Health and Safety
Health Insurance in Cuba
Students will not be permitted to participate in the program without valid U.S. health insurance. They will either need to demonstrate that they have health insurance independently or purchase coverage through their home university. Students will need to present evidence of coverage to their home CASA institution before they travel abroad, and check with their home university's study abroad office for additional details.
Brown University students and those from non-Consortium universities applying through Brown will also be automatically covered by a supplementary travel assistance plan administered by International SOS, whose services range from telephone advice and referrals to full-scale evacuation by private air ambulance. International SOS has more than 3,500 professionals in 24-hour alarm centers, international clinics and remote-site medical facilities across five continents. Keep in mind that International SOS is not health insurance.
All students on the CASA program will also be provided with local health insurance to receive care at the Cira García Clinic in Miramar and other international health clinics in Cuba.
Cuba is known internationally for its well-developed public health system. Even in the most remote areas of the country, there are highly trained doctors and health facilities - so students are never far away from good medical care. Cuba has two healthcare systems: one for Cuban nationals and another for tourists and international visitors/residents. The one for foreign residents does not suffer from the same sort of shortages (due to the US embargo) from which the regular public health system suffers. Unless a student is in a remote area, far away from an international clinic, it is recommended that they seek care in the second system for foreign visitors/residents. Students will be provided with a local Cuban health insurance through ASISTUR for the duration of the program, which is accepted at the Cira Garcia clinic. Havana has good doctors who can provide excellent care. The main facility for foreigners in Havana is the:
Clínica Internacional Cira García
Calle 20 No. 4101 esq. 41
La Habana, Cuba
Tel: (+53) 7 204-2811
Cira Garcia is similar to a student health center on campus. There is an emergency room and walk-in clinic, and students can also make appointments for seeing specialists. During orientation we will visit to make sure that students know how to get there and feel comfortable with using the services. There is also a very good pharmacy there, as well as one across the street. In the unlikely event that a student experiences an emergency in a remote area of Cuba with no international clinic, they should go to the nearest health center and will be transferred to the international clinic system once stabilized.
Students should make sure they are up-to-date on routine vaccines before every trip. These vaccines include measles-mumps-rubella (MMR) vaccine, diphtheria-tetanus-pertussis vaccine, varicella (chickenpox) vaccine, polio vaccine, and the yearly flu shot.
- Typhoid: Anyone can get typhoid through contaminated food or water in Cuba. CDC recommends this vaccine for most travelers, especially if they are staying with friends or relatives, visiting smaller cities or rural areas, or are an adventurous eater.
- Hepatitis A: We recommend this vaccine because anyone can get hepatitis A through contaminated food or water in Cuba, regardless of where they are eating or staying.
- Hepatitis B: Anyone can get hepatitis B through sexual contact, contaminated needles, and blood products, so it is recommended to get this vaccine if a student might have sex with a new partner, get a tattoo or piercing, or has had any medical procedures.
Preventive Care in Havana
Students are required to complete a Physician’s Medical Report form in order to participate in the program; students should be sure it indicates any allergies they have, in particular to medications, as well as dietary restrictions. This information is confidential and has no bearing on student participation in the program. If a student has a chronic illness that needs medical attention, they should have their doctor write a clinical report that can be given to a specialist in Cuba if necessary. In addition, we strongly urge students to have a complete physical and dental checkup before departing.
Students should inform the resident staff of any existing health problems, including mental health, or any potential problems one may anticipate arising throughout the course of the program. This includes allergies to any medications or foods. CASA staff will use this information to ensure that appropriate accommodations are made. Students should inform the resident staff if they become ill during the program.
If a student suffers from asthma, allergies, or any other medical conditions, they will be expected to take responsibility for their own condition and to keep staff informed in case the student needs assistance in accessing care. It is very important to seek medical advice and to follow doctor’s orders.
If a student requires prescription medication, they should bring a supply with them to last the entire time that they will be abroad. Although many medications are available worldwide, they are not always identical in strength or composition to what someone takes at home. Bring an adequate supply of medications in carry-on luggage, in their original containers, along with a letter from your doctor explaining the dosage, why the medication has been prescribed, and why you are traveling with a large quantity. Students should be sure to get a typewritten diagnosis/prescription with the generic name of their prescription in case they lose their prescription or it is misplaced, so a doctor in Cuba may use it to write a valid prescription. If a student uses contraceptives, they should bring an adequate supply with them. International or very specialized drugs may be difficult to obtain. Since brand names vary, it is important to know the generic (chemical) names of your medications. Students who wear glasses or contact lenses may choose to bring an extra pair as well as a copy of their prescription; however, it is relatively cheap and simple to get an eye exam and a new pair of glasses made in Havana.
It is recommended that students bring their own supply of common over-the-counter medications, as they are often not available for purchase (or only after scouring the city’s international pharmacies - when one is sick, it is preferable to take a pill and go to sleep than going from pharmacy to pharmacy looking for cough syrup!)
It is best to be prepared for the common cold, allergies, and stomach and intestinal disorders often caused by changes in diet and drinking water. Bring medications in case these problems arise; your doctor may suggest which drugs to consider. Over the counter cold/flu medications are very hard to come by in Cuba, so bring them along. Students should remember, however, to be careful about treating themselves, and be sure to seek professional help when necessary. Pack medication for constipation, heartburn or upset stomach, surface scratches and cuts, sore throat, yeast infections, coughs or colds. Be sure to bring medicine for any recent or chronic ailment which might reoccur in Cuba. Some over-the-counter medications are available, but it is highly advisable that students bring extra supplies of any medications or prescriptions that are used regularly. Most people seriously underestimate the amount of medicine they will need.
Mental Health Services
Mental health facilities in Cuba for international visitors are very limited and mostly available in Spanish. Should a student need access to mental health facilities, they should contact their home campus resources as one possibility, or International SOS. CASA can also help students identify local mental health resources.
Michele Frank, M.D., a Child & Adolescent Psychiatrist, is affiliated with CASA-Cuba and available to students upon request. Originally from the US, Michele Frank has studied, worked and taught in Cuba since 1983. She is co-founder of Eco Cuba Network, and a member of a number of Cuban and U.S. professional organizations, including the Cuban Society of Psychiatry; the Cuban Society of Natural, Traditional and Bio-Energetic Medicine; the American Academy of Child and Adolescent Psychiatry; and the American Orthopsychiatric Association.
Cuba is a tropical environment where everything flourishes, including bacteria and viruses. Hepatitis A, B, C, typhoid, cholera, and tuberculosis are all present, and dengue fever is common. Because it is a perfect climate for growing germs, students must be particularly careful to practice good hygiene. Drink only bottled, filtered, or boiled water. Avoid food cooked in areas where proper hygiene is not possible. Always wash hands before eating. We recommend several small units of disinfecting gel. Avoid exposure to the sun, and drink lots of water to avoid dehydration.
In recent years, dengue fever outbreaks have occurred with increasing frequency in Cuba and in most countries of the tropics. Cases are common in Havana. Cuba’s public health system has a rigorous prevention program in place, with regular fumigations in the city of Havana to destroy the larvae of the Aedes aegypti mosquito that spreads Dengue.
Dengue is a mosquito-transmitted viral disease occurring chiefly in tropical and subtropical areas of the world. Generally, there is a low risk of acquiring dengue during travel to tropical areas except during periods of epidemic transmission (during or shortly after the rainy season). Dengue viruses are transmitted by Aedes mosquitoes, which are most active during the day. Mosquitoes that transmit dengue usually are found near human dwellings and are often present indoors. Dengue is predominant in urban centers, but may be found in rural areas. There is no vaccine for dengue fever. Therefore, the traveler should avoid mosquito bites by using insect repellents on skin and clothing and remaining in well screened or air-conditioned areas.
The Centers for Disease Control (CDC), U.S. Department of Health and Human Services, has a web page for students studying abroad. It pulls together a number of documents that participants can find on the CDC site, as well as a few links to other resources.
Havana, and Cuba in general, is a relatively safe destination for travelers and international visitors, although roaming through the urban centers of the country does require some common sense, vigilence, and minor precautions, especially at night. Energy and infrastruture in Cuba are comparatively limited, and side streets and roadways are often not illuminated.
Experience has shown that the single most important factor in assuring a safe study abroad experience is the sensible and cautious behavior of the participants themselves. When traveling abroad, students should exercise additional caution until they become familiar with their new surroundings. Students should always remain alert to what is going on around them, especially in crowded tourist areas and on public transportation.
Never accept rides from strangers and, when travelling, always use taxis colectivos (also known as máquinas, almendrones, boteros or colectivos), and buses operated by official providers. As in other large cities in the United States or other countries, jewelry and electronics are coveted in Cuba. If you do find yourself in trouble, the best way to avoid a situation is to avoid resistence.
If you encounter a health or security problem during your stay in Cuba, the first points of contact should be the CASA-Cuba director and the CASA staff, who can work within their network to assist students. All questions related to health risks and care while studying in Cuba should be planned well in advance of departure, and with the guidance of student services staff at the student's home university.