<table cellspacing="0" cellpadding="0" border="0" ><tr><td valign="top" style="font: inherit;"><blockquote style="border-left: 2px solid rgb(16, 16, 255); margin-left: 5px; padding-left: 5px;"><div class="plainMail">Yesterday at dinner, friends and I were discussing US v China re post-secondary education -- US still leads the world in that... and then we segued into med schools in India and (esp) Cuba... and then this was in my inbox today!! </div><div class="plainMail">Easier to read the original (see link) than the text below. </div><div class="plainMail"> --Jenifer</div><div class="plainMail"><br>---------- Forwarded message ----------<br><br>Cuban Medics in Haiti Put the World to Shame<br><br> Castro's doctors and nurses are the backbone of<br> the fight against cholera<br><br>By Nina Lakhani<br>Sunday, 26 December 2010<br>The Independent & The Independent on Sunday<br><a
href="http://www.independent.co.uk/life-style/health-and-families/health-news/cuban-medics-in-haiti-put-the-world-to-shame-2169415.html" target="_blank">http://www.independent.co.uk/life-style/health-and-families/health-news/cuban-medics-in-haiti-put-the-world-to-shame-2169415.html</a><br><br>They are the real heroes of the Haitian earthquake<br>disaster, the human catastrophe on America's doorstep<br>which Barack Obama pledged a monumental US humanitarian<br>mission to alleviate. Except these heroes are from<br>America's arch-enemy Cuba, whose doctors and nurses<br>have put US efforts to shame.<br><br>A medical brigade of 1,200 Cubans is operating all over<br>earthquake-torn and cholera-infected Haiti, as part of<br>Fidel Castro's international medical mission which has<br>won the socialist state many friends, but little<br>international recognition.<br><br>Observers of the Haiti earthquake could be forgiven for<br>thinking international aid agencies
were alone in<br>tackling the devastation that killed 250,000 people and<br>left nearly 1.5 million homeless. In fact, Cuban<br>healthcare workers have been in Haiti since 1998, so<br>when the earthquake struck the 350-strong team jumped<br>into action. And amid the fanfare and publicity<br>surrounding the arrival of help from the US and the UK,<br>hundreds more Cuban doctors, nurses and therapists<br>arrived with barely a mention. Most countries were gone<br>within two months, again leaving the Cubans and<br>Médecins Sans Frontières as the principal healthcare<br>providers for the impoverished Caribbean island.<br><br>Since 1998, Cuba has trained 550 Haitian doctors for<br>free at the Escuela Latinoamericana de Medicina en Cuba<br>(Elam), one of the country's most radical medical<br>ventures. Another 400 are currently being trained at<br>the school, which offers free education -- including<br>free books and a little spending money -- to
anyone<br>sufficiently qualified who cannot afford to study<br>medicine in their own country.<br><br>John Kirk is a professor of Latin American studies at<br>Dalhousie University in Canada who researches Cuba's<br>international medical teams. He said: "Cuba's<br>contribution in Haiti is like the world's greatest<br>secret. They are barely mentioned, even though they are<br>doing much of the heavy lifting."<br><br>This tradition can be traced back to 1960, when Cuba<br>sent a handful of doctors to Chile, hit by a powerful<br>earthquake, followed by a team of 50 to Algeria in<br>1963. This was four years after the revolution, which<br>saw nearly half the country's 7,000 doctors voting with<br>their feet and leaving for the US.<br><br>The travelling doctors have served as an extremely<br>useful arm of the government's foreign and economic<br>policy, winning them friends and favours across the<br>globe. The best-known programme is Operation
Miracle,<br>which began with ophthalmologists treating cataract<br>sufferers in impoverished Venezuelan villages in<br>exchange for oil. This initiative has restored the<br>eyesight of 1.8 million people in 35 countries,<br>including that of Mario Teran, the Bolivian sergeant<br>who killed Che Guevara in 1967.<br><br>The Henry Reeve Brigade, rebuffed by the Americans<br>after Hurricane Katrina, was the first team to arrive<br>in Pakistan after the 2005 earthquake, and the last to<br>leave six months later.<br><br>Cuba's constitution lays out an obligation to help the<br>worst-off countries when possible, but international<br>solidarity isn't the only reason, according to<br>Professor Kirk. "It allows Cuban doctors, who are<br>frightfully underpaid, to earn extra money abroad and<br>learn about diseases and conditions they have only read<br>about. It is also an obsession of Fidel's and it wins<br>him votes in the UN."<br><br>A third of Cuba's 75,000
doctors, along with 10,000<br>other health workers, are currently working in 77 poor<br>countries, including El Salvador, Mali and East Timor.<br>This still leaves one doctor for every 220 people at<br>home, one of the highest ratios in the world, compared<br>with one for every 370 in England.<br><br>Wherever they are invited, Cubans implement their<br>prevention-focused holistic model, visiting families at<br>home, proactively monitoring maternal and child health.<br>This has produced "stunning results" in parts of El<br>Salvador, Honduras and Guatemala, lowering infant and<br>maternal mortality rates, reducing infectious diseases<br>and leaving behind better trained local health workers,<br>according to Professor Kirk's research.<br><br>Medical training in Cuba lasts six years -- a yearlonger than in the UK -- after which every graduate<br>works as a family doctor for three years minimum.<br>Working alongside a nurse, the family doctor looks<br>after
150 to 200 families in the community in which<br>they live.<br><br>This model has helped Cuba to achieve some of the<br>world's most enviable health improvements, despite<br>spending only $400 (£260) per person last year compared<br>with $3,000 (£1,950) in the UK and $7,500 (£4,900) in<br>the US, according to Organisation for Economic Co-<br>operation and Development figures.<br><br>Infant mortality rates, one of the most reliable<br>measures of a nation's healthcare, are 4.8 per 1,000<br>live births -- comparable with Britain and lower than<br>the US. Only 5 per cent of babies are born with a low<br>birth weight, a crucial factor in long-term health, and<br>maternal mortality is the lowest in Latin America,<br>World Health Organisation figures show. Cuba's<br>polyclinics, open 24 hours a day for emergencies and<br>specialist care, are a step up from the family doctors.<br>Each provides for 15,000 to 35,000 patients via a group<br>of full-time
consultants as well as visiting doctors,<br>ensuring that most medical care is provided in the<br>community.<br><br>Imti Choonara, a paediatrician from Derby, leads a<br>delegation of international health professionals at<br>annual workshops in Cuba's third city, Camaguey.<br>"Healthcare in Cuba is phenomenal, and the key is the<br>family doctor, who is much more proactive, and whose<br>focus is on prevention ... The irony is that Cubans<br>came to the UK after the revolution to see how the NHS<br>worked. They took back what they saw, refined it and<br>developed it further; meanwhile we are moving towards<br>the US model," Professor Choonara said.<br><br>Politics, inevitably, penetrates many aspects of Cuban<br>healthcare. Every year hospitals produce a list of<br>drugs and equipment they have been unable to access<br>because of the American embargo which prevents many US<br>companies from trading with Cuba, and persuades other<br>countries to follow
suit. The 2009/10 report includes<br>drugs for childhood cancers, HIV and arthritis, some<br>anaesthetics, as well as chemicals needed to diagnose<br>infections and store organs. Pharmacies in Cuba are<br>characterised by long queues and sparsely stacked<br>shelves, though in part this is because they stock only<br>generic brands.<br><br>Antonio Fernandez, from the Ministry of Public Health,<br>said: "We make 80 per cent of the drugs we use. The<br>rest we import from China, former Soviet countries,<br>Europe -- anyone who will sell to us -- but this makes<br>it very expensive because of the distances."<br><br>On the whole, Cubans are immensely proud and supportive<br>of their contribution in Haiti and other poor<br>countries, delighted to be punching above their weight<br>on the international scene. However, some people<br>complain of longer waits to see their doctor because so<br>many are working abroad. And, like all commodities in<br>Cuba, medicines
are available on the black market for<br>those willing to risk large fines if caught buying or<br>selling.<br><br>International travel is beyond the reach of most<br>Cubans, but qualified nurses and doctors are among<br>those forbidden from leaving the country for five years<br>after graduation, unless as part of an official medical<br>team.<br><br>Like everyone else, health professionals earn paltry<br>salaries of around $20 (£13) a month. So, contrary to<br>official accounts, bribery exists in the hospital<br>system, which means some doctors, and even hospitals,<br>are off-limits unless patients can offer a little<br>something, maybe lunch or a few pesos, for preferential<br>treatment.<br><br>Cuba's international ventures in healthcare are<br>becoming increasingly strategic. Last month, officials<br>held talks with Brazil about developing Haiti's public<br>health system, which Brazil and Venezuela have both<br>agreed to help finance.<br><br>Medical
training is another example. There are<br>currently 8,281 students from more than 30 countries<br>enrolled at Elam, which last month celebrated its 11th<br>anniversary. The government hopes to inculcate a sense<br>of social responsibly into the students in the hope<br>that they will work within their own poor communities<br>for at least five years.<br><br>Damien Joel Suarez, 27, a second year from New Jersey,<br>is one of 171 American students; 47 have already<br>graduated. He dismisses allegations that Elam is part<br>of the Cuban propaganda machine. "Of course, Che is a<br>hero here but he isn't forced down your neck."<br><br>Another 49,000 students are enrolled in the El Nuevo<br>Programa de Formacion de Medicos Latinoamericanos, the<br>brainchild of Fidel Castro and Hugo Chavez, who pledged<br>in 2005 to train 100,000 doctors for the continent. The<br>course is much more hands-on, and critics question the<br>quality of the training.<br><br>Professor
Kirk disagrees: "The hi-tech approach to<br>health needed in London and Toronto is irrelevant for<br>millions of people in the Third World who are living in<br>poverty. It is easy to stand on the sidelines and<br>criticise the quality, but if you were living somewhere<br>with no doctors, then you'd be happy to get anyone."<br><br>There are nine million Haitians who would probably<br>agree.<br><br>___________________________________________<br><br>Portside aims to provide material of interest to people<br>on the left that will help them to interpret the world<br>and to change it.<br><br>Submit via email: <a ymailto="mailto:portside@portside.org" href="/mc/compose?to=portside@portside.org">portside@portside.org</a><br><br>Submit via the Web: <a href="http://portside.org/submittous3" target="_blank">http://portside.org/submittous3</a><br><br>Frequently asked questions: <a href="http://portside.org/faq"
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