OFFICIAL VOICE OF THE COMMUNIST PARTY OF CUBA CENTRAL COMMITTEE
Miguel Ángel Martínez Alfonso PhD recommends bariatric surgery to treat severe obesity and its related conditions. Photo: Yander Zamora

Obesity can not only be fatal; it is the leading cause of chronic non-transmissible diseases such as diabetes, cardiovascular, kidney, respiratory and joint conditions. Obesity can also affect a person’s self-esteem; lead to a negative body image, depression, stigmatization, marginalization, and isolation.

A possible treatment for this condition is bariatric surgery which encompasses a series of procedures designed to remove a portion of the stomach or re-route the small intestine to a small stomach pouch, in order to restrict the amount of food the stomach can hold.

Several years ago, these were large-scale invasive procedures with high mortality rates. Now, however, they are preformed using a minimally invasive technique known as laparoscopic surgery, which allows the surgeon to work with precision, and reduces patient recovery time, post-surgery pain, and damage to the body.

Bariatric surgery is provided by various Cuban health institutions, but principally the National Center for Minimal Access Surgery (CNCMA), located in the Havana municipality of 10 de Octubre. The CNCMA is also a national reference center which specializes in endoscopic and minimally invasive procedures performed by highly qualified processions using state-of-the-art technology.

In this regard, Miguel Ángel Martínez Alfonso PhD, speaking to Granma International explained that the procedure has been available in Cuba since 2004, with successful results to date. He highlighted the low risk of infection associated with the surgery, and improvements in patients’ quality of life.

The General Surgery specialist and tenured professor explained, “We have been offering international medical care since 2014, and bariatric surgery is one of our most popular programs. We receive international patients who come here to be treated for a health problem which affects many people around the world. International organizations estimate that more than 40% of the world’s population is obese, above all women, who represent 47.1% of the total.”

Nursing graduate Maydelis Gamboa Correa highlights the work of nurses in assisting the doctors and caring for patients. Photo: Yander Zamora

One of the most popular internationally regulated and accepted weight-loss procedures is a gastric sleeve which consists of removing around 80% of the stomach and leaving a small tube able to hold between 150 and 200 milliliters of food.

Meanwhile, gastric bypass surgery contributes to weight-loss by dividing the stomach into a small upper pouch and a much larger lower "remnant" pouch after which the small intestine is rearranged to connect to both.

According to Martínez Alfonso, to be eligible for the procedure a patient must suffer from severe obesity and/or related non-transmissible chronic diseases, and have an understanding of the type of surgery they are going to receive. They must show evidence, validated by specialists, of previous unsuccessful attempts to lose weight, after which they undergo a pre-op evaluation to measure their health parameters.

Martínez Alfonso went on to note that patients must remain in the country for over a week, during the first three days of which they undergo pre-op medical checks, as either an out patient or admitted, depending on their preference. They must then remain in the hospital for 72 hours after the procedure to undergo post-op assessments and rigorous observation, while the length of a patients’ stay can be extended depending on the results of their evaluation and recommendation of their doctors.

According to the specialist, patients will notice immediate results, but must continue to follow a specialized treatment plan which includes lifestyle changes, above all in regards to diet.

The National Center for Minimal Access Surgery (CNCMA), located in the Havana municipality of 10 de Octubre, is also a national reference center. Photo: Yander Zamora

“We advise patients on what kind of foods they should be eating, how much, when, with what, and in what way, as well as information on the right kind of exercises to do,” noted Martínez Alfonso.

Nursing graduate, Maydelis Gamboa Correa, who has been working at the CNCMA for over 13 years, shares a similar opinion; highlighting the important work nurses do to educate patients in the right type of treatments to follow to ensure their swift recovery. “While they are in the hospital, patients will never feel alone,” stated Gamboa Correa.

According to the health professional, the nurses’ work consists of three key stages: before the operation, during which they receive the patient and their families, prepare the bed and room where they will be staying; measure their vital signs, weight, and height, and handle all the necessary pre-op preparation.

They assist the surgeon during the procedure, and keep the family updated on the patient’s progress throughout the surgery.

Afterwards, they rigorously monitor the patient, and carry out post-op analyses and care, including cleaning the wound, taking laboratory samples, monitoring the patient’s eating during the first 48 hours after the operation, and instructing them in the new dietary habits they must assume.

Gamboa Correa recalls fond memories of many of her international patients, noting that she maintains contact via email in order to find out how they are doing after their surgery. Some send her photos showing how much weight they have lost, while others have returned to visit, visibly slimmer and healthier, and happy to have improved their chronic diseases and physical appearance.

For more information regarding health tourism in Cuba contact Servicios Médicos Cubanos (Cuban Medical Services) via their website, Facebook page, or email: tursalud@cce.sld.cu; or directly at its headquarters: No. 215, Párraga Street, between San Mariano and Vista Alegre, Reparto Víbora, municipality 10 de Octubre.

Both health professionals highlighted the development of the CNCMA since it was founded in 1993 by eminent doctor, Julián Francisco Ruiz Torres.

At that time a multi-disciplinary team ofgastroenterologist, surgeons, anesthesiologists, radiologists, and nurses at the General Calixto García University Hospital, came up with the idea to offer patients high-quality endoscopic surgeries and therapies as well asinterventional radiology services with the use of state-of-the-art technology.

Their work was so successful that it gave rise to the National Reference Center for Minimal Access Surgery and Endoscopic Therapies.

The institution provides assistance, teaching and research services related to health problems affecting the Cuban population, and also offers regular and specialist courses, training, as well as Masters and post-graduate degree programs for sector professionals and technicians.

Meanwhile, a center to train minimal access surgery specialists, who provide their services across 120 associated departments nationwide, as well as colleagues from the continent undertaking their residency or post-graduate studies in Cuba, was recently inaugurated.

The facility is equipped with machines and digital simulators on which surgeons can practice and refine their skills.

Although many specialists have been trained at the CNCMA, this new center allows over 30 surgeons, specializing in different areas, to be trained at the same time, for a total of over 700 doctors a year, triple that of the current figure.

Meanwhile, 200 international experts have graduated from the center, with enrolment figures expected to rise over the coming years given the fact that a large number of developing nations lack this kind of facility, which is the only one of its kind in Central America and the Caribbean.

As such the CNCMA can be described as a successful organization, with highly competent and professional staff; committed to its continued development through ensuring patient satisfaction, supporting scientific research, and prioritizing human resource training.