Cuba outpaces Canada in medical diplomacy

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This article was published 10/10/2014 (1740 days ago), so information in it may no longer be current.

When you look at how the international community has responded to the deadly Ebola outbreak in West Africa, few people think about the small Caribbean country of Cuba (population 11.2 million and roughly twice the size of Nova Scotia). Yet, Cuba is punching well above its weight against this huge pandemic challenge.

By way of comparison, the Canadian government has promised hundreds of doses of the experimental ZMapp vaccine and relatively small sums of cash. It has also provided a handful of Canadian specialists and two mobile labs for disease-ravaged Sierra Leone. The U.S. has sent mostly soldiers; Cuba is sending medical professionals.

To date, Cuba has sent more than 165 doctors and nurses — all trained in how to combat this diseases — to Sierra Leone. A further 296 are to follow to Guinea and Liberia, and 15,000 medical workers have volunteered to go if necessary. By working in smaller teams in Ebola treatment centres and community clinics, the Cuban medical professionals will concentrate their efforts on infection control and intensive care for the next six months.

Director-general of the World Health Organization (WHO), Margaret Chan, has singled out the Cubans for offering the largest team of medical professionals from among the contributing countries. "Money and materials are important, but those two things alone cannot stop Ebola virus transmission. Human resources are clearly our most important need," she said

She went on to add: "Cuba is world-famous for its ability to train outstanding doctors and nurses and for its generosity in helping fellow countries on the route to progress."

Few people know that Cuba has been engaged in medical diplomacy or "medical internationalism" since the beginning of the Cuban Revolution. It began in earnest in 1960 by sending a team of doctors to assist after a major earthquake in Chile, and since then it has led to some 325,000 health-care workers being dispatched to some 158 countries (including more than 4,000 to 32 African countries). Currently, there are 50,731 medical personnel working in 66 countries—more than those deployed by the G7 countries combined.

There are numerous examples of this tradition. Hundreds of Cuban doctors were already in Haiti to deal with the massive fallout of the 7.0-magnitude earthquake in 2010. Cuban media reported that more than 1,000 desperate Haitians were treated by their doctors within the first critical 24 hours of the disaster.

Almost 30,000 Cuban medical personnel are working in Venezuela, and infant-mortality and maternal-mortality rates have been significantly reduced. Through their ophthalmology surgery program, Operation Miracle, they have also performed three million eye surgeries for free throughout Latin America. And the Cubans have, at little or no cost, provided anti-retroviral drugs to several countries in the AIDS-plagued Caribbean region.

It is also worth mentioning that Cuba takes in thousands of medical students from more than 120 impoverished countries (for most, at no cost) to train at their highly acclaimed medical schools. In the last decade, more than 24,000 have graduated from Havana's Latin American Medical School, the largest medical school in the world, and a further 10,000 are presently registered in the six-year program. Instead of paying tuition, they are expected to return to their own countries to practise medicine to those without medical care.

Additionally, the Cuban government's overseas medical program is profitable, bringing in more foreign exchange than all its exports, as well as its tourism receipts and foreign remittances, combined. Government figures show it generates roughly $8.2 billion annually.

Equally important, Cuba's medical diplomacy has enabled the country to be a player on the world stage — and well above what it should be for a tiny, developing country. In fact, its overseas medical activities have provided the Cubans with a tremendous amount of respect, prestige and valuable standing in the world. Last October, 188 countries at the United Nations supported Cuba and condemned the U.S. embargo, with only the United States and Israel voting against.

Not everyone, of course, is thrilled by Cuba's largesse in this area, especially health-care professionals in the recipient countries, who fear the competition and the different approach to medicine. There are also nervous politicians and self-interested unions are sometimes uncomfortable with the "army of Cubans in white coats."

Still, few can deny that Cuba's medical internationalism is bringing much-needed care to poor countries and saving lives in the process. The Ebola crisis in Africa is just the most recent illustration of that commitment, and will most surely not be its last.

 

Professors John M. Kirk of Dalhousie University and Peter McKenna of UPEI are co-authors of the book, Competing Voices from Revolutionary Cuba.