COVID-19 brought health systems worldwide to their knees, but Cuba’s National Health Protocol stood firm. In the middle of this health crisis, Cuba, a cash-strapped nation, had to grapple with substantial disruptions. Its economy, largely based on tourism, took a severe hit. Even so, Cuban authorities effectively handled public health safety, implementing robust preventive strategies to tackle the pandemic.
COVID-19’s Arrival in Cuba
COVID-19 started in Wuhan, China, and quickly spread across the globe, reaching Cuba. On March 11, 2020, four Italian tourists became the first confirmed coronavirus cases in Cuba (NBC, 2020). Owing to the influx of tourists, the virus spread rapidly, leading to 207,322 cases and 1,372 COVID-19 deaths (Worldometers, 2021). Despite this rapid spread, Cuban authorities managed to contain the situation effectively, thanks to a thorough national protocol that prioritized public health safety.
Cuba’s Response to COVID-19
In 2019, tourism contributed a whopping 2.97 billion US dollars to Cuba’s economy (Statista, 2021). When the pandemic hit, Cuban authorities had to make a tough choice between safeguarding lives and protecting the economy. They decided to prioritize the health and safety of Cubans.
Travel Rules in Response to COVID-19 in Cuba
Given that tourists were the first detected cases in Cuba, strict travel rules were implemented. The national protocol introduced measures like requiring a negative PCR COVID-19 test result before entry, health declarations, mandatory testing upon arrival, and compulsory isolation for all visitors (Gardaworld, 2021).
In a bid to curb exposure, Cuban authorities cut down flight frequency, banned non-essential transportation, and enforced a nationwide lockdown (Gardaworld, 2021).
Coping with Sanctions and Implementing National Strategy
US sanctions on Cuba made the pandemic’s impact even harder by cutting off international financing. Despite these financial hurdles, Cuba’s government rolled out a strong response, which included training medical workers early, preparing medical students for contact tracing, and launching public information campaigns (Morris and Kelman, 2020). They also introduced large-scale online buying and selling and used private vehicles to move essential workers (Morris and Kelman).
Homegrown Vaccine Development in Cuba
Cuba’s decision to develop its own COVID-19 vaccines rather than importing them raised many eyebrows at first. However, after rigorous clinical trials, they produced two vaccines, Abdala and Soberana, which the World Health Organization (WHO) approved.
Success of the Vaccines
With an efficacy rate of 92.8 percent for Abdala and 62 percent for Soberana, these vaccines surpassed the 50 percent WHO validation mark (Nature, 2021). Increasing global demand for these vaccines validated Cuba’s choice to develop their own solutions. The nation now ranks fourth globally for the effectiveness of its COVID-19 vaccines.
The Health Infrastructure and Public Education’s Role
Cuba’s primary health care system played a vital role in containing the virus. Before recording the first cases, Cuban authorities had already started diagnostics and a comprehensive public education campaign (Taylor, 2021). This public education significantly increased acceptance of the homegrown vaccines.
Despite lacking certain medical supplies, Cuba made the best of the situation by deploying well-trained medical workers.
Conclusion: Learning from Cuba’s Response
Cuba’s swift and comprehensive response to COVID-19 serves as a lesson for other countries. Their strategic approach, including lockdowns, phased travel bans, public health education, and the development of globally recognized vaccines, showcases Cuba’s robust leadership.
By prioritizing the health and safety of its citizens, Cuba mitigated the devastating effects of the pandemic. Cuba’s experience shows that even countries with limited resources can effectively handle a health crisis. Cuba’s resilient and adaptable health protocol provides a valuable blueprint for managing public health crises worldwide.
The COVID-19 pandemic began at an unprecedented time when humans, organizations and institutes were not prepared. Like the global cases and deaths, Cuba had a recurring cases and deaths totaling 70,000 and 408 respectively as at March 2021 (Yaffe, 2021). The severity of cases and the resulting deaths influenced the production of COVID-19 vaccine in Cuba. Among countries that made great efforts at seeing to safety, and the containment of coronavirus, Cuba played an intensive role in not only competing with top-tier countries like the United States, the United Kingdom, Germany and India among others; but also demonstrating an exceptional feat by the production of “Abdala” and “Soberana” vaccines for COVID-19.
COVID-19 is viral disease that emanates from coronaviruses. The disease-causing virus was first discovered in Wuhan, China in 2019 but has since spread to other countries of the world including Cuba. Although, the virus is from the family of severe acute respiratory syndrome (SARS) and was in spread in 2002-2003, the latest variants have shown to cause severe respiratory disorders (Kandola, 2020). Thus, the virus is code-named, COVID-19.
The Abdala Vaccine
Cuban’s COVID-19 “Abdala” vaccine has been found with a 92.28 percent efficacy in combating coronavirus. The vaccine effectiveness declaration comes after the last-stage clinical trials made in the country (Frank, 2021). The vaccine’s potency is evident in the drastic reduction of coronavirus cases and deaths across the country. According to Cuban’s authorities, COVID-19 cases reduced by half after a country-wide vaccination in the country using “Abdala” (Frank, 2021). The vaccine production has been found sufficient as over 11.2 million Cubans are considered for vaccination—a huge stride considering the resources of the country.
Abdala, a coronavirus vaccine produced in Cuba was a rapid response to containing the virus. The rapidity in the vaccine’s development influenced the trial stages and the eventual manufacturing. The clinicals at the first stage showed that, “safety and reactogenicity profile of the immunogen was favorable for the two doses of the vaccine candidate”. In other words, the first stage of the trial was tested valid for immune efficacy (Santos, Martin and Medina, 2021). 760 volunteers participated in the second stage trial for the 11.25 million population of people in Cuba including people between 19 and 54 years and a special involvement of people around 80 years (Santos et al, 2021). The vaccine development process had a preferential consideration for people with comorbidities and those with chronic diseases; their inclusion was monitored and medically controlled (Santo et al, 2021). The effect of the trial stages is shown in the quality of the vaccine and its reliability at performing that which it was manufactured for. The third stage of the vaccine development was charged for immunogen results in the third phase trial participants. The third phase had a total of 48,290 volunteers from provinces including Granma, Guantanamo and Santiago de Cuba (Mola, 2021). The trials show that, the vaccine generates antibodies against COVID-19 and that, it yields a “viral neutralization assay” with “functional activity” (Santo et al, 2021).
Mola (2021) reports that Abdala was developed by the Center for Genetic Engineering and Biotechnology in Havana, Cuba. The center also manufactured Mambisa but mainly for nasal administration the reporter says. Abdala vaccine is protein subunit and contains a synthetic segment of the SARS-CoV-2 S protein, which is identified as an RBD (receptor binding domain) (Mola, 2021). The notable part of the vaccine product is its quality. Abdala is thus ranked fourth in the list of vaccine production mostly among first world countries—right after US’s Moderna third, US and Germany’s Pfizer second and US’s Novavax as the first ranked COVID-19 vaccine globally. The World Health Organization (WHO) has attested to the efficacy of Abdala with a test response that, the vaccine rates above the 50 percent benchmark set for coronavirus production as a global standard (Mola, 2021). Despite being short of funds, Cuba has risen beyond its financial incapability to competing medically with rich nations globally. Although, Cuba is placed on a financial blockade by the United States for over sixty years, Cuban authorities rose to the occasion to protect Cubans from the haphazard effects of coronavirus; placing the country high among comity of nations (Mola, 2021).
Notably, Cuba has been able to present five vaccine candidates to containing COVID-19; Abdala tops the candidates based on its near perfect efficacy. The center in charge of Abdala production claims the vaccine is capable of elevating immune responses through antibody generation. Abdala was tested active for efficacy, the production was inspected and certified for standard and safe practices. The vaccine production centers were equally validated—a step which places the vaccine in a public light that would later yield a global audience, purchase and revenue for Cuba. The country’s authorities have been able to maximize Abdala’s production to source revenue for the country. The benefit of Abdala’s production has been identified as reducing COVID-19 cases, reducing coronavirus related deaths, strengthening the country’s biotechnological infrastructure and professionalism, generating income through Abdala’s exportation and sales and competing on a global standard with well-resourced nations.
Cuba’s Abdala Against Other Vaccines: Testimonials
Cuban authorities pulled off the risk and opted for ‘homemade’ coronavirus vaccine. Although, medical professionals advised the authorities such a decision was risky but it paid after the success Abdala and Soberana. Cuban government supported the vaccine production from the outset; a testament to this is the tweet from the President, Miguel Diaz-Canel that despite a hard hit of COVID-19 in Cuba, the authorities were set to provided needed support for the vaccine production institutes including Finlay Institute and Center for Genetic Engineering and Biotechnology (Reuters, 2021). Testimonials from the authorities indicate that Abdala does not only cater for COVID-19 containment and public safety, it is also targeted at boosting the morale of medical professionals in the country while revamping the health sector for more rapid and responsive public health cases and emergencies. The government’s justification for the homegrown component vaccine is that, “it would create a centrally controlled and free health care system in Cuba toward a fast-pace vaccination and coronavirus suppression” (VOI, 2021). The implication of Abdala’s successful production in Cuba is that it reveals the tenacity of the authorities, the ingenuity of the biotechnologists and medical experts and the resilience of the public in safely receiving the vaccine. World Health Organization (WHO) commends the efficacy of Abdala noting that the vaccine creates optimism for the country and a great news for the people. The representative, Jose Moya is described to have knowledge of the formula for Abdala, a vaccine which has become globally competitive and required by different countries in combating the prevalence of COVID-19 (Vincent, 2021). Upon a successful production of vaccines for coronavirus, Cuban authorities targeted a 70 percent vaccination of the people. However, Reuters’ report indicates that only 6.4 million of the 11.2 million population have been vaccinated (Reuters, 2021).
Global Importance and Demand for Abdala
Abdala has proven to be an effective vaccine in generating antibodies against COVID-19. The vaccine has been robustly used in the island country and is now yielding respects from international level. Venezuela has received Abdala from Cuba and has embarked on populating it to the tune of four million doses for local use in the country. Venezuelan authorities have been reported to receive a shipment of the vaccine toward public use (Berti, 2021). The Cuban vaccine is named Abdala, the name of the country’s independence hero; this shows how significant the name is supported by the potency of the vaccine for local and resulting global use.
COVID-19 was unexpected globally. Although, there had been variants of the SARS virus earlier before 2020, the emergence of the pandemic caught the world unaware. The unaware nature of the virus influenced its effects in cases, prevalence and eventual deaths. However, countries with research and biotechnological infrastructure were able to produce vaccine for the containment of the virus. Among the top-leading countries of the world who made COVID-19 vaccine, Cuba impacted with a giant stride coming fourth in a league of countries including the United States, Germany and India. The vaccine has been found efficacious in arresting coronavirus; it has thus been in widely-accepted use in Cuba and beyond.
The novel coronavirus of 2019, known as COVID-19, fiercely swept across the entire world within just a matter of months, causing panic, fear, and uncertainty. For over a year now, COVID-19 has been the daily talk of the world as we have all been fighting this devastating pandemic together. Quarantines, shutdowns, social distancing, and mask mandates have been put in place all around the world in hopes of slowing down the spread of this deadly virus, and these precautions are still in effect in many places today as cases continue to rise and new variants of the virus emerge.
COVID-19 Vaccines Show Promise Against the Coronavirus
The United States’ recent development of their COVID-19 vaccines has shown promise in being effective against the coronavirus. Based on clinical trials, Pfizer’s BioNTech mRNA two-shot COVID-19 vaccine has shown to be 95% effective at preventing COVID-19 infection in those who received both doses of the vaccine and had no prior infection.1 Based on clinical trials, Moderna’s mRNA two-shot COVID-19 vaccine has shown to be 94.1% effective at preventing COVID-19 infection in those who received both doses of the vaccine and had no prior infection.2 In clinical trials, Johnson & Johnson’s Janssen viral vector COVID-19 vaccine has shown to be 66.3% effective at preventing COVID-19 infection in those who received the single-dose vaccine and had no prior infection.3
The United States aren’t the only ones trying to stop COVID-19 for good with their immunizations. Cuba has now joined the race to beat COVID-19 as new cases continue to rise and new variants of the virus emerge.
Can Cuba’s Homegrown Vaccines Help Solve the Worsening COVID-19 Pandemic?
Cuba is working to become the first Latin America country to develop and manufacture its own COVID-19 vaccines.4 Cuba’s development of two new COVID-19 vaccine candidates has been reported in the news a lot during the past few weeks. Cuba is betting that its own vaccines, made by local laboratories, can beat COVID-19 on its own.5 “Vicente Vérez Bencomo, director-general of the state-owned Finlay Institute of Vaccines in Havana, where one of Cuba’s most advanced vaccine candidates was created, thinks the chances are good.”4
Guaranteeing Cuba’s Sovereignty with Its Own COVID-19 Vaccines
Cuba decided to develop and manufacture its own coronavirus vaccines rather than compete with richer countries for vaccines6 to immunize its tiny island of 11 million inhabitants.6 After the COVID-19 pandemic began, “Cuban leader Miguel Díaz-Canel said that guaranteeing the nation’s sovereignty was the main goal of producing a homegrown vaccine,”6 naming the first vaccine candidate Soberana which is Spanish for “sovereign.”6 Abdala, another of Cuba’s vaccine candidates, was named after a poem by independence hero José Martí.6 For Cubans, the names of these homegrown vaccines show that the tiny island of 11 million inhabitants “cannot be broken by a deadly virus.”7
Cuba is Hopeful That Its Homegrown Vaccine Candidates Will Be Effective Against COVID-19
As of today, Cuba has five coronavirus vaccine candidates at various stages of [clinical] trials.6 Just last week, Cuba said that two out of five vaccine candidates have shown to be highly effective against COVID-19.6 The Cuban government-owned pharmaceutical company, BioCubaFarma, said that its three-dose Abdala vaccine has shown to be 92.28% effective in Phase III trials.6 However, The Pan American Health Organization says Cuba has yet to “publish trial data on its Abdala vaccine in peer-reviewed scientific journals so that the global scientific community can evaluate efficacy rates of the COVID-19 [vaccine].”6
Cuba has already been administering its vaccines “even before receiving certification from local authorities”6 after a surge in coronavirus cases led to an emergency response in May.6 According to Díaz-Canel, more than one million Cubans have already been vaccinated with at least one dose of the Abdala or Soberana 02 vaccines.6
Cuba’s Surge in COVID-19 Cases: A Race Against Time
Cases of the coronavirus have been steadily rising since November 2020 after Cuba reopened its borders to tourists.6 The island is now dealing with its worst outbreak for the first time since the pandemic started,8 registering more than 3,000 daily cases. According to the Ministry of Public Health, since the start of the pandemic, Cuba’s total cases have reached 188,000 with 1,270 deaths.6 The government is aiming to have 70% of Cuba’s population fully vaccinated by August 2021.7
Is Cuba’s Abdala COVID-19 Vaccine One of the World’s Most Effective Coronavirus Vaccines?
With its reported 92.28% efficacy against COVID-19 in Phase III clinical trials,6 Cuba’s three-shot Abdala COVID-19 vaccine may become one of the most effective coronavirus vaccines in the world, rivaling Pfizer-BioNTech’s 95% efficacy,1 Moderna’s 94.1% efficacy,2 and Russia’s Sputnik V’s 91.6 efficacy.9
Countries including Argentina, Bolivia, Jamaica, Mexico, and Venezuela are interested in obtaining Cuba’s coronavirus vaccines.7 The reported high rate of efficacy of Cuba’s Abdala vaccine, as well as the hope for efficacy with other Cuban vaccine candidates in various stages of clinical trials, could enable vaccine exports to other countries to help lift Cuba out of its economic crisis.9 In fact, Venezuela received their first batch of Abdala just this week.10 And Caracas signed a deal to buy 12 million doses of Abdala.10 Cuba has plans to manufacture 100 million doses in 2021 for export to more than 30 countries10 around the globe.
Cuba’s COVID-19 National Protocol
Although vaccines are being developed and administered to people all over the world, Cuba still has protocols in place to protect the country and its tourists from COVID-19 infection. In fact, Cuba is facing its worst outbreak since the beginning of the pandemic.8 As a result, Cuba is under a level 4 travel alert (DO NOT TRAVEL).11
According to the U.S. Embassy in Cuba, all travelers must present a negative COVID-19 polymerase chain reaction (PCR) test administered no more than 72 hours prior to entry into Cuba.11 “All travelers are required to fill out a health declaration card,”11 take a COVID-19 PCR test at the port of entry, and self-isolate until results of the COVID PCR test are received.11 If the results are negative, another PCR test will be administered on the fifth day of isolation; if the second PCR results are negative, the isolation period is over.11 Travelers who test negative upon arrival can self-isolate in a government-run facility or at a hotel participating in the government’s COVID-19 isolation protocol.11 Travelers who test positive will be moved to the National Institute of Tropical Diseases Pedro Kouri.11
All individuals are required to wear a facemask in all enclosed public spaces and comply with sanitization and social distancing requirements.12
Commercial flights are operating but are limited and can be cancelled unexpectedly.11 According to the U.S. Embassy in Cuba, “if U.S. citizens choose to travel to Cuba despite the level 4 alert for Cuba, they should stay in close contact with their travel agents and/or airlines and be prepared to cover their living expenses in Cuba should their return flight(s) be cancelled. The U.S. Embassy is closed for routine services and cannot assist with travel arrangements.”11
Public transportation is operating but is limited11,12 to essential workers.12
Fines for Non-Compliance
If individuals do not comply with Cuban government measures and hygiene protocols, a fine and/or criminal penalty may be issued.11
Cuba’s Hope to End the World’s Common Enemy
As the world continues to fight the common enemy known as COVID-19, Cuba remains hopeful that its homegrown vaccines will officially beat the virus.
Pfizer-BioNTech COVID-19 Vaccine Overview and Safety. Centers for Disease Control and Prevention. Updated June 24, 2021. Accessed July 2, 2021. https://www.cdc.gov/corona
Johnson & Johnson’s Janssen COVID-19 Vaccine Overview and Safety. Centers for Disease Control and Prevention. Updated June 23, 2021. Accessed July 2, 2021. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/janssen.html.
Mega E. Can Cuba beat COVID with its homegrown vaccines? Published April 29, 2021. Accessed July 2, 2021. https://www.nature.com/articles/d41586-021-01126-4.
Wyss J. Cuba Bets Big on Its Own Vaccines as Covid Surges. Bloomberg Businessweek. Published May 25, 2021. Accessed July 3, 2021. https://www.bloomberg.com/news/arti
Brasileiro A. WHO tells CUBA to publish its COVID-19 vaccine data and to seek approval for COVAX. Miami Herald. Published July 1, 2021. Updated July 1, 2021. Accessed July 3, 2021. https://www.miamiherald.com/news/nation-world/world/americas/cuba/article2
Pieper O. Cuba’s COVID vaccine rivals BioNTech-Pfizer, Moderna. Published June 27, 2021. Accessed July 3, 2021. https://www.dw.com/en/cubas-covid-vaccine-rivals-biontech-pfizer-moderna/a-58052365.
Cuba says Abdala vaccine 92.28% effective against coronavirus. Reuters®. Published June 22, 2021. Accessed July 3, 2021. https://www.reuters.com/business/healthcare-pharmaceuticals/cuba-says-abdala-vaccine-9228-effective-against-coronavirus-2021-06-21/.
Cuba reports a high success rate for its homegrown Abdala vaccine. The New York Times. Accessed July 3, 2021. https://www.nytimes.com/2021/06/22/world/americas/
Berti L. Venezuela receives first batch of Abdala vaccine from Cuba. Published June 30, 2021. Accessed July 3, 2021. The Brazilian Report. https://brazilian.report/liveblog/2021
COVID-19 Information. S. Embassy in Cuba. Updated June 16, 2021. Accessed July 3, 2021. https://cu.usembassy.gov/covid-19-information/.
Cuba: COVID-19-related travel protocols and domestic restrictions in force as of May 4 remain largely unchanged /update 21. Published May 4, 2021. https://www.garda.com/crisis24/news-alerts/474861/cuba-covid-19-related-travel-protocols-and-domestic-restrictions-in-force-as-of-may-4-remain-largely-unchanged-update-21.
In the 21st century, we are facing the fact that the global population is ageing quite rapidly. The reason for this increasing trend lies in several factors. Firstly, the number of babies brought to this world declines and more and more couples face fertility issues. Second, more important factor includes better availability and quality of healthcare worldwide, which in return prolongs life expectancy. Western countries, and those with high quality of primary healthcare, are impacted the most with ageing phenomenon. According to some estimations provided by the World Health Organization (WHO), the total world’s population over 60 years of age will nearly double by the 2050. Shown in numbers, we can anticipate an increase from 900 million today, up to nearly 2 billion people of elderly people in thirty years. These, what appears to be dramatic data have multiple consequences, including social, economical, as well as healthcare issues.
Mental problems are well recognized health issue in the elderly. It is estimated that approximately one fifth of the global elderly population suffers from some form of psychological disorder which prevents them from independently performing everyday activities. As a society, we sometimes perceive intellectual and mental decline almost as a natural consequence of ageing. On the other hand, stigma that surrounds these conditions often prevents elderly people and their families from seeking professional help and assistance. Support and care are crucial when we discuss about how to overcome the challenges related to psychological problems in the old age.
What are the risk factors?
The spectrum of risk factors responsible for developing psychological problems in old age is quite extensive. Multiple chronic illnesses, especially those of cardiovascular and cerebrovascular origin (hypertension, stroke, coronary heart disease) may have direct consequences to the brain, thereby producing cognitive disturbances and mental issues. Chronic pain is a perfect trigger of psychological distress in the old age. Hospital admission and any change of the environment (moving to a care setting) can also have a negative impact for the overall psychological well-being in the elderly. Social isolation, reduced income during retirement and loss of close family members are significant stressors to cope with – these may produce severe psychological disturbances leading to anxiety or depression. In fact, any severe and long-term illness, such as cancer, tends to affect the behavioral and psychological status of an older person.
Sadly, people of older age are also recognized as a population group prone to abuse. There is evidence that one in six older people will experience some type of abuse. Loss of dignity and respect is, not surprisingly, tightly linked with severe psychological issues.
Are there any symptoms?
Close family members and caregivers should be aware of signs and symptoms related to mental disorders in the elderly in order to seek professional help in a timely manner. When we see our loved ones age, occasional forgetfulness is usually not something to especially worry about. However, persistent loss of memory is a clear indication of a severe health condition needing medical attention.
Significant changes in appearance including changes in clothing may implicate a psychological and behavioral problem. Confusion, disorientation, inability to concentrate or make decisions represent early signs of cognitive decline and dementia. If you experience that your loved ones persistently ask the same questions, forget important dates, frequently misplace their belongings, this is a clear sign to refer them to a medical professional.
It is advisable to especially keep an eye on the feelings of guilt, worthlessness, helplessness – such symptoms are linked with depression. Mood swings, ranging from e.g. being carefree to anxious are indicative of psychological issues. Inability to cope with everyday routine, problems in maintaining hygiene, home or garden should not be disregarded – they are often a sign of mental illness in older people.
Noticing any type of social withdrawal should be taken seriously. If your loved ones lose interest in social activities that they used to be excited about, or just avoid regular social engagements, you should consider seeking professional support for them.
Common psychological issues in old age
It is probably not that surprising that cognitive decline and dementia represent the most common mental health disorder in people older than 65 years. This severe and progressive disease affects approximately five million senior Americans or fifty million seniors worldwide. Concerning is the fact that this number will almost triple in the next twenty years. The disease by itself is estimated to take more lives than breast and prostate cancer combined. Any type of dementia can produce significant physical, emotional and economic pressure to patients and their caregivers. This is why an early diagnosis and appropriate care are essential for patients and their caregivers.
Depression and mood disorders are also quite frequent among seniors, however, the problem with this health condition is that it often goes undiagnosed and, therefore, untreated. Center for Disease Control (CDC) estimates that 5% of elderly individuals suffer from depressive disorder. It is worth mentioning that some medications such as those for the treatment of increased blood pressure may cause depression. Sadness is not the only symptom. Lack of motivation and energy are the usual complaints linked to depression. Prolonged suffering and impairment in performing daily activities are well recognized consequences of untreated depression. Timely diagnosis, accompanied with adequate treatment, care and support is crucial for increasing the quality of life of elderly individuals.
Anxiety is also quite prevalent and may encompass a wide range of mental issues including obsessive-compulsive disorder, post-traumatic stress disorder, panic disorder or phobias. Women are more prone to anxiety than men. Anxiety related disorders tend to occur after a stressful situation such as loss of a spouse or side by side to other chronic and prolonged disease. As in depression, anxiety disorders are usually overseen in elderly individuals, which may have severe implications to the overall well-being of seniors.
Sleep disorders including are common among seniors. Prolonged time needed to fall asleep (usually more than 45 minutes), trouble in maintaining sleep with frequent periods of being awake during night, as well as short overall duration of sleep represent clear signs of insomnia. Proper sleep is very important as it will reduce the probability of a severe psychological disorder. Maintaining a “sleep hygiene” reduces the need for sleep medications, which are sometimes responsible for memory impairment or poor daytime performance.
Is there a solution ( psychotherapy )?
It is important to mention that all of the above-mentioned disorders may coexist, and it is usually the case that seniors suffer from more then just one mental disorder. This is why they need all our support. WHO clearly recommends as a standard of care both psychological and medicinal treatment of seniors affected with mental disorders. This approach is essential for improving both physical and mental health and keeping an optimal quality of life of elderly individuals.
The demand for care and support of seniors with mental issues will increase as the elderly population grows. Providing a timely, high-quality professional help to older people directly reduces the number of complications that may arise as a consequence of mental disorders and prolongs the physical and emotional well-being of the elderly.
Solutions at CubaHeal
CubaHeal offers specialized programs for diagnosis and treatment of psychological problems in the elderly. An array of psychological therapies is available at CubaHeal facilities. Our team of health professionals can provide top-notch, evidence-based medical expertise. This includes diagnosis and treatment for our users, no matter the psychological condition and its stage.
Eczema, often referred to as atopic dermatitis (AD) in the literature, is the most common form of chronic dermatitis. This non-contagious skin condition manifests as an itchy rash, predominantly affecting children. Over time, symptoms usually improve, though adults can experience it too.
Unraveling the underlying triggers of this condition, however, isn’t straightforward. Present understanding implies that a blend of genetic and environmental influences play a role. In simpler terms, it appears both the individual’s genetic makeup and their surrounding environment contribute to its emergence.
This initial explanation may not fully satisfy the curiosity of those interested in this skin ailment. Nonetheless, we intend to probe further, aiming to offer a more detailed understanding of its multifaceted origins.
Unraveling Eczema: Two Key Theories
While we understand eczema’s mechanisms, the specific factors triggering them remain under academic debate. Two prevalent hypotheses have emerged.
The first hypothesis suggests that an imbalance in the immune system is a leading cause. The second theory points to a defect in the skin barrier.
These hypotheses offer plausible explanations, despite the lack of a definitive answer to Atopic dermatitis’s cause.
Importantly, we should not consider these hypotheses in isolation. Rather, we should view them as complementary perspectives, each adding valuable insight to our understanding of this complex condition.
The imbalance in the immune system hypothesis
The first theory proposes that eczema arises from an imbalance in the production of T cells .
Individuals with Atopic dermatitis often have an overabundance of T-helper 1 and T-regulatory cells.
This imbalance results in an increased production of interleukins, substances that amplify the body’s inflammatory response. Consequently, the inflammation intensity in the body’s affected areas heightens.
The skin barrier hypotheses
The newer theory suggests that mutations in the filaggrin gene increase eczema risk. Filaggrin binds upper skin layer cells and seals tiny cracks, preventing water loss and allergen penetration. In those with the mutation, filaggrin production drops, impairing the skin barrier and making the skin more permeable to water, allergens, and microorganisms.
The toll on health goes beyond the skin surface
Let’s take a pause from eczema causes here and briefly discuss the phenomenon known as “The Atopic March.”
The immune system’s defects often have body-wide effects. Atopic dermatitis, while a skin condition, is influenced by genetic factors affecting other body parts. “The Atopic March” describes conditions stemming from a flawed immune response often seen in eczema patients, including a flaw in T-helper cells.
lymphocyte function also can cause food allergies, asthma or allergic rhinitis. The Atopic dermatitis kicks in first and, in the early years of life, is often followed by the rest of the atopic cascade. The importance of this phenomenon lies in the fact that a timely treatment of eczema can reduce the severity of or prevent in temporary conditions that follow it.
Environmental factors of Atopic dermatitis
As mentioned earlier, the leading cause of eczema is a combination of genetic and environmental factors. Not all people with the “right genetic code” develop the condition. Atopic dermatitis happens only if all or the majority of contributing factors align, creating a perfect storm. In this section, we’ll take a look at contributing environmental factors. The prevalence (the number of cases of a disease present in a particular population in a given time) of eczema has increased in the past few decades at a pace that changes in gene pool cannot explain. So, the increase in prevalence is explained by changes in environmental factors. At this moment, we can’t tell for sure what those factors are. Still, the growing body of scientific evidence suggests that exposure to dust mites, various allergens, infections, irritants and antibiotics increases the prevalence of Atopic dermatitis 1.
The theory was introduced to the public back in 1989, and it suggests that the main cause of increased eczema prevalence may be the development and “sanitization” of society. The theory argues that the lack of adequate stimulation of the immune system in early life (children that are “too clean”) and failure of maintaining balanced gut flora in adulthood (antibiotics in food) are triggering factors in the pathogenesis of Atopic dermatitis. Furthermore, the hygiene hypothesis explains the rapid rise in prevalence among smaller, wealthier and more educated families in comparison with larger families and those attending a nursery.
The bottom line is that exposure to some pathogens in early life, as well as the timing of exposure, play an essential role in the pathogenesis of eczema. However, some pathogens may trigger the condition; for example, measles infection increases the risk of the disease.
References : 2,3,4,5
Soap acts as an irritant. It causes skin dryness, increases its pH, and transepidermal water loss. Several studies have shown that exposure to soap is in relation to increased eczema prevalence and that removal or avoidance of such chemicals reduces its prevalence.
Some studies have shown that eczema prevalence is increased in areas with harder water, but in recent years this hypothesis has been rejected. Namely, the increased hardness of water requires increased use of soap, so the scientific community accepted the use of irritants as the cause of Atopic dermatitis rather than the water harness.
The avoidance of irritants early in life is vital as a preventive measure – once the condition establishes, exclusion of those chemicals do not affect further development of the disease (eczema, followed by atopic march).
So, what is the main cause of Eczema?
After this discussion, it is essential to underline that eczema is a multifactorial disease. Its causes are not yet fully understood, and some claims about it are still wrapped in a veil of controversy. However, here are some important takeaway notes:
– The condition is a multifactorial disease caused by a combination of genetic and environmental factors.
– The genetic mutations in people with eczema affect not only the skin but potentially other organ systems, primarily respiratory organs. Atopic dermatitis is often only the first in a cascade of health issues that arise from altered genes.
– Restriction from exposure to the microbes in the environment is in association with the increased prevalence of eczema, but some infective agents may increase the chance of disease establishment.
– Once the condition establishes, it is impossible to reverse the process, but it tends to milden or completely disappear during puberty.
– Exposure to skin irritants, soap in the first place, plays an important role in the pathogenesis of the disease.
90 % of head and neck cancers are mostly squamous cell carcinomas. These carcinomas include nasopharyngeal cancer, nasal cavity, paranasal sinus cancer, oral and oro pharyngeal cancer, laryngeal cancer, hypo pharyngeal cancer and salivary gland cancer. As carcinomas their name indicates they are malignant tumors.
Oral and oro pharyngeal, laryngeal, hypo pharyngeal and salivary gland cancers are included in oral cavity cancers which are all squamous cell carcinomas and salivary gland carcinomas are adenocarcinomas. 95% of oral cavity cancers are squamous cell carcinomas. This aggressive epithelial malignancy is the sixth most common neoplasm in the world today .The overall long term survival rate has been less than 50% for the most past years. Multiple primary tumours will be present in initial diagnosis .These multiple primary tumours develop independently as a result of years of chronic mucosal epithelium exposure to carcinogens such as alcohol or tobaccos .Oropharynx cancer is due to mutations in TP53 gene and genes that regulate the differentiation of squamous cells such as p63 and notch1. Squampous cell carcinoma can arise anywhere in the oral cavity .The most common locations are the ventral surfaces of the tongue floor of the mouth lower lip soft palate and gingiva. These tumors
appear as raised firm pearly plaques. Republic of CUBA has succeeded in combating these cancers.
Salivary gland adenocarcinomas include pleomorphic adenoma and muco epidermis carcinoma. Pleomorphic adenomas are painless slowly growing mobile discrete masses. They represent about 60% in parotid and are less common in submandibular glands. While muco epidermoid carcinoma are composed of variable mixture of squamous cells, mucus secreting cells and intermediate cells.
Nasal cavity and paranasal sinus cancers. Squamous epithelial cells of the normal nasal cavity or sinuses can become squamous cell carcinomas. This is the most common type of cancer in the nasal cavity and Paranasal sinuses. Apillomas are warts that can grow inside the nasal cavity or paranasal sinuses and destroy healthy tissue. They usually have a bumpy surface. Papillomas are not cancer, but sometimes a squamous cell carcinoma will start in a papilloma .Republic of CUBA is trying to cure these carcinomas. Different drugs are given in CUBA and 24 hour observation of a patient is done.
Treatment by Cuba health centre.
The Republic of Cuba is in the forefront in battling these cancers. Cuba is taking measures to stop these carcinomas. Available Treatments are surgery radiations and chemotherapy in combination with immunotherapy. The treatment is based on the stage of cancer and on the health of the patient.
The program is carried by guiding the patient properly and thoroughly. If the cancer has not metastasized and its size is small, we can do surgery and also can treat him through radiations. Some drugs will also be given .Chemotherapeutic agents will be given according to their effects and by keeping in mind the condition of individual because chemotherapeutic agents also destroy the normal cells. Treatment procedure is mostly same in all the cancerous patients. But it depends upon the severity and stage of cancer In CUBA by the following method we treat cancer
First of all a proper medical check-up is done .or we can say pre-application medical
check-up is applied.
Anti-cancerous drugs are given.
These drugs include cyclophosphamide 200mg. This is a nitrogen mustard agent.it inhibits DNA function and its synthesis. It is given for breast cancer, ovarian cancer and chronic lymphocytic lymphoma. In republic of CUBA this drug is given with proper dosage and according to the condition, otherwise every drug has some adverse effects. This drug is given for 15 days and when further treatment starts.
Another drug which is given in republic of CUBA is NIMOTUZUMAB it is also called CIMAher EGF. It is given for head and neck cancers in combination with radiotherapy and chemotherapy. 24 Vials are given for 6 weeks treatment. It should be given with precautions otherwise nausea tremors and chills can develop.It is given in IV form.
The induction phase last six weeks corresponding to the 24 vials of the drug. The first dose will be given in republic of Cuba , and next dose he can take himself in CUBA or any other country.
There are many drugs available for the chemotherapy. These drugs are bortizomib imatinib, antimetabolites, vincristine, and etoposide. Each drug first dose is given in CUBA. Patient is monitored. If this drug found successful then second dose of the drug he can take himself.
Surgeries are also performed. That involves dissecting of the whole infected part. If less part is infected then a small part is dissected but mostly if small part is infected we took out large part even the whole part is not infected as a precaution.
These surgeries involve Total glossectomy semi glossectomy semi glossectomy partial glossectomy, trans maxillary glossectomy with neck dissection.
Total glassectomy : It is performed for the tongue .if whole tongue is affected whole tongue we be cut down so that the tumour does not metastasize. This is done in republic of CUBA with proper care.
Semi-glossectomy :It is the removal of half the tongue. This can also be done in republic of CUBA with proper care. If half tongue is not infected and other half is infected so we can perform partial dissection with proper care. We will cut half tongue if there is no chance of spreading this tumour to the other half.
Trans maxillary glassectomy with neck dissection. When cancer in the oral cavity is spread to the lymph nodes in the neck so removal of these lymph nodes is necessary because there are many lymph nodes are present in different sites of body. So cancer can spread to the different organs through lymph nodes which will be worst condition. Neck surgery is also performed in republic of CUBA. These include partial and modified neck dissections. Radical neck dissections are also performed.in which few or all lymph nodes are removed. There are also some maxillary and larynx medical programs in republic of CUBA in which partial or full dissection of the affected region is performed.
So CUBA is making a great progress in the treatment of cancer.
Cuba had the honor to host the first international conference regarding autism and inclusion in 2013. Island’s extraordinary efforts to understand, recognize and manage the condition in it’s early stages highlight the prestige and excellence of Cuba’s autism management. Cuban physicians represent global subject-matter-experts in the field of autism spectrum disorder (ASD). Cuba strives to find the best possible solutions for individuals suffering from ASD through the development of specialized ASD centers that focus on ASD treatment and inclusion of families within the society – of course, absolutely cost-free.
ASD represents a complex condition requiring multidisciplinary approach – a burden for profit- based healthcare systems. The fact that the management of ASD has been assessed as costly best illustrates the difficulties of western systems to properly address the issue of growing incidence of ASD. Waiting lists, inefficiency, high prices are the characteristics of profit-based healthcare systems that often result in inadequate management of those requiring prompt and intensive treatment. Cuba has developed a sustainable program for the management of individuals suffering from ASD focused on meeting the needs of each child.
Cuba offers a carefully tailored program for individuals suffering from autism spectrum disorder (ASD). The main goal of this program is to improve the child’s learning capabilities and reduce the symptoms of ASD. Overall, the program aims to boost the development capacity of each child with ASD. As a result, a visible improvement is seen in the child’s physical and mental abilities, due to the specific nature of the program design that is specifically tailored to meet the needs of each child individually. The program offers a peaceful and comfortable treatment environment and expert medical attention, which is very relevant for achieving the favorable treatment outcome. The facility is equipped with services and amenities such as cable TV, internet, pool, sauna, gym, pharmacy, and laundry services.
The program duration is 38 days. During this period, a set of activities is performed that may be divided into two main stages – evaluation and treatment. A detailed description of each phase is given below.
Stage 1 – Evaluation
During the evaluation phase, the information regarding the ASD nature of each child is obtained through consultation with specialists, laboratory and clinical investigations, as well as specific assessments necessary for evaluation and staging of the disease.
The initial steps in the evaluation phase include consultations with the team of experienced specialists in order to plan and tailor the comprehensive treatment and rehabilitation program for each child. This includes assessments performed by pediatricians, neuro-pediatricians, child psychologists, genetics specialists, logophobia specialists as well as otorhinolaryngologists. Furthermore, detailed laboratory investigations are required for disease evaluation and assessments. Biochemistry panel includes measurements of urea, creatinine, serology investigations, urine metabolic testing, complete blood count, sedimentation rate, blood glucose level, including but not limited to liver function tests.
Following initial testing, complex assessments are performed in order to get the clear picture regarding disease nature and severity. The assessments are performed by highly experienced subject-matter-experts and include logopedic evaluation, neuropsychologic assessment, Brunet-Lezine scale evaluation, as well as psychotherapy assessment and evaluation. Additionally, during the assessment period imaging studies may be performed such as brain MRI, evoked potential studies, EEG etc.
Once all the information has been gathered and a treatment plan has been tailored, the findings and possible management options are discussed with the family. The duration of this phase is dependable on the nature of the underlying disease as well as the child’s abilities to adapt to the new environment. Approximately, it takes no longer than 10 days in order to complete the evaluation and tailor the specific treatment.
Stage 2 – ASD Management
ASD represents a complex disorder requiring multidisciplinary and individual treatment approach for each child. This program offers multiple treatment modalities including equine therapy, sensorial stimulation techniques, occupational therapy, language therapy, ozone treatment as well as trans-cranial electric stimulation, which has been proven useful in hyperkinetic patients. Treatment is conducted by highly experienced experts with the constant involvement of parents.
The focus is on speech therapy that lasts for 20 days and involves both therapists and parents. This treatment modality lasts approximately 20 days and is conducted each day excluding Sundays and public holidays. Depending on the child’s ability to accept the treatment approach, initial sessions may last from 20 minutes to one hour. Protocol for conducting the therapy is tailored based on the individual characteristics of each child. It is strongly advised for the child to continue this treatment approach at home, once the language therapy is finished since this will ensure the long-lasting results in the future.
Occupational therapy will last approximately 30 days where the intensive treatment will aim to reduce neurological, mental and physical barriers of each child with ASD. This program allows a child to develop and maintain self-care activities, increases the overall productivity and enables a child to participate in leisure activities. The intensive treatment protocol is comprised of two treatment sessions during the day (in the morning and in the afternoon) approximately lasting for an hour or longer. The responsiveness of a child is stimulated by various methods including images projection, object identification, interactive and didactic games, palpation exercises as well as equine therapy.
At the end of each treatment, a detailed report is issued to parents with all of the activities performed at the site including detailed expert recommendations for further treatment and rehabilitation.
CubaHeal Medical is a global organization specialized in facilitating medical treatments, medical education, in addition to patient and student care in the Republic of Cuba. CubaHeal is a loyal supporter of the Republic of Cuba, the Cuban people, the Cuban revolution, and the Cuban revolutionary leadership.