[News] Cuban Medical Aid to Haiti
Anti-Imperialist News
news at freedomarchives.org
Thu Apr 1 12:18:23 EDT 2010
http://www.counterpunch.org/kirk04012010.html
April 1, 2010
One of the World's Best Kept Secrets
Cuban Medical Aid to Haiti
By EMILY J. KIRK and JOHN M. KIRK
Media coverage of Cuban medical cooperation
following the disastrous recent earthquake in
Haiti was sparse indeed. International news
reports usually described the Dominican Republic
as being the first to provide assistance, while
Fox News sang the praises of U.S. relief efforts
in a report entitled "U.S. Spearheads Global
Response to Haiti Earthquake"-a common theme of
its extensive coverage. CNN also broadcast
hundreds of reports, and in fact one focused on a
Cuban doctor wearing a T-shirt with a large image
of Che Guevara--and yet described him as a "Spanish doctor".
In general, international news reports ignored
Cuba's efforts. By March 24, CNN for example,
had 601 reports on their news website regarding
the earthquake in Haiti-of which only 18
(briefly) referenced Cuban assistance. Similarly,
between them the New York Times and the
Washington Post had 750 posts regarding the
earthquake and relief efforts, though not a
single one discusses in any detail any Cuban
support. In reality, however, Cuba's medical
role had been extremely important-and had been present since 1998.
Cuba and Haiti Pre-Earthquake
In 1998, Haiti was struck by Hurricane Georges.
The hurricane caused 230 deaths, destroyed 80% of
the crops, and left 167,000 people homeless.[1]
Despite the fact that Cuba and Haiti had not had
diplomatic relations in over 36 years, Cuba
immediately offered a multifaceted agreement to
assist them, of which the most important was medical cooperation.
Cuba adopted a two-pronged public health approach
to help Haiti. First, it agreed to maintain
hundreds of doctors in the country for as long as
necessary, working wherever they were posted by
the Haitian government. This was particularly
significant as Haiti's health care system was
easily the worst in the Americas, with life
expectancy of only 54 years in 1990 and one out
of every 5 adult deaths due to AIDS, while 12.1%
of children died from preventable intestinal infectious diseases.[2]
In addition Cuba agreed to train Haitian doctors
in Cuba, providing that they would later return
and take the places of the Cuban doctors (a
process of "brain gain" rather than "brain
drain"). Significantly, the students were
selected from non-traditional backgrounds, and
were mainly poor. It was thought that, because
of their socio-economic background, they fully
understood their country's need for medical
personnel, and would return to work where they
were needed. The first cohort of students began
studying in May, 1999 at the Latin American School of Medicine (ELAM).
By 2007, significant change had already been
achieved throughout the country. It is worth
noting that Cuban medical personnel were
estimated to be caring for 75% of the
population.[3] Studies by the Pan American
Health Organization (PAHO) indicated clear
improvements in the health profile since this
extensive Cuban medical cooperation began.
Improvements in Public Health in Haiti, 1999-2007[4]
Health Indicator 1999 2007
Infant Mortality, per 1,000 live births 80 33
Child Mortality Under 5 per 1,000 135 59.4
Maternal Mortality per 100,000 live births 523 285
Life Expectancy (years) 54 61
Cuban medical personnel had clearly made a major
difference to the national health profile since
1998, largely because of their proactive role in
preventive medicine-as can be seen below.
Selected Statistics on Cuban Medical Cooperation
Dec. 1998-May 2007[5]
Visits to the doctor 10,682,124
Doctor visits to patients 4,150,631
Attended births 86,633
Major and minor surgeries 160,283
Vaccinations 899,829
Lives saved (emergency) 210,852
By 2010, at no cost to medical students, Cuba had
trained some 550 Haitian doctors, and is at
present training a further 567. Moreover, since
1998 some 6,094 Cuban medical personnel have
worked in Haiti. They had given over 14.6 million
consultations, carried out 207,000 surgical
operations, including 45,000 vision restoration
operations through their Operation Miracle
programme, attended 103,000 births, and taught
literacy to 165,000. In fact at the time of the
earthquake there were 344 Cuban medical personnel
there. All of this medical cooperation, it must
be remembered, was provided over an 11-year
period before the earthquake of January 12, 2010.[6]
Cuba and Haiti Post-Earthquake
The earthquake killed at least 220,000, injured
300,000 and left 1.5 million homeless.[7] Haitian
PrimeMinister Jean-Max Bellerive described it as
"the worst catastrophe that has occurred in Haiti in two centuries".[8]
International aid began flooding in. It is
important to note the type of medical aid
provided by some major international players.
Médecins Sans Frontières (MSF), for example, an
organization known for its international medical
assistance, flew in some 348 international staff,
in addition to the 3,060 national staff it
already employed. By March 12 they had treated
some 54,000 patients, and completed 3,700 surgical operations.[9]
Canada's contribution included the deployment of
2,046 Canadian Forces personnel, including 200
DART personnel. The DART (Disaster Assistance
Response Team) received the most media attention,
as it conducted 21,000 consultations-though it
should be noted they do not treat any serious
trauma patients or provide surgical care. Indeed,
among the DART personnel, only 45 are medical
staff, with others being involved in water
purification, security, and reconstruction. In
total, the Canadians stayed for only 7 weeks.[10]
The United States government, which received
extensive positive media attention, sent the USNS
"Comfort", a 1,000-bed hospital ship with a
550-person medical staff and stayed for 7 weeks,
in which time they treated 871 patients,
performing 843 surgical operations.[11] Both the
Canadian and US contributions were important-while they were there.
Lost in the media shuffle was the fact that,
for the first 72 hours following the earthquake,
Cuban doctors were in fact the main medical
support for the country. Within the first 24
hours, they had completed 1,000 emergency
surgeries, turned their living quarters into
clinics, and were running the only medical
centers in the country, including 5 comprehensive
diagnostic centers (small hospitals) which they
had previously built. In addition another 5 in
various stages of construction were also used,
and they turned their ophthalmology center into a
field hospital-which treated 605 patients within
the first 12 hours following the earthquake.[12]
Cuba soon became responsible for some 1,500
medical personnel in Haiti. Of those, some 344
doctors were already working in Haiti, while over
350 members of the "Henry Reeve" Emergency
Response Medical Brigade were sent by Cuba
following the earthquake. In addition, 546
graduates of ELAM from a variety of countries,
and 184 5th and 6th year Haitian ELAM students
joined, as did a number of Venezuelan medical
personnel. In the final analysis, they were
working throughout Haiti in 20 rehabilitation
centers and 20 hospitals, running 15 operating
theatres, and had vaccinated 400,000. With reason
Fidel Castro stated, "we send doctors, not soldiers".[13]
A glance at the medical role of the various key players is instructive.
Comparative Medical Contributions in Haiti by March 23[14]
MSF Canada United States Cuba
No. of Staff
3,408 45 550 1,504
No. of Patients Treated
54,000 21,000 871 227,143
No. of Surgeries
3,700 0 843 6,499
These comparative data, compiled from several
sources, are particularly telling as they
indicate the significant (and widely ignored)
medical contribution of the Cubans. In fact, they
have treated 4.2 times the number of patients
compared with MSF (which has over twice as many
workers, as well as significantly more financial
resources), and 10.8 times more than the Canadian
DART team. (As noted, Canadian and US medical
personnel had left by March 9). Also notable is
the fact that the Cuban medical contingent was
roughly three times the size of the American
staff, although they treated 260.7 times more
patients than U.S. medical personnel. Clearly,
there have been significant differences in the
nature of medical assistance provided.
It is also important to note that approximately
one-half of the Cuban medical staff was working
outside the capital, Port-au-Prince, where there
was significant damage as well. Many medical
missions could not get there, however, due to
transportation issues. Significantly, the Cuban
medical brigade also worked to minimize epidemics
by making up 30 teams to educate communities on
how to properly dispose of waste, as well as how
to minimize public health risks. Noted Cuban
artist Kcho also headed a cultural brigade made
up of clowns, magicians and dancers, supported by
psychologists and psychiatrists, to deal with the
trauma experienced by Haitian children.
Perhaps most impressively, following the growing
concern for the health of the country, due to a
poor and now largely destroyed health care system
Cuba, working with ALBA (the Alianza Bolivariana
para los Pueblos de Nuestra América) countries,
presented to the WHO an integral program to
reconstruct the health care system of Haiti.
Essentially, they are offering to rebuild the
entire health care system. It will be supported
by ALBA and Brazil, and run by Cubans and
Cuban-trained medical staff. This is to include
hospitals, polyclinics, and medical schools. In
addition, the Cuban government has offered to
increase the number of Haitian students attending
medical school in Cuba. This offer of medical
cooperation represents an enormous degree of
support for Haiti.[15] Sadly, this generous
offer has not been reported by international media.
While North American media might have ignored
Cuba's role, Haiti has not. A pointed remark was
made by Haitian President Mr. René Préval, who
noted, "you did not wait for an earthquake to
help us".[16] Similarly, Haiti's Prime Minister
Jean-Max Bellerive has also repeatedly noted that
the first three countries to help were Cuba, the
Dominican Republic and Venezuela.
Sadly (but not surprisingly), while Cuba's
efforts to assist Haiti have increased,
international efforts have continued to dwindle.
The head of the Cuban medical mission, Dr. Carlos
Alberto García, summed up well the situation just
two weeks after the tragedy: "many foreign
delegations have already begun to leave, and the
aid which is arriving now is not the same it used
to be. Sadly, as always happens, soon another
tragedy will appear in another country, and the
people of Haiti will be forgotten, left to their
own fate". Significantly, he added "However we
will still be here long after they have all
gone."[17] This in fact has been the
case. Canadian forces, for example, returned
home and the USNS Comfort sailed several weeks
ago. By contrast, Cuban President Raúl Castro
noted: "we have accompanied the Haitian people,
and we will continue with them whatever time is
needed, no matter how many years, with our very modest support".[18]
A representative of the World Council of Churches
to the United Nations made the telling comment
that "humanitarian aid could not be human if it
was only publicized for 15 days".[19] Today Cuba,
with the support of ALBA and Brazil, is working
not to build a field hospital, but rather a
health care system. And, while international
efforts have been largely abandoned, the Cuban
staff and Cuban-trained medical staff will
remain, as they have done for the past 11 years,
for as long as necessary. This is a story that
international media have chosen not to tell-now
that the television cameras have gone. Yet it is
an extraordinary story of true humanitarianism,
and of great success in saving lives since
1998. Moreover, in light of Cuba's success in
providing public health care (at no cost to the
patients) to millions of Haitians, this approach
to preventive, culturally sensitive, low cost and
effective medicine needs to be told. That
significant contribution to this impoverished
nation, and Cuba's ongoing commitment to its
people, clearly deserve to be recognized. Until
then it will sadly remain as one of the world's best- kept secrets.
Emily J. Kirk will be an M.A. student in Latin
American Studies at Cambridge University in September.
John Kirk is a professor of Latin American
Studies at Dalhousie University, Canada. Both are
working on a project on Cuban medical
internationalism sponsored by Canada's Social
Science and Humanities Research Council of Canada
(SSHRC). Professor Kirk co-wrote with Michael
Erisman the 2009 book "Cuba's Medical
Internationalism: Origins, Evolution and Goals"
(Palgrave Macmillan). He spent most of February
and March in El Salvador and Guatemala,
accompanying the Henry Reeve Brigade in El
Salvador, and working with the Brigada Medica Cubana in Guatemala.
Notes
[1] "Audit of USAID/HAITI Hurricane Georges
Recovery Programme". USAID. 15 May, 2001.
Retrieved 10 March, 2010 from <
<http://www.usaid.gov/oig/public/fy01rpts/1-521-01-005-p.pdf>http://www.usaid.gov/oig/public/fy01rpts/1-521-01-005-p.pdf>
[2] See entry for "Haiti" on the Pan American
Health Organization website, found at
<http://www.paho.org/english/dd.ais/cp_332.htm>http://www.paho.org/english/dd.ais/cp_332.htm.
Accessed February 2, 2010.
[3] William Steif, "Cuban Doctors Aid Strife-Torn
Haiti." The State. April 26, 2004, and found at
<http://havanajournal.com/culture/entry/cuban_doctors_aid_strife_torn_haiti/>http://havanajournal.com/culture/entry/cuban_doctors_aid_strife_torn_haiti/
Accessed June 21, 2007.
[4] See entry for "Haiti" on the Pan American
Health Organization website, found at
<http://www.paho.org/english/dd/ais/cp_332.htm>http://www.paho.org/english/dd/ais/cp_332.htm.
Accessed February 2 2010.
[5] Anna Kovac, "Cuba Trains Hundred of Haitian
Doctors to Make a Difference," August 6, 2007.
Located on the MEDICC website at
<http://www.counterpunch.org/www.medicc.org/cubahealthreports/chr-article.php?&a=1035>http:www.medicc.org/cubahealthreports/chr-article.php?&a=1035.
Accessed February 2, 2010.
[6] Ibid., "Haitian Medical Students in Cuba".
Medical Education Cooperation With Cuba. 12
January, 2010. Retrieved 12 January, 2010 from
<<http://www.mwdicc.org/ns/index.php?p=4&s=33>http://www.mwdicc.org/ns/index.php?p=4&s=33>,
"La colabaración cubana permanecerá en Haití los
años que sean necesarios", Cubadebate. 24
February, 2010. Retrieved 9 March, 2010 from
<<http://www.cubadebate.cu/opinion/2010/02/24/cuba-estara-en-haiti-anos-quesean-necesario>http://www.cubadebate.cu/opinion/2010/02/24/cuba-estara-en-haiti-anos-que
sean-necesario>, "Fact Sheet: Cuban Medical
Cooperation With Haiti". Medicc Review. 15
January, 2009. Retrieved 2 February, 2010 from
<http://www.medicc.org/ns/index.php?s=104>http://www.medicc.org/ns/index.php?s=104.
[7] "Haiti Earthquake: Special Coverage". CNN. 20
March, 2010. Retrieved 22 March, 2010
from
<<http://www.cnn.com/SPECIALS/2010/haiti.quake/>http://www.cnn.com/SPECIALS/2010/haiti.quake/>
[8] Tyler Maltbie, "Haiti Earthquake: The Nations
That Are Stepping Up To Help", The Christian
Science Monitor, Posted January 14, 2010 on
<http://www.csmonitor.com/layout/set/print/content/view/print273879>http://www.csmonitor.com/layout/set/print/content/view/print273879.
Accessed January 28, 2010.
[9] "Two Months After the Quake, New Services and
New Concerns". MSF. 12 March, 2010. Retrieved 17
March, 2010 from
<<http://www.doctorswithoutborders.org/news/article_printcfm?id=4320>http://www.doctorswithoutborders.org/news/article_printcfm?id=4320>
[10] "Canada's Response to the Earthquake in
Haiti: Progress to Date". Foreign Affairs and
International Trade Canada. March 17, 2010.
Retrieved 17 March, 2010 from
<<http://www.internaitonal.gc.ca/humanitarian-humanitaire/earthquake_seisme_haiti_effort>http://www.internaitonal.gc.ca/humanitarian-humanitaire/earthquake_seisme_h
aiti_effort>
[11] "USNS Comfort Completes Haiti Mission, March
9, 2010". American Forces Press Service. 9 March,
2010. Retrieved 11 March, 2010 from
<<http://www.trackpads.com/forum/defenselink/928304-usns-comfort-completes-hati-mission>http://www.trackpads.com/forum/defenselink/928304-usns-comfort-completes-ha
ti-mission>
[12] John Burnett, "Cuban Doctors Unsung Heroes
of Haitian Earthquake", National Public Radio
report, January 24, 2010, and found at
<http://www.npr.org/templates/story.ph?storyID=122919202>http://www.npr.org/templates/story.ph?storyID=122919202.
Accessed 28 January, 2010.
[13] José Steinsleger. "Haiti, Cuba y la ley
primera," La Jornada, February 3, 2010., Data in
this section came from the address given by
Ambassador Rodolfo Reyes Rodríguez on January,
27, 2010 in Geneva at the 13th Special Session of
the U.N. Human Rights Council on Haiti. It can be
accessed at "Cuba en Ginebra: 'Ante tan difícil
situación humanitaria en Haití no puede haber
titubeos ni indiferencia," on the Cubbadebate
website:
<<http://www.cubadebate.cu/especiales/2010/01/27/cuba-en-ginebra-sobre-reconstruccion-haiti>http://www.cubadebate.cu/especiales/2010/01/27/cuba-en-ginebra-sobre-recons
truccion-haiti>
[14] Connor Gorry. "Two of the 170,000 + Cases".
Medicc Review. March 8, 2010. Retrieved 10 March,
2010
from
<<http://mediccglobal.wordpress.com/>http://mediccglobal.wordpress.com/>,
"Cooperación con Haití debe ser a largo plazo."
Juventud Rebelde. 23 March, 2010. Retrieved March
23, 2010 from
<<http://juventudrebelde.cu/internacionales/2010-03-23/cooperacion-con-haiti-debe-ser-a-largo-plazo>http://juventudrebelde.cu/internacionales/2010-03-23/cooperacion-con-haiti-
debe-ser-a-largo-plazo>, "Haiti: Two Months After
The Quake, New Services and New Concerns". MSF.
12 March, 2010. Retrieved 17 March, 2010 from
<http://www.doctorswithoutborders.org/news/article_print.cfm?id=4320>http://www.doctorswithoutborders.org/news/article_print.cfm?id=4320>,
"Haiti-USNS Comfort Medical And Surgical
Support". U.S. Department of Health and Human
Services. 11 March, 2010. Retrieved 11 March,
2010 from
<<http://www.counterpunch.org/www.hhs.gov/Haiti/usns_comfort.html>http:www.hhs.gov/Haiti/usns_comfort.html>,
Brett Popplewell. "This Haitian Town Is Singing
Canada's Praise". The Star. 26 January, 2010.
Retrieved 17 March from
<<http://www.thestar.com/printarticle/755843>http://www.thestar.com/printarticle/755843>,
"USNS Comfort Leaves Haiti". 13 News. 11 March,
2010. Retrieved 11 March, 2010 from
<<http://www.wvec.com/internaternalz?st=print&id=87243182&path=/home>http://www.wvec.com/internaternalz?st=print&id=87243182&path=/home>
[15] In a March 27, 2010 meeting in
Port-au-Prince between President Préval and the
Cuban and Brazilian ministers of health (José
Ramón Balaguer and José Gomes), details were
provided about what Balaguer termed "a plot of
solidarity to assist the Haitian people". Gomes
added "We have just signed an agreement-Cuba,
Brazil and Haiti-according to which all three
countries make a commitment to unite our forces
in order to reconstruct the health system in
Haiti. An extraordinary amount of work is
currently being carried out in terms of meeting
the most basic and most pressing needs, but now
it is necessary to think about the future [.]
Haiti needs a permanent, quality healthcare
system, supported by well-trained professionals
[.] We will provide this, together with Cuba-a
country with an extremely long internationalist
experience, a great degree of technical ability,
great determination, and an enormous amount of
heart. Brazil and Cuba, two nations that are so
close, so similar, now face a new challenge:
together we will unite our efforts to rebuild
Haiti, and rebuild the public health system of
this country". See "Cuba y Brasil suman
esfuerzos con Haití," Juventud Rebelde, March 28,
2010 (Translation to English provided by authors).
[16] "Presidente Preval agradece a Fidel y Raúl
Castro ayuda solidaria a Haití". 8 February,
2010. Retrieved 9 February, 2010 from <
<http://www.cubadebate.cu/noticias/2010/02/08presidente-preval-agradece-fidel>http://www.cubadebate.cu/noticias/2010/02/08presidente-preval-agradece-fidel
-raul-castro>
[17] María Laura Carpineta, "Habla el jefe de los
344 médicos cubanos instalados en Haití desde
hace doce años". Página 12 [Argentina]. February
4, 2010, found at
<mailto:CUBA-L at LISTA.UNM.EDU>CUBA-L at LISTA.UNM.EDU
[18] Ibid. [19] "Press Conference on Haiti
Humanitarian Aid," held at the United Nations on
March 23, 2004 and found at
htto://<http://www.un.org/News/briefings/docs/2004/CanadaPressCfc.doc.htm>www.un.org/News/briefings/docs/2004/CanadaPressCfc.doc.htm.
Accessed November 21, 2008.
Emily J. Kirk will be an M.A. student in Latin
American Studies at Cambridge University in September.
John Kirk is a professor of Latin American
Studies at Dalhousie University, Canada. Both are
working on a project on Cuban medical
internationalism sponsored by Canada's Social
Science and Humanities Research Council of Canada
(SSHRC). Professor Kirk co-wrote with Michael
Erisman the 2009 book "Cuba's Medical
Internationalism: Origins, Evolution and Goals"
(Palgrave Macmillan). He spent most of February
and March in El Salvador and Guatemala,
accompanying the Henry Reeve Brigade in El
Salvador, and working with the Brigada Medica Cubana in Guatemala.
Freedom Archives
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