Through its Doctors, Cuba Influences Global Health Programs

Cuban doctors equipped for emergency missions. (EFE)

14ymedio bigger14ymedio, Miriam Celaya, West Palm Beach, 21 November 2018 — Perhaps never before has a Latin American leader been able to raise such a stir before his inauguration as the newly elected Brazilian president, Jair Bolsonaro, has done. His proposal is to grant work, with full salary and permanent residence for them and their families to the doctors who work in the Mais Médicos (More Doctors) program, after they revalidate their credentials in Brazil, has provoked a drastic response from Havana, which has announced the departure of Cuba from the program and has ordered its health professionals to return to Cuba.

The fate of Cuban doctors in Brazil has become one of the most prominent issues in numerous media and social networks. It has, once again, focused on the many dark stains of the humiliating exploitation system that has been systematically applied by the Cuban Government to these professionals, and it has also stirred passions between the critics of the Castro regime and some of the faithful who – in spite of all the evidence – still justify and defend it.

Thus, while a growing chorus calls for the doctors’ insurgency, urging them to defect and to continue offering their services in the communities where they have been working so far – this time receiving all the advantages offered by the new Brazilian president – certain voices of the radical left regret what they consider a low blow to a program that has brought primary health care to the most impenetrable and poor places in Brazil where it did not exist before.

The questionable decision of the Cuban regime to withdraw the doctors has exposed the true interests behind the Castro pantomime of solidarity, altruism, cooperation and Latin American brotherhood. The fate of millions of poor Brazilians who receive basic care thanks to Cuban professionals is completely irrelevant to the Palace of the Revolution.  Their concern is the irreparable loss of the more than 300 million dollars it has been receiving annually, lifted from the doctors’ salaries.

The questionable decision of the Cuban regime to withdraw its doctors has exposed the true interests behind the Castro pantomime of solidarity

The loss of such lucrative income constitutes a devastating and possibly irreparable blow for the Castro regime. And for greater injury, the Island masters would also lose a good part of the supply of skilled workers in conditions of semi-slavery that have brought them so much wealth over the years.

In the middle of the political tug-of-war from this or the other side, the future of doctors and patients gets decided. On November 19th, the Pan American Health Organization (PAHO), the new specialized agency of the inter-American system, the intermediary between the Mais Médicos program promoted in 2013 by Brazilian President Dilma Rousseff and the Cuban Government, launched a statement that reflects an identical instrumental perception of Cuba’s medical personnel and reinforces the customary congratulatory position towards the Cuban authorities. At the same time, it distances itself from the conflict and avoids committing itself to the free hiring of Cuban doctors, by clarifying that “the Organization has agreements with the governments of both countries (Cuba and Brazil, in this case) for Mais Médicos, but it does not enter into contracts with doctors…”

“Cuba has the highest number of physicians per one thousand inhabitants in the world, 7.5,” said the note, pointing out where their sympathies are by mentioning that the lack of doctors in Brazil motivated the signing of the agreement, since Cuba has “extensive experience in providing doctors.”

Nothing else is needed. It is clear that PAHO needs the Cuban dictatorship as medical personnel guarantor to cover the programs of the organization. The fact that Havana uses its doctors as semi-slave labor, both in this and in other international programs in which it participates, in open violation of the International Covenant on Economic, Social and Cultural Rights of the International Bill of Human Rights created to watch over the guarantee, among others, also of the labor rights of these doctors and other Cuban health professionals, is only a minor detail for PAHO, despite its being a body affiliated with the World Health Organization (WHO)

It becomes clear that PAHO needs the Cuban dictatorship as guarantor of medical personnel to cover the programs of the organization

Thus, and without detracting from the importance of the existence of agencies that promote cooperation between countries and governments in favor of primary health care for all, and the undeniable ability of these to promote general policies aimed at preventing epidemics and chronic diseases, develop vaccination programs and reduce child mortality among the most vulnerable population groups, among other commendable functions, both PAHO and WHO have left their serious limitations exposed.  By applying the maxim “the end justifies the means” they manage to fulfill their functions with relative success, and justify their own existence, but they violate important legal instruments established by the UN and become accomplices of a long dictatorship.

Thus, the essential remains in the background. The Mais Médicos program was created, at least on paper, to provide medical services to millions of people from the poorest social sectors of Brazil, not to fatten the coffers of the Cuban dictatorship. Therefore, both international organizations, PAHO and WHO, in their roles as coordinators, should not be limited to being just intermediaries between the party that pays for the services (Brazil) and the one that provides the labor and benefits from the highest gains (Cuba), let alone take sides with one of these parties and, consequently, political interests that have nothing to do with the health of vulnerable populations.

Perhaps this is a good time for both organizations to reconsider their commitments and assume a more coherent vision in the future between the fulfillment of their programs and the basic principles that justify the very existence of the United Nations. Perhaps it is time for the competent organizations to remind Cuba that the UN Covenants on Economic, Social and Cultural Rights are still waiting to be ratified by the Cuban government.

There is no doubt that Bolsonaro’s proposal has been more effective and forceful than the US embargo itself

In the case of the crisis of the Cuban doctors in Brazil, the ideal would have been if, from the current crisis, they had established a new contract in which Cuban doctors were acknowledged with the sacred labor right to collect their salaries in full and, in return, fully carry out their duties in places needing their services. But the PAHO statement has closed that door. The bureaucrats coordinating world health know that wherever financial resources appear to apply the health programs that justify their own existence, qualified manpower is usually scarce to carry them out. Hence, they tip the scales in favor of Havana.

Only Cuba, possessing an army of poor and poorly paid physicians, subordinate to the will of political power in exchange for ridiculous salaries, can guarantee the necessary human capital for such missions. International organizations try not to irritate the owner of the only resource they lack with uncomfortable demands or suggestions.

And so it is that we will have to continue the saga until the curtain falls on this new soap opera that is capturing the attention of the regional public. Meanwhile, and in spite of the accolades, the Cuban regime continues fanning the flames. There is no doubt that Bolsonaro’s proposal has been more effective and forceful than the US embargo itself, and that 2018 is probably proving to be the worst year endured by the Castro regime since the fall of the Soviet Union and the disappearance of the Eastern Europe socialist bloc.

Translated by Norma Whiting


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