From Cuba with love: Cuban doctors in Pakistan

Summer 2006

Guy Smallman gives a moving firsthand account of the work of the Cuban medical brigades in Pakistan

As I approach the remote village of Bakot in the mountains near the Pakistan-Kashmir border a small boy runs out to greet us at the entrance. “Que pasa?” he exclaims before demonstrating a few boxing moves and skipping back into the village to tell others of our arrival. ‘The Cubans have brought more than just medical expertise to our community’ explains Ishtiak my guide for this visit.

Bakot is very typical of the towns and villages of Kashmir and North East Pakistan that were ravaged by last year’s South Asia Earthquake. The village is a local hub for about ten thousand people living in the surrounding mountains. In just seven minutes on October 8th 2005 it was struck by the most powerful quake in living memory and raised to rubble. The School, Police station and hundreds of homes were demolished with dozens left dead and hundreds injured. The legacy of homelessness and untreated injuries left by the disaster looked to spell yet more tragedy to the community. Fortunately the arrival of a dedicated team of professionals from a country that many of the locals have never heard has averted a second disaster.

The sixty-six Cuban doctors and medics who run Bakot’s field hospital are in an upbeat mood on the day we arrive. They have just saved the life of a small boy suffering a burst appendix. An emergency operation in the spotlessly clean operating theatre brought the child back from the brink of death. No one is in any doubt that the boy would have died on the bumpy 3-hour journey to the nearest hospital. They have also been cheered up by the arrival of a satellite dish, which has enabled them to watch the boxing and baseball for the first time in months. However the atmosphere is also tinged with sadness as the one of the medic’s dearest comrades has died tragically after his vehicle plunged off one of the nearby mountain roads.

Omar Fidel Caraballo was an electrical engineer charged with supplying power to the Cuban field facilities and a veteran of many of the 100 medical operations that Cuba runs abroad. Ironically he had plied his trade in many war zones only to die here in Pakistan in a simple road accident. Still coming to terms with his passing are Doctor Alberto Vega and administrator Fransisco Gonzalez Lam who run the Bakot operation. During their 3 months here they have overseen a truly staggering amount of medical care for the area. 25,000 cases, 90 operations, 2,000 patients in physiotherapy and so many babies delivered they have lost count. “It has been very hard work but the rewards are beyond words” says Dr Vega as we tour the MASH style field hospital. “It has also been a valuable learning experience for us. It has been wonderful to get to know these people. Sometimes the media project a bad image of Muslim people, of them as terrorists. Like having a beard and being Muslim makes you a terrorist. This is untrue. We know these people better. These people are so gentle, humble, hard working and so welcoming. We were worried about the task of setting up the hospital and its infrastructure when we arrived. We worked alongside the local people to have this up and running quicker than we could have ever expected. The relationship with the community is strong, we are always being invited to weddings, festivals and social gatherings.”

My guide and translator is Ishtiak Abassi a local man who has returned here after spending most of his life in Rotherham working as a senior social worker. “Before they came there was barely a sticking plaster in the village. Now we have the best medics in the world in a community that was previously hours away from a hospital. This winter with so many homeless in tents we have seen outbreaks of pneumonia, tuberculosis and scabies. They have saved many lives. Also they have improved the quality of people’s lives. Many with horrific injuries from the quake are having physio and trauma treatment. Aside from the rehabilitation we have simple cases like my neighbour who is being treated for his arthritis for the first time in his life.” The women of Bakot have also benefited from the presence of the Cuban nurses. Ishtiak tells me: “To have another woman to discuss their medical issues with has been very important. Before they would have to rely on a male relative to take them to a town, probably to see a male doctor.”

Across the border in Kashmir, the capital city Muzzaffarabad is the biggest casualty of the quake. Up to half of the 87,000 deaths occurred here and in the surrounding district. I am shown round Cuba’s biggest operation in the region by Dr Osmani and Dr Juan Carlo. Like their counterparts in Bakot they look more like professional wrestlers than qualified surgeons. They administer a facility with dozens of wards specializing in all areas of health. The respiratory unit is particularly busy treating dozens of TB and pneumonia cases following the winter. Even now, months after the disaster, people are showing up from remote areas with broken and fractured limbs that have not been properly treated. For the many amputees and patients recovering from breaks and spinal injuries there is a dedicated physio unit. Dr Juan Carlo is called away during our tour to see a little girl who is suffering serious scalding to her arms. Afterwards he tells me “with tens of thousands living and cooking in overcrowded tent cities, the cases of burns have been many, it has been one of our toughest challenges.”

Before heading out of the disaster zone I visit 3 year old Talal Abassi whom I first encountered months before in Bakot. He was showered with boiling cooking oil when the disaster struck. His burns had become infected and the staff at the hospital undoubtedly saved his life. His father’s eyes fill with tears when I show him a picture of Talal being treated by a Cuban nurse. “I cannot put into words what she did for my family, how can you repay someone for the gift of life?”

During my travels across the quake zone I was struck by the number of Cuban flags flying around the region, often in some of the most remote locations. Though poor in dollars the Cubans seemed rich in medical expertise and determined to share it. It seems ironic to me that Cuba is clearly one of the main players in the relief effort yet its economy is dwarfed by most other countries. When you consider that Britain and America call Pakistan a valued ally in their ‘War on Terror’; I can’t help thinking that two other red, white and blue flags were conspicuous by their absence.

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