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<a href="http://www.counterpunch.org/kirk04012010.html" eudora="autourl">
http://www.counterpunch.org/kirk04012010.html<br><br>
</a></font><font face="Verdana" size=2 color="#990000">April 1,
2010<br><br>
</font><h1><font face="Times New Roman, Times" size=4><b>One of the
World's Best Kept Secrets <br><br>
<br>
</i></font><font face="Times New Roman, Times" size=5 color="#990000">
Cuban Medical Aid to Haiti
</b></font></h1><font face="Times New Roman, Times" size=4>By EMILY J.
KIRK and JOHN M. KIRK <br><br>
</font><font face="Verdana" size=6 color="#990000">M</font><font size=3>
edia 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".<br><br>
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.<br><br>
Cuba and Haiti Pre-Earthquake<br><br>
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.<br><br>
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]<br><br>
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).<br><br>
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.<br><br>
</font>
<dl>
<dd>Improvements in Public Health in Haiti, 1999-2007[4]<br><br>
<dd>Health
Indicator
1999 2007<br><br>
<dd>Infant Mortality, per 1,000 live
births
80 33
<br>
<dd>Child Mortality Under 5 per
1,000
135 59.4 <br>
<dd>Maternal Mortality per 100,000 live
births
523 285 <br>
<dd>Life Expectancy
(years)
54 61<br><br>
</dl>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.<br><br>
<dl>
<dd>Selected Statistics on Cuban Medical Cooperation <br>
<dd>Dec. 1998-May 2007[5]
<br><br>
<dd>Visits to the
doctor
10,682,124 <br>
<dd>Doctor visits to patients
4,150,631 <br>
<dd>Attended
births
86,633 <br>
<dd>Major and minor surgeries
160,283 <br>
<dd>
Vaccinations
899,829 <br>
<dd>Lives saved
(emergency)
210,852<br><br>
</dl>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]<br><br>
Cuba and Haiti Post-Earthquake<br><br>
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]<br><br>
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]<br><br>
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]<br><br>
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.<br><br>
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]<br><br>
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]<br><br>
A glance at the medical role of the various key players is
instructive.<br><br>
<dl>
<dd>Comparative Medical Contributions in Haiti by March 23[14]<br><br>
<dd>MSF
Canada United States
Cuba<br>
<dd>No. of Staff <br>
<dd>3,408
45
550
1,504 <br><br>
<dd>No. of Patients Treated
<br>
<dd>54,000
21,000
871
227,143 <br><br>
<dd>No. of Surgeries <br>
<dd>3,700
0
843
6,499<br><br>
</dl>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.<br><br>
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.<br><br>
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.<br><br>
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.<br><br>
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]<br><br>
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.<br><br>
Emily J. Kirk</b> will be an M.A. student in Latin American Studies at
Cambridge University in September. <br><br>
John Kirk</b> 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.<br><br>
Notes<br><br>
[1] "Audit of USAID/HAITI Hurricane Georges Recovery
Programme". USAID. 15 May, 2001. Retrieved 10 March, 2010 from <
<a href="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</a>>
<br><br>
[2] See entry for "Haiti" on the Pan American Health
Organization website, found at
<a href="http://www.paho.org/english/dd.ais/cp_332.htm">
http://www.paho.org/english/dd.ais/cp_332.htm</a>. Accessed
February 2, 2010. <br><br>
[3] William Steif, "Cuban Doctors Aid Strife-Torn Haiti." The
State. April 26, 2004, and found at
<a href="http://havanajournal.com/culture/entry/cuban_doctors_aid_strife_torn_haiti/">
http://havanajournal.com/culture/entry/cuban_doctors_aid_strife_torn_haiti/</a>
Accessed June 21, 2007. <br><br>
[4] See entry for "Haiti" on the Pan American Health
Organization website, found at
<a href="http://www.paho.org/english/dd/ais/cp_332.htm">
http://www.paho.org/english/dd/ais/cp_332.htm</a>. Accessed February 2
2010. <br><br>
[5] Anna Kovac, "Cuba Trains Hundred of Haitian Doctors to Make a
Difference," August 6, 2007. Located on the MEDICC website at
<a href="http://www.counterpunch.org/www.medicc.org/cubahealthreports/chr-article.php?&a=1035">
http:www.medicc.org/cubahealthreports/chr-article.php?&a=1035</a>.
Accessed February 2, 2010. <br><br>
[6] Ibid., "Haitian Medical Students in Cuba". Medical
Education Cooperation With Cuba. 12 January, 2010. Retrieved 12 January,
2010 from
<<a href="http://www.mwdicc.org/ns/index.php?p=4&s=33">
http://www.mwdicc.org/ns/index.php?p=4&s=33</a>>, "La
colabaración cubana permanecerá en Haití los años que sean
necesarios", Cubadebate. 24 February, 2010. Retrieved 9 March, 2010
from
<<a href="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</a>>, "Fact Sheet: Cuban Medical Cooperation With
Haiti". Medicc Review. 15 January, 2009. Retrieved 2 February, 2010
from
<a href="http://www.medicc.org/ns/index.php?s=104">
http://www.medicc.org/ns/index.php?s=104</a>. <br><br>
[7] "Haiti Earthquake: Special Coverage". CNN. 20 March, 2010.
Retrieved 22 March, 2010 from
<<a href="http://www.cnn.com/SPECIALS/2010/haiti.quake/">
http://www.cnn.com/SPECIALS/2010/haiti.quake/</a>> <br><br>
[8] Tyler Maltbie, "Haiti Earthquake: The Nations That Are Stepping
Up To Help", The Christian Science Monitor, Posted January 14, 2010
on
<a href="http://www.csmonitor.com/layout/set/print/content/view/print273879">
http://www.csmonitor.com/layout/set/print/content/view/print273879</a>.
Accessed January 28, 2010. <br><br>
[9] "Two Months After the Quake, New Services and New
Concerns". MSF. 12 March, 2010. Retrieved 17 March, 2010 from
<<a href="http://www.doctorswithoutborders.org/news/article_printcfm?id=4320">
http://www.doctorswithoutborders.org/news/article_printcfm?id=4320</a>
> <br><br>
[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
<<a href="http://www.internaitonal.gc.ca/humanitarian-humanitaire/earthquake_seisme_haiti_effort">
http://www.internaitonal.gc.ca/humanitarian-humanitaire/earthquake_seisme_h
aiti_effort</a>> <br><br>
[11] "USNS Comfort Completes Haiti Mission, March 9, 2010".
American Forces Press Service. 9 March, 2010. Retrieved 11 March, 2010
from
<<a href="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</a>> <br><br>
[12] John Burnett, "Cuban Doctors Unsung Heroes of Haitian
Earthquake", National Public Radio report, January 24, 2010, and
found at
<a href="http://www.npr.org/templates/story.ph?storyID=122919202">
http://www.npr.org/templates/story.ph?storyID=122919202</a>. Accessed 28
January, 2010. <br><br>
[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:
<<a href="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</a>> <br><br>
[14] Connor Gorry. "Two of the 170,000 + Cases". Medicc Review.
March 8, 2010. Retrieved 10 March, 2010 from
<<a href="http://mediccglobal.wordpress.com/">
http://mediccglobal.wordpress.com/</a>>, "Cooperación con Haití
debe ser a largo plazo." Juventud Rebelde. 23 March, 2010. Retrieved
March 23, 2010 from
<<a href="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</a>>, "Haiti: Two Months After The Quake,
New Services and New Concerns". MSF. 12 March, 2010. Retrieved 17
March, 2010 from
<a href="http://www.doctorswithoutborders.org/news/article_print.cfm?id=4320">
http://www.doctorswithoutborders.org/news/article_print.cfm?id=4320</a>
>, "Haiti-USNS Comfort Medical And Surgical Support". U.S.
Department of Health and Human Services. 11 March, 2010. Retrieved 11
March, 2010 from
<<a href="http://www.counterpunch.org/www.hhs.gov/Haiti/usns_comfort.html">
http:www.hhs.gov/Haiti/usns_comfort.html</a>>, Brett Popplewell.
"This Haitian Town Is Singing Canada's Praise". The Star. 26
January, 2010. Retrieved 17 March from
<<a href="http://www.thestar.com/printarticle/755843">
http://www.thestar.com/printarticle/755843</a>>, "USNS Comfort
Leaves Haiti". 13 News. 11 March, 2010. Retrieved 11 March, 2010
from
<<a href="http://www.wvec.com/internaternalz?st=print&id=87243182&path=/home">
http://www.wvec.com/internaternalz?st=print&id=87243182&path=/home</a>
> <br><br>
[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). <br><br>
[16] "Presidente Preval agradece a Fidel y Raúl Castro ayuda
solidaria a Haití". 8 February, 2010. Retrieved 9 February, 2010
from <
<a href="http://www.cubadebate.cu/noticias/2010/02/08presidente-preval-agradece-fidel">
http://www.cubadebate.cu/noticias/2010/02/08presidente-preval-agradece-fidel</a>
-raul-castro> <br><br>
[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
<a href="mailto:CUBA-L@LISTA.UNM.EDU">CUBA-L@LISTA.UNM.EDU</a> [18] Ibid.
[19] "Press Conference on Haiti Humanitarian Aid," held at the
United Nations on March 23, 2004 and found at
htto://<a href="http://www.un.org/News/briefings/docs/2004/CanadaPressCfc.doc.htm">
www.un.org/News/briefings/docs/2004/CanadaPressCfc.doc.htm</a>. Accessed
November 21, 2008.<br><br>
Emily J. Kirk</b> will be an M.A. student in Latin American Studies at
Cambridge University in September. <br><br>
John Kirk</b> 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.<br><br>
<br><br>
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