Margarita Pullés was a family doctor in the Sierra Maestra, and went on to join international missions. Photo: Jorge Oller

Thirty-five years have passed since the founding of the Cuban family doctor program – originally known as the “120 families doctor,” created in 1984 on the initiative, and continuously followed, by Fidel, in the Havana neighborhood of Lawton, which would soon thereafter become an experimental institution across the entire country.

In the end, it became one of the country’s most important programs, an antecedent to the Cuban medical brigades that have offered, and offer, their services in places far from the island, and often in extremely dangerous conditions created by nature.

Moving across difficult terrain, mountainous for the most part, to exercise their profession, was a unique experience for the recently graduated doctors who joined the noble family doctor project in the Sierra Maestra. Fidel himself took note of the locations, the beginnings, in the provinces of Santiago de Cuba and Granma, including the most remote and difficult to access sites.

It is important to remember those pioneers, now more than ever, at a time when we are recognizing the exceptional work of doctors returning from Brazil, having accomplished true feats on human missions in especially difficult places. They had precursors: the family doctors in the Sierra Maestra.

In a prologue by Cuban writer Lisandro Otero, regarding the emergence of this type of assistance in the Sierra Maestra, the great reporter and novelist, a National Prize for Literature winner, now deceased, wrote: “... It was Hippocrates who in his Oath of Honor conditioned the practice of the art of Medicine on the patient’s benefit. In his code of ethics, the doctor’s obligation to the promotion of life was emphasized (...). Almost 2,500 years later it can be read in a report - referring to the family doctor in the Sierra Maestra - who participates actively in the life of the community, enjoys its successes, suffers its dilemmas... becomes the family’s best friend...”That is what Cuban doctors have experienced, who have returned from missions in remote and difficult places, as many have said.Among those who for the first time worked as family doctors in the Sierra Maestra, beginning as said, in Santiago de Cuba and Granma, many would later be part of internationalist contingents.Dr. Margarita Pullés is worth mentioning, for example, one of the first 28 who began as family doctors, in her case in San Antonio, municipality of Buey Arriba, Granma. She, like others among her colleagues, was part of the first brigade that went to Venezuela and worked for three years in Maracaibo, Zulia.Or Dr. Graciliano Díaz Bartolo, in the Bolivian Andes, and not to make his story too long, in many, many other brigades, including the contingent that fought Ebola in Africa. Just two examples.From Dr. Pullés, we learned that she was returned, like Graciliano, to her home doctor’s office, and faced hurricanes and other contingencies. They live today, like many other pioneers, modestly, in the provinces where they were born, and not only practice their profession, but have also earned advanced degrees.And by the way, Dr. Graciliano Díaz Bartolo was one of the Santiago doctors, if not the most important, whose specific work was of interest to a group of leading U.S. scientists who recently visited the heroic city of Santiago de Cuba, to interact with colleagues in the scientific program developed by Medic Review magazine, which has been in existence for 20 years.But the development since its inception of the family doctors program, in rural areas of the eastern provinces, was a special object of their interest, for them a surprise, given their geographical characteristics and clearly difficult access.

Family doctor offices can be found in the most difficult to access communities. Photo: Jorge Oller

Cuba has a population of more than 11,200,000 inhabitants, who have access to:

450 neighborhood polyclinics

More than 10,800 family doctor and nurse offices

150 hospitals

12 research institutions

2,500 pharmacies

131 maternity homes

287 community centers for older adults

150 rest homes for older adults

13 universities of Medical Sciences, among other institutions

482,308 health workers across the country

92,084 doctors, one for every 122 inhabitants
16,675 dentists, one for every 602 inhabitants
85,870 nurses, one for every 123 inhabitants

59,846 health technicians, one for every 188 inhabitants

Source: Anuario Estadístico de Salud Pública