WEBVTT

00:00:00.537 --> 00:00:02.159
I want to tell you

00:00:02.159 --> 00:00:06.850
how 20,000 remarkable young people

00:00:06.850 --> 00:00:08.706
from over 100 countries

00:00:08.706 --> 00:00:10.518
ended up in Cuba

00:00:10.518 --> 00:00:14.321
and are transforming health in their communities.

00:00:14.321 --> 00:00:16.401
Ninety percent of them would never

00:00:16.401 --> 00:00:17.973
have left home at all

00:00:17.973 --> 00:00:21.317
if it weren't for a scholarship
to study medicine in Cuba

00:00:21.317 --> 00:00:23.128
and a commitment to go back

00:00:23.128 --> 00:00:26.756
to places like the ones they'd come from —

00:00:26.756 --> 00:00:30.203
remote farmlands, mountains, ghettos —

00:00:30.203 --> 00:00:33.689
to become doctors for people like themselves,

00:00:33.689 --> 00:00:35.781
to walk the walk.

NOTE Paragraph

00:00:35.781 --> 00:00:38.447
Havana's Latin American Medical School:

00:00:38.447 --> 00:00:41.372
It's the largest medical school in the world,

00:00:41.372 --> 00:00:44.274
graduating 23,000 young doctors

00:00:44.274 --> 00:00:47.002
since its first class of 2005,

00:00:47.002 --> 00:00:50.611
with nearly 10,000 more in the pipeline.

00:00:50.611 --> 00:00:54.432
Its mission, to train physicians for the people

00:00:54.432 --> 00:00:56.483
who need them the most:

00:00:56.483 --> 00:00:58.419
the over one billion

00:00:58.419 --> 00:01:00.682
who have never seen a doctor,

00:01:00.682 --> 00:01:04.515
the people who live and die

00:01:04.515 --> 00:01:08.009
under every poverty line ever invented.

00:01:08.009 --> 00:01:10.259
Its students defy all norms.

00:01:10.259 --> 00:01:12.530
They're the school's biggest risk

00:01:12.530 --> 00:01:14.990
and also its best bet.

00:01:14.990 --> 00:01:17.505
They're recruited from the poorest,

00:01:17.505 --> 00:01:20.076
most broken places on our planet

00:01:20.076 --> 00:01:22.350
by a school that believes they can become

00:01:22.350 --> 00:01:23.857
not just the good

00:01:23.857 --> 00:01:25.792
but the excellent physicians

00:01:25.792 --> 00:01:28.545
their communities desperately need,

00:01:28.545 --> 00:01:32.197
that they will practice where most doctors don't,

00:01:32.197 --> 00:01:34.623
in places not only poor

00:01:34.623 --> 00:01:37.176
but oftentimes dangerous,

00:01:37.176 --> 00:01:40.202
carrying venom antidotes in their backpacks

00:01:40.202 --> 00:01:42.821
or navigating neighborhoods

00:01:42.821 --> 00:01:46.142
riddled by drugs, gangs and bullets,

00:01:46.142 --> 00:01:48.842
their home ground.

00:01:48.842 --> 00:01:50.168
The hope is that they will help

00:01:50.168 --> 00:01:52.768
transform access to care,

00:01:52.768 --> 00:01:55.187
the health picture in impoverished areas,

00:01:55.187 --> 00:01:57.346
and even the way medicine itself

00:01:57.346 --> 00:01:59.889
is learned and practiced,

00:01:59.889 --> 00:02:04.140
and that they will become pioneers in our global reach

00:02:04.140 --> 00:02:06.660
for universal health coverage,

00:02:06.660 --> 00:02:09.378
surely a tall order.

00:02:09.378 --> 00:02:13.504
Two big storms and this notion of "walk the walk"

00:02:13.504 --> 00:02:17.588
prompted creation of ELAM back in 1998.

00:02:17.588 --> 00:02:20.591
The Hurricanes Georges and Mitch

00:02:20.591 --> 00:02:22.143
had ripped through the Caribbean

00:02:22.143 --> 00:02:24.348
and Central America,

00:02:24.348 --> 00:02:26.727
leaving 30,000 dead

00:02:26.727 --> 00:02:29.610
and two and a half million homeless.

00:02:29.610 --> 00:02:33.303
Hundreds of Cuban doctors
volunteered for disaster response,

00:02:33.303 --> 00:02:35.148
but when they got there,

00:02:35.148 --> 00:02:37.231
they found a bigger disaster:

00:02:37.231 --> 00:02:40.427
whole communities with no healthcare,

00:02:40.427 --> 00:02:42.751
doors bolted shut on rural hospitals

00:02:42.751 --> 00:02:44.630
for lack of staff,

00:02:44.630 --> 00:02:47.301
and just too many babies dying

00:02:47.301 --> 00:02:50.236
before their first birthday.

00:02:50.236 --> 00:02:54.070
What would happen when these Cuban doctors left?

00:02:54.070 --> 00:02:56.784
New doctors were needed to make care sustainable,

00:02:56.784 --> 00:02:58.096
but where would they come from?

00:02:58.096 --> 00:03:00.901
Where would they train?

NOTE Paragraph

00:03:00.901 --> 00:03:05.344
In Havana, the campus of a former naval academy

00:03:05.344 --> 00:03:08.269
was turned over to the Cuban Health Ministry

00:03:08.269 --> 00:03:11.620
to become the Latin American Medical School,

00:03:11.620 --> 00:03:13.633
ELAM.

00:03:13.633 --> 00:03:16.107
Tuition, room and board, and a small stipend

00:03:16.107 --> 00:03:18.018
were offered to hundreds of students

00:03:18.018 --> 00:03:21.051
from the countries hardest hit by the storms.

00:03:21.051 --> 00:03:23.330
As a journalist in Havana,

00:03:23.330 --> 00:03:26.047
I watched the first 97 Nicaraguans arrive

00:03:26.047 --> 00:03:28.589
in March 1999,

00:03:28.589 --> 00:03:31.305
settling into dorms barely refurbished

00:03:31.305 --> 00:03:34.984
and helping their professors not
only sweep out the classrooms

00:03:34.984 --> 00:03:39.663
but move in the desks and the
chairs and the microscopes.

00:03:39.663 --> 00:03:41.542
Over the next few years,

00:03:41.542 --> 00:03:43.454
governments throughout the Americas

00:03:43.454 --> 00:03:46.627
requested scholarships for their own students,

00:03:46.627 --> 00:03:48.505
and the Congressional Black Caucus

00:03:48.505 --> 00:03:51.880
asked for and received hundreds of scholarships

00:03:51.880 --> 00:03:55.120
for young people from the USA.

00:03:55.120 --> 00:03:58.832
Today, among the 23,000

00:03:58.832 --> 00:04:01.847
are graduates from 83 countries

00:04:01.847 --> 00:04:04.851
in the Americas, Africa and Asia,

00:04:04.851 --> 00:04:10.454
and enrollment has grown to 123 nations.

00:04:10.454 --> 00:04:12.658
More than half the students are young women.

00:04:12.658 --> 00:04:14.050
They come from 100 ethnic groups,

00:04:14.050 --> 00:04:16.075
speak 50 different languages.

00:04:16.075 --> 00:04:19.216
WHO Director Margaret Chan said,

00:04:19.216 --> 00:04:23.254
"For once, if you are poor, female,

00:04:23.254 --> 00:04:25.516
or from an indigenous population,

00:04:25.516 --> 00:04:27.221
you have a distinct advantage,

00:04:27.221 --> 00:04:31.950
an ethic that makes this medical school unique."

NOTE Paragraph

00:04:31.950 --> 00:04:36.100
Luther Castillo comes from San Pedro de Tocamacho

00:04:36.100 --> 00:04:38.970
on the Atlantic coast of Honduras.

00:04:38.970 --> 00:04:40.882
There's no running water,

00:04:40.882 --> 00:04:42.682
no electricity there,

00:04:42.682 --> 00:04:46.282
and to reach the village, you have to walk for hours

00:04:46.282 --> 00:04:49.195
or take your chances in a pickup truck like I did

00:04:49.195 --> 00:04:52.490
skirting the waves of the Atlantic.

00:04:52.490 --> 00:04:57.131
Luther was one of 40 Tocamacho children

00:04:57.131 --> 00:04:59.134
who started grammar school,

00:04:59.134 --> 00:05:01.878
the sons and daughters of a black indigenous people

00:05:01.878 --> 00:05:03.734
known as the Garífuna,

00:05:03.734 --> 00:05:07.210
20 percent of the Honduran population.

00:05:07.210 --> 00:05:12.363
The nearest healthcare was fatal miles away.

00:05:12.363 --> 00:05:15.850
Luther had to walk three hours every day

00:05:15.850 --> 00:05:17.751
to middle school.

00:05:17.751 --> 00:05:19.832
Only 17 made that trip.

00:05:19.832 --> 00:05:21.936
Only five went on to high school,

00:05:21.936 --> 00:05:24.100
and only one to university:

00:05:24.100 --> 00:05:26.121
Luther, to ELAM,

00:05:26.121 --> 00:05:30.130
among the first crop of Garífuna graduates.

00:05:30.130 --> 00:05:33.000
Just two Garífuna doctors had preceded them

00:05:33.000 --> 00:05:36.044
in all of Honduran history.

00:05:36.044 --> 00:05:41.945
Now there are 69, thanks to ELAM.

NOTE Paragraph

00:05:41.945 --> 00:05:45.145
Big problems need big solutions,

00:05:45.145 --> 00:05:48.937
sparked by big ideas, imagination and audacity,

00:05:48.937 --> 00:05:51.940
but also solutions that work.

00:05:51.940 --> 00:05:55.270
ELAM's faculty had no handy evidence base

00:05:55.270 --> 00:05:58.790
to guide them, so they learned the hard way,

00:05:58.790 --> 00:06:02.479
by doing and correcting course as they went.

00:06:02.479 --> 00:06:04.741
Even the brightest students

00:06:04.741 --> 00:06:06.654
from these poor communities

00:06:06.654 --> 00:06:08.330
weren't academically prepared

00:06:08.330 --> 00:06:11.023
for six years of medical training,

00:06:11.023 --> 00:06:14.680
so a bridging course was set up in sciences.

00:06:14.680 --> 00:06:16.255
Then came language:

00:06:16.255 --> 00:06:19.416
these were Mapuche, Quechuas, Guaraní, Garífuna,

00:06:19.416 --> 00:06:21.193
indigenous peoples

00:06:21.193 --> 00:06:23.393
who learned Spanish as a second language,

00:06:23.393 --> 00:06:26.190
or Haitians who spoke Creole.

00:06:26.190 --> 00:06:28.127
So Spanish became part

00:06:28.127 --> 00:06:32.285
of the pre-pre-med curriculum.

00:06:32.285 --> 00:06:35.227
Even so, in Cuba,

00:06:35.227 --> 00:06:38.461
the music, the food, the smells,

00:06:38.461 --> 00:06:41.150
just about everything was different,

00:06:41.150 --> 00:06:46.155
so faculty became family, ELAM home.

00:06:46.155 --> 00:06:48.968
Religions ranged from indigenous beliefs

00:06:48.968 --> 00:06:53.000
to Yoruba, Muslim and Christian evangelical.

00:06:53.000 --> 00:06:57.484
Embracing diversity became a way of life.

NOTE Paragraph

00:06:57.484 --> 00:06:59.474
Why have so many countries

00:06:59.474 --> 00:07:01.949
asked for these scholarships?

00:07:01.949 --> 00:07:05.201
First, they just don't have enough doctors,

00:07:05.201 --> 00:07:06.967
and where they do, their distribution

00:07:06.967 --> 00:07:09.409
is skewed against the poor,

00:07:09.409 --> 00:07:11.871
because our global health crisis

00:07:11.871 --> 00:07:14.836
is fed by a crisis in human resources.

00:07:14.836 --> 00:07:18.688
We are short four to seven million health workers

00:07:18.688 --> 00:07:21.152
just to meet basic needs,

00:07:21.152 --> 00:07:23.010
and the problem is everywhere.

00:07:23.010 --> 00:07:25.562
Doctors are concentrated in the cities,

00:07:25.562 --> 00:07:28.172
where only half the world's people live,

00:07:28.172 --> 00:07:29.960
and within cities,

00:07:29.960 --> 00:07:34.139
not in the shantytowns or South L.A.

00:07:34.139 --> 00:07:35.905
Here in the United States,

00:07:35.905 --> 00:07:38.406
where we have healthcare reform,

00:07:38.406 --> 00:07:40.954
we don't have the professionals we need.

00:07:40.954 --> 00:07:43.469
By 2020, we will be short

00:07:43.469 --> 00:07:47.608
45,000 primary care physicians.

00:07:47.608 --> 00:07:49.765
And we're also part of the problem.

00:07:49.765 --> 00:07:52.232
The United States is the number one importer

00:07:52.232 --> 00:07:56.596
of doctors from developing countries.

NOTE Paragraph

00:07:56.596 --> 00:07:59.465
The second reasons students flock to Cuba

00:07:59.465 --> 00:08:01.692
is the island's own health report card,

00:08:01.692 --> 00:08:04.662
relying on strong primary care.

00:08:04.662 --> 00:08:06.484
A commission from The Lancet

00:08:06.484 --> 00:08:08.990
rates Cuba among the best performing

00:08:08.990 --> 00:08:11.839
middle-income countries in health.

00:08:11.839 --> 00:08:13.785
Save the Children ranks Cuba

00:08:13.785 --> 00:08:18.421
the best country in Latin
America to become a mother.

00:08:18.421 --> 00:08:21.410
Cuba has similar life expectancy

00:08:21.410 --> 00:08:24.642
and lower infant mortality than the United States,

00:08:24.642 --> 00:08:26.823
with fewer disparities,

00:08:26.823 --> 00:08:28.623
while spending per person

00:08:28.623 --> 00:08:31.638
one 20th of what we do on health

00:08:31.638 --> 00:08:33.787
here in the USA.

NOTE Paragraph

00:08:33.787 --> 00:08:36.779
Academically, ELAM is tough,

00:08:36.779 --> 00:08:40.410
but 80 percent of its students graduate.

00:08:40.410 --> 00:08:41.756
The subjects are familiar —

00:08:41.756 --> 00:08:44.230
basic and clinical sciences —

00:08:44.230 --> 00:08:46.656
but there are major differences.

00:08:46.656 --> 00:08:50.267
First, training has moved out of the ivory tower

00:08:50.267 --> 00:08:53.169
and into clinic classrooms and neighborhoods,

00:08:53.169 --> 00:08:56.533
the kinds of places most of these grads will practice.

00:08:56.533 --> 00:09:00.627
Sure, they have lectures and hospital rotations too,

00:09:00.627 --> 00:09:05.657
but community-based learning starts on day one.

00:09:05.657 --> 00:09:09.423
Second, students treat the whole patient,

00:09:09.423 --> 00:09:11.337
mind and body,

00:09:11.337 --> 00:09:13.843
in the context of their 
families, their communities

00:09:13.843 --> 00:09:15.990
and their culture.

00:09:15.990 --> 00:09:18.890
Third, they learn public health:

00:09:18.890 --> 00:09:21.990
to assess their patients' drinking water, housing,

00:09:21.990 --> 00:09:25.286
social and economic conditions.

00:09:25.286 --> 00:09:27.817
Fourth, they are taught

00:09:27.817 --> 00:09:30.584
that a good patient interview

00:09:30.584 --> 00:09:32.688
and a thorough clinical exam

00:09:32.688 --> 00:09:35.523
provide most of the clues for diagnosis,

00:09:35.523 --> 00:09:39.426
saving costly technology for confirmation.

00:09:39.426 --> 00:09:42.976
And finally, they're taught over and over again

00:09:42.976 --> 00:09:45.020
the importance of prevention,

00:09:45.020 --> 00:09:47.420
especially as chronic diseases

00:09:47.420 --> 00:09:51.580
cripple health systems worldwide.

NOTE Paragraph

00:09:51.580 --> 00:09:54.770
Such an in-service learning

00:09:54.770 --> 00:09:57.370
also comes with a team approach,

00:09:57.370 --> 00:10:00.237
as much how to work in teams

00:10:00.237 --> 00:10:02.183
as how to lead them,

00:10:02.183 --> 00:10:04.310
with a dose of humility.

00:10:04.310 --> 00:10:07.110
Upon graduation, these doctors share

00:10:07.110 --> 00:10:09.820
their knowledge with nurse's aids, midwives,

00:10:09.820 --> 00:10:11.790
community health workers,

00:10:11.790 --> 00:10:14.176
to help them become better at what they do,

00:10:14.176 --> 00:10:16.121
not to replace them,

00:10:16.121 --> 00:10:19.250
to work with shamans and traditional healers.

NOTE Paragraph

00:10:21.311 --> 00:10:23.870
ELAM's graduates:

00:10:23.870 --> 00:10:28.527
Are they proving this audacious experiment right?

00:10:28.527 --> 00:10:30.822
Dozens of projects give us an inkling

00:10:30.822 --> 00:10:33.390
of what they're capable of doing.

00:10:33.390 --> 00:10:35.153
Take the Garífuna grads.

00:10:35.153 --> 00:10:37.343
They not only went to work back home,

00:10:37.343 --> 00:10:39.750
but they organized their communities to build

00:10:39.750 --> 00:10:43.151
Honduras' first indigenous hospital.

00:10:43.151 --> 00:10:45.300
With an architect's help,

00:10:45.300 --> 00:10:49.777
residents literally raised it from the ground up.

00:10:49.777 --> 00:10:51.959
The first patients walked through the doors

00:10:51.959 --> 00:10:54.299
in December 2007,

00:10:54.299 --> 00:10:56.808
and since then, the hospital has received

00:10:56.808 --> 00:10:59.958
nearly one million patient visits.

00:10:59.958 --> 00:11:02.119
And government is paying attention,

00:11:02.119 --> 00:11:04.640
upholding the hospital as a model

00:11:04.640 --> 00:11:09.819
of rural public health for Honduras.

NOTE Paragraph

00:11:09.819 --> 00:11:13.467
ELAM's graduates are smart,

00:11:13.467 --> 00:11:16.920
strong and also dedicated.

00:11:16.920 --> 00:11:21.274
Haiti, January 2010.

00:11:21.274 --> 00:11:23.109
The pain.

00:11:23.109 --> 00:11:27.112
People buried under 30 million tons of rubble.

00:11:27.112 --> 00:11:29.261
Overwhelming.

00:11:29.261 --> 00:11:31.139
Three hundred forty Cuban doctors

00:11:31.139 --> 00:11:33.580
were already on the ground long term.

00:11:33.580 --> 00:11:35.983
More were on their way. Many more were needed.

00:11:35.983 --> 00:11:39.227
At ELAM, students worked round the clock

00:11:39.227 --> 00:11:42.445
to contact 2,000 graduates.

00:11:42.445 --> 00:11:45.629
As a result, hundreds arrived in Haiti,

00:11:45.629 --> 00:11:49.926
27 countries' worth, from Mali in the Sahara

00:11:49.926 --> 00:11:54.414
to St. Lucia, Bolivia, Chile and the USA.

00:11:54.414 --> 00:11:57.710
They spoke easily to each other in Spanish

00:11:57.710 --> 00:12:00.399
and listened to their patients in Creole

00:12:00.399 --> 00:12:02.525
thanks to Haitian medical students

00:12:02.525 --> 00:12:04.752
flown in from ELAM in Cuba.

00:12:04.752 --> 00:12:06.440
Many stayed for months,

00:12:06.440 --> 00:12:09.218
even through the cholera epidemic.

NOTE Paragraph

00:12:09.218 --> 00:12:11.558
Hundreds of Haitian graduates

00:12:11.558 --> 00:12:14.280
had to pick up the pieces,

00:12:14.280 --> 00:12:16.294
overcome their own heartbreak,

00:12:16.294 --> 00:12:18.160
and then pick up the burden

00:12:18.160 --> 00:12:21.728
of building a new public health system for Haiti.

00:12:21.728 --> 00:12:24.225
Today, with aid of organizations and governments

00:12:24.225 --> 00:12:26.778
from Norway to Cuba to Brazil,

00:12:26.778 --> 00:12:29.004
dozens of new health centers have been built,

00:12:29.004 --> 00:12:32.575
staffed, and in 35 cases, headed

00:12:32.575 --> 00:12:36.497
by ELAM graduates.

NOTE Paragraph

00:12:36.497 --> 00:12:38.365
Yet the Haitian story

00:12:38.365 --> 00:12:40.424
also illustrates some of the bigger problems

00:12:40.424 --> 00:12:42.640
faced in many countries.

00:12:42.640 --> 00:12:44.384
Take a look:

00:12:44.384 --> 00:12:50.166
748 Haitian graduates by 
2012, when cholera struck,

00:12:50.166 --> 00:12:53.912
nearly half working in the public health sector

00:12:53.912 --> 00:12:55.983
but one quarter unemployed,

00:12:55.983 --> 00:13:02.093
and 110 had left Haiti altogether.

00:13:02.093 --> 00:13:04.861
So in the best case scenarios,

00:13:04.861 --> 00:13:06.731
these graduates are staffing

00:13:06.731 --> 00:13:09.980
and thus strengthening public health systems,

00:13:09.980 --> 00:13:13.159
where often they're the only doctors around.

00:13:13.159 --> 00:13:15.950
In the worst cases, there are simply not enough jobs

00:13:15.950 --> 00:13:17.592
in the public health sector,

00:13:17.592 --> 00:13:20.158
where most poor people are treated,

00:13:20.158 --> 00:13:22.957
not enough political will, not enough resources,

00:13:22.957 --> 00:13:25.163
not enough anything —

00:13:25.163 --> 00:13:28.616
just too many patients with no care.

00:13:28.616 --> 00:13:31.600
The grads face pressure from their families too,

00:13:31.600 --> 00:13:33.903
desperate to make ends meet,

00:13:33.903 --> 00:13:36.479
so when there are no public sector jobs,

00:13:36.479 --> 00:13:39.100
these new MDs decamp into private practice,

00:13:39.100 --> 00:13:43.115
or go abroad to send money home.

NOTE Paragraph

00:13:43.115 --> 00:13:46.300
Worst of all, in some countries,

00:13:46.300 --> 00:13:49.236
medical societies influence accreditation bodies

00:13:49.236 --> 00:13:52.251
not to honor the ELAM degree,

00:13:52.251 --> 00:13:54.568
fearful these grads will take their jobs

00:13:54.568 --> 00:13:58.123
or reduce their patient loads and income.

00:13:58.123 --> 00:14:01.104
It's not a question of competencies.

00:14:01.104 --> 00:14:03.612
Here in the USA, the California Medical Board

00:14:03.612 --> 00:14:07.212
accredited the school after rigorous inspection,

00:14:07.212 --> 00:14:09.260
and the new physicians are making good

00:14:09.260 --> 00:14:11.451
on Cuba's big bet,

00:14:11.451 --> 00:14:13.262
passing their boards and accepted

00:14:13.262 --> 00:14:15.647
into highly respected residencies

00:14:15.647 --> 00:14:19.738
from New York to Chicago to New Mexico.

00:14:19.738 --> 00:14:22.363
Two hundred strong, they're coming

00:14:22.363 --> 00:14:24.748
back to the United States energized,

00:14:24.748 --> 00:14:27.335
and also dissatisfied.

00:14:27.335 --> 00:14:28.966
As one grad put it,

00:14:28.966 --> 00:14:32.420
in Cuba, "We are trained to provide quality care

00:14:32.420 --> 00:14:34.422
with minimal resources,

00:14:34.422 --> 00:14:36.998
so when I see all the resources we have here,

00:14:36.998 --> 00:14:39.160
and you tell me that's not possible,

00:14:39.160 --> 00:14:41.330
I know it's not true.

00:14:41.330 --> 00:14:46.949
Not only have I seen it work, I've done the work."

NOTE Paragraph

00:14:46.949 --> 00:14:48.910
ELAM's graduates,

00:14:48.910 --> 00:14:52.427
some from right here in D.C. and Baltimore,

00:14:52.427 --> 00:14:55.595
have come from the poorest of the poor

00:14:55.595 --> 00:14:57.928
to offer health, education

00:14:57.928 --> 00:15:00.844
and a voice to their communities.

00:15:00.844 --> 00:15:03.496
They've done the heavy lifting.

00:15:03.496 --> 00:15:05.510
Now we need to do our part

00:15:05.510 --> 00:15:09.127
to support the 23,000 and counting,

00:15:09.127 --> 00:15:10.481
All of us —

00:15:10.481 --> 00:15:14.115
foundations, residency directors, press,

00:15:14.115 --> 00:15:17.299
entrepreneurs, policymakers, people —

00:15:17.299 --> 00:15:19.452
need to step up.

00:15:19.452 --> 00:15:21.443
We need to do much more globally

00:15:21.443 --> 00:15:24.382
to give these new doctors the opportunity

00:15:24.382 --> 00:15:26.775
to prove their mettle.

00:15:26.775 --> 00:15:27.778
They need to be able

00:15:27.778 --> 00:15:30.982
to take their countries' licensing exams.

00:15:30.982 --> 00:15:33.930
They need jobs in the public health sector

00:15:33.930 --> 00:15:35.685
or in nonprofit health centers

00:15:35.685 --> 00:15:39.532
to put their training and commitment to work.

00:15:39.532 --> 00:15:41.815
They need the chance to be

00:15:41.815 --> 00:15:46.674
the doctors their patients need.

NOTE Paragraph

00:15:46.674 --> 00:15:48.531
To move forward,

00:15:48.531 --> 00:15:51.523
we may have to find our way back

00:15:51.523 --> 00:15:53.706
to that pediatrician who would

00:15:53.706 --> 00:15:55.393
knock on my family's door

00:15:55.393 --> 00:15:58.579
on the South Side of Chicago when I was a kid,

00:15:58.579 --> 00:16:00.489
who made house calls,

00:16:00.489 --> 00:16:03.380
who was a public servant.

00:16:03.380 --> 00:16:05.203
These aren't such new ideas

00:16:05.203 --> 00:16:07.565
of what medicine should be.

00:16:07.565 --> 00:16:10.290
What's new is the scaling up

00:16:10.290 --> 00:16:13.673
and the faces of the doctors themselves:

00:16:13.673 --> 00:16:17.130
an ELAM graduate is more likely to be a she

00:16:17.130 --> 00:16:19.060
than a he;

00:16:19.060 --> 00:16:21.987
In the Amazon, Peru or Guatemala,

00:16:21.987 --> 00:16:24.338
an indigenous doctor;

00:16:24.338 --> 00:16:27.352
in the USA, a doctor of color

00:16:27.352 --> 00:16:29.748
who speaks fluent Spanish.

00:16:29.748 --> 00:16:33.427
She is well trained, can be counted on,

00:16:33.427 --> 00:16:37.071
and shares the face and culture of her patients,

00:16:37.071 --> 00:16:40.480
and she deserves our support surely,

00:16:40.480 --> 00:16:44.946
because whether by subway, mule, or canoe,

00:16:44.946 --> 00:16:47.944
she is teaching us to walk the walk.

NOTE Paragraph

00:16:47.944 --> 00:16:53.514
Thank you. (Applause)