Posts Tagged ‘cuban doctors’

Cuban health care draws worldwide praise

September 21, 2015

Health care for Cubans and the care Cuba extends to the world have gained high praise. Cuba’s health care reforms, in the making for 50 years, became the basis for health care planners and providers to be able to extend medical care, medical education, and disease prevention throughout the world. This report surveys Cuban health care both at home and abroad.

1.     Health Care in Cuba

Numbers and narrative alike tell the story of a health care project comprehensive, effective and accessible to all Cuban people.  Actual health care in Cuba and public health – for U.S. health care planners, a separate entity – are identical. Both the community and individual are at once objects of care in Cuba. Payment for care is not an individual responsibility. Cuba has emphasized provision ofhealth facilities, services, and practitioners to rural areas in response to deprivations there prior to the Revolution. Health authorities have emphasized data collection, prevention strategies, health education for all, biomedical research, and medical-education capabilities. Cuba has devised full-spectrum health care, from specialty hospitals for complicated and unusual illnesses, to mid-level centers providing consultations, emergency care, and laboratory services, to thousands of family doctor-nurse teams providing first – contact care in rural areas and crowded cities alike. In developing their system of care, health care leaders frequently have resorted to improvisation, taking advantage of innovative examples elsewhere.

Article 50 of Cuba’s revised 1976 Constitution proclaims that, “Everyone has the right to health protection and care.” Political commitment is what drives planning. In 1965, Fidel Castro led 475 new doctors, the first to be educated under the Revolution, to the summit of Pico Turquino, Cuba’s highest mountain. There the students vowed “to expand rural medical services, to promote preventive health care among the population and to providing selfless aid to needy peoples.” (1)  Describing “RevolutionaryMedicine” to a group of soldiers in 1960, Che Guevara established the duty of the state, “to provide public health services for the greatest possible number of persons, institute a program of preventive medicine … and to orient the creative abilities of all medical professionals toward the tasks of social medicine.”

The role of political leadership was clear in 1983 when Fidel Castro urged specialists at Cuba’s principle infectious disease institute to make certain that the oncoming HIV/AIDS epidemic “does not constitute a health problem for Cuba.” (2) Thus preventative measures were already in place when Cuba’s first case of the disease was diagnosed two years later. Infection rates are still the lowest in the region.  

Data from the World Health Organization and Pan American Health Organization confirm Cuba’s own figures on health outcome. (3) Estimates of infant mortality rates (IMR) during the 1950’s, prior to the Cuban Revolution, vary widely, from 65 babies dying in their first year of life (out of 1000 births) to 39 infant deaths (in 1960).  Life expectancy at birth was 64 or less, according to varying tallies. Cuba had one medical school, eight small nursing schools, and 6286 practicingand teaching physicians, two thirds of whom were based in Havana. Within two years 3000 physicians would leave for foreign exile.

Data from the World Health Organization and Pan American Health Organization confirm Cuba’s own figures on health outcome. (3) Estimates of infant mortality rates (IMR) during the 1950’s, prior to the Cuban Revolution, vary widely, from 65 babies dying in their first year of life (out of 1000 births) to 39 infant deaths (in 1960).  Life expectancy at birth was 64 or less, according to varying tallies. Cuba had one medical school, eight small nursing schools, and 6286 practicing and teaching physicians, two thirds of whom were based in Havana. Within two years 3000 physicians would leave for foreign exile.

In 2013 Cuban life expectancy was 78.5 years (79 in the United States).  Cuba’s 2014 IMR was 4.2. The U. S. rate in 2011 was 6.1 and is unchanged since, with black infants dying at twice that rate. (The IMR for Canada was 4.8 recently – 15.7 for all of Latin America.)  Cuba’s rate of child deaths under age five, per thousand births, was 5.7 in 2014; the most recent U. S. rate was 7.1.  Cuba has recently spent 10 percent of its GDP on health care; the United States 17.6 percent; Canada 11.4; and the UK 9.6 percent. Cuba has one physician for 149 persons, 85,563 in all; the U. S. rate is one per 413 persons. Cuba, with 24 medical schools, graduated more than 10,000 physicians in 2013; the United States graduated 18,154 that year.  

Cuban health care extends to biomedical research and production, also export of multiple vaccines, diagnostic test kits, and generic drugs – including anti-HIV agents. That sector has prioritized immunotherapy products and anti-cancer vaccines. “In one section of Havana,” an observer notes,” there are 24 research and 58 manufacturing facilities, employing some 7000 scientists and engineers, and [that] accounted for $711 million (USD) in export earnings in 2011.”  (4)    Cuban scientists have developed innovative products, among them: interferons, a vaccine against Type B meningococcal meningitis, a drug directed at foot ulcers caused by diabetes, recombinant streptokinase used for myocardial infarctions, and epidermal growth factor helpful in the treatment of burns.  

2.     Cuban International Medical Solidarity

It started in 1960. Cuba sent a relief team of health workers to Chile after an earthquake there. They went to Algeria in 1963 to establish a public health system. Since then, according to Professor John M. Kirk of Dalhousie University in Nova Scotia, over 325,000 Cuban medical personnel have provided assistance in 158 countries. (5) Indeed, the Cuban Constitution refers to “proletarian internationalism, brotherly friendship, help, cooperation, and solidarity with the peoples of the world.”

Kirk believes that,  “Cuba has provided an example for the planet, showing how its successful medical collaboration programs have been far more successful, and more far-reaching, than anything provided by all of the G-8 countries’ efforts combined. For over fifty years Cuban medical personnel have served the poorest and most neglected areas of the world, going where other doctors refused to go. At present they are looking after the well-being of some 70 million people.”

He adds that, “As of January 2015 there are 51,847 Cuban medical personnel (of whom 50.1% are physicians) working in 67 countries–mainly in the developing world … [I]n Africa over 4,000 medical personnel are working in 32 countries”  The situation, he says, is comparable to  “having 223,000 US doctors serving in developing countries.”

Some notable examples:

·        Cuban medical teams went to Sub-Saharan Africa in the 1970’s in conjunction with anti-apartheid military actions there.

·        Beginning in 1990 Cuba developed comprehensive medical-care programs centered in Tarará, Cuba, for the 21,874 children and 4,240 adults who were victims of the 1986 nuclear disaster in Chernobyl, Ukraine. Cuba provided medical care and provisions at no cost.

·        During the 1990’s, disaster relief efforts culminated in help given to Haiti and Central American countries following Hurricanes George and Mitch in 1998. The latter took tens of thousands of lives.

·        Hundreds of Cuban doctors remained in Haiti and were there when the disastrous 2010 earthquake occurred. New physician arrivals took the lead in providing care and rehabilitation for injuries and responding to the cholera epidemic that followed. They stayed; currently 700 Cuban doctors are working in Haiti. In all 11,000 Cuban health workers have served there since 1998.

·        Cuban doctors have cared for patients in East Timor since 2003; 350 were there in 2008, and four years later hundreds of that country’s young people were training as physicians in Cuba, also in an East Timorese medical school established and staffed by Cubans.

·        From 2004 on, as part of “Operation Miracle,” Cuban eye surgeons with logistical support from Venezuela have performed sight-restoring surgery, mainly for cataracts and glaucoma, for 3.4 million patients in 31 countries.

·        In 2005 in Pakistan within two weeks of an earthquake that killed 250,000 people, over 3000 Cuban medical personnel were caring for the injured in 32 field hospitals, in the snow and mountains. They stayed for six months. 

·        Earlier that year Cuban disaster-relief teams working abroad became the “Henry Reeve Brigade,” named in honor of a young U. S. soldier who joined rebel forces in Cuba’s first War for Independence.  Some 1500 Cuban doctors preparing to go to New Orleans in the wake of Hurricane Katrina – The U. S. government turned them down. – were the first contingent to be so designated. By that time 36 disaster relief teams had already worked in 24 countries.

·        In late 2014, 251 Brigade members traveled to East Africa to combat the Ebola epidemic. Recruited from 15,000 volunteers, they stayed for six months. For its anti-Ebola contribution, Norway’s Conference of Trade Unions in February 2015, nominated the Henry Reeve Brigade for the Nobel Peace Prize.  

·        “Brigade 41” of the Brigade, with 49 health workers, arrived in Katmandu, Nepal, in May 2015 to deal with suffering caused by a major earthquake.  This was the 41st mobilization of the Brigade since its formation in 2005.

·        In August 2015, 16 Cubans – physicians, nurses, and epidemiologists – were on the Caribbean island of Dominica helping victims of flooding caused by Hurricane Erika. They brought 1.2 tons of medical supplies and provisions. 

·        Since 2005, Cuban physicians, usually from 12,000 to 15,000 at a time, have served in Venezuela as practitioners and medical teachers. In return, Cuba gains an assured, reasonably priced supply of Venezuelan oil.

·        Some 11,000 Cuban physicians, the majority of them women, have been working since 2013 in underserved areas of Brazil, whose government reimburses its Cuban counterpart.

Medical education is a big part of Cuban medical internationalism.  Kirk reports that in Africa, for example, 5,500 Cuban professionals were working there in 2012, and also that “40,000 Africans have graduated from Cuban universities and there are currently 3,000 studying in Cuba.” 

Cuba has established medical faculties in 15 countries and provided teachers for 13 of them.  According to <spanstyle=”” id=”yui_3_15_0_1_1442845244782_1020″>journalist Salim Lamrani, Cuba annually provides training in medicine, nursing, or medical technology for some 29,000 students from over 100 foreign countries. (6)  Every year half of Cuba’s medical graduates are foreign students. Cuba-Venezuela cooperation has resulted in some 25,000 Venezuelans now studying medicine under Cubans’ tutelage as part of an innovative program that has students studying in their own communities. Kirk reports that Cuban teachers have helped train “more than 80,000 midwives, 65 health promoters and 3,000 nurses” in developing countries.

The jewel in the crown of Cuba’s overseas medical work is the Latin American School of Medicine (ELAM).  Formed in 1999, the Havana-based institution, which utilizes teaching hospitalsacross the island, provides medical education at no personal cost to students who arrive from Africa, Latin America, Asia, and from the United States – almost 100 counties in all. Up to 1500 students graduate from the School every year and, as of August 2015, some 23,000 physicians have returned to their own countries, where, as promised, they will be serving where they are most needed. United Nations Secretary General Ban Ki-moon, visiting the School, told students, “ELAM does more than train doctors.  You produce miracle workers.”

Perhaps the most remarkable aspect of Cuban health care relates to the community orientation of practitioners and teachers alike, in Cuba and abroad. 

<fontcolor=”#1e1c11″>Kirk quotes El Salvador’s Public Health Minister María Isabel Rodríguez:  “The Cubans treat them [their patients] as individuals, recognizing their human quality, and spending time with them. Their medical treatment is different – the Cuban doctors respect their patients and listen to them.”

Kirk suggests that patients “are not seen as suffering from a singular ailment … instead they are viewed in the wider bio-psycho-social context.”  And, “the system is based upon medical training in which ethical considerations and the responsibilities of professionals are emphasized far more than in medical schools of the industrialized world. … The result is that the Cuban system has developed a cost-effective, pragmatic, highly ethical and sustainable system of public healthcare.”

In January 2015 Professor Kirk wrote to the Norwegian Nobel Committee indicating he was “delighted to nominate the Cuban medical internationalism program for the Nobel Peace Prize.” Ban Ki-moon would concur: Cuban “doctors are with communities through thick and thin – before disasters strike … throughout crises … and long after storms have passed. They are often the first to arrive and the last to leave.”

Notes:

1. http://www.banderasnews.com/0511/hb-cubadoctors.htm

2. http://www.hhrjournal.org/2013/09/06/hivaids-in-cuba-a-rights-based-analysis/

3. The web site www.medicc.org is a valuable resource providing access to epidemiologic data from the Cuban Ministry of Health, the World Health Organization, and the Pan American Health Organization.

4. http://aaaspolicyfellowships.org/sci-fly/cuban-biotech-and-medicine-waiting-introduce-themselves-us

5. http://www.counterpunch.org/2012/12/14/medical-internationalism-in-cuba/ The research and observations of Professor Kirk are fundamental to an understanding of Cuban medical internationalism

6. http://www.cubadebate.cu/opinion/2012/08/04/cuba-forma-hoy-en-un-ano-mas-medicos-que-el-total-que-tenia-en-1959/#.VfbYtv_lu1s

7. http://www.nnoc.info/nomination-of-the-cuban-medical-internationalism-programme-for-nobel-peace-prize%E2%80%8F/

8. http://www.un.org/apps/news/infocus/sgspeeches/statments_full.asp?statID=2125#.VfbWqf_lu1s

http://peoplesworld.org/cuban-health-care-draws-worldwide-praise/,

Cuban ebola team nominated for Nobel Peace Prize

May 20, 2015

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by: Emile Schepers

The Annual Conference of Norwegian Trade Unions, meeting in Trondheim, Norway, voted unanimously in February to nominate Cuba’s Henry Reeve Brigade of internationalist health care workers for the Nobel Peace Prize.

The Henry Reeve Brigade, named for a U.S. born medical doctor who participated in Cuba’s war of independence from Spain in the 19th century, and which was formed in 2005, consists of doctors, nurses and other health  care workers who volunteer to provide care in dangerous and unusual emergency situations around the world.

When the Ebola outbreak began in Liberia, Guinea and Sierra Leone in West Africa last year, 461 members of the brigade, trained by the Pedro Kouri Institute of Tropical Medicine in Havana, were quickly sent out to do the extremely dangerous direct face to face work with patients in a region where health care facilities and even basic infrastructure such as roads and communications systems are minimal.  Cuba’s role, far out of proportion to the countries small size and modest material resources, has been widely praised worldwide, including by the World Health Organization.

The Henry Reeve Brigade is only a small part of Cuba’s vast system of medical solidarity help to scores of poorer countries.

The Ebola epidemic has infected at least 22,000 people in the three countries, of whom 9,000 have died.  At least one of the  Cuban Reeve Brigade participants, Dr. Felix Baez, came down with the disease, but has survived.  One Cuban administrator died, but of malaria, not Ebola.  Currently the epidemic has been beaten down, but could flare up again, either in that area or somewhere else.

Surely there are few entities that are more deserving of the Nobel Peace Prize nomination!

Photo: Cuban health worker wearing protective gear.  |  telesurv

http://www.peoplesworld.org/cuban-ebola-team-nominated-for-nobel-peace-prize/,

Cubans’ ‘revolutionary ethics’ lead to advances against Ebola

April 6, 2015

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The Militant

Vol. 79/No. 13      April 13, 2015

BY SETH GALINSKY
With only one new case of Ebola in Liberia in the last few weeks and a steep drop in new infections in Sierra Leone, Cuban volunteers, who have been at the forefront of combating the epidemic in those two countries, are returning home. The 38 internationalist volunteers in Guinea-Conakry, where the epidemic is not yet under control, continue to fight the virus.

At the outset of the epidemic, Cuba’s revolutionary government organized the largest delegation from anywhere in the world of medical personnel, all volunteers, to fight the disease.

“The Cuban doctors didn’t care about the risk, they said they were brothers from across the ocean and they came to help us as brothers,” Liberian Foreign Affairs Minister Augustine Kpehe Ngafuan told Cuban reporters in late March.

Juventud Rebelde reported that 150 Cuban doctors and nurses who have been fighting Ebola for the last six months in Liberia and Sierra Leone returned home March 23. The 66 volunteers remaining in Sierra Leone will return April 1. All will spend 21 days in quarantine to ensure that the disease is not introduced onto the island.

Dr. Leandro Castellanos Vivancos described his experience in Sierra Leone in an article on the Cubadebate website. Castellanos was stationed in the Port Loko district, a rural area 35 miles from the capital Freetown.

“We first arrived at a small camp very similar to what in Cuba are known as rural schools, with the difference that we had air conditioning for 12 hours a day,” Castellanos wrote.

“We could see all along the road some of the customs of the people, for example, the long treks of women, with huge logs on their heads and an ax in their hands,” he said. “Yes, here the women do the hard work and sometimes the men accompany them as if to raise their spirits.”

“The patients were not used to being in beds and we would find them on the floor. Some of them feared us, they didn’t have even a little bit of faith in the ‘astronaut’ they had in front of them,” Castellanos said, referring to the protective clothing doctors and nurses have to wear.

“Little by little we did what was necessary, it wasn’t easy,” he said. “Sometimes we had to communicate with gestures, crazy antics, since just a few of them spoke English.”

Brought down death rate

The Cubans worked out of a field hospital with volunteers from other countries, including the United States, and with local personnel, succeeding in bringing the death rate down from 70 percent to 30 percent, Castellanos said.

“We’ve done our duty, with revolutionary ethics, with medical ethics,” Dr. Leonardo Fernández, one of the Cuban brigadistas in Liberia, told Granma in an interview published in the March 20 issue.

Fernández said that the training they received at Cuba’s Institute of Tropical Medicine was excellent. “We left knowing what we faced, knowing the dangers, and prepared psychologically and technically,” he said. “During the first week we started out with a tremendous fear, but as time went by we had to slow down some of the volunteers, because they wanted to do more than what we had been asked to do.”

“We saw entire families die, children who were alone, their mom, their dad, three little brothers who died, it was terrible,” Fernández said. “But we also saw how Ebola survivors picked up and adopted orphan children. There isn’t any better pay for us than seeing this solidarity among the Liberians themselves.”

Fernández noted that when the brigade first arrived in Liberia the streets were deserted because of fear of contracting the disease. “Now, what a difference,” he said. “People on the street greet us, whenever we go out to eat or buy anything, they treat us with tremendous affection.”

Like other volunteers, Fernández has been on previous internationalist missions, including in Pakistan after an earthquake, in Nicaragua, East Timor and in Haiti.

‘I always volunteer for missions’

“Whenever they ask for volunteers I raise my hand and then I ask later what I’m volunteering for,” he said.

All the Cuban volunteers agreed to serve for at least six months. Only one of the Cuban volunteers, Félix Báez, contracted Ebola. He survived and returned to complete his assignment in Sierra Leone. Two Cuban volunteers were infected with malaria and died during the mission.

Fernández said he didn’t see what they did in Liberia as heroic. Thousands of Cuban internationalists have carried out missions around the world, he said, pointing to medical brigades deep in the jungle in Brazil, in indigenous communities in Venezuela and in villages in other parts of Africa. “The only difference is that this international mission is well known in the media,” he said. You had to be brave, “but it was just another assignment.”

“We don’t need any monetary compensation,” Fernández said. “I am recognized as a complete revolutionary, firm in my principles. That’s enough.”

“The first thing you feel is satisfaction at having carried out our assignment,” Dr. Ronald Hernández, who was part of the Liberia brigade, told Cubadebate. “Having helped those peoples is one of the best things I have personally ever done.”

“The people of Africa deserve a better destiny,” Hernández said. “I have seen social problems in my previous missions, but in Africa everything is more complicated. They need a few Fidels over there.”

The Brazilians are coming…

September 9, 2013

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by Stephen Wilkinson

As Brazil is about to import 4,000 Cuban doctors to ease its shortage of medical professionals, it has been annunced that Brazil’s President Dilma Rousseff (pictured beklow with Raúl Castro) is expected to visit Cuba at the end of this year to attend the official opening of the Port of Mariel which is being built by Brazilian construction firm Odebrecht.
The first 700 metres of new berths at the port, situated 80 miles West of Havana, are scheduled to be completed by December and the port is expected to be fully operational by next year.
The visit will be the second by President Rousseff to Cuba in two years and is a sign of deepening relations.
Brazil’s national development bank BNDES is financing 85% of the port project, including the creation of the adjacent Mariel development zone, with Cuba funding the remaining 15%. Almost all the supplies and services for the project are being provided by Brazilian companies.
The new Mariel Port will include facilities for offshore oil exploration and development, a container terminal with the capacity to store up to one million containers, along with general cargo, bulk and refrigerated handling facilities.
The Mariel terminal will provide access for large vessels of up to 15 metres draft, which cannot currently dock in Cuba. Mariel’s new facilities will be operated by the Port Authority of Singapore’s PSA Panama International, which is based in Panama City.
The special development zone will be operated by a subsidiary of GAESA, the Cuban military holding company and aims to encourage more foreign investors to produce high value-added goods and services for export in Cuba.
It is expected that beyond the industrial zone an area of residential property, hotels and other facilities are envisaged. The zone is covered by special laws and has a tax status that is different from that on national territory.
The government published a decree on 3 April 2013 detailing rules for the “maquiladoras”, the manufacturing plants in the free-trade zone that will import and assemble duty-free components for export. The decree establishes rules for the area and its operations, including customs fees, tax exemptions and exemptions from the payment of import taxes. Brazil indicated last year that it would be helping Cuba draw up a legal framework for special development zones.
“We have a lot of interest in cooperating in the definition of this model, in order to bring in the biggest possible number of Brazilian companies,” Brazil’s Foreign Trade Minister Fernando Pimentel said last year. Havana has said that it is interested in “more integration” between Cuban and Brazilian companies and is offering “technology transfer in exchange for investment in plants”.
The São Paulo-based glassmaker Fanavid has already indicated that it will open a manufacturing facility special development zone to supply Cuba, Brazil and the Caribbean region with architectural glass. Brazilian bus manufacturer Marcopolo could also be interested in opening a manufacturing plant in the zone, which lies 49km west of Havana, Cuban officials say. Marcopolo is the third-largest bus maker in the world.
BNDES has lent Cuba over US$40m since 1999 to buy buses and cars. Cuba secured a rotating credit facility of US$400m to Cuba last year for food purchases, as well as a US$200m loan from Brazil to fund Mais Alimentos Cuba, a food production programme to enable private farmers in Cuba to buy Brazilian-made tractors and other equipment, and benefit from Brazilian training and technology transfer. Brazil’s agriculture research institute Embrapa is also cooperating with Cuba on a number of projects, including one on soy and corn production, one to diversify sugar production, one on development and know-how transfer in biological pest control, and one on reducing heavy metals in agricultural products.
All the projects are funded by Brazil’s foreign-aid agency Agência Brasileira de Cooperação. Odebrecht, meanwhile, formed a joint production agreement last year with state company AZCUBA to operate a sugar mill in the province of Cienfuegos. Airport upgrades are also being carried out by Odebrecht and other Brazilian companies. BNDES agreed in May 2013 to provide US$176m for five airport modernisation projects in Cuba.
Brazil has also indicated that it is studying potential investments in generic pharmaceuticals, including anti-cancer drugs, petroleum refining, and the production of lubricants, while Cuban officials have said that Brazil and Cuba are studying projects in the areas of health care, education, computers and agriculture and livestock.

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Cuban Doctors Bring Eyesight, Healthcare to Haiti

August 29, 2013

Cuban Doctors Bring Eyesight, Healthcare to Haiti
By Patricia Grogg

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Many Haitian women have their blood pressure taken for the first time at mobile clinics like this one staffed by a Cuban medical brigade in Salomon market in Port-au-Prince. Credit: Patricia Grogg/IPS

PORT-AU-PRINCE, Aug 28 2013 (IPS) – It’s Saturday, and the entrance hall of a police station in front of the busy market in Salomon in the Haitian capital has become an improvised health post. In a few minutes there is a long queue of people waiting to be seen by the Cuban medical brigade.

The police officer on duty said he was not authorised to speak to journalists, but the extent of police cooperation is obvious. The police stations’ tables and chairs are quickly lined up along the entrance hall to facilitate the work of La Renaissance hospital workers, who carry out preventive health work here once a week.

“We are a mobile clinic,” said Damarys Ávila, the head of La Renaissance hospital, which is staffed by the Cuban medical mission. “We check for high blood pressure, cataracts, pterygium (a benign tumour of the conjunctiva) and glaucoma,” she told IPS. “We send people with these conditions to the hospital.”

Women are the majority of those waiting in line. “Women have the highest rate of high blood pressure because they bear the greatest burden of labour. Then there are dietary factors, like eating too much hot, spicy food, refined flour and salt,” she said.

“Many people have their blood pressure taken here for the first time in their lives,” Ávila said.

On a tour of this unusual health post, where in a single morning 167 poor women and men receive attention, expressions of gratitude abound.

“We seek out the Cuban doctors because they treat people well and they don’t charge. We are poor, we cannot afford to pay,” said a resident of Port-au-Prince before she raised the heavy load she was carrying on to her head.

The first Cuban medical brigade to Haiti arrived on Dec. 4, 1998, bringing relief in the aftermath of hurricane Georges. Since then cooperation has been uninterrupted and has had a decisive effect in this impoverished country, which in 2010 suffered an earthquake that killed 316,000 people, according to government figures, along with an ongoing cholera epidemic that has also claimed thousands of lives.

During this period Cuban medical personnel have seen 18 million patients, carried out 300,000 operations, saved 300,000 lives and restored eyesight to 53,000 people. According to official reports, there are 640 Cuban health professionals in Haiti, including 357 women.

The international healthcare aid to Haiti stands out not only due to its scope – it reaches the entire country – and its humanitarian impact, but also because it is preparing the country for the future by putting in place a public health system, including the reconstruction of hospital infrastructure.

Financial contributions towards these efforts come from Cuba, and also from Australia, Germany, Namibia, Norway, South Africa, Venezuela, and to a lesser extent from other countries.

The Cuban programme involves remodelling and building 30 community hospitals to act as reference centres, more than half of which have already been completed. Some 39 Haitian health ministry units are to be fitted out as healthcare centres, with or without beds, as well as 30 comprehensive rehabilitation wards.

There are two ophthalmological missions, part of Operation Miracle, one based permanently in Port-au-Prince and the other touring the interior of the country. There is a laboratory for prosthetic and orthopaedic devices, three electromedical workshops and a network for epidemiological and environmental surveillance.

Operation Miracle got underway in 2004, and by 2011 (the latest figures released) had restored or improved vision for more than two million people in 34 countries of Latin America, the Caribbean and Africa.

John M. Kirk, a professor at Dalhousie University in Canada, said that Haitian doctors who trained in Cuba have a key role to play in creating a stronger health system in Haiti.

According to his figures, 430 of the 625 Haitians who graduated from Cuba’s Latin American School of Medicine (ELAM http://instituciones.sld.cu/elam/, ) in early 2011 are already working in their country. Another 115 Haitians graduated from the University of Santiago de Cuba in 2011.

ELAM was established in November 1999, and was proposed to the 9th Ibero-American Summit, held that year in Havana (http://segib.org/es/node/4775,), as a project for training health personnel in the regional grouping, made up of 19 Latin American countries, Andorra, Spain and Portugal.

But although the initiative was praised, it was not taken up by the high officials present at its inauguration. Cuba went ahead with the programme, which today embraces 122 countries and trains “young people mainly from the poorest strata of society, who are ethnically, educationally and culturally diverse,” its website says.

In an essay on the topic, Kirk said that since the 1970s, Cuba has helped to found medical schools in various countries, like Yemen (1976), Guyana (1984), Ethiopia (1984), Uganda (1986), Ghana (1991), Gambia (2000), Equatorial Guinea (2000), Haiti (2001), Guinea-Bissau (2004) and East Timor (2005).

A report given by the Cuban health ministry to IPS says 39,310 health professionals, including 25,521 women, are on “missions” in 60 countries. Of these, 34,794 are in the Americas, 3,919 in Africa, 554 in Asia and Oceania and 43 in Europe.

As a result of the economic reforms initiated in 2010, free provision of Cuban cooperation is being reduced, although it will continue to be “absolutely free” in the Sahrawi Arab Democratic Republic, and Operation Miracle will also be free in Haiti, Honduras, Paraguay and Ecuador, among other countries.

Meanwhile, the Comercializadora de Servicios Médicos Cubanos (SMC – Cuban Medical Services Marketing Company, http://smcsalud.cu/smc/servlet/wpinicio,) is expanding: it offers fee-paying medical attention in Cuba and abroad to raise revenue to finance Cuba’s free public health system.

Through the SMC, Brazil has hired 4,000 Cuban doctors to work in poor areas in the north of the country.
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Related IPS Articles ( http://www.ipscuba.net/, )
Doctors in Brazil: Too Few, or Just Too Far Between?
CUBA-AFRICA: Decades of Assistance and Cooperation
HAITI: Patchy Healthcare Adds to Miseries of Women and Girls


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