Cuba and International Healthcare
In the 1970s, the Cuban state initiated bilateral service contracts and various money-making strategies. Cuba has entered into agreements with United Nations agencies specializing in health: PAHO/WHO, UNICEF, the United Nations Food and Agriculture Organization (FAO), the United Nations Population Fund (UNFPA) and the United Nations Development Fund (UNDP). Since 1989, this collaboration has played a very important role in that Cuba, in addition to obtaining the benefits of being a member country, has strengthened its relations with institutions of excellence and has been able to disseminate some of its own advances and technologies In the 1980s, Cuba's decision to withdrawal military assistance from the Marxist-Leninist regimes in Ethiopia and Angola was partly rooted in their inability to meet payments. In 1986, Cuba had 219 doctors per 100,000 people (compared with 423.7 doctors in the Soviet Union, which had the most doctors among industrialized countries).
The supply of physicians came to exceed the domestic market. Moreover, Cuban doctors work on much lower salaries than local doctors. A Guatemalan doctor noted, "No one's going to work in the mountains for a salary of $400," the salary for which Cuban doctors work. The $400 is 16 times the doctor's salary in Cuba - allowing Cuban doctors to buy refrigerators, stereos and other items that they couldn't afford in Cuba. Cuba's missions in 68 countries are manned by 25,000 Cuban doctors, and medical teams have worked in crisis such as the South Asian Tsunami and the 2005 Kashmir earthquake. Nearly 2,000 Cuban doctors are currently working in Africa in countries including South Africa, Gambia, Guinea Bissau and Mali. Since the Chernobyl nuclear plant exploded in 1986, more than 20,000 children from Ukraine, Belarus and Russia have traveled to Cuba for treatment of radiation sickness and psychologically based problems associated with the radiation disaster. In response to the 2005 Hurricane Katrina disaster, Castro offered to send a "brigade" of 1,500 doctors to the U.S. to provide humanitarian aid, but was never accepted.
Cuba currently exports considerable health services and personnel to Venezuela in exchange for subsidized oil. Cuban doctors play a primary role in the Mission Barrio Adentro (Spanish: "Mission Into the Neighborhood") social welfare program established in Venezuela under current Venezuelan president Hugo Chávez. The program, which is popular among Venezuela's poor and is intended to bring doctors and other medical services to the most remote slums of Venezuela, has not been without its detractors. Operación Milagro (Operation Miracle) is a joint health program between Cuba and Venezuela, set up in 2005. The Venezuelan Medical Federation has criticized the appointment of Cuban doctors to high-ranking positions, and protests have taken place in the capital Caracas by Venezuelan medical staff who fear that the Cubans are a threat to Venezuelan jobs. Questions have also been raised by protesters about the level of Cuban medical qualifications, and there have been claims that the Cubans are "political agents" who have come to Venezuela to indoctrinate the workforce. Opposition supporters in Venezuela have called Cuban doctors "Fidel's ambassadors" and refused to go to their clinics. Two defected doctors have claimed that they were told their job was to keep Chavez in power, by asking patients to vote for Chávez in the 2004 recall referendum.
Human Rights Watch complains that the government "bars citizens engaged in authorized travel from taking their children with them overseas, essentially holding the children hostage to guarantee the parents' return. Given the widespread fear of forced family separation, these travel restrictions provide the Cuban government with a powerful tool for punishing defectors and silencing critics." Doctors are reported to be monitored by "minders" and subject to curfew. The Cuban government uses relatives as hostages to prevent doctors from defecting. According to a paper published in The Lancet medical journal, "growing numbers of Cuban doctors sent overseas to work are defecting to the USA", some via Colombia, where they have sought temporary asylum.
According to Luis Zuñiga, director of human rights for the Cuban American National Foundation, Cuban doctors are "slave workers" who labor for meager wages while bolstering Cuba's image as a donor nation and "the Cuban government exports these doctors as merchandise".
Cuban doctors have been part of a large-scale plan by the Cuban state to provide free medical aid and services to the international community (especially third world countries) following natural disasters. Currently dozens of American medical students are trained to assist in these donations at the Escuela Latino Americana de Medicina (ELAM) in Cuba.
Read more about this topic: Healthcare In Cuba
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