[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:00.54,0:00:02.16,Default,,0000,0000,0000,,I want to tell you
Dialogue: 0,0:00:02.16,0:00:06.85,Default,,0000,0000,0000,,how 20,000 remarkable young people
Dialogue: 0,0:00:06.85,0:00:08.71,Default,,0000,0000,0000,,from over 100 countries
Dialogue: 0,0:00:08.71,0:00:10.52,Default,,0000,0000,0000,,ended up in Cuba
Dialogue: 0,0:00:10.52,0:00:14.32,Default,,0000,0000,0000,,and are transforming health in their communities.
Dialogue: 0,0:00:14.32,0:00:16.40,Default,,0000,0000,0000,,Ninety percent of them would never
Dialogue: 0,0:00:16.40,0:00:17.97,Default,,0000,0000,0000,,have left home at all
Dialogue: 0,0:00:17.97,0:00:21.32,Default,,0000,0000,0000,,if it weren't for a scholarship\Nto study medicine in Cuba
Dialogue: 0,0:00:21.32,0:00:23.13,Default,,0000,0000,0000,,and a commitment to go back
Dialogue: 0,0:00:23.13,0:00:26.76,Default,,0000,0000,0000,,to places like the ones they'd come from —
Dialogue: 0,0:00:26.76,0:00:30.20,Default,,0000,0000,0000,,remote farmlands, mountains, ghettos —
Dialogue: 0,0:00:30.20,0:00:33.69,Default,,0000,0000,0000,,to become doctors for people like themselves,
Dialogue: 0,0:00:33.69,0:00:35.78,Default,,0000,0000,0000,,to walk the walk.
Dialogue: 0,0:00:35.78,0:00:38.45,Default,,0000,0000,0000,,Havana's Latin American Medical School:
Dialogue: 0,0:00:38.45,0:00:41.37,Default,,0000,0000,0000,,It's the largest medical school in the world,
Dialogue: 0,0:00:41.37,0:00:44.27,Default,,0000,0000,0000,,graduating 23,000 young doctors
Dialogue: 0,0:00:44.27,0:00:47.00,Default,,0000,0000,0000,,since its first class of 2005,
Dialogue: 0,0:00:47.00,0:00:50.61,Default,,0000,0000,0000,,with nearly 10,000 more in the pipeline.
Dialogue: 0,0:00:50.61,0:00:54.43,Default,,0000,0000,0000,,Its mission, to train physicians for the people
Dialogue: 0,0:00:54.43,0:00:56.48,Default,,0000,0000,0000,,who need them the most:
Dialogue: 0,0:00:56.48,0:00:58.42,Default,,0000,0000,0000,,the over one billion
Dialogue: 0,0:00:58.42,0:01:00.68,Default,,0000,0000,0000,,who have never seen a doctor,
Dialogue: 0,0:01:00.68,0:01:04.52,Default,,0000,0000,0000,,the people who live and die
Dialogue: 0,0:01:04.52,0:01:08.01,Default,,0000,0000,0000,,under every poverty line ever invented.
Dialogue: 0,0:01:08.01,0:01:10.26,Default,,0000,0000,0000,,Its students defy all norms.
Dialogue: 0,0:01:10.26,0:01:12.53,Default,,0000,0000,0000,,They're the school's biggest risk
Dialogue: 0,0:01:12.53,0:01:14.99,Default,,0000,0000,0000,,and also its best bet.
Dialogue: 0,0:01:14.99,0:01:17.50,Default,,0000,0000,0000,,They're recruited from the poorest,
Dialogue: 0,0:01:17.50,0:01:20.08,Default,,0000,0000,0000,,most broken places on our planet
Dialogue: 0,0:01:20.08,0:01:22.35,Default,,0000,0000,0000,,by a school that believes they can become
Dialogue: 0,0:01:22.35,0:01:23.86,Default,,0000,0000,0000,,not just the good
Dialogue: 0,0:01:23.86,0:01:25.79,Default,,0000,0000,0000,,but the excellent physicians
Dialogue: 0,0:01:25.79,0:01:28.54,Default,,0000,0000,0000,,their communities desperately need,
Dialogue: 0,0:01:28.54,0:01:32.20,Default,,0000,0000,0000,,that they will practice where most doctors don't,
Dialogue: 0,0:01:32.20,0:01:34.62,Default,,0000,0000,0000,,in places not only poor
Dialogue: 0,0:01:34.62,0:01:37.18,Default,,0000,0000,0000,,but oftentimes dangerous,
Dialogue: 0,0:01:37.18,0:01:40.20,Default,,0000,0000,0000,,carrying venom antidotes in their backpacks
Dialogue: 0,0:01:40.20,0:01:42.82,Default,,0000,0000,0000,,or navigating neighborhoods
Dialogue: 0,0:01:42.82,0:01:46.14,Default,,0000,0000,0000,,riddled by drugs, gangs and bullets,
Dialogue: 0,0:01:46.14,0:01:48.84,Default,,0000,0000,0000,,their home ground.
Dialogue: 0,0:01:48.84,0:01:50.17,Default,,0000,0000,0000,,The hope is that they will help
Dialogue: 0,0:01:50.17,0:01:52.77,Default,,0000,0000,0000,,transform access to care,
Dialogue: 0,0:01:52.77,0:01:55.19,Default,,0000,0000,0000,,the health picture in impoverished areas,
Dialogue: 0,0:01:55.19,0:01:57.35,Default,,0000,0000,0000,,and even the way medicine itself
Dialogue: 0,0:01:57.35,0:01:59.89,Default,,0000,0000,0000,,is learned and practiced,
Dialogue: 0,0:01:59.89,0:02:04.14,Default,,0000,0000,0000,,and that they will become pioneers in our global reach
Dialogue: 0,0:02:04.14,0:02:06.66,Default,,0000,0000,0000,,for universal health coverage,
Dialogue: 0,0:02:06.66,0:02:09.38,Default,,0000,0000,0000,,surely a tall order.
Dialogue: 0,0:02:09.38,0:02:13.50,Default,,0000,0000,0000,,Two big storms and this notion of "walk the walk"
Dialogue: 0,0:02:13.50,0:02:17.59,Default,,0000,0000,0000,,prompted creation of ELAM back in 1998.
Dialogue: 0,0:02:17.59,0:02:20.59,Default,,0000,0000,0000,,The Hurricanes Georges and Mitch
Dialogue: 0,0:02:20.59,0:02:22.14,Default,,0000,0000,0000,,had ripped through the Caribbean
Dialogue: 0,0:02:22.14,0:02:24.35,Default,,0000,0000,0000,,and Central America,
Dialogue: 0,0:02:24.35,0:02:26.73,Default,,0000,0000,0000,,leaving 30,000 dead
Dialogue: 0,0:02:26.73,0:02:29.61,Default,,0000,0000,0000,,and two and a half million homeless.
Dialogue: 0,0:02:29.61,0:02:33.30,Default,,0000,0000,0000,,Hundreds of Cuban doctors\Nvolunteered for disaster response,
Dialogue: 0,0:02:33.30,0:02:35.15,Default,,0000,0000,0000,,but when they got there,
Dialogue: 0,0:02:35.15,0:02:37.23,Default,,0000,0000,0000,,they found a bigger disaster:
Dialogue: 0,0:02:37.23,0:02:40.43,Default,,0000,0000,0000,,whole communities with no healthcare,
Dialogue: 0,0:02:40.43,0:02:42.75,Default,,0000,0000,0000,,doors bolted shut on rural hospitals
Dialogue: 0,0:02:42.75,0:02:44.63,Default,,0000,0000,0000,,for lack of staff,
Dialogue: 0,0:02:44.63,0:02:47.30,Default,,0000,0000,0000,,and just too many babies dying
Dialogue: 0,0:02:47.30,0:02:50.24,Default,,0000,0000,0000,,before their first birthday.
Dialogue: 0,0:02:50.24,0:02:54.07,Default,,0000,0000,0000,,What would happen when these Cuban doctors left?
Dialogue: 0,0:02:54.07,0:02:56.78,Default,,0000,0000,0000,,New doctors were needed to make care sustainable,
Dialogue: 0,0:02:56.78,0:02:58.10,Default,,0000,0000,0000,,but where would they come from?
Dialogue: 0,0:02:58.10,0:03:00.90,Default,,0000,0000,0000,,Where would they train?
Dialogue: 0,0:03:00.90,0:03:05.34,Default,,0000,0000,0000,,In Havana, the campus of a former naval academy
Dialogue: 0,0:03:05.34,0:03:08.27,Default,,0000,0000,0000,,was turned over to the Cuban Health Ministry
Dialogue: 0,0:03:08.27,0:03:11.62,Default,,0000,0000,0000,,to become the Latin American Medical School,
Dialogue: 0,0:03:11.62,0:03:13.63,Default,,0000,0000,0000,,ELAM.
Dialogue: 0,0:03:13.63,0:03:16.11,Default,,0000,0000,0000,,Tuition, room and board, and a small stipend
Dialogue: 0,0:03:16.11,0:03:18.02,Default,,0000,0000,0000,,were offered to hundreds of students
Dialogue: 0,0:03:18.02,0:03:21.05,Default,,0000,0000,0000,,from the countries hardest hit by the storms.
Dialogue: 0,0:03:21.05,0:03:23.33,Default,,0000,0000,0000,,As a journalist in Havana,
Dialogue: 0,0:03:23.33,0:03:26.05,Default,,0000,0000,0000,,I watched the first 97 Nicaraguans arrive
Dialogue: 0,0:03:26.05,0:03:28.59,Default,,0000,0000,0000,,in March 1999,
Dialogue: 0,0:03:28.59,0:03:31.30,Default,,0000,0000,0000,,settling into dorms barely refurbished
Dialogue: 0,0:03:31.30,0:03:34.98,Default,,0000,0000,0000,,and helping their professors not\Nonly sweep out the classrooms
Dialogue: 0,0:03:34.98,0:03:39.66,Default,,0000,0000,0000,,but move in the desks and the\Nchairs and the microscopes.
Dialogue: 0,0:03:39.66,0:03:41.54,Default,,0000,0000,0000,,Over the next few years,
Dialogue: 0,0:03:41.54,0:03:43.45,Default,,0000,0000,0000,,governments throughout the Americas
Dialogue: 0,0:03:43.45,0:03:46.63,Default,,0000,0000,0000,,requested scholarships for their own students,
Dialogue: 0,0:03:46.63,0:03:48.50,Default,,0000,0000,0000,,and the Congressional Black Caucus
Dialogue: 0,0:03:48.50,0:03:51.88,Default,,0000,0000,0000,,asked for and received hundreds of scholarships
Dialogue: 0,0:03:51.88,0:03:55.12,Default,,0000,0000,0000,,for young people from the USA.
Dialogue: 0,0:03:55.12,0:03:58.83,Default,,0000,0000,0000,,Today, among the 23,000
Dialogue: 0,0:03:58.83,0:04:01.85,Default,,0000,0000,0000,,are graduates from 83 countries
Dialogue: 0,0:04:01.85,0:04:04.85,Default,,0000,0000,0000,,in the Americas, Africa and Asia,
Dialogue: 0,0:04:04.85,0:04:10.45,Default,,0000,0000,0000,,and enrollment has grown to 123 nations.
Dialogue: 0,0:04:10.45,0:04:12.66,Default,,0000,0000,0000,,More than half the students are young women.
Dialogue: 0,0:04:12.66,0:04:14.05,Default,,0000,0000,0000,,They come from 100 ethnic groups,
Dialogue: 0,0:04:14.05,0:04:16.08,Default,,0000,0000,0000,,speak 50 different languages.
Dialogue: 0,0:04:16.08,0:04:19.22,Default,,0000,0000,0000,,WHO Director Margaret Chan said,
Dialogue: 0,0:04:19.22,0:04:23.25,Default,,0000,0000,0000,,"For once, if you are poor, female,
Dialogue: 0,0:04:23.25,0:04:25.52,Default,,0000,0000,0000,,or from an indigenous population,
Dialogue: 0,0:04:25.52,0:04:27.22,Default,,0000,0000,0000,,you have a distinct advantage,
Dialogue: 0,0:04:27.22,0:04:31.95,Default,,0000,0000,0000,,an ethic that makes this medical school unique."
Dialogue: 0,0:04:31.95,0:04:36.10,Default,,0000,0000,0000,,Luther Castillo comes from San Pedro de Tocamacho
Dialogue: 0,0:04:36.10,0:04:38.97,Default,,0000,0000,0000,,on the Atlantic coast of Honduras.
Dialogue: 0,0:04:38.97,0:04:40.88,Default,,0000,0000,0000,,There's no running water,
Dialogue: 0,0:04:40.88,0:04:42.68,Default,,0000,0000,0000,,no electricity there,
Dialogue: 0,0:04:42.68,0:04:46.28,Default,,0000,0000,0000,,and to reach the village, you have to walk for hours
Dialogue: 0,0:04:46.28,0:04:49.20,Default,,0000,0000,0000,,or take your chances in a pickup truck like I did
Dialogue: 0,0:04:49.20,0:04:52.49,Default,,0000,0000,0000,,skirting the waves of the Atlantic.
Dialogue: 0,0:04:52.49,0:04:57.13,Default,,0000,0000,0000,,Luther was one of 40 Tocamacho children
Dialogue: 0,0:04:57.13,0:04:59.13,Default,,0000,0000,0000,,who started grammar school,
Dialogue: 0,0:04:59.13,0:05:01.88,Default,,0000,0000,0000,,the sons and daughters of a black indigenous people
Dialogue: 0,0:05:01.88,0:05:03.73,Default,,0000,0000,0000,,known as the Garífuna,
Dialogue: 0,0:05:03.73,0:05:07.21,Default,,0000,0000,0000,,20 percent of the Honduran population.
Dialogue: 0,0:05:07.21,0:05:12.36,Default,,0000,0000,0000,,The nearest healthcare was fatal miles away.
Dialogue: 0,0:05:12.36,0:05:15.85,Default,,0000,0000,0000,,Luther had to walk three hours every day
Dialogue: 0,0:05:15.85,0:05:17.75,Default,,0000,0000,0000,,to middle school.
Dialogue: 0,0:05:17.75,0:05:19.83,Default,,0000,0000,0000,,Only 17 made that trip.
Dialogue: 0,0:05:19.83,0:05:21.94,Default,,0000,0000,0000,,Only five went on to high school,
Dialogue: 0,0:05:21.94,0:05:24.10,Default,,0000,0000,0000,,and only one to university:
Dialogue: 0,0:05:24.10,0:05:26.12,Default,,0000,0000,0000,,Luther, to ELAM,
Dialogue: 0,0:05:26.12,0:05:30.13,Default,,0000,0000,0000,,among the first crop of Garífuna graduates.
Dialogue: 0,0:05:30.13,0:05:33.00,Default,,0000,0000,0000,,Just two Garífuna doctors had preceded them
Dialogue: 0,0:05:33.00,0:05:36.04,Default,,0000,0000,0000,,in all of Honduran history.
Dialogue: 0,0:05:36.04,0:05:41.94,Default,,0000,0000,0000,,Now there are 69, thanks to ELAM.
Dialogue: 0,0:05:41.94,0:05:45.14,Default,,0000,0000,0000,,Big problems need big solutions,
Dialogue: 0,0:05:45.14,0:05:48.94,Default,,0000,0000,0000,,sparked by big ideas, imagination and audacity,
Dialogue: 0,0:05:48.94,0:05:51.94,Default,,0000,0000,0000,,but also solutions that work.
Dialogue: 0,0:05:51.94,0:05:55.27,Default,,0000,0000,0000,,ELAM's faculty had no handy evidence base
Dialogue: 0,0:05:55.27,0:05:58.79,Default,,0000,0000,0000,,to guide them, so they learned the hard way,
Dialogue: 0,0:05:58.79,0:06:02.48,Default,,0000,0000,0000,,by doing and correcting course as they went.
Dialogue: 0,0:06:02.48,0:06:04.74,Default,,0000,0000,0000,,Even the brightest students
Dialogue: 0,0:06:04.74,0:06:06.65,Default,,0000,0000,0000,,from these poor communities
Dialogue: 0,0:06:06.65,0:06:08.33,Default,,0000,0000,0000,,weren't academically prepared
Dialogue: 0,0:06:08.33,0:06:11.02,Default,,0000,0000,0000,,for six years of medical training,
Dialogue: 0,0:06:11.02,0:06:14.68,Default,,0000,0000,0000,,so a bridging course was set up in sciences.
Dialogue: 0,0:06:14.68,0:06:16.26,Default,,0000,0000,0000,,Then came language:
Dialogue: 0,0:06:16.26,0:06:19.42,Default,,0000,0000,0000,,these were Mapuche, Quechuas, Guaraní, Garífuna,
Dialogue: 0,0:06:19.42,0:06:21.19,Default,,0000,0000,0000,,indigenous peoples
Dialogue: 0,0:06:21.19,0:06:23.39,Default,,0000,0000,0000,,who learned Spanish as a second language,
Dialogue: 0,0:06:23.39,0:06:26.19,Default,,0000,0000,0000,,or Haitians who spoke Creole.
Dialogue: 0,0:06:26.19,0:06:28.13,Default,,0000,0000,0000,,So Spanish became part
Dialogue: 0,0:06:28.13,0:06:32.28,Default,,0000,0000,0000,,of the pre-pre-med curriculum.
Dialogue: 0,0:06:32.28,0:06:35.23,Default,,0000,0000,0000,,Even so, in Cuba,
Dialogue: 0,0:06:35.23,0:06:38.46,Default,,0000,0000,0000,,the music, the food, the smells,
Dialogue: 0,0:06:38.46,0:06:41.15,Default,,0000,0000,0000,,just about everything was different,
Dialogue: 0,0:06:41.15,0:06:46.16,Default,,0000,0000,0000,,so faculty became family, ELAM home.
Dialogue: 0,0:06:46.16,0:06:48.97,Default,,0000,0000,0000,,Religions ranged from indigenous beliefs
Dialogue: 0,0:06:48.97,0:06:53.00,Default,,0000,0000,0000,,to Yoruba, Muslim and Christian evangelical.
Dialogue: 0,0:06:53.00,0:06:57.48,Default,,0000,0000,0000,,Embracing diversity became a way of life.
Dialogue: 0,0:06:57.48,0:06:59.47,Default,,0000,0000,0000,,Why have so many countries
Dialogue: 0,0:06:59.47,0:07:01.95,Default,,0000,0000,0000,,asked for these scholarships?
Dialogue: 0,0:07:01.95,0:07:05.20,Default,,0000,0000,0000,,First, they just don't have enough doctors,
Dialogue: 0,0:07:05.20,0:07:06.97,Default,,0000,0000,0000,,and where they do, their distribution
Dialogue: 0,0:07:06.97,0:07:09.41,Default,,0000,0000,0000,,is skewed against the poor,
Dialogue: 0,0:07:09.41,0:07:11.87,Default,,0000,0000,0000,,because our global health crisis
Dialogue: 0,0:07:11.87,0:07:14.84,Default,,0000,0000,0000,,is fed by a crisis in human resources.
Dialogue: 0,0:07:14.84,0:07:18.69,Default,,0000,0000,0000,,We are short four to seven million health workers
Dialogue: 0,0:07:18.69,0:07:21.15,Default,,0000,0000,0000,,just to meet basic needs,
Dialogue: 0,0:07:21.15,0:07:23.01,Default,,0000,0000,0000,,and the problem is everywhere.
Dialogue: 0,0:07:23.01,0:07:25.56,Default,,0000,0000,0000,,Doctors are concentrated in the cities,
Dialogue: 0,0:07:25.56,0:07:28.17,Default,,0000,0000,0000,,where only half the world's people live,
Dialogue: 0,0:07:28.17,0:07:29.96,Default,,0000,0000,0000,,and within cities,
Dialogue: 0,0:07:29.96,0:07:34.14,Default,,0000,0000,0000,,not in the shantytowns or South L.A.
Dialogue: 0,0:07:34.14,0:07:35.90,Default,,0000,0000,0000,,Here in the United States,
Dialogue: 0,0:07:35.90,0:07:38.41,Default,,0000,0000,0000,,where we have healthcare reform,
Dialogue: 0,0:07:38.41,0:07:40.95,Default,,0000,0000,0000,,we don't have the professionals we need.
Dialogue: 0,0:07:40.95,0:07:43.47,Default,,0000,0000,0000,,By 2020, we will be short
Dialogue: 0,0:07:43.47,0:07:47.61,Default,,0000,0000,0000,,45,000 primary care physicians.
Dialogue: 0,0:07:47.61,0:07:49.76,Default,,0000,0000,0000,,And we're also part of the problem.
Dialogue: 0,0:07:49.76,0:07:52.23,Default,,0000,0000,0000,,The United States is the number one importer
Dialogue: 0,0:07:52.23,0:07:56.60,Default,,0000,0000,0000,,of doctors from developing countries.
Dialogue: 0,0:07:56.60,0:07:59.46,Default,,0000,0000,0000,,The second reasons students flock to Cuba
Dialogue: 0,0:07:59.46,0:08:01.69,Default,,0000,0000,0000,,is the island's own health report card,
Dialogue: 0,0:08:01.69,0:08:04.66,Default,,0000,0000,0000,,relying on strong primary care.
Dialogue: 0,0:08:04.66,0:08:06.48,Default,,0000,0000,0000,,A commission from The Lancet
Dialogue: 0,0:08:06.48,0:08:08.99,Default,,0000,0000,0000,,rates Cuba among the best performing
Dialogue: 0,0:08:08.99,0:08:11.84,Default,,0000,0000,0000,,middle-income countries in health.
Dialogue: 0,0:08:11.84,0:08:13.78,Default,,0000,0000,0000,,Save the Children ranks Cuba
Dialogue: 0,0:08:13.78,0:08:18.42,Default,,0000,0000,0000,,the best country in Latin\NAmerica to become a mother.
Dialogue: 0,0:08:18.42,0:08:21.41,Default,,0000,0000,0000,,Cuba has similar life expectancy
Dialogue: 0,0:08:21.41,0:08:24.64,Default,,0000,0000,0000,,and lower infant mortality than the United States,
Dialogue: 0,0:08:24.64,0:08:26.82,Default,,0000,0000,0000,,with fewer disparities,
Dialogue: 0,0:08:26.82,0:08:28.62,Default,,0000,0000,0000,,while spending per person
Dialogue: 0,0:08:28.62,0:08:31.64,Default,,0000,0000,0000,,one 20th of what we do on health
Dialogue: 0,0:08:31.64,0:08:33.79,Default,,0000,0000,0000,,here in the USA.
Dialogue: 0,0:08:33.79,0:08:36.78,Default,,0000,0000,0000,,Academically, ELAM is tough,
Dialogue: 0,0:08:36.78,0:08:40.41,Default,,0000,0000,0000,,but 80 percent of its students graduate.
Dialogue: 0,0:08:40.41,0:08:41.76,Default,,0000,0000,0000,,The subjects are familiar —
Dialogue: 0,0:08:41.76,0:08:44.23,Default,,0000,0000,0000,,basic and clinical sciences —
Dialogue: 0,0:08:44.23,0:08:46.66,Default,,0000,0000,0000,,but there are major differences.
Dialogue: 0,0:08:46.66,0:08:50.27,Default,,0000,0000,0000,,First, training has moved out of the ivory tower
Dialogue: 0,0:08:50.27,0:08:53.17,Default,,0000,0000,0000,,and into clinic classrooms and neighborhoods,
Dialogue: 0,0:08:53.17,0:08:56.53,Default,,0000,0000,0000,,the kinds of places most of these grads will practice.
Dialogue: 0,0:08:56.53,0:09:00.63,Default,,0000,0000,0000,,Sure, they have lectures and hospital rotations too,
Dialogue: 0,0:09:00.63,0:09:05.66,Default,,0000,0000,0000,,but community-based learning starts on day one.
Dialogue: 0,0:09:05.66,0:09:09.42,Default,,0000,0000,0000,,Second, students treat the whole patient,
Dialogue: 0,0:09:09.42,0:09:11.34,Default,,0000,0000,0000,,mind and body,
Dialogue: 0,0:09:11.34,0:09:13.84,Default,,0000,0000,0000,,in the context of their \Nfamilies, their communities
Dialogue: 0,0:09:13.84,0:09:15.99,Default,,0000,0000,0000,,and their culture.
Dialogue: 0,0:09:15.99,0:09:18.89,Default,,0000,0000,0000,,Third, they learn public health:
Dialogue: 0,0:09:18.89,0:09:21.99,Default,,0000,0000,0000,,to assess their patients' drinking water, housing,
Dialogue: 0,0:09:21.99,0:09:25.29,Default,,0000,0000,0000,,social and economic conditions.
Dialogue: 0,0:09:25.29,0:09:27.82,Default,,0000,0000,0000,,Fourth, they are taught
Dialogue: 0,0:09:27.82,0:09:30.58,Default,,0000,0000,0000,,that a good patient interview
Dialogue: 0,0:09:30.58,0:09:32.69,Default,,0000,0000,0000,,and a thorough clinical exam
Dialogue: 0,0:09:32.69,0:09:35.52,Default,,0000,0000,0000,,provide most of the clues for diagnosis,
Dialogue: 0,0:09:35.52,0:09:39.43,Default,,0000,0000,0000,,saving costly technology for confirmation.
Dialogue: 0,0:09:39.43,0:09:42.98,Default,,0000,0000,0000,,And finally, they're taught over and over again
Dialogue: 0,0:09:42.98,0:09:45.02,Default,,0000,0000,0000,,the importance of prevention,
Dialogue: 0,0:09:45.02,0:09:47.42,Default,,0000,0000,0000,,especially as chronic diseases
Dialogue: 0,0:09:47.42,0:09:51.58,Default,,0000,0000,0000,,cripple health systems worldwide.
Dialogue: 0,0:09:51.58,0:09:54.77,Default,,0000,0000,0000,,Such an in-service learning
Dialogue: 0,0:09:54.77,0:09:57.37,Default,,0000,0000,0000,,also comes with a team approach,
Dialogue: 0,0:09:57.37,0:10:00.24,Default,,0000,0000,0000,,as much how to work in teams
Dialogue: 0,0:10:00.24,0:10:02.18,Default,,0000,0000,0000,,as how to lead them,
Dialogue: 0,0:10:02.18,0:10:04.31,Default,,0000,0000,0000,,with a dose of humility.
Dialogue: 0,0:10:04.31,0:10:07.11,Default,,0000,0000,0000,,Upon graduation, these doctors share
Dialogue: 0,0:10:07.11,0:10:09.82,Default,,0000,0000,0000,,their knowledge with nurse's aids, midwives,
Dialogue: 0,0:10:09.82,0:10:11.79,Default,,0000,0000,0000,,community health workers,
Dialogue: 0,0:10:11.79,0:10:14.18,Default,,0000,0000,0000,,to help them become better at what they do,
Dialogue: 0,0:10:14.18,0:10:16.12,Default,,0000,0000,0000,,not to replace them,
Dialogue: 0,0:10:16.12,0:10:19.25,Default,,0000,0000,0000,,to work with shamans and traditional healers.
Dialogue: 0,0:10:21.31,0:10:23.87,Default,,0000,0000,0000,,ELAM's graduates:
Dialogue: 0,0:10:23.87,0:10:28.53,Default,,0000,0000,0000,,Are they proving this audacious experiment right?
Dialogue: 0,0:10:28.53,0:10:30.82,Default,,0000,0000,0000,,Dozens of projects give us an inkling
Dialogue: 0,0:10:30.82,0:10:33.39,Default,,0000,0000,0000,,of what they're capable of doing.
Dialogue: 0,0:10:33.39,0:10:35.15,Default,,0000,0000,0000,,Take the Garífuna grads.
Dialogue: 0,0:10:35.15,0:10:37.34,Default,,0000,0000,0000,,They not only went to work back home,
Dialogue: 0,0:10:37.34,0:10:39.75,Default,,0000,0000,0000,,but they organized their communities to build
Dialogue: 0,0:10:39.75,0:10:43.15,Default,,0000,0000,0000,,Honduras' first indigenous hospital.
Dialogue: 0,0:10:43.15,0:10:45.30,Default,,0000,0000,0000,,With an architect's help,
Dialogue: 0,0:10:45.30,0:10:49.78,Default,,0000,0000,0000,,residents literally raised it from the ground up.
Dialogue: 0,0:10:49.78,0:10:51.96,Default,,0000,0000,0000,,The first patients walked through the doors
Dialogue: 0,0:10:51.96,0:10:54.30,Default,,0000,0000,0000,,in December 2007,
Dialogue: 0,0:10:54.30,0:10:56.81,Default,,0000,0000,0000,,and since then, the hospital has received
Dialogue: 0,0:10:56.81,0:10:59.96,Default,,0000,0000,0000,,nearly one million patient visits.
Dialogue: 0,0:10:59.96,0:11:02.12,Default,,0000,0000,0000,,And government is paying attention,
Dialogue: 0,0:11:02.12,0:11:04.64,Default,,0000,0000,0000,,upholding the hospital as a model
Dialogue: 0,0:11:04.64,0:11:09.82,Default,,0000,0000,0000,,of rural public health for Honduras.
Dialogue: 0,0:11:09.82,0:11:13.47,Default,,0000,0000,0000,,ELAM's graduates are smart,
Dialogue: 0,0:11:13.47,0:11:16.92,Default,,0000,0000,0000,,strong and also dedicated.
Dialogue: 0,0:11:16.92,0:11:21.27,Default,,0000,0000,0000,,Haiti, January 2010.
Dialogue: 0,0:11:21.27,0:11:23.11,Default,,0000,0000,0000,,The pain.
Dialogue: 0,0:11:23.11,0:11:27.11,Default,,0000,0000,0000,,People buried under 30 million tons of rubble.
Dialogue: 0,0:11:27.11,0:11:29.26,Default,,0000,0000,0000,,Overwhelming.
Dialogue: 0,0:11:29.26,0:11:31.14,Default,,0000,0000,0000,,Three hundred forty Cuban doctors
Dialogue: 0,0:11:31.14,0:11:33.58,Default,,0000,0000,0000,,were already on the ground long term.
Dialogue: 0,0:11:33.58,0:11:35.98,Default,,0000,0000,0000,,More were on their way. Many more were needed.
Dialogue: 0,0:11:35.98,0:11:39.23,Default,,0000,0000,0000,,At ELAM, students worked round the clock
Dialogue: 0,0:11:39.23,0:11:42.44,Default,,0000,0000,0000,,to contact 2,000 graduates.
Dialogue: 0,0:11:42.44,0:11:45.63,Default,,0000,0000,0000,,As a result, hundreds arrived in Haiti,
Dialogue: 0,0:11:45.63,0:11:49.93,Default,,0000,0000,0000,,27 countries' worth, from Mali in the Sahara
Dialogue: 0,0:11:49.93,0:11:54.41,Default,,0000,0000,0000,,to St. Lucia, Bolivia, Chile and the USA.
Dialogue: 0,0:11:54.41,0:11:57.71,Default,,0000,0000,0000,,They spoke easily to each other in Spanish
Dialogue: 0,0:11:57.71,0:12:00.40,Default,,0000,0000,0000,,and listened to their patients in Creole
Dialogue: 0,0:12:00.40,0:12:02.52,Default,,0000,0000,0000,,thanks to Haitian medical students
Dialogue: 0,0:12:02.52,0:12:04.75,Default,,0000,0000,0000,,flown in from ELAM in Cuba.
Dialogue: 0,0:12:04.75,0:12:06.44,Default,,0000,0000,0000,,Many stayed for months,
Dialogue: 0,0:12:06.44,0:12:09.22,Default,,0000,0000,0000,,even through the cholera epidemic.
Dialogue: 0,0:12:09.22,0:12:11.56,Default,,0000,0000,0000,,Hundreds of Haitian graduates
Dialogue: 0,0:12:11.56,0:12:14.28,Default,,0000,0000,0000,,had to pick up the pieces,
Dialogue: 0,0:12:14.28,0:12:16.29,Default,,0000,0000,0000,,overcome their own heartbreak,
Dialogue: 0,0:12:16.29,0:12:18.16,Default,,0000,0000,0000,,and then pick up the burden
Dialogue: 0,0:12:18.16,0:12:21.73,Default,,0000,0000,0000,,of building a new public health system for Haiti.
Dialogue: 0,0:12:21.73,0:12:24.22,Default,,0000,0000,0000,,Today, with aid of organizations and governments
Dialogue: 0,0:12:24.22,0:12:26.78,Default,,0000,0000,0000,,from Norway to Cuba to Brazil,
Dialogue: 0,0:12:26.78,0:12:29.00,Default,,0000,0000,0000,,dozens of new health centers have been built,
Dialogue: 0,0:12:29.00,0:12:32.58,Default,,0000,0000,0000,,staffed, and in 35 cases, headed
Dialogue: 0,0:12:32.58,0:12:36.50,Default,,0000,0000,0000,,by ELAM graduates.
Dialogue: 0,0:12:36.50,0:12:38.36,Default,,0000,0000,0000,,Yet the Haitian story
Dialogue: 0,0:12:38.36,0:12:40.42,Default,,0000,0000,0000,,also illustrates some of the bigger problems
Dialogue: 0,0:12:40.42,0:12:42.64,Default,,0000,0000,0000,,faced in many countries.
Dialogue: 0,0:12:42.64,0:12:44.38,Default,,0000,0000,0000,,Take a look:
Dialogue: 0,0:12:44.38,0:12:50.17,Default,,0000,0000,0000,,748 Haitian graduates by \N2012, when cholera struck,
Dialogue: 0,0:12:50.17,0:12:53.91,Default,,0000,0000,0000,,nearly half working in the public health sector
Dialogue: 0,0:12:53.91,0:12:55.98,Default,,0000,0000,0000,,but one quarter unemployed,
Dialogue: 0,0:12:55.98,0:13:02.09,Default,,0000,0000,0000,,and 110 had left Haiti altogether.
Dialogue: 0,0:13:02.09,0:13:04.86,Default,,0000,0000,0000,,So in the best case scenarios,
Dialogue: 0,0:13:04.86,0:13:06.73,Default,,0000,0000,0000,,these graduates are staffing
Dialogue: 0,0:13:06.73,0:13:09.98,Default,,0000,0000,0000,,and thus strengthening public health systems,
Dialogue: 0,0:13:09.98,0:13:13.16,Default,,0000,0000,0000,,where often they're the only doctors around.
Dialogue: 0,0:13:13.16,0:13:15.95,Default,,0000,0000,0000,,In the worst cases, there are simply not enough jobs
Dialogue: 0,0:13:15.95,0:13:17.59,Default,,0000,0000,0000,,in the public health sector,
Dialogue: 0,0:13:17.59,0:13:20.16,Default,,0000,0000,0000,,where most poor people are treated,
Dialogue: 0,0:13:20.16,0:13:22.96,Default,,0000,0000,0000,,not enough political will, not enough resources,
Dialogue: 0,0:13:22.96,0:13:25.16,Default,,0000,0000,0000,,not enough anything —
Dialogue: 0,0:13:25.16,0:13:28.62,Default,,0000,0000,0000,,just too many patients with no care.
Dialogue: 0,0:13:28.62,0:13:31.60,Default,,0000,0000,0000,,The grads face pressure from their families too,
Dialogue: 0,0:13:31.60,0:13:33.90,Default,,0000,0000,0000,,desperate to make ends meet,
Dialogue: 0,0:13:33.90,0:13:36.48,Default,,0000,0000,0000,,so when there are no public sector jobs,
Dialogue: 0,0:13:36.48,0:13:39.10,Default,,0000,0000,0000,,these new MDs decamp into private practice,
Dialogue: 0,0:13:39.10,0:13:43.12,Default,,0000,0000,0000,,or go abroad to send money home.
Dialogue: 0,0:13:43.12,0:13:46.30,Default,,0000,0000,0000,,Worst of all, in some countries,
Dialogue: 0,0:13:46.30,0:13:49.24,Default,,0000,0000,0000,,medical societies influence accreditation bodies
Dialogue: 0,0:13:49.24,0:13:52.25,Default,,0000,0000,0000,,not to honor the ELAM degree,
Dialogue: 0,0:13:52.25,0:13:54.57,Default,,0000,0000,0000,,fearful these grads will take their jobs
Dialogue: 0,0:13:54.57,0:13:58.12,Default,,0000,0000,0000,,or reduce their patient loads and income.
Dialogue: 0,0:13:58.12,0:14:01.10,Default,,0000,0000,0000,,It's not a question of competencies.
Dialogue: 0,0:14:01.10,0:14:03.61,Default,,0000,0000,0000,,Here in the USA, the California Medical Board
Dialogue: 0,0:14:03.61,0:14:07.21,Default,,0000,0000,0000,,accredited the school after rigorous inspection,
Dialogue: 0,0:14:07.21,0:14:09.26,Default,,0000,0000,0000,,and the new physicians are making good
Dialogue: 0,0:14:09.26,0:14:11.45,Default,,0000,0000,0000,,on Cuba's big bet,
Dialogue: 0,0:14:11.45,0:14:13.26,Default,,0000,0000,0000,,passing their boards and accepted
Dialogue: 0,0:14:13.26,0:14:15.65,Default,,0000,0000,0000,,into highly respected residencies
Dialogue: 0,0:14:15.65,0:14:19.74,Default,,0000,0000,0000,,from New York to Chicago to New Mexico.
Dialogue: 0,0:14:19.74,0:14:22.36,Default,,0000,0000,0000,,Two hundred strong, they're coming
Dialogue: 0,0:14:22.36,0:14:24.75,Default,,0000,0000,0000,,back to the United States energized,
Dialogue: 0,0:14:24.75,0:14:27.34,Default,,0000,0000,0000,,and also dissatisfied.
Dialogue: 0,0:14:27.34,0:14:28.97,Default,,0000,0000,0000,,As one grad put it,
Dialogue: 0,0:14:28.97,0:14:32.42,Default,,0000,0000,0000,,in Cuba, "We are trained to provide quality care
Dialogue: 0,0:14:32.42,0:14:34.42,Default,,0000,0000,0000,,with minimal resources,
Dialogue: 0,0:14:34.42,0:14:36.100,Default,,0000,0000,0000,,so when I see all the resources we have here,
Dialogue: 0,0:14:36.100,0:14:39.16,Default,,0000,0000,0000,,and you tell me that's not possible,
Dialogue: 0,0:14:39.16,0:14:41.33,Default,,0000,0000,0000,,I know it's not true.
Dialogue: 0,0:14:41.33,0:14:46.95,Default,,0000,0000,0000,,Not only have I seen it work, I've done the work."
Dialogue: 0,0:14:46.95,0:14:48.91,Default,,0000,0000,0000,,ELAM's graduates,
Dialogue: 0,0:14:48.91,0:14:52.43,Default,,0000,0000,0000,,some from right here in D.C. and Baltimore,
Dialogue: 0,0:14:52.43,0:14:55.60,Default,,0000,0000,0000,,have come from the poorest of the poor
Dialogue: 0,0:14:55.60,0:14:57.93,Default,,0000,0000,0000,,to offer health, education
Dialogue: 0,0:14:57.93,0:15:00.84,Default,,0000,0000,0000,,and a voice to their communities.
Dialogue: 0,0:15:00.84,0:15:03.50,Default,,0000,0000,0000,,They've done the heavy lifting.
Dialogue: 0,0:15:03.50,0:15:05.51,Default,,0000,0000,0000,,Now we need to do our part
Dialogue: 0,0:15:05.51,0:15:09.13,Default,,0000,0000,0000,,to support the 23,000 and counting,
Dialogue: 0,0:15:09.13,0:15:10.48,Default,,0000,0000,0000,,All of us —
Dialogue: 0,0:15:10.48,0:15:14.12,Default,,0000,0000,0000,,foundations, residency directors, press,
Dialogue: 0,0:15:14.12,0:15:17.30,Default,,0000,0000,0000,,entrepreneurs, policymakers, people —
Dialogue: 0,0:15:17.30,0:15:19.45,Default,,0000,0000,0000,,need to step up.
Dialogue: 0,0:15:19.45,0:15:21.44,Default,,0000,0000,0000,,We need to do much more globally
Dialogue: 0,0:15:21.44,0:15:24.38,Default,,0000,0000,0000,,to give these new doctors the opportunity
Dialogue: 0,0:15:24.38,0:15:26.78,Default,,0000,0000,0000,,to prove their mettle.
Dialogue: 0,0:15:26.78,0:15:27.78,Default,,0000,0000,0000,,They need to be able
Dialogue: 0,0:15:27.78,0:15:30.98,Default,,0000,0000,0000,,to take their countries' licensing exams.
Dialogue: 0,0:15:30.98,0:15:33.93,Default,,0000,0000,0000,,They need jobs in the public health sector
Dialogue: 0,0:15:33.93,0:15:35.68,Default,,0000,0000,0000,,or in nonprofit health centers
Dialogue: 0,0:15:35.68,0:15:39.53,Default,,0000,0000,0000,,to put their training and commitment to work.
Dialogue: 0,0:15:39.53,0:15:41.82,Default,,0000,0000,0000,,They need the chance to be
Dialogue: 0,0:15:41.82,0:15:46.67,Default,,0000,0000,0000,,the doctors their patients need.
Dialogue: 0,0:15:46.67,0:15:48.53,Default,,0000,0000,0000,,To move forward,
Dialogue: 0,0:15:48.53,0:15:51.52,Default,,0000,0000,0000,,we may have to find our way back
Dialogue: 0,0:15:51.52,0:15:53.71,Default,,0000,0000,0000,,to that pediatrician who would
Dialogue: 0,0:15:53.71,0:15:55.39,Default,,0000,0000,0000,,knock on my family's door
Dialogue: 0,0:15:55.39,0:15:58.58,Default,,0000,0000,0000,,on the South Side of Chicago when I was a kid,
Dialogue: 0,0:15:58.58,0:16:00.49,Default,,0000,0000,0000,,who made house calls,
Dialogue: 0,0:16:00.49,0:16:03.38,Default,,0000,0000,0000,,who was a public servant.
Dialogue: 0,0:16:03.38,0:16:05.20,Default,,0000,0000,0000,,These aren't such new ideas
Dialogue: 0,0:16:05.20,0:16:07.56,Default,,0000,0000,0000,,of what medicine should be.
Dialogue: 0,0:16:07.56,0:16:10.29,Default,,0000,0000,0000,,What's new is the scaling up
Dialogue: 0,0:16:10.29,0:16:13.67,Default,,0000,0000,0000,,and the faces of the doctors themselves:
Dialogue: 0,0:16:13.67,0:16:17.13,Default,,0000,0000,0000,,an ELAM graduate is more likely to be a she
Dialogue: 0,0:16:17.13,0:16:19.06,Default,,0000,0000,0000,,than a he;
Dialogue: 0,0:16:19.06,0:16:21.99,Default,,0000,0000,0000,,In the Amazon, Peru or Guatemala,
Dialogue: 0,0:16:21.99,0:16:24.34,Default,,0000,0000,0000,,an indigenous doctor;
Dialogue: 0,0:16:24.34,0:16:27.35,Default,,0000,0000,0000,,in the USA, a doctor of color
Dialogue: 0,0:16:27.35,0:16:29.75,Default,,0000,0000,0000,,who speaks fluent Spanish.
Dialogue: 0,0:16:29.75,0:16:33.43,Default,,0000,0000,0000,,She is well trained, can be counted on,
Dialogue: 0,0:16:33.43,0:16:37.07,Default,,0000,0000,0000,,and shares the face and culture of her patients,
Dialogue: 0,0:16:37.07,0:16:40.48,Default,,0000,0000,0000,,and she deserves our support surely,
Dialogue: 0,0:16:40.48,0:16:44.95,Default,,0000,0000,0000,,because whether by subway, mule, or canoe,
Dialogue: 0,0:16:44.95,0:16:47.94,Default,,0000,0000,0000,,she is teaching us to walk the walk.
Dialogue: 0,0:16:47.94,0:16:53.51,Default,,0000,0000,0000,,Thank you. (Applause)