♪ cuba is roughly 90 miles off the coast of florida, but it feels a world away. the old cars, the architecture, the music. it's the sights and sounds of havana. this is "vital signs." i'm dr. sanjay gupta. despite being relatively poor, they have a strong health system. as you might guess, a lot of the focus is on prevention. that's because it's easier to prevent disease and prevent them than to treat them. there's also a very robust vaccination program. but keeping track of 11 million on the largest caribbean island

often requires a personal touch. this is a family doctor's clinic in havana. they are known as polyclinics and are the primary facilities of cuban health care. dr. marta beatrice de hassa runs this clinic and is responsible for the surrounding neighborhood. how many patients do you care for? how many patients come to this clinic? >> translator: programs usually cover 1100 to 1500 people. >> what is the most common types of things that you see here? >> translator: the diseases that we see more often in our population are high blood pressure, diabetes, heart disease, asthma and chronic obstructive pulmonary diseases. >> reporter: in the morning dr. dehassa sees patients and then in the afternoon she makes house

calls. we are going to be tagging along to visit patients in their homes to understand why that is important here, let's first take a step back. a pivot toll moment in cuba's history came on january 1, 1959, when fidel castro overthrows u.s.-backed president batista, the combination of the cuban v revolution and being one dictatorship and starting another. two years later, january 1961, cuba and the united states end diplomatic relations. cuba turns to the soviet union for economic support but sees its economy crash with the soviet union collapsing in the early 1990s. with the u.s. embargo in place and a centralized soviet-style economy, cuba struggles and forit's free government-run health care system, that means a need to keep costs low. preventing disease as i said is cheaper that treating it. so cuba focuses intensely on

preventive care. the u.s. trade embargo also means limited access to resources, even medications. in this clinic, you can see how bare it is, just the essentials here. a cabinet with medication organized into plastic cups, a single bed. sometimes you hear that it is difficult to get medications, is that true? have you found that? >> translator: well, you know, we're a country which has been located and the number of medications we can import are not as many as needed, but we do have those that are essential in the local offices. remember, this is a primary health assistance office. here we focus on health prevention and promotion. if the patient needs other kinds of medications and assistance, they'll go to the secondary institutions which are the hospitals where they can find other drugs that are needed by

the patients at the time. >> time for house calls, the first patient is a baby boy. to our surprise, we take a left out of the clinic and then straight up the stairwell. so literally next door to where the office is is the first patient of the afternoon. a little baby is what we're hearing. >> please come in. >> are you worried about anything or just a routine visit? >> no, no. >> translator: we plan field visits. we see them once a month in the office and once a month in the field. if the child is ill, we come more often until we discharge them. >> dr. dehassa talked about nolan's diet to his teeth and his motor skills.

>> translator: this is the height and the weight curve that we record on each visit. and this measures the baby evolution as a percentile. and here we have the foods with information to the families and what has to be eaten month by month. here are the vaccines that reflects a follow-up of the child's development. >> so healthy, baby is healthy? >> translator: very, very healthy. >> a clean bill of health and its time for the next patient. so this is a bit of an uni shall sight, but you see a doctor and a nurse just walking down the sidewalk making house calls in this neighborhood. a few minutes later we arrive at the home of a woman suffering from alzheimer's dementia. does she have a caretaker, somebody that lives here with

her? >> translator: she is her caretaker and is here eight hours until her daughter comes home from work. >> how often do you see her? >> translator: i see her almost every day. >> on average cubans have a long life span, nearly 80 years. the focus on preventive health care has contributed to that. it also means a growing aging population. diseases like alzheimer's are becoming more common here. along with a focus on preventive care, cuba places a heavy emphasis on prenatal care for babies and their mothers, boasting one of the lowest infant mortality rates in the region. now keep in mind these numbers are coming from the cuban government and we can't independently confirm them. but the world health organization validated the cuban health system a few years ago calling it, quote, a model for the world. making the rounds, you can tell this is a personal doctor/patient relationship. dr. dehassa provides consistency

as well as care. it's a unique system that does seem to be working here. for cuba a country cutoff from the united states for so many years, finding these unique solutions has led to impressive innovations. so next, we're headed to a research center developing cuba's own vaccines including one for lung cancer. >> "vital signs" with dr. sanjay gupta is brought to you by dubai health care city. go to cnn.com/vitalsigns for how the world is impacted around us.

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through innovation. much of that happens at the center for molecularolo biology. in this building researchers have made their own vaccines for everything from hepatitis to meningitis. >> we are producing more than 70% of the medication that we need for our population. >> there is one vaccine that has caught the attention of countries all over the world including the united states. the vaccine is for lung cancer and it's called scimovax. >> it means we have more than half a chance to cure lung cancer patient each year.

and in the same period of time, they say patients die from this cause. >> is it the lifestyle, like pollution, smoking, cigars. >> smoking in cuba is a very common habit because we are the main producer of tobacco. >> this man is 77 years old and was a smoker all his life, starting at age 7, saying he spoked as much as a box of cigars every day. in 2007 he was diagnosed with lung cancer. when they told you you had lung cancer, were you surprised? >> translator: yes, yes. it was like a house fell on top of me. it hit me really hard. but thanks to the help that i have had from my doctors, especially the doctor here, she gave me the treatment, the chemotherapy and then invited me to the clinical trials with the vaccines.

>> the critical distinction between this treatment is that the word vaccine is a big misleading. in its current form, it does not prevent disease like a traditional vaccine but rather keeps diagnosed tumors in check by inhibiting their growth. it's a form of amenotherapy harnessing the power of the body's own immune system. this is completely free. >> yes, in cuba is it's completely free. >> other countries are participating in a study for the vaccine, like japan. those who received the vaccine lived 11 months longer than those who didn't receive the vaccine. this is part of a newly formed health collaboration between the united states and cuba. signed just a week before our visit to havana. after 54 years, the united states and cuba normalized diplomatic relations last july. but not all contact had been cut off between americans and cubans

before that. in fact, house havana there's a medical school with a unique mission. take people from impoverished areas, train them to be doctors and then send them back home to provide medical care. since it opened in 1999 it has trained 25,000 doctors from all over the world, 84 countries around the world, including the united states. one of the biggest draws of the latin american medical school is the cost. as in there isn't any cost. it's free. in fact, the students actually receive a small stipend to attend the six-year program. the only agreement they make is to return to their community and serve impoverished communities in need of medical care. though cuba pays for the trains, the doctors don't actually stay in cuba. how many of you are from the united states? almost all of you. how many of you had ever visited cuba before coming to medical

school here? just two of you. how many of you plan on going back to the united states after finishing your school? all of you. all right. i spent some time just now with many students from the united states. they don't pay to come to school here. and when they're done, they're going to go back to the united states. what is cuba getting out of that relationship? >> translator: this university was founded in 1999 because of several problems that occurred in central america related to hurricanes mitch and george. but sending cuba medical teams could be the definite solution. >> the idea of medical diplomacy has been a running theme in fidel castro's cuba. cuban doctors often go on medical missions to other countries and cuba sent hundreds of health care workers to west africa to fight ebola. they have also exported doctors to other latin american

countries in exchange for badly needed oil and hard currency. which some cubans complain has led to a shortage of experienced doctors in their own country. i left the latin american medical school impressed by these students who took such a huge leap of faith to come to a country most of them had never even visited to study medicine in a foreign language and to give a true commitment to this style of health care. that's pretty good. next, we take a ride for a classic tour of this historic city. regardless of the conditions. ♪ get great offers at the lexus golden opportunity sales event. get up to $5,000 customer cash on select 2016 models. ends september 5th. see your lexus dealer.

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according to the world bank, life expectancy here in cuba is 80 years old. that's one of the highest in the

world. to give you some context, the united states is 79 years old. brazil is 75 years old. a lot of that likely has to do with what they don't eat here. but also with what they do eat. the vegetable markets like the one you're looking at here weren't even able some ten years ago. and even today to buy cucumbers, for example, two cucumbers would cost more than a day's salary for the average cuban. the cost of living is a common theme we heard from nearly everyone we spoke to. in fact, many look for a second job to supplement their state salaries, which averaged $20 to $25 a month here. for doctors, we're told it's a bit higher, roughly $50 to $60 a month. we heard stories of some doctors and nurses occasionally taking supplies to resell on the black market. or patients bringing gifts to appointments to ensure access to those limited supplies. so as much as things may be improving here, there's still a long way to go. with people looking to increase their income, tourism appears

promising as the united states and cuba further improve diplomatic relations, that means more american tourists. and one of the first things they want is a tour of the city and a classic american car. several of the drivers we spoke to had other jobs. some were chefs, some were engineers, and they said a few of the fellow drivers were in fact doctors. we didn't find any full-time doctors who were also part-time drivers that day, so i hitched a ride with ridalpho, a 43-year-old cuban driving these cars for 20 years. hi, ridalpho, glad to meet you. >> nice to meet you, too. >> what kind of car is this? >> a chevy. >> i'll sit with you. what kind of car is this? >> '52 chevrolet. >> safe? >> yes, of course.

okay, let's go. >> let's roll. as far as careers in cuba go, this is a pretty good career. you're making good money doing this. >> yes, of course. >> it costs us $25 to rent this car for about an hour. so in one hour ridalpho makes as much as the average state salary in an hour. >> in my opinion, it's very, very good. because it is free for them. >> what is the worst thing about the health care system? >> the system is really good. the problem is, for example, for the medicine, they present them with the american embargo. we know that. that is impossible to send to

another country every single day for the cuban citizen. >> reporter: on our drive we passed cuba's revolution square. >> this is the revolution square. >> revolution square. and the american embassy with the flag flying high out front. that's a recent addition here in havana. this is monaco, the most famous avenue. and in the front is the american embassy. >> there is the flag. does it make you happy to see the flag go up? >> yes. we are looking here now, oh, my god, look at the american embassy. that is possibly in cuba? yes, it's quite possible. after 50 years that is possible. >> cuba, people live a long time in cuba. the life expectancy is 80 years old here. and the united states, 79, lower

than cuba. but why do you think? >> in my opinion that's happened maybe because we live more quiet, more free in the spirit. given the spirit is free because cubans in this country have to work for a living. we don't have bviolence or crim in the street. >> no crime or violence in the street. >> no, very, very low crime and the violence. for example, in cuba, you can see the -- >> no worries. >> they play very happy because it is a very safe country for

living. that is the one reason between anyone. >> what other reasons do you think? >> for example, the food in cuba is natural. >> natural. >> yes. the americans use so many chemicals in their food. not just in america, around the world. people use so many chemicals in the food, yeah. >> yeah, i think you're right. how about fixing the car? it has a problem. you? >> myself. >> you fix it yourself? >> yeah. >> you a mechanic? >> so-so. in cuba when you talk about the cuban freeport, you can get h t hurt -- we make everything.

>> as we drive around this beautiful and fascinating place, i can't help to think what the classic cars represent. ridalpho's 1953 chevrolet has make-shift parts added on like the battery. it probably shouldn't work but it does thanks to ingenuity from a self-proclaimed so-so mechanic and a tremendous amount of pride. like the old cars, cuba is also doing more with less and has been for decades. a count industry on the brink of chain change and a lot more to offer.

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office depot officemax. gear up for school. gear up for great. hi, everyone. it is 3:00 eastern, noon pacific. i'm poppy harlow. donald trump makes a hard sell for african-american voters at a predominantly black church in detroit. his efforts though met with protests from some. >> no trump! no trump! no trump! no trump! no trump! >> at one point today several of the protestors tried to rush the church gate. but while this played out outside, take a look at what happened inside.