FACES OF EXPATRIATION – CUBA
Born in Germany as an “Air Force Brat,” Rafael Don Q. Montalvo moved to Colorado and was raised in a very diverse community within the Denver/Aurora areas. After the untimely death of his mother at 16 years old, he was forced quickly into adulthood, needing to find a way to handle many adult responsibilities like maintaining a budget, keeping a tidy home, purchasing groceries, and successfully navigating through the college application process, not the least of all was paying for college.
While majoring in Mechanical Engineering at the Colorado School of Mines his resourcefulness was noted by a professor, and he was selected to participate in an internship at the Centre for Robotics and Intelligent Systems (CRIS). At CRIS he helped design a shoe insole that helped reduce foot ulceration in diabetic patients by monitoring their temperature levels. This helped patients and doctors determine what activities precipitated the formation of ulcers so that doctors could tailor lifestyle modifications to the patient. Working with doctors during this project and seeing the strong relationships they had with their patients is what impressed him most about medicine. This was the moment that inspired him to become a doctor.
Although he didn’t choose to pursue medicine immediately after college, he was determined to find a way to become a doctor later in life. After working several years as an Engineer/consultant and then as a math and science teacher in Harlem, where he witnessed first-hand the glaring disparities that exist within underserved communities with regards to education and health-related resources, he decided it was time to pursue his dreams of becoming a doctor.
He’d heard about the Latin American School of Medicine (ELAM-Escuela Latinoamericana de Medicina) in Cuba and how its training model emphasizes primary healthcare, community/family medicine, and hands-on internship experience. Cuba’s reputation for the superior training of doctors who were equipped to travel the globe and provide immediate health care that is culturally conscious is what intrigued him the most and he considered this to be a unique way to learn medicine.
After applying to ELAM, he received a full economic scholarship based upon my merits and dedication to underserved communities. Upon accepting this scholarship, he made a personal promise to take a vested interest in ensuring that vulnerable urban and rural communities received high-quality medical care from someone who shares the same culture and language. Since becoming an international physician, he attended the Family Medicine residency program at UCLA and has been involved in healthcare in Uganda, assisting at the Bwindi Community Hospital efforts to decrease maternal morbidity and mortality rates.
For our Ex-Files series, interviewing Black expatriates across the globe, we asked Dr. Montalvo several questions regarding his studies abroad and his life as an expat in the medical field. Though his journey is unique to him, you’ll find lessons in his story that may help you in your search for a life abroad.
How difficult was it for you to leave the US and study and live abroad?
I was raised to believe that a pessimist sees the difficulty in every opportunity; an optimist sees the opportunity in every difficulty. Aside from having to sacrifice a more profound involvement in the upbringing of my then 8 year old daughter, it wasn’t that difficult to leave the US for Cuba because I saw it as an opportunity to grow and experience a culture that most of the world respects and reveres in spite of the many negative perspectives that have been portrayed. As a Black-Latino, it provided the opportunity to be culturally immersed in a language, art, and culinary preparations that my ancestors used and provided that cultural connection through the Afro-Cuban culture. On the other hand, there was some risk and a “leap of faith” involved since there had been no US graduate from ELAM and the university was not initially recognized under US standards. This caused some initial doubt of whether anyone would be able to practice medicine upon our return to the US, especially given the political relationship between these two countries.
Would you make the same choices again and why?
There is no doubt that I would make the same choice if given the same situation again. Not only to study in Cuba specifically because of its dynamic culture that is full of pride, spirit and unique flare on its approach to humanity as a whole. I would also make the same choice to study and live abroad generally because life is lived outside one’s comfort zone. There is no way to repay the opportunity I had to study and experience the cultures of colleagues and healthcare professionals from 23 Latin American and African countries that taught me the importance of international collaboration. I understood the richness that travel provides. It offers a personal and unique immersion experience that is long-standing and causes one to at least understand the lives of others that are around us as they live it day to day. So often this make you more cosmopolitan and moves the needle in one’s own cultural consciousness.
What challenges did you face professionally and culturally while studying abroad?
Hands-on training in local clinics broadened my horizons, challenged me, and taught me to adapt to stressful situations like managing high patient loads with very limited resources. Often times local endemics of Dengue outbreaks and hurricanes forced us to become resourceful as we continued to treat not only these issues but as well as global issues of chronic diseases such as cardiac, liver, and renal failure, complicated diabetes or hypertension. This was challenging coming from a country where resources seem limitless in comparison. The Spanish language provided a unique intellectual challenge that many foreign students experience. It was demanding yet rewarding as I learned complex medical concepts and was able to teach those concepts in Spanish with proficiency to the communities in Central Havana. This challenge matured me and provided extensive skills that I use even today as an Urgent Care Physician in the largely Latin populated area of San Fernando Valley, California.
Are there any resources, that you would recommend, that assist foreigners in acclimating to life in Cuba? Resources for individuals preparing to move abroad?
There is a pretty good website, therewardboss.com, that provides some pretty accurate info and experiences and answers some of the basic questions. I am not aware of anything that I used that prepared me to move abroad other than the literature that was given to me by the University that was more focused toward being a student in Cuba.
What are 3 things you would you advise anyone considering moving abroad?
- Research your new country. Have an open mind and limit any preconceived views or notions with regard to the culture that you are about to enter. Be ready to experience everything at least once before casting judgment.
- Find a liaison (ie. family, friends) that knows you and the culture well, and currently lives there so that you will be able to have a smoother transition and you will be able to focus on making new friends, which changes the whole game.
- Pack lightly. You will quickly realize that we often live in excess and learning to live in a new culture using their resources will broaden your horizons.
What are your thoughts, if any, on the current political climate between the US and Cuba?
I believe that there was an instance when relations were improving, particularly around when the embargo easement was being discussed during the Obama administration, but when the lift was rejected it appeared that there was a “stalemate” relationship. It was good to see many more US citizens there when I went back several years after my graduation in 2010. I have spoken with many who have gone and mostly all agree that their culture is rich and beautiful and many of the propaganda that they were exposed to, prior to travel, was largely incongruent with the experience that they had. Many, including myself, agree that the relations between the US and Cuba could certainly be better and its been far too long for this relationship to continue this way.
What’s the biggest lesson you have learned since leaving the US?
The US is a formidable country but is only a small part of humanity. Travel outside the US allows me to engage in cultural exchange and provides some spiritual and cultural enrichment. Many who have traveled abroad quickly realized how diverse the world is and how viewpoints change based on your life experiences and the lens in which you look through. While the world is vast, you often find how small it is; especially when you see another culture many miles away doing many of the same things you do with a whole different set of resources. I find solace in cultural immersion and since my travel to more than 15 different countries across the globe, I now strive to enrich my life with new cultural experiences.