Exporting healthcare: Cuba and the real meaning of internationalism

Spring 2006

The true secret of Cuba’s longevity, of its commitment to its ideas - has been its internationalism, argue Natasha Hickman and Bob Oram

Today Cuba has 130,000 healthcare professionals with a university education, 25,845 of whom are serving as volunteers in international missions in 68 different countries. Of these, 17,651 are doctors, 3,069 are dentists and 3,117 are healthcare technicians working in areas such as optics.

Cuba created these international medical brigades in 1998 following Hurricane Mitch which caused devastation throughout Central America, killing tens of thousands of children and adults, mostly the poor and vulnerable. As part of its Comprehensive Healthcare Programs Cuba promised to send enough doctors to save as many lives each year as were taken by the hurricane.

As part of this assistance, Cuba sent 1700 medical personnel to Guatemala, one of the countries most affected by the hurricane. Between 1998 and 2003 these doctors saw 10,795,361 patients, saving the lives of 157,226 people. They performed 32,034 free operations in addition to organising efforts to alleviate and cure diseases such as cancer, malaria and AIDS.

In the same year, Cuba established the Latin American School of Medicine (ELAM) to provide free medical scholarships to young people from Latin America and the Caribbean. Today, more than 12,000 students from around the world are studying medicine in Cuba completely free of charge, and their numbers continue to grow rapidly.

In 2005, the first 1,610 students graduated from ELAM and at their graduation ceremony in September, President Fidel Castro further announced the formation of the Henry Reeves International Contingent of Doctors Specialising in Disaster Situations and Serious Epidemics - a brigade to provide specialist medical aid in disaster and emergency situations around the world. The Henry Reeves brigade arose from Cuba’s offer to the US to send 1,600 medical doctors to the Gulf Coast to help the victims of Hurricane Katrina. This offer has never even received a response.

Who was Henry Reeves?

The Henry Reeves brigade is named after one of a group of North Americans who went to Cuba in May 1869 to join the rebel side fighting for Cuba’s independence from Spain. Born in Brooklyn, Henry Reeves fought in 400 battles, until, when incapable of fighting from the wounds sustained in the course of 7 years of war, he finally fell in combat on August 4 1876, near Yaguaramas, today in the province of Cienfuegos. His name is etched next to that of Lincoln and other Americans on the pillars of the Plaza, built in 2001 at the time of the struggle for the return of Elián González by Cuba, in front of the U.S. Special Interest Section in Havana.

The first 1,500 physician members of the Henry Reeves brigade averaged 32 years of age and had 10 years of medical experience. They were 857 women and 729 men, and 699 of them had already worked overseas, collectively in 43 countries. The first contingent included 1,100 family medicine doctors, plus surgeons, paediatricians, internists and epidemiologists all of whom speak two or more languages.

Doctors from the Henry Reeves brigade are currently working with victims of the earthquake in Pakistan, where it is estimated that 73 per cent of patients have been treated by Cuban doctors. After recent devastating floods in Bolivia, 140 members of the brigade travelled with 20 hospital tents and 16.5 tons of medicines to provide assistance to Bolivians affected by the disaster.

In countries like Belize, Haiti, Honduras, Venezuela, Gambia, Paraguay and Equatorial Guinea, Cuba is developing Medical Schools, Cubans are fighting infant mortality, Cubans are building entire health-care programs, Cubans are repairing medical equipment and building clinics.

But the governments and media of rich nations in the West give little recognition to this or the fact that that even living under an illegal genocidal embargo, Cuba exports more doctors to the developing world than the World Health Organisation itself.

As Fidel has said -“Graduating as a doctor is like opening a door to a long road leading to the noblest action that a human being can do for others....... Not once, throughout the selfless history of the Revolution, have our people failed to offer its supportive medical assistance to other nations in need of this aid at times when catastrophes have hit them, regardless of wide ideological and political differences, or the serious insults received from the government of any of these countries”.

Cuban internationalism is not only limited to healthcare. Education at basic levels is intensely supported. In just one example, 1600 Cuban educators helped the municipality of Cotacachi in Ecuador become the first area in that country to rid itself of illiteracy. In just one year the illiteracy rate dropped from 22.3% to 3.8%. Subsequently, UNESCO declared the area illiteracy free.

After more than four decades of blockade, and with the healthcare system now a vital export sector, Cuba continues to offer its medical assistance completely free of charge to those lacking economic resources. The enormous task of preserving and restoring the sight to no less than six million people from Latin America and the Caribbean (Operation Miracle), and of training 200 thousand healthcare professionals in 10 years, is completely unprecedented. It is testament to Cuba’s humanity and the real meaning of internationalism.