CUBA's INTERNATIONAL COMMITMENT

Despite the scarcities and difficulties caused by the blockade, Cuba remains true to its internationalist values of sharing the resources and expertise that they have with the rest of the world.

Cuba’s history of internationalism stretches back to the early days of the Revolution when in 1960 they sent a small emergency medical brigade following an earthquake in Chile. Che Guevera, assisted in a number of campaigns against colonialism and oppression in the 1960s, and in the 1970s and 1980s Cuba was at the forefront of international action against Apartheid in South Africa.

On his release from prison Nelson Mandela declared, “if it were not for Cuba I would not be a free man today.”

In the last 30 years Cuban internationalism has focussed on health and education, especially emergency medical brigades and training medical students from developing countries. In 2015 there were 65,000 Cubans internationalists working in 89 countries. Cuba’s Latin America School of Medicine has also been responsible for training more than 30,000 medical students, who make up 68,000 professionals and technicians to have graduated on the island up 2015.

Cuba’s internationalism in numbers

• More than 250 voluntary and specialised health cooperation workers of the "Henry Reeve" medical brigade took part in the struggle against Ebola in West Africa
• Following the 2005 earthquake, Cuba sent 2,400 medical volunteers to Pakistan who were responsible for treating more than 70% of those affected
• Nine million people have graduated from the Cuban literacy programme Yes, I Can, (Yo Si Peudo) which teaches literacy learning with minimal resources
• Following the 2010 earthquake in Haiti, Cuban medical brigades sent the largest contingent and cared for 40% of the victims
• Following the two earthquakes in Nepal in May 2015, Cuba sent a brigade with their own medical equipment and a team of surgeons, anaesthetists, obstetricians, nurses and GPs.
• More than 4 million people have had their sight saved or restored with free eye surgery, part of Operation Miracle, an joint Cuban-Venezuelan initiative
• Since the Chernobyl disaster in 1986, 20,000 children have been treated for radiation-related illnesses free of charge in Cuba

 Cuba and International Solidarity

 By Dan Kovalik

 “Never . . . was so much owed by so many to so few“— Winston Churchill.

In his book, In Cuba, Father Ernesto Cardenal — the famous Nicaraguan priest, revolutionary and poet who is known to don a black beret a la Che Guevara — described Cuba as a giant monastery, with the residents living austere but meaningful lives in service to others. While this is a romantic portrait, of course, and Father Cardenal said as much, there is still much truth to it. Certainly, it is more true than the portrait of the island gulag which the United States and its compliant press would have us believe Cuba to be.

(Of course, there is a gulag on the island of Cuba: it is called Guantanamo and it is owned and administered by the United States. Meanwhile, in Cuba proper, according to a January 27, 2012 Financial Times article, entitled, “Freedom comes slowly to Cuba,” “there are currently no prisoners of conscience.”)

Nowhere is this monastic spirit of true Christian giving and solidarity better seen than in the doctors and medical staff which Cuba sends to minister to the poor throughout the world. As I recently learned in reading Conflicting Missions by Piero Gleijeses, Cuba began this medical solidarity work in Algeria where it sent 29 doctors, three dentists, 15 nurses, and eight medical technicians in 1963 — that is, just after Algeria’s independence from France and just four years after Cuba’s own revolution.

As Piero Gleijeses, a professor at John Hopkins University, explains: It was an unusual gesture: an underdeveloped country tendering free aid to another in even more dire straits. It was offered at a time when the exodus of doctors from Cuba following the revolution had forced the government to stretch its resources while launching its domestic programs to increase mass access to health care. ‘It was like a beggar offering his help, but we knew the Algerian people needed it even more than we did and that they deserved it,’ [Cuban Minister of Public Health] Machado Ventura remarked. It was an act of solidarity that brought no tangible benefit and came at real material cost.

These words are just as true today as they were then, as this act of solidarity is repeated by Cuba over and over again throughout the world. And, it has been done even as Cuba has struggled to survive in the face of a 50-year embargo by the United States as well as numerous acts of terrorism by the United States and U.S.-supported mercenaries over the years.

For example, just yesterday I was reminded by a story in Prensa Latina of the fact that, for the past 21 years, Cuba has been treating “26,000 Ukrainian citizens, mostly children, affected by the Chernobyl nuclear accident” at its Tarara international medical center in Havana. Cuba has continued to do so, it must be emphasized, though even the potential for any help for this effort from the Soviet Union passed over 20 years ago.

In addition, Cuba’s medical team, which was in Haiti well before the 2010 earthquake, has been the first line of defense against the spread of cholera in that country. Even the New York Times recognized this in an article from November of 2011, entitled, “Cuba Takes Lead Role in Haiti’s Cholera Fight.” This is contrasted with the United States which sent troops, instead of doctors, after the earthquake, and which over the years has done little but undermine any chance for democracy and development in that country.

As we speak, Cuba has hundreds of doctors working in the slums of Caracas, Venezuela where Venezuelan doctors fear to tread. There are Cuban-trained doctors in remote parts of Honduras which are otherwise not served by the Honduran government. Patients from 26 Latin American & Caribbean countries have traveled to Cuba to have their eyesight restored by Cuban doctors. Among this list is Mario Teran, the Bolivian soldier who shot and killed Che Guevara, who the Cubans forgave and to whom they returned his eyesight. All in all, Cuba sends doctors to 70 different, mostly poor countries throughout the world. Cuba even offered to send 1,500 doctors to minister to the victims of the Hurricane Katrina, though this kind offer was rejected by the United States.

I first learned of this solidarity when I traveled at age 19 to Nicaragua in the 1980s, at a time when the U.S. was terrorizing that country with its support of the Contras. I went to Nicaragua open-minded, but also with beliefs and sentiments very much informed by Cold War hysteria. While there, I naively asked some Nicaraguans if they feared that Cuba would try to take over their country (as President Reagan often claimed it would). Those I talked to on this subject would simply smile and say, “Cuba sends us doctors and teachers to help us. Why would we fear them?” Indeed. And, what do we have to fear of Cuba? Nothing.

Today, I am on the Board of Global Links, an organization in Pittsburgh which provides much-needed medical supplies to nine Latin American and Caribbean countries, including Cuba. And, in the other eight countries, the medical teams we work with are often times staffed by Cuban doctors or by doctors trained in Cuba. We see every day what Cuba is doing for the poor of our Hemisphere, and with very little resources.

The Cubans’ efforts, and indeed their country, are worth supporting and defending against the constant assaults by our own government which wants to destroy their worthy experiment in human, and may I even say, Christian, compassion.

Author: Dan Kovalik, Human & Labor Rights Lawyer, Adjunct Professor of International Human Rights Law

Source: TheWorldPost, published by the Berggruen Institute

EBOLA CONTROL: THE CUBAN APPROACH

This article originally appeared in the Lancet Journal | Saturday, 6 December 2014 | Click here for original article

More than 160 Cuban doctors and nurses arrived in Sierra Leone on Oct 2, 2014, to support local teams in controlling the Ebola epidemic. 300 more are being trained in Cuba at present and will be on their way to Liberia and Guinea in the coming weeks. The worldwide response to the Ebola epidemic has been slow and small. More nurses and doctors are certainly needed, not only from Cuba, but also from other countries.

The Cuban health-care system is capable of responding to international crises quickly. After the 2010 earthquake in Haiti, more than 1000 health-care professionals were deployed. Cuba has provided freemedical training for Haitians, graduating nearly 1000 doctors, with a further 400 in training at present. The Cuban approach to a crisis is not just a high-profile acute-phase response, but also involves going to where services are most needed, working with local communities, setting up infrastructure, with a long-term view.

Cuban medical education is backed by a rigorous accreditation system, which includes medical schools established in partnership with other Latin American and African countries. The Cuban approach emphasises prevention and social responsibility. Although conventional medical education trains all doctors to a particular level at which they can choose their specialty, primary care being one of these, the Cuban model (curriculum runs for 5 years with a 1 year internship) trains all doctors to become primary care and community practitioners first; further specialisation comes later. This approach is especially relevant in low-income countries where a commitment exists to universal health coverage with few financial and human resources.

The stated goals of the Cuban medical education system are to scale up physician training to meet the needs of the whole population; recruit and train scientifically prepared and socially committed students; and match competencies, knowledge bases, and the scope of responsibilities to the concrete health needs of people in Cuba and other countries where these future physicians might serve. Moreover, the Cuban approach delivers better health outcomes at lower cost than most health-care systems.

During the past 50 years, the Cuban Medical Cooperation programme has worked in more than 100 countries. In 2013, more than 50 000 Cuban health-care professionals (19 000 of them medical doctors) were present in 66 countries, mostly in rural and remote areas. Since the establishment of the Latin American School of Medicine in 1999, it has trained over 20 000 doctors from Latin America and the Caribbean, Africa, and Asia, offering free scholarships to students coming from rural, remote, and low-income families.

The transferability of the Cuban model of training in Africa is now well established, with medical schools established in Angola, Equatorial Guinea, Guinea-Bissau, Eritrea, and Tanzania, and partnerships with existing African universities in 25 countries. To date, these initiatives have graduated over 560 doctors, with a further 5700 in training. The Cuban model might well deliver better value for money in Africa and is redressing the inequity in rural–urban distribution of doctors.

Worldwide, medical education has not kept pace with health challenges; it is fragmented, outdated, and produces ill-equipped graduates for patient and population needs. The effects on the health-care system are profound: poor teamwork; predominant hospital orientation at the expense of primary care; and weak leadership to improve health-care system performance. A redesign of professional health-care education is necessary.

In May, 2014, the World Health Assembly called for a Global Strategy on Human Resources for Healthin response to slow progress in expansion of the workforce since the World Health Report 2006. Universal health coverage will only be achieved if health-care workforce challenges are addressed,and yet, examples of effective action are few. The Cuban model of medical education—supporting the rapid expansion of the health-care workforce in partner countries and responding to worldwide crises, such as Ebola—provides a rich case study to inform the Global Strategy on Human Resources for Health.

In their analysis of the Cuban health-care system, Cooper and colleagues stated that “If the accomplishments of Cuba could be reproduced across a broad range of poor and middle-income countries the health of the world's population would be transformed.” Surely the time has come to put this statement to the test.

We declare no competing interests.

 Acknowledgement, Cuba-solidarity website