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January 20, 2002

Hola Colleague,

It's a wintry day in Western Massachusetts. Four inches of fresh snow cover the paths and the world here is devoid of color. I have just returned from a sunny week in Cuba at the "first ever" Cuba-U.S. Dermatology Exchange. Fifteen North American dermatologists traveled to Havana for scientific sessions, conversation with about 30 Cuban skin doctors and an introduction to Cuban culture.

We had an incredible time! Our countries have been divided for over four decades and the political rhetoric is loud and virulent. But, what we found were colleagues who share common interests, goals and aspirations.

Cuban physicians earn around $250 per year. This is less than cab drivers, waiters or hotel maids. Most physicians can not afford textbooks, journals, even simple items like surgical blades. There are almost 500 dermatologists in Cuba, which works out to 1/22,000 citizens. In the US, the ratio is approximately 1/32,000. While Cuba has the resources to educate skin specialists, they are sadly bereft of the tools to practice efficiently.

We brought down textbooks, CD ROMs, equipment, teaching slides and drugs. These were greatly appreciated. It's hard to fathom practicing without journals or up-to-date texts. Hard to do surgery without # 15 blades. In spite of this, there was no complaining or self-pity.

Strangely, considering the rhetoric of some politicians in the U.S. and Cuba and the often tense relationship between our leaders, we all felt welcomed and at home. The Cuban people were genuinely friendly and quite open. One feels safer in Havana than in many U.S. cities.

From the social and cultural standpoints our delegates also had a great time. We had long talks with Cubans from many walks of life.

The week raced by, and it was a sad group that departed the sunny island nation for the mainland USA. It was bittersweet to bid adios to many new friends and colleagues. I wrote some of this on the tarmac in Charlotte, NC, where it was 35 degrees F and raining hard. The memory of the bright Cuban sun, the fanciful Havana architecture, and the beautiful melange of ethnic groups permeated my mind.

Best wishes,

David J. Elpern, M.D.