In its hard-currency-based health economy, Cuba has tried to attract foreign patients from all over the world, who come for the country's inexpensive or unique therapies, such as a surgery for retinitis pigmentosa or vitiligo treatment with a substance extracted from the human placenta. Although many physicians outside Cuba have frowned on these treatments, a number are applauding a research program at Havana's International Center for Neurological Restoration (CIREN). The center has assumed a leading role in developing a surgical procedure that appears to provide significant relief for patients experiencing the slowness of movement, tremor and muscle rigidity in middle- to late-stage Parkinson's disease.

In the surgery, physicians create lesions in either one or both subthalamic nuclei, deep-brain structures that, in Parkinson's, trigger movement disorders. The center, which has U.S. and Spanish collaborators, reported at the American Neurological Association meeting last October that two years after undergoing a bilateral dorsal subthalamotomy, 17 Cuban patients improved by an average of 50 percent on movement tests --and they could dramatically reduce their daily ingestion of the Parkinson's drug levodopa.

This article was originally published with the title Sustainable Surgery.

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