Just a few months ago, work carried out by Cuba’s medical brigade in efforts to combat Ebola attracted international attention and made headlines in a number of important media. The humanism and dedication of our professionals was widely noted as testimony to the solid foundation of Cuba’s National Public Health System.
Our medical principles were also demonstrated 10 years ago, in August of 2005, when Hurricane Katrina hit New Orleans causing major material and human losses, and Cuba offered its disinterested support to the U.S. government, via a contingent of healthcare workers to assist victims. This was the lead-up to the creation of the Henry Reeve International Medical Contingent Specializing in Disaster Situations and Serious Epidemics, which in November of this same year gave the first examples of its courageousness, coming to the aid of those affected by a devastating earthquake in Pakistan.
Cuba has placed improving the population’s health high among its priorities. Its accomplishments are the result of a political commitment, social participation and joint efforts across sectors. Development continues based on emphasizing ethical training and a high level of competency among professionals.
Since the very triumph of the Revolution there have been obstacles which we have been obliged to face, along with attempts to impede and destabilize the development of a public health system, which despite the limitations of underdevelopment itself and the U.S. blockade, we are proud to say offers free, universal care to the entire population.
We should not forget that in the first five years of the Revolution, close to half of the country’s doctors emigrated. Only 3,600 stayed, but their contribution was decisive to training younger generations, developing public healthcare, and carrying out needed scientific investigation.
We now have more than 85,000 doctors, and the world’s best per capita rate: 7.7 doctors per 1,000 inhabitants, in other words one doctor for every 130 persons. Taking into account the 25,000 Cuban doctors who are on international missions still yields a per capita rate of 5.4, among the highest worldwide.
Precisely in the spirit of sharing what we have, not giving away what is left over, which has characterized the Cuban Revolution since its very beginning, our healthcare professionals offered their services and solidarity in Chile, following the 1960 earthquake there, and in Algeria in 1963, among other examples.
These were a few of the first pages in a history which today is being written by more than 50,000 collaborators completing missions in 68 countries, half of whom are doctors. Over the years, more than 325,000 healthcare workers have completed 580,000 international missions.
More than 56,500 medical students have been trained in our classrooms, among them some 10,700 from other nations, as a modest contribution to the development of other peoples. Likewise, some 25,000 specialists have been prepared, among them 2,201 from abroad.
The scientific level of our personnel, their training, human values and the way they establish a patient-doctor relationship, among other qualities, have made Cuban healthcare professionals among the most sought-after in numerous locations around the world. Thus, government-to-government collaboration agreements have been reached in which mutually beneficial compensation has been established. Nevertheless, Cuba has not forgotten its internationalist principles, and never will. We will continue to give disinterested help, free of charge to countries which need it, as is currently the case in Haiti, Niger, Honduras, Eritrea, and other nations.
The aforementioned has not been exempt from defamation campaigns to discredit the work of our doctors, and more than a few unethical actions have been taken by professional groups and colleges, which see Cuban professionals as a threat to the lucrative business that is capitalist medicine.
The notable prestige of our public health system internationally has encouraged the interest of clinics in hiring Cuban professionals for the private practice of medicine. This has also been occurring in friendly countries, even when their governments do not favor or engage in such practices.
One of the principal promoters of this theft of talent has been the United States government, which since the early days of the Revolution has obliged us to adopt measures and migratory regulations to deal with this situation, and has continued its destabilization efforts via lotteries, selective emigration, and the Cuban Adjustment Act.
Remaining in full force is the Cuban Medical Professional Parole Program, established in August of 2006 during the George W. Bush administration, and designed to incite desertion by Cuban medical professionals completing missions in third countries. To carry out this effort, agents and activists are deployed in locations where Cuban doctors work under governmental agreements, to pressure and offer all kinds of incentives to those who desert and emigrate to the U.S. – with promises of a better professional future which in reality is possible for only a small minority.
This program has been questioned by several U.S. media, including the New York Times, which described it as an instrument of “brain drain, courtesy of the United States.”
Given these circumstances, Cuba will continue to share its modest experience through international cooperation, and at the same time reiterates our need to negotiate the contracting of human resources via institutional agreements, which permit adjusting and updating of staff availability, to ensure that our population’s healthcare services are not impacted.
The will exists to favor all possible ways of improving the working and living conditions of our doctors. Progress is being made in increasing access to information technology, which, among other advantages, allows them to a see the latest documents related to their different specialties; in seeking scholarships abroad to learn new techniques; broadening the modes of collaboration in missions for shorter periods of time (i.e. using itinerate teams); promoting participation in national and international congresses and events with the goal of disseminating scientific work and exchanging experiences with colleagues; as well as in adopting measures which will allow our doctors to continue developing professionally and give their best in a profession which they chose as a vocation, to give meaning to their lives, due to its humanitarian virtues.
Health professionals who have left the country on the basis of the country’s updated migratory policy, be it for economic, family, or professional reasons, including those who have been victims of deceptive practices used in the crass theft of brain power, have the opportunity, if they so desire, to rejoin the National Public Health System. They are guaranteed placement in a position similar to that previously held.
Cuba will continue its commitment to the integrity of our healthcare system, to strengthening research and scientific-technical production, in an effort to resolve the population’s main problems, as it has done to date.
The Cuban healthcare system has as its principal strength our human capital, developed over the course of many years, which allows us to guarantee the health of our people and, at the same time, continue international collaboration.