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Cuban Medical Diplomacy

Aug 07, 2009 Editorial

Twenty-four years ago this week, the first Executive President of Guyana Mr. Linden Forbes Sampson Burnham died on the operating table at the Georgetown Public Hospital.

The doctors in charge of the surgical procedure on his throat were all Cubans. The gradual destruction of the infrastructure of the country following the collapse of the economy in the seventies had not left the medical sector unaffected.

To fill the gap created by the widespread emigration of doctors to the developed countries, the government by 1972 had eagerly accepted the offer of Cuba to send some replacements.

Just four years after the Cuban Revolution of 1959, Castro had embarked on a programme of assigning Cuban doctors to Third World countries (initially “revolutionary” ones were favoured) in dire need, even though there had been an exodus immediately after his victory.

The contribution was so well received and generated so much goodwill, that the programme was institutionalised as Cuba focused on free universal health care for its citizens and created the institutions for sustaining the latter.

The new medical schools created by the communist state were soon churning out so many doctors that by 2007, more than 67,000 health workers had served in 94 countries spread across the globe. Guyana is one of those countries.

Obviously, these countries could not all be ‘revolutionary” and in fact, several of them were actually opposed to the Marxist philosophy of Castro. Especially in national emergencies such as earthquakes (Iran) and mudslides (Venezuela) the help was invaluable.

In 2005 during our great flood, Cuba rushed 40 doctors – above the twenty or so that were already doing two-year stints here – to deal with the spate of health problems that had erupted.

From an ideological perspective Castro was able to dull much criticisms of the nature of his regime when he contrasted the behaviour of the “developed” countries that castigated the “political” control over his citizens yet pulled away the health professionals from underdeveloped countries – leaving them even deeper in the hole.

The Cubans did not just send out health professionals – they actually started sending individuals stricken with various ailments of the eye from several Caribbean nations to Cuba where they were operated on and returned to their country of origin.

It has been claimed that every day in Cuba, some 1500 eye operations are conducted – most of them for free, on foreigners. Over the last half-decade almost 4,000 Guyanese have benefited from this programme.

The Cubans have also begun building health facilities in poor countries. The Port Mourant Ophthalmology Centre is a Cuban initiative – including the fourteen eye care specialists that will serve there until Guyanese doctors can step into their shoes.

The latter task becomes even easier when one considers the medical scholarships that Cuba has extended to Guyana – both for the initial training of doctors and follow-up specialisations. This week, thirty graduated medical students in Cuba returned to serve as interns in Guyana under the tutelage of the senior Cuban doctors posted here. Another three hundred are scheduled to return in the next two years.

While there has been some criticism of the Cuban health aid – primarily stemming from the difficulties in doctor-patient communication and the alleged low-level training of the Cuban medical personnel – most Guyanese are not looking at a gift horse in the mouth. The bottom line for them is that until the overall economic situation in Guyana – as with most developing countries – improves dramatically, the endemic shortage of doctors will not end and Cuban doctors will be a boon.

The Cuban experiment to provide “real” freedom by taking care of social needs such as education and health care while restricting the rights of citizens to choose their government has been severely criticised – especially by the US.

However, the 2006 programme by President George Bush to undercut the medical diplomacy by facilitating Cuban doctors serving abroad to defect to the US has backfired since most beneficiary countries saw it as mean spirited.

The way to go would be for the developed world to follow Cuba and accept health care as a human right that should be available to all. Let medical diplomacy be broadened.

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