14ymedio, Havana, 28 December 2020 — The Panamanian Society of Cardiology has addressed an open letter to the authorities of that country in which it describes the regulations that have been violated in the hiring of Cuban doctors to support the fight against Covid-19. The association believes that is appropriate for them to weigh in because, although the number and specialties of the personnel arriving from the island have not been specified, it has transpired that there are cardiologists among the 230 Cuban brigadistas.
The physicians demand to know the economic terms of the agreement, since it has been reported that Panama will paid $591,197, but there is no information about how much each doctor will receive. The association estimates that it will be approximately $ 2,687, more than what the national staff earn.
“It is unacceptable that our health professionals are not paid on time for the hours they work, but the foreigners hired are better paid,” says the statement, which does not address the fact that the Cuban government usually keeps between 70% and 90% of the salary paid for each doctor.
As reviewed by cardiologists, the law provides that the hiring of foreign doctors expressly requires that they must be hired as individuals and not as a group. The regulations also indicate that the contractors must meet a series of requirements, among which is the completion of “a theoretical-practical examination of each area of accredited expertise (…) with a minimum grade of approval, as established by each discipline in the Republic of Panama. For those disciplines that demand particular requirements from nationals, they must comply with said requirements.”
To practice cardiology in Panama, a doctor needs three years of practice in internal medicine and three more years of cardiology. “The training plans for cardiologists in Cuba only contemplate three years of cardiology, without the requirement of internal medicine, so what they have told us is false (…) in relation to the fact that they can help with the base of internal medicine, which they don’t have.”
The statement also gives an account of the legal requirement to consult with the Society of Cardiology and the Faculty of Medicine of the University of Panama to contract doctors in their area of expertise. If “there is a need to hire foreign specialized medical personnel, after consensus with the corresponding specialized medical societies, all degrees and the academic repertoire will be evaluated by the Technical Health Council,” the law states. However, that opinion has not been sought.
“We were not consulted about the need to hire foreign cardiologists, nor have we evaluated their academic preparation,” the association said.
The association notes that public funds are being used to bring in health professionals from abroad and transparency prevails. However, the details of the contracts are unknown, which is inconsistent with complying with the requirement that “foreign technical health professionals hired will enjoy the benefits and conditions that are stipulated.”
Cuban doctors “have not been evaluated or approved according to our current legislation,” the letter concludes.
In addition, the letter broadly addresses what they consider a lack of planning by the Government of the health situation during the pandemic. Cardiologists consider that their area of expertise, which is one of the leading causes of death in the country, is neglected and patients are forced to go to consultations where they should not happen or, directly, they refuse to go to the doctor due to the hospital situation and the danger of contagion, which means an increase in mortality from cardiovascular causes.
Almost 500 people die each month from cardiovascular diseases, they say, many more than from coronavirus. “The public health system has not exercised the leadership that is its role in the health care of all Panamanians, as established in article 109 of the Constitution, by concentrating exclusively on the problem of Covid-19, forgetting that there is a population majority not infected with Covid-19, which also requires attention to their serious health problems,” the statement said.
The forceful letter joins the rejection by the dean of the Faculty of Medicine of the University of Panama, Enrique Mendoza, who resigned his position as a member of the advisory council that advises the Government because he is opposed to the agreement with the Cuban Government.
However, this Sunday, at a press conference, Sharomay Osma, medical chief of the Figali Convention Center, authorized to treat Covid patients, said that the team of Cuban specialists has received instruction on all biosafety practices, the model of care and how the process is carried out within the health structures in the country.
According to Osma, Cubans “must abide by” the guidelines and protocols developed by the group of specialist doctors in Panama for the care and management of Covid patients in relation to the drugs, parameters and monitoring of these patients.
Panama added 43 deaths and 2,064 infections this Saturday, the Ministry of Health reported on Sunday. This brings deaths to 3,799 and positives to 228,724 since the pandemic began (in a country of 4.18 million).
In a first phase of training, the Cuban doctors will learn about the facilities, mobility and safety in the proper use of personal protective equipment, according to official information.
Carlos Pérez Díaz, head of the Cuban team of ten brigades and 230 doctors who arrived in Panama in the early morning of December 24, stressed that “they have been summoned and prepared (by the Panamanian Government) to help overcome the difficult moments that the country is facing.”
According to data from Cuban Prisoners Defenders, medical missions represent a net profit for the Government of 8.5 billion dollars (in 2018 it was 6.4 billion dollars, according to the latest official data available), three times the profit that tourism reports, and the group described the missions as “the great capitalist slave business of that country.” Although the authorities have lost many of their large contracts in recent years, with countries such as Bolivia, Ecuador and Brazil, the pandemic has meant a new line of business during 2020, with the dispatch of Henry Reeve brigades to almost fifty countries.
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