Doctors Continue Returning From Brazil While Revelations About the ‘More Doctors’ Program Are On-Going

Doctors continue arriving from Brazil after the Cuba’s break with that country’s Mais Medicos (More Doctors) program. (Granma/Juvenal Balán)

14ymedio bigger14ymedio, Havana | November 26, 2018 — Vice-President Salvador Valdés Mesa and the Minister of Public Health, José Ángel Portal, welcomed the second group of Cuban doctors to return to the Island following the Government’s decision not to continue with the Mais Médicos (More Doctors) program. The contingent, made up of 203 doctors from Brazil, arrived Sunday morning at the José Martí International Airport in Havana.

The deputy minister of the department, Luis Fernando Navarro, directed a few words to the doctors, whom he distinguished for their solidarity and commitment to travel to the most remote places in Brazil where the population has less access to health care.

Meanwhile, in Brazil, details of the creation of the Mais Médicos program with Cuban participation have become known. The leaks of telegrams that reconstruct the negotiations carried out between the governments of Havana and Brasila have revealed details until now unknown such as the length of the talks, which began at least a year before the program was announced, or Cuba’s request for payment of $8,000 monthly per doctor.

In March 2012 a Cuban mission visited Brazil and made proposals ranging from “sending doctors and nurses” to consulting “for the construction of hospitals” and for the development of health systems”, at advantageous prices, according to Alexandre Ghisleni, in charge of business on the Island

On April 4, representatives from the Federal Council of Medicine, the Brazilian Medical Association and the National Federation of Physicians went to Planalto Palace (the official seat of the president of Brazil) to protest against these agreements, then still in the shadows, but then Brazilian President Dilma Rousseff did not confirm them, although she did not deny them, either.

In June 2012, the Ministry of Health organized a visit to Havana to address the creation of the medical program for providing health professionals in remote areas of the country. For the embassy, the project was “initiated in a reserved way, in view of the concern about repercussions from the Brazilian medical community due to the entrance of the doctors.”

The delegation was led by Secretary Mozart Sales of the Ministry of Health, and included Alberto Kleiman, then international adviser of the portfolio and now the current director of international relations and associations for the Pan-American Health Organization (PAHO).

“The Brazilian side proposed payment $4,000 ($3,000 for the Cuban government and $1,000 for the doctor),” states one of the telegrams. “The Cuban side, for its part, said that it had assumed $8,000 per doctor and made a counter offer of $6,000 ($5,000 for the government and $1,000 for the doctor).

The Cuban authorities demanded that the evaluation of the doctors take place in Cuba and that Brazil limit itself to “familiarizing the doctors, above all, in the language and the procedural and administrative practices of the legislation”.

The papers document the Brazilian suggestion that the payment to the Cuban government be made through what they called a “compensation system” to settle the debts of Havana with the National Economic and Social Development Bank (BNDES), which financed the large works of construction in the port of Mariel, among other projects.

Given Cuba’s refusal and Brazil’s fear of having to request the approval of Congress, it was decided at the last minute to triangulate the business by making payment to the PAHO, which would contract with Cuba, which would in turn hire the doctors.

Translated by Wilfredo Díaz Echevarria


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