbour, rail and airport facilities

Military zones and any other restricted or heavily guarded areas are not always identified.

Identification

Authorities may request to see your ID at any time.

• Keep a photocopy of your passport in case it’s lost or seized
• Keep a digital copy of your ID and travel documents

Dual citizenship is not legally recognized in Cuba.

If local authorities consider you a citizen of Cuba, they may refuse to grant you access to Canadian consular services. This will prevent us from providing you with those services.

Dual citizens

International Child Abduction

The Hague Convention on the Civil Aspects of International Child Abduction is an international treaty. It can help parents with the return of children who have been removed to or retained in certain countries in violation of custody rights. It does not apply between Canada and Cuba.

If your child was wrongfully taken to, or is being held in Cuba by an abducting parent:

• act as quickly as you can
• consult a lawyer in Canada and in Cuba to explore all the legal options for the return of your child
• report the situation to the nearest Canadian government office abroad or to the Vulnerable Children's Consular Unit at Global Affairs Canada by calling the Emergency Watch and Response Centre

If your child was removed from a country other than Canada, consult a lawyer to determine if The Hague Convention applies.

Be aware that Canadian consular officials cannot interfere in private legal matters or in another country's judicial affairs.

• International Child Abductions: A guide for affected parents
• Canadian embassies and consulates by destination
• Request emergency assistance

Imports and exports

Personal effects and medicine.

Tourists are allowed to enter Cuba with personal effects but items entering the country for donations may be subject to import rules. They could be seized and taxed in accordance with local legislation. This includes:

• new or used material goods
• personal care products
• medications

Cuban customs officials have the authority to decide what they deem to be for the tourist's personal use. They may apply steep tariffs for personal baggage exceeding the allowable weight.

You may export:

• up to 20 cigars without documentation
•  up to 50 cigars if they are in their original container, closed and sealed with the official hologram

If exceeding these amounts, you must provide a guarantee of origin certificate.

Failure to comply with this regulation will lead to the seizure of the cigars without compensation.

Art objects

Art objects, including artifacts and paintings purchased in Cuba, must be accompanied by an export permit. It’s usually provided by state-owned galleries.

In the absence of such a permit, items must be registered with the Registro Nacional de Bienes Culturales.

Ministry of Culture – Government of Cuba

Electronic devices

Electronic devices with GPS technology may be confiscated upon entry and returned upon departure.

Satellite telephones are forbidden.

Electronic cigarettes and personal vaporizers

You cannot bring electronic cigarettes or personal vaporizers to Cuba.

Customs officials will seize these items upon arrival.

Black market

Street vendors may offer you black-market goods, such as cigars, or ask to change dollars for Cuban currency.

Engaging in black-market transactions is illegal and can lead to difficulties with the Cuban authorities.

Cuban Customs Administration  – Government of Cuba

Boat traffic

The U.S. government closely monitors boat traffic in the Straits of Florida. It will seize any vessel not bearing a licence from the Office of Foreign Assets Control (OFAC) if it believes it’s headed for Cuba.

You’re subject to these measures if you dock your Canadian-registered boat in Florida. You’ll be exempted if you are simply en route to Cuba via the U.S.

If travelling by boat to Cuba from the US:

• Make sure to know the regulation related to docking and port controls
• Expect thorough search and interrogations

You should carry an international driving permit.

International Driving Permit

Traffic accidents

Traffic accidents have led to arrest and detentions of Canadians in the past.

Accidents resulting in death or injury are treated as crimes. The onus is on the driver to prove innocence. If you’re found to bear responsibility in a traffic accident resulting in serious injury or death, you may face up to 10 years in prison.

If you’re involved in an accident:

• don’t leave the scene
• don’t move your vehicle
• call the police

While car insurance is mandatory for foreign drivers and foreign-registered vehicles, it's not for Cuban citizens. As a result, most local drivers don't carry a car insurance. You shouldn’t expect compensation for vehicle damage or personal injury from a Cuban driver following a car accident.

Vehicle rentals

Car insurance coverage in Cuba differs from that in Canada.

Rental agencies are government-controlled. If you’re found to be at fault in an accident, the rental agency will nullify your coverage and seek compensation to cover the cost of repairs.

Cuban authorities can prohibit you from leaving the country unless the rental agency receives payment or until all claims associated with an accident are settled.

Contract agreements don’t cover occasional drivers. As a result, the signatory is responsible for all people driving the vehicle.

• Be cautious if you rent a vehicle in Cuba
• Avoid renting a scooter; thieves target them and you may be responsible for the cost of its replacement
• Make sure to obtain a receipt when returning a rental vehicle

The currency of Cuba is the Cuban peso (CUP).

Credit cards issued by U.S. financial institutions or affiliated with U.S. banks are not accepted in Cuba.

Canadian credit cards are increasingly accepted at restaurants and hotels. However, the system is unreliable and bank cards may not work or may stop working without notice.

ATMs are rare and also unreliable. Each withdrawal is limited to 5 000 CUP, when possible.

You may obtain credit card cash advances at banks, hotels or a state-run exchange bureau, but in CUP only.

When travelling to Cuba, you should plan to bring enough currency to cover the duration of your stay. You should also plan for small bank notes to facilitate daily transactions such as, street food, taxis and tips.  

You can easily exchange Canadian and American dollars, as well as euros for CUP at:

• the money exchange bureaus in Cuba’s international airports
• major hotels
• official exchange bureaus

It’s illegal to change money on the street or anywhere else other than authorized entities.

You cannot go through Cuban customs with more than 5 000 CUP.

Hurricane season

Hurricanes usually occur from mid-May to the end of November. During this period, even small tropical storms can quickly develop into major hurricanes.

These severe storms can put you at risk and hamper the provision of essential services. You could face serious safety risks during a hurricane.

If you decide to travel to a coastal area during the hurricane season:

• be prepared to change your travel plans on short notice, including cutting short or cancelling your trip
• stay informed of the latest regional weather forecasts
• carry emergency contact information for your airline or tour operator
• follow the advice and instructions of local authorities
• Severe storms outside Canada
• Large-scale emergencies outside Canada
• Active storm tracking and hurricane watches and warnings – U.S. National Hurricane Center

Rainy season

The rainy season extends from April to October.

Seasonal flooding can hamper overland travel and reduce the delivery of essential services. Roads may become impassable due to mudslides and landslides. Bridges, buildings, and infrastructure may be damaged.

Earthquakes

Cuba is located in an active seismic zone.

Earthquakes may occur. Even minor earthquakes can cause significant damage.

In the event of an earthquake:

• monitor local media to stay informed of the evolving situation
• follow the instructions of local authorities, including evacuation orders
• Earthquakes – What to Do?
• Latest earthquakes  - U.S. Geological Survey

Local services

In case of emergency, dial:

• police: 106
• medical assistance: 104
• firefighters: 105

Consular assistance

Guardalavaca, Varadero

For emergency consular assistance, call the Embassy of Canada to Cuba, in Havana, and follow the instructions. At any time, you may also contact the Emergency Watch and Response Centre in Ottawa.

The decision to travel is your choice and you are responsible for your personal safety abroad. We take the safety and security of Canadians abroad very seriously and provide credible and timely information in our Travel Advice to enable you to make well-informed decisions regarding your travel abroad.

The content on this page is provided for information only. While we make every effort to give you correct information, it is provided on an "as is" basis without warranty of any kind, expressed or implied. The Government of Canada does not assume responsibility and will not be liable for any damages in connection to the information provided.

If you need consular assistance while abroad, we will make every effort to help you. However, there may be constraints that will limit the ability of the Government of Canada to provide services.

Learn more about consular services .

Risk Levels

  take normal security precautions.

Take similar precautions to those you would take in Canada.

  Exercise a high degree of caution

There are certain safety and security concerns or the situation could change quickly. Be very cautious at all times, monitor local media and follow the instructions of local authorities.

IMPORTANT: The two levels below are official Government of Canada Travel Advisories and are issued when the safety and security of Canadians travelling or living in the country or region may be at risk.

  Avoid non-essential travel

Your safety and security could be at risk. You should think about your need to travel to this country, territory or region based on family or business requirements, knowledge of or familiarity with the region, and other factors. If you are already there, think about whether you really need to be there. If you do not need to be there, you should think about leaving.

  Avoid all travel

You should not travel to this country, territory or region. Your personal safety and security are at great risk. If you are already there, you should think about leaving if it is safe to do so.

Cuban Healthcare: 11 Interesting Facts You Didn’t Know

• Written by MTM Editorial Team
• April 6, 2020

During the Cuban revolution, Fidel Castro pledged to adopt universal healthcare and to take Cuban medical expertise abroad. When he came into power in 1959, he held onto his promises and went on to plant the seeds of a healthcare system that has become the pride of the Cuban government ever since.

According to state media, Cuba has sent over 400,000 healthcare professionals to work in 147 countries since the practice of sending doctors abroad began. During the Covid-19 pandemic, Cuba has been at the forefront of global headlines once again, as it was recently reported to have sent a team of medical professionals to Italy to help them to manage the surge in coronavirus cases.

Here are 11 interesting facts about Cuban healthcare that you probably don’t know:

1. Healthcare is free and a fundamental human right

Healthcare in Cuba is free for everyone, whether that means going for a preventative screening or undergoing the most complicated surgery. There are no private clinics, and the Cuban government runs the entire system. However, one of the criticisms in recent times has been the lack of modernisation in hospital infrastructure and equipment.

2. Health indicators are on par with developed countries

Cuba has impressively high rankings in all significant healthcare indicators. Life expectancy is on a par with the US at 79 years, and infant mortality is lower than many countries at  4.2 deaths per 1000 live births . Given that Cuba spends almost a tenth less than the US on healthcare per person, how are these achievements even possible? The simple answer is that Cuba’s lack of resources forces the system to focus on prevention and keeping people healthy.

3. Innovative community care model  

The secret to Cuba’s success has been its primary care model. Cuba has 498 polyclinics set up in neighbourhoods, which are run by a team made up of a family physician, a nurse, and often a social worker. This team usually lives above the clinic and is responsible for the wellbeing of all the families living in the surrounding area. Family physicians will knock on the doors of residents at least once a year to ask about their health and conduct a thorough medical exam. 

4. Highest number of doctors per person  

These extraordinary community outreach efforts require a sizeable medical workforce, which Cuba has trained up over the years. Today, Cuba has amongst the highest ratio of doctors to population size, with 8.2 per 1,000 people. This is significant in comparison to major economic powers, considering Germany has 4.2, Italy 4.1, France 3.2, the UK 2.8 and the US 2.6.

5. Overseas medical missions 

Cuba has been sending doctors on foreign missions since 1963, and today over 28,000 professionals are working in over 59 countries, stretching from South Africa to the Middle East. There is even a government hospital in Qatar , staffed with Cuban-trained personnel. The Cuban government has used the supply of doctors to build diplomatic ties with other countries, and this has also provided Cuba with a steady flow of revenues.

6. First to respond to global disaster relief efforts

Cuban medical professionals have worked in the most demanding conditions. Whenever there is a global crisis, it is not uncommon to see Cuban healthcare workers come to another country’s aid in the relief efforts. Recent examples include supporting the response to the Kashmir earthquake, the Ebola outbreak in West Africa and today, the Covid-19 pandemic.

7. Inbound medical care efforts

An often overlooked fact has been Cuba’s inbound relief efforts in bringing patients into Cuba for healthcare treatment and recovery. One example,  reported by Helen Yaffe , was the Cuban aid effort during the Chernobyl nuclear disaster in 1989:

Under the ‘Children of Chernobyl’ programme, which ran from 1989 to 2013 some 22,000 children and 4,000 adults, victims of the Chernobyl nuclear disaster, received free medical care, accommodation, food and therapy in Tarará, 10 miles outside Havana. Despite the severe economic crisis following the collapse of the Soviet bloc, the Cubans footed the bill — an astonishing expression of solidarity that has received almost no acknowledgement. Helen Yaffe - Author of We Are Cuba!

8. Average health professional wage is only $65

The Cuban government pays the salaries of healthcare professionals, and these are reported to be around $65 per month. This is extremely low compared to developed nations, but it is also important to note that Cuba is a communist country run on a different set of rules. The government owns 90% of the country  and controls salaries in return for free healthcare, education, housing, food and other basic needs.

9. Agreements have included oil in exchange for doctors 

One of the largest deployments of overseas Cuban healthcare workers was to neighbouring Venezuela in the new millennium. There are reported to be thousands of Cuban medics working in Venezuela as part of a bilateral trade agreement between the two nations, which has seen Cuba receive up to 53,000 barrels of oil  per day.

10. Integrated medical education  

Cuba has a reputable medical education system, which draws on research from its vast network of global healthcare missions. Classroom theory is integrated with community-based practice, and students are taught about the importance of international solidarity. Beyond education, the Ministry of Public Health is also active in several international clinical research projects.

11. Medical tourism in Cuba

Cuban healthcare facilities treat around 20,000 paying medical tourists a year, and these are usually in specially assigned facilities catering for foreigners and VIPs. The availability of quality healthcare at very affordable prices is an attractive proposition for medical tourists coming from all countries, especially the US.

Cuba’s healthcare model is one of a kind. Despite a severe lack of resources, Cuba has accomplished universal healthcare, is keeping its people healthy on par with developed countries and continues to support humanitarian medical efforts around the world. 

Discover Health Tourism Worldwide

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Foreigners flock to Cuba for medical care

Foreigners seeking medical treatment are flocking to Havana, lured by advertisements and lower costs. Cuban officials have said that 3500 foreigners came for health care last year.

“People with a lot of money are looking for our services,” said Dr Carlos Leyvsa, vice president of Cubanacan Tourism and Health. “For them it's not an issue of price but of quality.”

Cira Garcia is a clinic adjoining Havana's wealthy Miramar section, which last year attracted nearly 1300 foreign tourists as inpatients and thousands more as outpatients. Its website proclaims that it is a “leading healthcare organisation for foreigners.”

Cira Garcia offers everything from herniated disc repair—for $4750 (£3400) including anaesthesia and a two week hospital stay—to laser eye surgery and liposuction.

Dr Ramon Prado, the clinic director, said that its prices average about a third lower than those in the United States. For example, according to the American Society of Plastic and Reconstructive Surgeons, in 1999 rhinoplasty cost $3100 in the United States compared with $1710 at Cira Garcia, and abdominoplasty (“tummy tuck”) cost $4198 in the United States compared with $2340 at the clinic.

About 80% of the patients come from Latin America and the Caribbean, but the facility has attracted patients from as far away as Japan and Finland.

Cuba's increasing promotion of health tourism has roused criticism by those who see a two tier health system developing. In a country with one of the highest concentrations of doctors in the world, foreigners and Cuban party elite receive first class service. But ordinary Cubans must make do with dilapidated facilities, outdated equipment, and meagre medical supplies, in part because of the longstanding US embargo against Cuba.

Cuban officials defend their system, however, saying that the $20m or more that the foreign tourists bring to the island each year bolsters Cuba's general finances and helps to support free universal health care for Cuban workers and their families.

Cuba: ideal for sun, sea and plastic surgery

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Americans May See Appeal of Medical Tourism in Cuba

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By William Neuman

• Feb. 17, 2015

HAVANA — Anuja Agrawal jumped on the phone. President Obama had just announced that he would restore diplomatic relations with Cuba — and Ms. Agrawal, who runs a medical tourism company in Orlando, Fla., did not want to miss her opening.

She reached a health care administrator in Cuba, agreeing to move ahead with a deal that they had been discussing for months in the hope that American patients could soon start traveling to the island for medical treatment.

“There was a lot of excitement about it,” said Ms. Agrawal, the chief executive of Health Flights Solutions, adding that if Americans start traveling to Cuba for affordable medical treatments, it could mean a big economic boost for the country’s health system. “For them, they’re looking at it literally like winning the lottery.”

As the Obama administration chips away at the economic isolation of Cuba, whittling at an embargo that is older than most people on this island, industries of many kinds are trying to figure out what the easing of tension will mean for them, and exactly how much wiggle room there will be.

Thousands of people from other countries go to Cuba each year for what is known as medical tourism: travel abroad for surgery or other medical care, often because the treatment is less expensive there or is not available where patients live.

Now, the Obama administration has relaxed restrictions on travel to Cuba. Americans can come here for a range of reasons , including family visits, academic conferences, public performances, and religious and educational activities. While tourism or traveling to receive health care are still not allowed, the administration lifted a restriction requiring many Americans to travel with authorized groups or get a license in advance to visit the island.

“It’s a relaxation, a loosening of the restrictions,” Ms. Agrawal said, adding that once the door is open, “I always think it’s going to get looser and looser.”

In practice, the changes could mean that many more people will feel free to travel to Cuba, even for purposes outside the allowed categories. Thousands of Americans already travel to Cuba for tourism or other reasons that fall outside the guidelines, and even before the changes, many Cuban-Americans visiting family would take the opportunity to schedule medical treatments, many people here said.

A Treasury Department spokeswoman said that Americans wishing to travel to Cuba for reasons that fell outside the authorized activities could apply for permission, known as a special license, and that such requests would be evaluated on a case-by-case basis.

But the spokeswoman, who said she was authorized to speak only on background, said that Americans traveling to Cuba were required to keep records of their trip for five years and could be subject to audits to show that their travel met the guidelines.

Jonathan Edelheit, the chief executive of the Florida-based Medical Tourism Association, said some hospitals in the United States had expressed interest in forming partnerships with Cuban medical institutions, which could include the training of Cuban doctors. Such partnerships in other countries often go hand in hand with medical tourism, and that could eventually be the case in Cuba, he said.

“You’re going to see a tremendous amount of movement, whether it’s travel agents or medical tourism facilitators, so once it does normalize, they can start sending patients over there,” Mr. Edelheit said.

Cuba made health care a priority after its 1959 revolution, and it has earned a reputation for providing good, mostly free care to its people. Thousands of Cuban doctors also work abroad, in Venezuela, Brazil and other developing countries, in an exchange that provides the government of President Raúl Castro with hard currency or goods, such as oil, in return.

Mr. Edelheit said Cuban health care would be likely to appeal to some Americans because the island is so close, about an hour’s flight from Miami to Havana.

But for now, the most popular destinations for Americans who travel abroad for health care are Canada, the United Kingdom, Israel, Singapore and Costa Rica, according to a study by the Medical Tourism Association. It found that some of the most common procedures included spinal, weight-loss and cosmetic surgery, and cancer treatment.

Ms. Agrawal said she had been speaking to a Cuban health care facility for months, anticipating an eventual opening between the two countries.

“In terms of being a viable destination, what was holding it back, of course, was the travel restrictions and embargo,” she said of Cuba. “Now, with some of that opening up, they’ve got extremely good health care. They’re very close in terms of travel.”

Unlike Americans, Canadians do not have travel restrictions, and Cuba is a popular vacation destination; many Canadians travel there for health care as well.

David McBain, 47, a Toronto landscaper who fractured his spine in a car accident, went to Cuba three times last year for extensive physical therapy.

“The physiotherapists and the doctors are extremely knowledgeable and well trained in Cuba, and you just can’t beat the price,” Mr. McBain said. “The price is a fraction of what it would be in Canada or the U.S. for a therapist.”

Mr. McBain, who is partly paralyzed and uses a wheelchair, said he was treated for several weeks during each visit at a Havana facility. He said the treatment in Cuba cost about $200 a day, which includes about six hours of physical therapy daily, a comfortable room and board. Canada’s national health system does not provide for the type of therapy he needs, he said, and a private neurological physical therapist would charge about $93 an hour.

Mr. McBain arranged for his care in Cuba through a Toronto company called Global HealthQuest. Ben Soave and Rosemary Toscani, who run the company, said they regularly sent patients to Cuba for physical therapy, drug and alcohol rehabilitation, and for treatment of an eye disease called retinitis pigmentosa.

The eye surgery and related treatments, pioneered at a Cuban clinic, are not available in Canada or the United States, and they have stirred controversy. Independent studies have raised questions about the effectiveness of the treatments, and doctors at the clinic have been criticized for not publishing the results of studies in peer-reviewed medical journals.

“If you’re not presenting your results and publishing, then there’s something not right,” said Dr. Byron L. Lam, a specialist in the disease at the Bascom Palmer Eye Institute in Miami.

Mr. Soave said patients gave good reviews of the care they received in Cuba, although they sometimes complained about other aspects.

“There’s other things that are not so great, like the food, the accommodations, the lack of some of the things we consider basic services, like the Internet, the phones, that sort of thing,” he said. “In terms of medical care, it has been excellent.”

He also said the patients he had worked with did not seek out treatment in Cuba because they had political sympathies with its socialist government.

“We have people asking, ‘Where can we go to get the best care?’ ” Mr. Soave said. “They’re thinking health, not politics.”

While Cuba is well known for its government-run health care, the system also struggles with problems. Doctor appointments and hospital stays are free, but most patients must pay for their own medicines, which can be difficult on the island’s typically low salaries.

Some medicines are hard to find or unavailable, and hospitals may lack up-to-date equipment, although doctors said the government had recently been investing in modernizing some facilities. Health care workers also received a significant salary increase last year, with some of the higher-paid doctors seeing their monthly wages rise to $67 from $26.

Gail Reed, an American who edits a medical journal here in Havana, said she hoped that additional income from Americans traveling to Cuba for medical care would be invested back into the Cuban health care system.

“Any injection of real, new sources of funding into the health system would be a boon to Cuba and Cubans,” Ms. Reed said.

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• Section 6 - Perspectives : Avoiding Poorly Regulated Medicines & Medical Products During Travel
• Section 7 - Pregnant Travelers

Medical Tourism

Cdc yellow book 2024.

Author(s): Matthew Crist, Grace Appiah, Laura Leidel, Rhett Stoney

• Categories Of Medical Tourism

The Pretravel Consultation

Risks & complications, risk mitigation, additional guidance for us health care providers.

Medical tourism is the term commonly used to describe international travel for the purpose of receiving medical care. Medical tourists pursue medical care abroad for a variety of reasons, including decreased cost, recommendations from friends or family, the opportunity to combine medical care with a vacation destination, a preference to receive care from a culturally similar provider, or a desire to receive a procedure or therapy not available in their country of residence.

Medical tourism is a worldwide, multibillion-dollar market that continues to grow with the rising globalization of health care. Surveillance data indicate that millions of US residents travel internationally for medical care each year. Medical tourism destinations for US residents include Argentina, Brazil, Canada, Colombia, Costa Rica, Cuba, the Dominican Republic, Ecuador, Germany, India, Malaysia, Mexico, Nicaragua, Peru, Singapore, and Thailand. Categories of procedures that US medical tourists pursue include cancer treatment, dental care, fertility treatments, organ and tissue transplantation, and various forms of surgery, including bariatric, cosmetic, and non-cosmetic (e.g., orthopedic).

Most medical tourists pay for their care at time of service and often rely on private companies or medical concierge services to identify foreign health care facilities. Some US health insurance companies and large employers have alliances with health care facilities outside the United States to control costs.

Categories of Medical Tourism

Cosmetic tourism.

Cosmetic tourism, or travel abroad for aesthetic surgery, has become increasingly popular. The American Society of Plastic Surgeons (ASPS) reports that most cosmetic surgery patients are women 40–54 years old. The most common procedures sought by cosmetic tourists include abdominoplasty, breast augmentation, eyelid surgery, liposuction, and rhinoplasty. Popular destinations often are marketed to prospective medical tourists as low cost, all-inclusive cosmetic surgery vacations for elective procedures not typically covered by insurance. Complications, including infections and surgical revisions for unsatisfactory results, can compound initial costs.

Non-Cosmetic Medical Tourism

Cancer treatment.

Oncology, or cancer treatment, tourism often is pursued by people looking for alternative treatment options, better access to care, second opinions, or a combination of these. Oncology tourists are a vulnerable patient population because the fear caused by a cancer diagnosis can lead them to try potentially risky treatments or procedures. Often, the treatments or procedures used abroad have no established benefit, placing the oncology tourist at risk for harm due to complications (e.g., bleeding, infection) or by forgoing or delaying approved therapies in the United States.

Dental Care

Dental care is the most common form of medical tourism among US residents, in part due to the rising cost of dental care in the United States; a substantial proportion of people in the United States do not have dental insurance or are underinsured. Dentists in destination countries might not be subject to the same licensure oversight as their US counterparts, however. In addition, practitioners abroad might not adhere to standard infection-control practices used in the United States, placing dental tourists at a potential risk for infection due to bloodborne or waterborne pathogens.

Fertility Treatments

Fertility tourists are people who seek reproductive treatments in another country. Some do so to avoid associated barriers in their home country, including high costs, long waiting lists, and restrictive policies. Others believe they will receive higher quality care abroad. People traveling to other countries for fertility treatments often are in search of assisted reproductive technologies (e.g., artificial insemination by a donor, in vitro fertilization). Fertility tourists should be aware, however, that practices can vary in their level of clinical expertise, hygiene, and technique.

Physician-Assisted Suicide

The practice of a physician facilitating a patient’s desire to end their own life by providing either the information or the means (e.g., medications) for suicide is illegal in most countries. Some people consider physician-assisted suicide (PAS) tourism, also known as suicide travel or suicide tourism, as a possible option. Most PAS tourists have been diagnosed with a terminal illness or suffer from painful or debilitating medical conditions. PAS is legal in Belgium, Canada, Luxembourg, the Netherlands, Switzerland, and New Zealand, making these the destinations selected by PAS travelers.

Rehab Tourism for Substance Use Disorders

Rehab tourism involves travel to another country for substance use disorder treatment and rehabilitation care. Travelers exploring this option might be seeking a greater range of treatment options at less expense than what is available domestically (see Sec. 3, Ch. 5, Substance Use & Substance Use Disorders , and Box 3-10 for pros and cons of rehab tourism).

Transplant Procedures

Transplant tourism refers to travel for receiving an organ, tissue, or stem cell transplant from an unrelated human donor. The practice can be motivated by reduced cost abroad or an effort to reduce the waiting time for organs. Xenotransplantation refers to receiving other biomaterial (e.g., cells, tissues) from nonhuman species, and xenotransplantation regulations vary from country to country. Many procedures involving injection of human or nonhuman cells have no scientific evidence to support a therapeutic benefit, and adverse events have been reported.

Depending on the location, organ or tissue donors might not be screened as thoroughly as they are in the United States; furthermore, organs and other tissues might be obtained using unethical means. In 2009, the World Health Organization released the revised Guiding Principles on Human Cell, Tissue, and Organ Transplantation, emphasizing that cells, tissues, and organs should be donated freely, in the absence of any form of financial incentive.

Studies have shown that transplant tourists can be at risk of receiving care that varies from practice standards in the United States. For instance, patients might receive fewer immunosuppressive drugs, increasing their risk for rejection, or they might not receive antimicrobial prophylaxis, increasing their risk for infection. Traveling after a procedure poses an additional risk for infection in someone who is immunocompromised.

Ideally, medical tourists will consult a travel medicine specialist for travel advice tailored to their specific health needs 4–6 weeks before travel. During the pretravel consultation, make certain travelers are up to date on all routine vaccinations, that they receive additional vaccines based on destination, and especially encourage hepatitis B virus immunization for unvaccinated travelers (see Sec. 2, Ch. 3, Vaccination & Immunoprophylaxis & General Principles , and Sec. 5, Part 2, Ch. 8, Hepatitis B ). Counsel medical tourists that participating in typical vacation activities (e.g., consuming alcohol, participating in strenuous activity or exercise, sunbathing, swimming, taking long tours) during the postoperative period can delay or impede healing.

Advise medical tourists to also meet with their primary care provider to discuss their plan to seek medical care outside the United States, to address any concerns they or their provider might have, to ensure current medical conditions are well controlled, and to ensure they have a sufficient supply of all regular medications to last the duration of their trip. In addition, medical tourists should be aware of instances in which US medical professionals have elected not to treat medical tourists presenting with complications resulting from recent surgery, treatment, or procedures received abroad. Thus, encourage medical tourists to work with their primary care provider to identify physicians in their home communities who are willing and available to provide follow-up or emergency care upon their return.

Remind medical tourists to request copies of their overseas medical records in English and to provide this information to any health care providers they see subsequently for follow-up. Encourage medical tourists to disclose their entire travel history, medical history, and information about all surgeries or medical treatments received during their trip.

All medical and surgical procedures carry some risk, and complications can occur regardless of where treatment is received. Advise medical tourists not to delay seeking medical care if they suspect any complication during travel or after returning home. Obtaining immediate care can lead to earlier diagnosis and treatment and a better outcome.

Among medical tourists, the most common complications are infection related. Inadequate infection-control practices place people at increased risk for bloodborne infections, including hepatitis B, hepatitis C, and HIV; bloodstream infections; donor-derived infections; and wound infections. Moreover, the risk of acquiring antibiotic-resistant infections might be greater in certain countries or regions; some highly resistant bacterial (e.g., carbapenem-resistant Enterobacterales [CRE]) and fungal (e.g., Candida auris ) pathogens appear to be more common in some countries where US residents travel for medical tourism (see Sec. 11, Ch. 5, Antimicrobial Resistance ).

Several infectious disease outbreaks have been documented among medical tourists, including CRE infections in patients undergoing invasive medical procedures in Mexico, surgical site infections caused by nontuberculous mycobacteria in patients who underwent cosmetic surgery in the Dominican Republic, and Q fever in patients who received fetal sheep cell injections in Germany.

Noninfectious Complications

Medical tourists have the same risks for noninfectious complications as patients receiving medical care in the United States. Noninfectious complications include blood clots, contour abnormalities after cosmetic surgery, and surgical wound dehiscence.

Travel-Associated Risks

Traveling during the post-operative or post-procedure recovery period or when being treated for a medical condition could pose additional risks for patients. Air travel and surgery independently increase the risk for blood clots, including deep vein thrombosis and pulmonary emboli (see Sec. 8, Ch. 3, Deep Vein Thrombosis & Pulmonary Embolism ). Travel after surgery further increases the risk of developing blood clots because travel can require medical tourists to remain seated for long periods while in a hypercoagulable state.

Commercial aircraft cabin pressures are roughly equivalent to the outside air pressure at 6,000–8,000 feet above sea level. Medical tourists should not fly for 10 days after chest or abdominal surgery to avoid risks associated with changes in atmospheric pressure. ASPS recommends that patients undergoing laser treatments or cosmetic procedures to the face, eyelids, or nose, wait 7–10 days after the procedure before flying. The Aerospace Medical Association published medical guidelines for air travel that provide useful information on the risks for travel with certain medical conditions.

Professional organizations have developed guidance, including template questions, that medical tourists can use when discussing what to expect with the facility providing the care, with the group facilitating the trip, and with their own domestic health care provider. For instance, the American Medical Association developed guiding principles on medical tourism for employers, insurance companies, and other entities that facilitate or incentivize medical care outside the United States ( Box 6-07 ). The American College of Surgeons (ACS) issued a similar statement on medical and surgical tourism, with the additional recommendation that travelers obtain a complete set of medical records before returning home to ensure that details of their care are available to providers in the United States, which can facilitate continuity of care and proper follow-up, if needed.

Box 6-07 American Medical Association’s guiding principles on medical tourism 1

• Employers, insurance companies, and other entities that facilitate or incentivize medical care outside the United States should adhere to the following principles:
• Receiving medical care outside the United States must be voluntary.
• Financial incentives to travel outside the United States for medical care should not inappropriately limit the diagnostic and therapeutic alternatives that are offered to patients or restrict treatment or referral options.
• Patients should only be referred for medical care to institutions that have been accredited by recognized international accrediting bodies (e.g., the Joint Commission International or the International Society for Quality in Health Care).
• Prior to travel, local follow-up care should be coordinated, and financing should be arranged to ensure continuity of care when patients return from medical care outside the United States.
• Coverage for travel outside the United States for medical care should include the costs of necessary follow-up care upon return to the United States.
• Patients should be informed of their rights and legal recourse before agreeing to travel outside the United States for medical care.
• Access to physician licensing and outcome data, as well as facility accreditation and outcomes data, should be arranged for patients seeking medical care outside the United States.
• The transfer of patient medical records to and from facilities outside the United States should be consistent with Health Insurance Portability and Accountability Action (HIPAA) guidelines.
• Patients choosing to travel outside the United States for medical care should be provided with information about the potential risks of combining surgical procedures with long flights and vacation activities.

1 American Medical Association (AMA). New AMA Guidelines on Medical Tourism . Chicago: AMA; 2008.

Reviewing the Risks

Multiple resources are available for providers and medical tourists assessing medical tourism–related risks (see Table 6-02 ). When reviewing the risks associated with seeking health care abroad, encourage medical tourists to consider several factors besides the procedure; these include the destination, the facility or facilities where the procedure and recovery will take place, and the treating provider.

Make patients aware that medical tourism websites marketing directly to travelers might not include (or make available) comprehensive details on the accreditations, certifications, or qualifications of advertised facilities or providers. Local standards for facility accreditation and provider certification vary, and might not be the same as those in the United States; some facilities and providers abroad might lack accreditation or certification. In some locations, tracking patient outcome data or maintaining formal medical record privacy or security policies are not standard practices.

Medical tourists also should be aware that the drugs and medical products and devices used in other countries might not be subject to the same regulatory scrutiny and oversight as in the United States. In addition, some drugs could be counterfeit or otherwise ineffective because the medication expired, is contaminated, or was improperly stored (for more details, see the previous chapter in this section, . . . perspectives: Avoiding Poorly Regulated Medicines & Medical Products During Travel ).

Table 6-02 Online medical tourism resources

Checking credentials.

ACS recommends that medical tourists use internationally accredited facilities and seek care from providers certified in their specialties through a process equivalent to that established by the member boards of the American Board of Medical Specialties. Advise medical tourists to do as much advance research as possible on the facility and health care provider they are considering using. Also, inform medical tourists that accreditation does not guarantee a good outcome.

Accrediting organizations (e.g., The Joint Commission International, Accreditation Association for Ambulatory Health Care) maintain listings of accredited facilities outside of the United States. Encourage prospective medical tourists to review these sources before committing to having a procedure or receiving medical care abroad.

ACS, ASPS, the American Society for Aesthetic Plastic Surgery, and the International Society of Aesthetic Plastic Surgery all accredit physicians abroad. Medical tourists should check the credentials of health care providers with search tools provided by relevant professional organizations.

Travel Health Insurance

Before travel, medical tourists should check their domestic health insurance plan carefully to understand what services, if any, are covered outside the United States. Additionally, travelers might need to purchase supplemental medical insurance coverage, including medical evacuation insurance; this is particularly important for travelers going to remote destinations or places lacking medical facilities that meet the standards found in high-income countries (see Sec. 6, Ch. 1, Travel Insurance, Travel Health Insurance & Medical Evacuation Insurance ). Medical tourists also should be aware that if complications develop, they might not have the same legal recourse as they would if they received their care in the United States.

Planning for Follow-Up Care

Medical tourists and their domestic physicians should plan for follow-up care. Patients and clinicians should establish what care will be provided abroad, and what the patient will need upon return. Medical tourists should make sure they understand what services are included as part of the cost for their procedures; some overseas facilities and providers charge substantial fees for follow-up care in addition to the base cost. Travelers also should know whether follow-up care is scheduled to occur at the same facility as the procedure.

Health care facilities in the United States should have systems in place to assess patients at admission to determine whether they have received medical care in other countries. Clinicians should obtain an explicit travel history from patients, including any medical care received abroad. Patients who have had an overnight stay in a health care facility outside the United States within 6 months of presentation should be screened for CRE. Admission screening is available free of charge through the Antibiotic Resistance Laboratory Network .

Notify state and local public health as soon as medical tourism–associated infections are identified. Returning patients often present to hospitals close to their home, and communication with public health authorities can help facilitate outbreak recognition. Health care facilities should follow all disease reporting requirements for their jurisdiction. Health care facilities also should report suspected or confirmed cases of unusual antibiotic resistance (e.g., carbapenem-resistant organisms, C. auris ) to public health authorities to facilitate testing and infection-control measures to prevent further transmission. In addition to notifying the state or local health department, contact the Centers for Disease Control and Prevention at [email protected] to report complications related to medical tourism.

The following authors contributed to the previous version of this chapter: Isaac Benowitz, Joanna Gaines

Bibliography

Adabi K, Stern C, Weichman K, Garfein ES, Pothula A, Draper L, et al. Population health implications of medical tourism. Plast Reconstr Surg. 2017;140(1):66–74.

Al-Shamsi, H, Al-Hajelli, M, Alrawi, S. Chasing the cure around the globe: medical tourism for cancer care from developing countries. J Glob Onc. 2018;4:1–3.

Kracalik I, Ham C, Smith AR, Vowles M, Kauber K, Zambrano M, et al. (2019). Notes from the field: Verona integron-encoded metallo-β-lactamase–producing carbapenem-resistant Pseudomonas aeruginosa infections in U.S. residents associated with invasive medical procedures in Mexico, 2015–2018. MMWR Morb Mortal Wkly Rep. 2019;68(20):463–4.

Pavli A, Maltezou HC. Infectious complications related to medical tourism. J Travel Med. 2021;28(1):taaa210.

Pereira RT, Malone CM, Flaherty GT. Aesthetic journeys: a review of cosmetic surgery tourism. J Travel Med. 2018;25(1):tay042.

Robyn MP, Newman AP, Amato M, Walawander M, Kothe C, Nerone JD, et al. Q fever outbreak among travelers to Germany who received live cell therapy & United States and Canada, 2014. MMWR Morb Mortal Wkly Rep. 2015;64(38):1071–3.

Salama M, Isachenko V, Isachenko E, Rahimi G, Mallmann P, Westphal LM, et al. Cross border reproductive care (CBRC): a growing global phenomenon with multidimensional implications (a systematic and critical review). J Assist Reprod Genet. 2018;35(7):1277–88.

Schnabel D, Esposito DH, Gaines J, Ridpath A, Barry MA, Feldman KA, et al. Multistate US outbreak of rapidly growing mycobacterial infections associated with medical tourism to the Dominican Republic, 2013–2014. Emerg Infect Dis. 2016;22(8):1340–7.

Stoney RJ, Kozarsky PE, Walker AT, Gaines JL. Population-based surveillance of medical tourism among US residents from 11 states and territories: findings from the Behavioral Risk Factor Surveillance System. Infect Control Hosp Epidemiol. 2022;43(7):870–5.

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‘Sloth fever’ in Florida? Oropouche cases are linked to Cuba. Here’s what to know.

• Michelle Marchante Miami Herald (TNS)

More than a dozen Floridians who traveled to Cuba this year were infected with Oropouche, a virus known as “sloth fever” and spread mainly by tiny biting flies and some mosquitoes, state data shows.

Florida has recorded 30 Oropouche infections this year, and Miami-Dade County has the most confirmed cases. State health officials say all of the infections are considered to be associated with travel to Cuba, which is experiencing an Oropouche outbreak.

The U.S. Centers for Disease Control and Prevention has Cuba under a health travel notice, and is cautioning travelers to take enhanced precautions to reduce their risk of bug bites.

Ten of the infections were reported during the week of Aug. 18-24, just a few days after the CDC issued a health advisory, asking doctors to consider testing sick people who recently traveled to countries where the disease is known to be spreading.

Here’s what to know about Oropouche:

How do people get sick with Oropouche?

Oropouche is spread to people by the bite of infected “biting midges,” which are tiny biting flies that are sometimes called “no-see-ums,” though some mosquitoes can also spread the disease, according to the CDC.

While infected people can’t spread the disease to others, there is “limited data from Brazil” that suggests there’s a possible risk pregnant women can transfer the virus to their baby, and that the virus could lead to complications including stillbirths and birth defects, the CDC says.

Countries with an Oropouche outbreak

More than 8,000 confirmed cases of Oropouche have been reported this year from countries in the Americas, according to the World Health Organization. The virus, which is endemic to the Amazon and was identified nearly 70 years ago, has spread outside the region and has been  linked to human deaths  for the first time, according to Nature.

While most of the cases have been reported in Brazil, people have also been infected in Bolivia, Colombia, Peru and Cuba. The CDC has a  travel health notice  for South America and is asking travelers to take “usual precautions” to prevent bug bites and reduce risk of infection. Pregnant travelers should speak with their doctor about travel plans and precautions.

The federal public health agency has put Cuba under a  travel health notice , and is asking travelers going to the island to take extra precautions to reduce their risk of infection. “Pregnant people should reconsider non-essential travel to Cuba.”

Where have Oropouche cases in Florida been reported?

Florida has confirmed 30 cases of Oropouche, or “sloth fever,” this year, and 14 of the cases were in Miami-Dade County, according to the state’s most recent mosquito surveillance report. That’s nearly half of the reported cases.

Other counties that have reported cases include Broward, Duval, Hillsborough, Lee, Orange, Palm Beach, Pasco, Polk and Sarasota.

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The Florida Department of Health says all of the cases were associated with travel to Cuba. The U.S. has also confirmed a case in New York that is associated with travel to Cuba.

Oropouche symptoms

Oropouche symptoms are similar to other mosquito-borne illnesses such as dengue, making it impossible to know if someone is infected with Oropouche unless they get tested.

Symptoms include fever, severe headache, nausea, vomiting, chills and muscle aches. Some people might also get a rash, pain behind the eyes and feel sensitivity to light, according to the CDC.

“Symptoms typically start 3-10 days after being bitten and last 3-6 days,” and most people recover, according to the agency. Some people can get seriously ill.

The CDC is recommending people who experience any of these symptoms during or within two weeks of travel to affected countries to “seek medical care immediately,” tell their doctor where they traveled and to take steps to prevent bug bites to reduce the risk of spreading the illness. Health officials say people should also avoid taking aspirin or other nonsteroidal anti-inflammatory drugs like ibuprofen to reduce the risk of bleeding.

Tips to reduce risk

There are no vaccines or medications to treat Oropouche. For people planning to travel to countries where Oropouche infections are occurring, health officials recommend  taking steps  to reduce the risk of bug bites. The tips are similar to how to reduce your risk of mosquito bites:

• Use an Environmental Protection Agency-registered insect repellent that is labeled for flies, biting flies or Culicoides (biting midges, punkies, granny nippers, and no-see-ums). The repellents should contain DEET, IR3535 or icaridin, according to the Pan American Health Organization.
• Wear protective clothing, such as long-sleeved shirts, pants and socks.
• Protect your home or lodging with “fine mesh mosquito nets on doors and windows, as well as beds and furniture where people rest. ... As midges are much smaller than mosquitoes,  traditional mosquito nets  will not protect against their bites,” according to the Pan American Health Organization.

©2024 Miami Herald. Visit miamiherald.com. Distributed by Tribune Content Agency LLC.

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CDC warns clinicians about Oropouche virus disease that has turned deadly

Between Jan. 1 and Aug. 1, more than 8,000 cases of the illness were reported in the Americas.

The Centers for Disease Control and Prevention is warning clinicians to be on the lookout for a viral disease that is spread by small flies and some types of mosquitoes and that causes sudden fever, severe headaches and chills.

Cases of Oropouche virus disease have been climbing in South America and the Caribbean in the past two years, and turned deadly for the first time this year.

The CDC advisory issued Friday recommends that pregnant people reconsider nonessential travel to Cuba, which reported its first confirmed case in June.

Between Jan. 1 and Aug. 1, more than 8,000 cases of Oropouche were reported in the Americas, the advisory said. That includes two deaths in Brazil this year in women who were otherwise healthy. Transmission of the virus during pregnancy resulted in one fetal death, one miscarriage and four cases of newborns with microcephaly , a condition characterized by an abnormally small head.

“This was the first report of deaths and Oropouche virus [mother-to-baby] transmission and associated adverse birth outcomes,” the CDC said.

In the United States and Europe this year, travelers returning from Cuba and Brazil have been diagnosed with the condition. Florida has reported 11 travel-related cases this year, according to the state health department.

No locally acquired Oropouche cases have been reported in the United States.

No vaccines to prevent Oropouche or medicines to treat it exist. The best form of protection is avoiding bites from midges and mosquitoes, the CDC said.

The virus is endemic to the Amazon basin region and has been reported in many countries, including Bolivia, Brazil, Colombia, Ecuador, French Guiana, Panama and Peru. In late 2023, the virus caused large outbreaks in new areas in South America.

Oropouche virus is spread to people primarily by the bite of infected midges. Some mosquitoes can also spread the virus.

The disease typically starts with sudden fever, often with severe headache, chills, muscle and joint pain. Other signs and symptoms include extreme light sensitivity, dizziness, eye pain, nausea and vomiting, or a rash that starts on the trunk and spreads to the extremities.

Symptoms typically last less than a week. But in up to 60 percent of patients, symptoms can recur a few days or even weeks later.

In many countries, outbreaks of dengue are occurring in areas with reported Oropouche transmission. The CDC is urging clinicians to rule out dengue virus infection in patients with suspected Oropouche virus disease.

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For more than 43 years the Cira Garcia Clinic has provided medical care to international patients from across the globe. This hospital was the first hospital to offer care for international patients in Cuba and is considered the pioneer of medical tourism services on the Island. The hospital is the chief provider of medical services to the surrounding diplomatic community of Miramar and to tourists who required medical attention.

The Cira Garcia offers a wide range of medical services provided by a multidisciplinary and multilingual team.  The doctors, nurses and clinical staff are highly trained and are well known as the leading specialists in their fields of medicine both locally and internationally.

Cira Garcia Clinical Services:

• Allergology
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• Gastroenterology
• Intensive Medicine
• Internal Medicine
• Physical Medicine and Rehabilitation
• Stomatological Specialties – Maxillofacial surgery, Orthodontics, Periodontology, Prosthesis

Emergency care is available 24 hours a day. Modern care units, surgical rooms as well as a wide range of treatment are available.

For patients who wish to extend their stay, the Cira Garcia Clinic has an international office to manage visa and travel changes.

Ensuring patients a risk-free standard of quality care and safety, the Cira Garcia is certified and in compliance with ISO 9001:2008 Quality Assurance Standards and the National Bureau of Standardization (ONN) and the Bureau Veritas.

Private rooms are available.  The Cira Garcia Clinic serves about 2,000 inpatients and outpatients a day.

Contact us for more information about the Cira Garcia Clinic in Havana.

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US CDC Reports 21 Oropouche Cases Among Travelers Returning From Cuba

FILE PHOTO: A general view of the Centers for Disease Control and Prevention (CDC) headquarters in Atlanta, Georgia September 30, 2014. REUTERS/Tami Chappell/File Photo

(Reuters) -The U.S. Centers for Disease Control and Prevention (CDC) said on Tuesday that a total of 21 Oropouche virus disease cases among U.S. travelers returning from Cuba have been reported as of Aug. 16.

The Oropouche virus is spread primarily through bites from midges as well as from some mosquitoes. Symptoms of the disease include headache, fever and muscle aches and joint pains, but the virus is rarely fatal.

Most patients returning from Cuba reported their symptoms between May and July.

Overall, three patients were hospitalized, and no deaths were reported, the agency said in its Morbidity and Mortality Weekly Report.

A dire economic crisis in Cuba has made it difficult to control the spread of Oropouche. Frequent power outages mean many sleep with windows open during the hot Caribbean summer. Few Cubans have access to insect repellent, and fumigation efforts have been stymied by fuel shortages.

Health officials in Cuba first began to report cases of the virus in May, and say it has spread quickly from rural areas to urban centers, including the capital Havana, a top tourist destination.

Cuba's health ministry said last week it had registered more than 400 cases of Oropouche on the island this year, though reports around Havana suggest a marked increase in recent weeks.

Earlier this month, the CDC issued a health alert to notify clinicians and public health authorities of an increase in the disease in the Americas region that has caused two deaths so far this year.

Authorities in Bolivia, Brazil, Colombia, Cuba and Peru have reported at least 8,000 locally acquired cases since late last year.

Currently, there are no specific treatments or vaccines available for the disease.

(Reporting by Sriparna Roy in Bengaluru and Dave Sherwood in Havana; Editing by Maju Samuel and Christopher Cushing)

Copyright 2024 Thomson Reuters .

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CDC Issues Warning as 'Sloth Fever' Arrives in US from South America

Health experts are raising red flags as what is commonly known as “sloth fever” has gained a foothold in the United States.

The Oropouche virus has been detected in two states, according to CBS .

Florida officials said they have spotted 30 cases, all connected with travelers from Cuba.

One case was diagnosed in New York state, also linked to travel from Cuba .

According to The Washington Post , Europe has had 19 cases this summer, with 12 in Spain, five in Italy and two in Germany. One case involved travel to Brazil; all the rest were linked to travelers returning from Cuba.

According to the federal Centers for Disease Control and Prevention , as of August, more than 8,000 cases of sloth fever have been confirmed in Bolivia, Brazil, Colombia, Cuba, and Peru.

The CDC said that “two deaths and vertical transmission associated with fetal death and possible congenital malformations in Brazil have raised concerns about the threat of Oropouche virus to human health."

More than 20 people returning to the U.S. from Cuba have been infected with a virus transmitted by bugs in recent months, federal health officials say. They all had Oropouche virus disease, also known as sloth fever. https://t.co/m2YmzHbxYb

— NBC News (@NBCNews) August 27, 2024

One expert stressed that pregnant women may face the worst dangers of infection.

“There is much we still do not know about the Oropouche virus but one of the main concerns arising from the current outbreak is its potential harmful effects on unborn fetuses,” Enny Paixao, associate professor at the London School of Hygiene and Tropical Medicine, said in a statement .

“The risks of Oropouche virus infection to fetal development remain uncertain and require closer scrutiny,” she wrote.

The CDC said it is watching the spread of the virus.

"We want to be at high alert and respond quickly to make sure that we are protecting the health of pregnant moms everywhere," CDC Director Mandy Cohen told CBS.

Dr. Céline Gounder, a CBS medical contributor, noted, “We're still at the very beginning of understanding that virus.”

The CDC said on its website that humans contract the disease after being bitten by midges, a small form of fly, or mosquitos.

The CDC said most people infected have “ fever, myalgia, and headache” and also suffer from “arthralgia, diarrhea, nausea or vomiting, and rash.” Some have had recurring symptoms.

The CDC said pregnant women should consider postponing trips to areas where there are outbreaks of sloth fever.

The agency said it is "currently developing a plan for rapid detection and response to Oropouche virus disease cases in the United States."

Health | ‘Sloth fever’ cases rising in South…

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Health | bullets that killed ups driver, bystander in 2019 shootout were from police officers’ guns, fdle report says, health | ‘sloth fever’ cases rising in south florida, carried by travelers from cuba, 21 of state’s 30 cases found in broward, miami-dade, palm beach counties.

The virus, also known as Oropouche, is spread to people by infected biting midges (small flies) and some mosquito species. Health officials and mosquito control staff are on high alert in South Florida, where the species that carries Oropouche, Culex quinquefasciatus, is prevalent.

A new Florida Department of Health report as of Aug. 24 shows five cases reported in each of Broward, Duval and Hillsborough counties, 14 in Miami-Dade, and two in each of Orange, Palm Beach, Pasco, Polk, Lee and Sarasota counties. All cases were from people who had traveled to Cuba.

“People who travel and get bitten, come back and could potentially spread it around,”  said Anh Ton, the director of Broward County’s mosquito control. “We are working with other state agencies and the health department to make sure we know  when and where there’s a travel-related case, and treat around their residence and business to make sure the person bitten doesn’t spread it.”

The virus can be passed to humans only through an insect bite, but if an insect bites an infected person, then bites another person, the virus can be transmitted.

The Centers for Disease Control and Prevention issued an alert on Tuesday to warn travelers to Cuba and Latin America to take extra precautions to prevent bug bites during travel and protect themselves from infection using insect repellent. Oropouche virus often is called “sloth fever” because it is spread from animals, such as sloths and rodents, to mosquitoes, which then transmit it to humans.

So far this year, the virus has caused significant concern in South America and the Caribbean, with more than 8,000 cases reported. In the U.S., the cases have been identified in travelers returning from Cuba and Brazil. Outside of Florida, one case of Oropouche was reported this month in New York.

Not everyone who gets bitten will show symptoms. About 60% of people infected with the Oropouche virus become symptomatic, with a high fever, headache, muscle aches, stiff joints, nausea, vomiting, chills, or sensitivity to light. Severe cases can result in meningitis. Two deaths in previously healthy young persons with Oropouche virus infection were recently reported in Brazil. In the U.S., the CDC reported that most infected people had fever and other symptoms that went away without specific treatment. At least three people had symptoms return after the initial illness ended, a common characteristic of Oropouche.

The CDC also is asking health providers to advise pregnant patients to reconsider non-essential travel to areas with an Oropouche Level 2 Travel Health Notice, currently issued for Cuba.

On Aug. 1, 2024, the Pan American Health Organization  issued an epidemiological alert about Oropouche cases, including deaths, in the Americas. There were also concerns about an increase of possible cases of Oropouche virus being passed from a pregnant person to their fetus with negative pregnancy outcomes.

Currently, there are no medicines to treat the virus or prevent infection.

Ton advises everyone in South Florida, particularly those outside at dusk and dawn, to wear insect repellent and to immediately report any potential symptoms after travel to the state health department.

South Florida Sun Sentinel health reporter Cindy Goodman can be reached at [email protected].

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