Salud International to back Cuban internationalist doctors
Summer 2004
Phil Lenton reports on a new initiative for the charity
The medical charity Salud International has decided to campaign to support the Cuban Medical Collaboration Programme in Latin America, the Caribbean and Africa after SI was invited by the Cuban Health Workers Union (SNTS) to meet the brigade in Haiti.
The Ernesto Che Guevara Cuban Medical Brigade has been in Haiti since 1999 when hurricane George devastated Haiti and hurricane Mitch destroyed much of Honduras and Nicaragua. More than 60,000 lost their lives and other countries suffered extensive material damage.
Cuba, along with many other countries sent doctors to help the survivors. After a month, most other aid agencies departed, but the Cuban doctors remained, despite the fact that there were no diplomatic relations and a history of hostility. Cuba appealed to the rich countries to send technical and pharmaceutical aid, but this appeal fell on deaf ears.
Cuba decided that it would develop a strategy to save at least 60,000 lives in the region as its contribution of solidarity.
The Cuban Naval Academy west of Havana was closed and converted into the Latin American School of Medicine provide medical training, free of charge, to poor students from Latin America and Africa. This was followed by the Caribbean Medical School in Santiago de Cuba which provided free training for poor students from French and English speaking Caribbean countries.
The five year training programme was the famous Cuban model. Cuba then offered to send its own doctors and health care professionals to poor countries free of charge. This concept began to be known as ‘Globalisation of Solidarity’ at a time when neo-liberal globalisation was seen as the biggest threat to these countries.
The Cuban Medical Brigade in Haiti.
The Ernesto Che Guevara Cuban Medical Brigade in Haiti comprises 575 doctors and health professionals, and operates the same Integral Health Programme, based on the Cuban domestic model, as the brigades in 62 other countries from Paraguay to the US(!) and from Venezuela to Cambodia. The model is the same (adapted to each country’s needs) and only the numbers vary, from 1 in Cambodia working with a team of Cambodian professionals to 10,169 in Venezuela.
The brigade in Haiti, the only medical team to remain in Haiti after the overthrow of President Aristides, comprises a National and Departmental structure with smaller units in remote localities and covers 70% of the Haitian population. Their work starts with a comprehensive analysis of the health situation, of the various risks to health and the existing resources.
This is followed by removing the risks that can be dealt with such as ensuring clean drinking water, changing diet, improving sanitation and sewage and by making visits to every house in the locality. This would probably be the first time that most Haitians have been visited by or even met a doctor. On their visits, they see every member of the household and make basic health checks.
They then organise ‘circles’ for the elderly, those with hypertension, pregnant women, adolescents and children to discuss and identify other risks and find solutions, some as basic as exercise for those with hypertension or elderly, prenatal examinations, use of condoms, and family hygiene, and others involving medical solutions including the surgery.
The brigades are composed of mainly young people, many of whom studied in the same medical school and year, along with some very experienced professionals. They comprise specialists in general medicine, internal medicine, orthopaedics, neuro and general surgery, paediatricians, gynaecologists, obstetricians, technicians and other professionals. In each brigade there are commissions for scientific advice, care of the gravely ill, quality, defence advice, finance, discipline and emulation. Their analyses include a detailed breakdown of the main causes of death, types and causes of disabilities and infectious diseases, methods of control of pre and post natal risks and infant and maternal mortality. Because of the shortage of medicines, each brigade grows its own plot of medicinal herbs.
Revolutionary professionalism.
The Cuban Health Workers Union (SNTS) is in the vanguard of this strategy. The Cuban doctors are committed to expanding the frontiers of medicine, of science, and to providing health care to the poor of the world despite personal risk of malaria and dengue, as well as being away from home for two years, as well as to the Cuban people. They are also committed to their country, the Cuban revolution and to their union. In the corner of every brigade house is a ‘patriotic corner’, with their flag, and items reminding them of Cuba. This is revolutionary professionalism in practice, only possible because of the revolutionary professionalism of their union.
In Haiti, this revolutionary professionalism has resulted in a verified saving of 81,856 lives since the Cuban Medical Brigade first went to the country. If the same model is at work in 62 countries, the mind boggles at the scale of the contribution of Cuban globalised solidarity. Just compare this with the scale of destruction wrought on the world by the British and US globalised contribution.
The ultimate in sustainability.
The question arises, however, how can all this be sustained. Part of the arrangement with the Haitian government, is that young Haitians from the poor areas where the Cubans are currently working, will be selected by their government to be trained as doctors and health professionals in Cuba or by the Cubans in Haiti, and they will return to those poor areas to work for a minimum of 10 years. So far 161 young Haitians have graduated as specialists in Integral General Medicine from the Cuban Medical Faculty in Port au Prince, Haiti, and a further 632 are studying at the Caribbean Medical School in Santiago de Cuba.
As they are all being trained in the Cuban model, it is hoped that they will develop the same revolutionary professionalism as the Cubans.
The Cubans, however, maintain absolute strict political neutrality in Haiti describing recent events as an internal Haitian problem. They are respected by both sides, who in the middle of their fights, would stop to allow safe passage only to the Cubans, who would end up anyway, having to treat their bullet wounds.
Salud International
Salud International has decided to respond to a request from SNTS by launching a campaign to support the Cuban Medical Brigades throughout the world by publicising their work, by raising funds to support their work, by raising funds to help their trade union look after their welfare and conditions and by looking for ‘third party’ partners for the various brigades. Will be launching this trade union campaign at the TUC.
