Cuba - If it’s such a health superpower, why have thousands of doctors fled?

Cuba: If it's such a health superpower, why have thousands of doctors fled?
A total of 1,278 Cuban medics fled to make use of a US parole programme
for doctors in 2013 alone.

"I LIVED IN Spain for 18 years but knew due to the economic crisis, I
couldn't continue my studies there. If I wanted to become a doctor,
there was only one country I could turn to and that was Cuba," says
Abderrahman Mohamed Sidi from the disputed territory of Western Sahara,
which borders Algeria, Morocco and Mauritania.
The 26-year-old medical student was born into a refugee camp like the
majority of his compatriots due to the ongoing dispute over control of
Western Sahara. At a young age, he moved to Spain to pursue his medical
studies but couldn't continue due to financial circumstances.
Instead, he applied and received a scholarship to study for free in Cuba
at the Latin American School of Medicine (ELAM as per the Spanish acronym).
"In my class, there are 15 students from 15 different nations including
Palestine, Chad, Tanzania and the United States," says Sidi who is in
his second year of six at the medical school.
ELAM hosts nearly 10,000 foreign medical students from 86 different
nations, the majority of whom are from poor backgrounds and developing
nations, almost all at the cost of the Cuban state.
It was set up in 1998 at the behest of then-leader Fidel Castro in
response to the devastation caused by Hurricane Mitch which tore through
many nations in Central America that lacked sufficient medical expertise
to treat those affected.

Health superpower
The medical school is one part of Cuba's international health efforts,
which has earned the Caribbean nation the title as a health superpower.
"When Ban Ki-Moon [Secretary General of the United Nations] called for
international help during the Ebola crisis in West Africa, he especially
communicated with four nations; United States, Britain and France for
their economic resources, and Cuba for its human resources," says Dr
Jorge Delgado who led a medical brigade of 165 Cuban doctors and nurses
to fight the Ebola outbreak in Sierra Leone.
The Socialist state sent more doctors to West Africa to fight Ebola than
any other nation, a fact which was also the case after the earthquake in
Haiti in 2010 and following many other humanitarian disasters worldwide.
It has also initiated health projects like Operation Miracle in which
Cuban doctors have performed over 600,000 eye operations worldwide to
treat cataracts and glaucoma.
In addition to training thousands of foreign students at home, Cuba
sends over 50,000 health workers abroad annually, a third of whom are
physicians, to work in developing countries mainly across Latin America
and Africa.
Almost 30,000 alone are in Venezuela as a result of the Oil-for-Doctors
agreement between the two Socialist states which sees Cuba receive
90,000 barrels of oil a day at cut-down prices.

Benefits
Cuba's international health efforts are seen as diplomatically advantageous.
Political observers noted that in Latin America especially, where many
states are dependent on Cuban medical professionals for services,
nations were reluctant to criticise Cuba, which served to isolate the
United States' hardline stance against its Caribbean neighbour and,
thus, facilitate the improvement in relations recently.
Cuban health officials though maintain any diplomatic benefits are
secondary and insist this misses the point of Cuba's health endeavours.
"When we sent hundreds of medics to Pakistan in response to the
humanitarian crisis caused by the earthquake there, we didn't do it
because we wanted a vote at the UN," says Delgado, referring to a 2015
vote on the US embargo at the United Nations where all but two nations
(USA and Israel) voted to condemn the blockade.
We did it because we Cubans believe that he who plants love, receives
love, he who seeks solidarity, gets solidarity.
At home, Cuba's health record internationally is a source of great
pride. Many billboards, used as propaganda rather than for
advertisements in the Caribbean nation, celebrate health missions going
back to the first to Angola in the early 1960s.
"It's something in the soul of a Cuban to want to do," says Lucia
Morales Ruiz, a former Microbiologist from Havana, referring to
travelling across the world on medical missions.
Due to the low wages given to health professionals, the mother was
forced to leave her job and now works as a minder.
"I would have loved to travel and help people from across the world, but
I never got the chance," she says.
The collaboration of Cuba sending doctors to other countries has,
nevertheless, been an extremely important source of hard currency for
the state which has struggled economically because of the blockade,
especially since the breakup of the Soviet Union, which meant the loss
of billions of dollars in subsidies.
Estimates put the amount of income derived at around $5 billion
annually, eclipsing all other industries for the Cuban economy.

Exploitation
This has led to criticisms, though, that the Cuban state is misusing its
doctors for economic gain. It's not made known how much states pay Cuba
for sending its doctors, but it's believed the medical personnel only
pocket a small percentage.
In Angola, for example, a Cuban medic earns about US$125 monthly, while
reports suggest the Cuban state is paid US$5,000 dollars per month per
doctor.
Conversely, as a Cuban medic receives so little at home (average wages
are around €40) and with limited possibilities to travel abroad –
historically few Cuban doctors are granted visas to leave the Caribbean
state – missions are much sought after by health workers as it gives
them a chance to earn money that's impossible to earn at home.
Dr Jorge Iglesias, a now retired primary care physician, travelled on a
two-year mission to Ghana in 1996.

He admits his primary motive to travel was economic.
"I earned $100 per month in Ghana, as well as my own salary back home,
so I could save money as a result," he says.

It was difficult being away from my family but the higher wages were a
driver to travel.

The pensioner, now living in Havana, was forced into retirement due to a
tumour in his knee which he was born with but was exacerbated by a car
accident in the African nation.
His state pension is only US$10 a month which he says means he struggles
to satisfy even basic needs.
Due to the temptations of better wages abroad, thousands of Cuban
doctors have deserted while on international missions with many heading
to the United States where a special programme called the 'Cuban Medical
Professional Parole Programme' offers Cuban doctors asylum in return for
deserting.
A total of 1,278 Cuban medics fled to make use of the programme in 2013
alone.
The health missions, while generally welcomed in most developing
nations, have been met with criticism and protests in Venezuela and
Brazil particularly, the latter has over 11,000 medical workers from
Cuba, where local doctors feel pushed out by cheaper imported Cuban labour.

Delgado dismisses the criticism though.
"The issue isn't the Cuban doctors. If a Venezuelan doctor emigrates to
Ireland, for example, to look for work, he's not going because he can't
get a job in his country, he leaves because he wants a better salary,"
the 66-year-old explains.
"A Cuban medic is motivated by helping people, not the remuneration."
Whether that motivation would still be as strong if doctors found
themselves with greater freedom of movement and higher salaries at home
remains uncertain.
This journalism was supported by the Simon Cumbers Media Fund.

Source: Cuba: If it's such a health superpower, why have thousands of
doctors fled? -
http://www.thejournal.ie/cuba-health-system-sending-docs-abroad-2676832-Mar2016/