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PORTSIDE  December 2010, Week 5

PORTSIDE December 2010, Week 5

Subject:

Cuban Medics in Haiti Put the World to Shame

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Date:

Fri, 31 Dec 2010 19:55:15 -0500

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Cuban Medics in Haiti Put the World to Shame

     Castro's doctors and nurses are the backbone of
     the fight against cholera

By Nina Lakhani
Sunday, 26 December 2010
The Independent & The Independent on Sunday
http://www.independent.co.uk/life-style/health-and-families/health-news/cuban-medics-in-haiti-put-the-world-to-shame-2169415.html

They are the real heroes of the Haitian earthquake
disaster, the human catastrophe on America's doorstep
which Barack Obama pledged a monumental US humanitarian
mission to alleviate. Except these heroes are from
America's arch-enemy Cuba, whose doctors and nurses
have put US efforts to shame.

A medical brigade of 1,200 Cubans is operating all over
earthquake-torn and cholera-infected Haiti, as part of
Fidel Castro's international medical mission which has
won the socialist state many friends, but little
international recognition.

Observers of the Haiti earthquake could be forgiven for
thinking international aid agencies were alone in
tackling the devastation that killed 250,000 people and
left nearly 1.5 million homeless. In fact, Cuban
healthcare workers have been in Haiti since 1998, so
when the earthquake struck the 350-strong team jumped
into action. And amid the fanfare and publicity
surrounding the arrival of help from the US and the UK,
hundreds more Cuban doctors, nurses and therapists
arrived with barely a mention. Most countries were gone
within two months, again leaving the Cubans and
Médecins Sans Frontières as the principal healthcare
providers for the impoverished Caribbean island.

Since 1998, Cuba has trained 550 Haitian doctors for
free at the Escuela Latinoamericana de Medicina en Cuba
(Elam), one of the country's most radical medical
ventures. Another 400 are currently being trained at
the school, which offers free education -- including
free books and a little spending money -- to anyone
sufficiently qualified who cannot afford to study
medicine in their own country.

John Kirk is a professor of Latin American studies at
Dalhousie University in Canada who researches Cuba's
international medical teams. He said: "Cuba's
contribution in Haiti is like the world's greatest
secret. They are barely mentioned, even though they are
doing much of the heavy lifting."

This tradition can be traced back to 1960, when Cuba
sent a handful of doctors to Chile, hit by a powerful
earthquake, followed by a team of 50 to Algeria in
1963. This was four years after the revolution, which
saw nearly half the country's 7,000 doctors voting with
their feet and leaving for the US.

The travelling doctors have served as an extremely
useful arm of the government's foreign and economic
policy, winning them friends and favours across the
globe. The best-known programme is Operation Miracle,
which began with ophthalmologists treating cataract
sufferers in impoverished Venezuelan villages in
exchange for oil. This initiative has restored the
eyesight of 1.8 million people in 35 countries,
including that of Mario Teran, the Bolivian sergeant
who killed Che Guevara in 1967.

The Henry Reeve Brigade, rebuffed by the Americans
after Hurricane Katrina, was the first team to arrive
in Pakistan after the 2005 earthquake, and the last to
leave six months later.

Cuba's constitution lays out an obligation to help the
worst-off countries when possible, but international
solidarity isn't the only reason, according to
Professor Kirk. "It allows Cuban doctors, who are
frightfully underpaid, to earn extra money abroad and
learn about diseases and conditions they have only read
about. It is also an obsession of Fidel's and it wins
him votes in the UN."

A third of Cuba's 75,000 doctors, along with 10,000
other health workers, are currently working in 77 poor
countries, including El Salvador, Mali and East Timor.
This still leaves one doctor for every 220 people at
home, one of the highest ratios in the world, compared
with one for every 370 in England.

Wherever they are invited, Cubans implement their
prevention-focused holistic model, visiting families at
home, proactively monitoring maternal and child health.
This has produced "stunning results" in parts of El
Salvador, Honduras and Guatemala, lowering infant and
maternal mortality rates, reducing infectious diseases
and leaving behind better trained local health workers,
according to Professor Kirk's research.

Medical training in Cuba lasts six years -- a yearlonger than in the UK -- after which every graduate
works as a family doctor for three years minimum.
Working alongside a nurse, the family doctor looks
after 150 to 200 families in the community in which
they live.

This model has helped Cuba to achieve some of the
world's most enviable health improvements, despite
spending only $400 (£260) per person last year compared
with $3,000 (£1,950) in the UK and $7,500 (£4,900) in
the US, according to Organisation for Economic Co-
operation and Development figures.

Infant mortality rates, one of the most reliable
measures of a nation's healthcare, are 4.8 per 1,000
live births -- comparable with Britain and lower than
the US. Only 5 per cent of babies are born with a low
birth weight, a crucial factor in long-term health, and
maternal mortality is the lowest in Latin America,
World Health Organisation figures show. Cuba's
polyclinics, open 24 hours a day for emergencies and
specialist care, are a step up from the family doctors.
Each provides for 15,000 to 35,000 patients via a group
of full-time consultants as well as visiting doctors,
ensuring that most medical care is provided in the
community.

Imti Choonara, a paediatrician from Derby, leads a
delegation of international health professionals at
annual workshops in Cuba's third city, Camaguey.
"Healthcare in Cuba is phenomenal, and the key is the
family doctor, who is much more proactive, and whose
focus is on prevention ... The irony is that Cubans
came to the UK after the revolution to see how the NHS
worked. They took back what they saw, refined it and
developed it further; meanwhile we are moving towards
the US model," Professor Choonara said.

Politics, inevitably, penetrates many aspects of Cuban
healthcare. Every year hospitals produce a list of
drugs and equipment they have been unable to access
because of the American embargo which prevents many US
companies from trading with Cuba, and persuades other
countries to follow suit. The 2009/10 report includes
drugs for childhood cancers, HIV and arthritis, some
anaesthetics, as well as chemicals needed to diagnose
infections and store organs. Pharmacies in Cuba are
characterised by long queues and sparsely stacked
shelves, though in part this is because they stock only
generic brands.

Antonio Fernandez, from the Ministry of Public Health,
said: "We make 80 per cent of the drugs we use. The
rest we import from China, former Soviet countries,
Europe -- anyone who will sell to us -- but this makes
it very expensive because of the distances."

On the whole, Cubans are immensely proud and supportive
of their contribution in Haiti and other poor
countries, delighted to be punching above their weight
on the international scene. However, some people
complain of longer waits to see their doctor because so
many are working abroad. And, like all commodities in
Cuba, medicines are available on the black market for
those willing to risk large fines if caught buying or
selling.

International travel is beyond the reach of most
Cubans, but qualified nurses and doctors are among
those forbidden from leaving the country for five years
after graduation, unless as part of an official medical
team.

Like everyone else, health professionals earn paltry
salaries of around $20 (£13) a month. So, contrary to
official accounts, bribery exists in the hospital
system, which means some doctors, and even hospitals,
are off-limits unless patients can offer a little
something, maybe lunch or a few pesos, for preferential
treatment.

Cuba's international ventures in healthcare are
becoming increasingly strategic. Last month, officials
held talks with Brazil about developing Haiti's public
health system, which Brazil and Venezuela have both
agreed to help finance.

Medical training is another example. There are
currently 8,281 students from more than 30 countries
enrolled at Elam, which last month celebrated its 11th
anniversary. The government hopes to inculcate a sense
of social responsibly into the students in the hope
that they will work within their own poor communities
for at least five years.

Damien Joel Suarez, 27, a second year from New Jersey,
is one of 171 American students; 47 have already
graduated. He dismisses allegations that Elam is part
of the Cuban propaganda machine. "Of course, Che is a
hero here but he isn't forced down your neck."

Another 49,000 students are enrolled in the El Nuevo
Programa de Formacion de Medicos Latinoamericanos, the
brainchild of Fidel Castro and Hugo Chavez, who pledged
in 2005 to train 100,000 doctors for the continent. The
course is much more hands-on, and critics question the
quality of the training.

Professor Kirk disagrees: "The hi-tech approach to
health needed in London and Toronto is irrelevant for
millions of people in the Third World who are living in
poverty. It is easy to stand on the sidelines and
criticise the quality, but if you were living somewhere
with no doctors, then you'd be happy to get anyone."

There are nine million Haitians who would probably
agree.

___________________________________________

Portside aims to provide material of interest to people
on the left that will help them to interpret the world
and to change it.

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