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<a class="gmail-domain gmail-reader-domain" href="https://peoplesdispatch.org/2023/05/26/60-years-of-cuban-international-medical-solidarity/">peoplesdispatch.org</a>
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<h1 class="gmail-reader-title">60 years of Cuban international medical solidarity</h1>
<div class="gmail-credits gmail-reader-credits">Peoples Health Dispatch - May 26, 2023<br></div>
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<div class="gmail-moz-reader-content gmail-reader-show-element"><div id="gmail-readability-page-1" class="gmail-page"><img src="cid:ii_li698xtq0" alt="image.png" width="392" height="221"><br><p>60 years of Cuban medical cooperation.
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<p><span>In May 1963, a group of Cuban health workers arrived in Algeria
to support the country’s efforts to rebuild after liberation from
France. As the team was assembled, none of its members knew what to
expect. “Now when you say that you have been on a mission people
understand what you mean; there is a history, a tradition. Back then
there wasn’t any. We were taking a first step; we were launching into
the unknown,” said Pablo Resik Habib, one of the doctors who traveled in
this contingent, to Cuban journalist Edelberto López Blanch.</span></p>
<p><span>Sixty years later, Cuban medical solidarity is one of the few
shining points in global health. Hundreds of thousands of people have
survived outbreaks of infectious diseases, and millions more were
guaranteed access to basic care, thanks to Cuba’s dedication to
supporting sister countries.</span></p>
<p><span>The wars waged by the United States after 2001 killed—</span><a href="https://watson.brown.edu/costsofwar/figures/2021/WarDeathToll"><span>directly</span></a><span>—at
least 906,000 people. Many more died as an indirect result of the
conflicts, and even more are still suffering from their consequences.
Meanwhile, s</span><span>ince the establishment of the international
health brigades, Cuban health workers have participated in the delivery
of more than two million children all over the world. Sending doctors,
not soldiers, as Fidel Castro implied in the aftermath of the 2010 Haiti
earthquake, makes all the difference.</span></p>
<h3><b>Building public health systems together</b></h3>
<p><span>The first group that traveled to Algeria counted some 60 health workers, including doctors, nurses, and dentists. By </span><a href="https://cubaminrex.cu/en/address-dr-jose-angel-portal-miranda-minister-public-health-republic-cuba-76th-world-health"><span>May 2022</span></a><span>,
605,000 health workers had served in 165 countries. Their involvement
ranges from participating in emergency programs for the response to
infectious disease outbreaks and the aftermath of hurricanes and
earthquakes to the provision of primary health care.</span></p>
<p><span>In addition to sending health workers to other countries, Cuba
also offers medical training to people from other countries of the
Global South. Between 2005 and 2016, some 25,000 students went through </span><a href="https://www.seer.ufrgs.br/rbea/article/download/104992/60696"><span>training </span></a><span>at
the Latin American School of Medicine (ELAM). The number climbs even
higher if we consider students from high income countries, including the
US. In that case, more than 27,000 students received training at ELAM.
Differently from most medical schools, ELAM prioritizes the enrollment
of women and students from peasant, working class, and Indigenous
backgrounds. This ensures that the health workers who graduate from the
school understand, at a very personal level, the conditions in which
their patients live.</span></p>
<p><span>Students at ELAM are not only trained in medical sciences, but
are also exposed to the idea of health heralded by the revolution. After
initial training, the students are sent to work together with one of
the nurse-physician teams distributed around the country. As Helen
Yaffe, an economic historian specializing in Latin America, points out
in her book </span><i><span>We are Cuba!</span></i><span>, these
students are taught to work in a very different way than medical
students in the Global North—with little reliance on high-tech
equipment, and in a spirit of comradeship with the community and
traditional healers. </span></p>
<p><span>They are also taught the revolutionary potential of medicine
and the importance of health workers’ participation in anti-colonial and
anti-imperialist movements. For example, this year the students of ELAM
<a href="https://www.instagram.com/p/Csj56AuPnMm/?igshid=MzRlODBiNWFlZA==">marked the 75th anniversary</a>
of the Nakba. As of today, 163 Palestinian students graduated from
ELAM. 50 more are still enrolled in undergraduate or postgraduate
courses, according to the Cuban Ministry of Public Health.</span></p>
<h3><b>Health for all in practice</b></h3>
<p><span>Medical training for foreign students is conducted in parallel
to local efforts to build and strengthen the health workforce. In </span><a href="https://www.bmj.com/content/376/bmj.o123/rr-5"><span>2022</span></a><span>,
Cuba had nine doctors to 1,000 patients, while the US had 2.5 to 1,000.
The distribution of health workers in Cuba is also organized in a very
different manner than in most high income countries. A network of
clinics and polyclinics, based on the principles of primary health care
and scattered around the island, ensures that care is easily accessible
to everyone who needs it, regardless of where they live. In contrast,
high income countries—again including the </span><a href="https://www.nytimes.com/2023/02/26/health/rural-hospitals-pregnancy-childbirth.html"><span>US</span></a><span>—are
increasingly facing the problem of medical deserts, where rural
communities or specific populations are cut off from essential health
care because of the health workers’ shortage.</span></p>
<p><span>In fact, in a period marked by an acute global shortage of
health workers, Cuba’s experience of building its own health workforce
and sharing it with others should be heralded as a way forward for
everyone. Yet, in the Global North it is rarely acknowledged outside of
the context of the COVID-19 pandemic response in Italy. </span></p>
<p><span>But it is wrong to reduce Cuban health internationalism to
technical assistance during moments of crises. As the efforts put into
educating nurses, doctors, and other health workers coming from other
parts of the world show, Cuba’s international health programs give a
glimpse into a different health landscape than the one dominating the
discussion: care available to everyone, no matter how poor, provided by
expert workers trained through a public education system.</span></p>
<p><span>As José Angel Portal Miranda, Cuba’s Minister of Public Health,
said at the 76th World Health Assembly, Cuba “has succeeded in
complying with the principle of ‘health for all.’” Cuba is one of the
very few members of the World Health Organization who can say that. What
he did not explicitly say in the speech is that, thanks to the
international solidarity heralded by the island’s health workers, Cuba
also reminds others that health for all is much more than a talking
point.</span></p>
<p><b><i>People’s Health Dispatch</i></b><i><span> is a fortnightly bulletin published by the</span></i><a href="http://www.phmovement.org/"> <b><i>People’s Health Movement</i></b></a><i><span> and </span></i><b><i>Peoples Dispatch</i></b><i><span>. For more articles and to subscribe to People’s Health Dispatch, click</span></i><a href="https://peoples-health-dispatch.ghost.io/"> <b><i>here</i></b></a><i><span>.</span></i></p>
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