The story behind Cuba’s deal to send doctors to Brazil

July 17, 2014

Daniel A. Medina – Quartz, 7/16/2014

Last summer, long before before Brazil was demolished 7-1 by Germany in the World Cup, the country faced a crisis of another sort. Millions of citizens marched in cities across the country to demand wholesale reforms to the country’s crippled public health care system, which faced huge shortages of doctors and a failing infrastructure.

That’s when the tiny island nation of Cuba stepped in to this neglected area of the world’s seventh-largest economy.

Under Brazil’s Mais Médicos (“More Doctors”) program, which pays foreign physicians to work in underserved areas of the country, Cuba sent 4,500 doctors to rural areas in the Amazon and to the underserved slums known as favelas in its booming cities. The move angered Brazil’s doctors’ unions, who protested outside hospitals, and the Brazilian Medical Association filed a lawsuit in the country’s Supreme Court questioning its existence. Protestors denounced the program as only a temporary solution to a systemic problem, saying the changes should come internally, not by importing doctors.

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Cuban doctor in Brazil triggers diplomatic tiff

February 14, 2014

Fernando Caulyt – Deutsche Welle, 2/13/2014

Many Cuban doctors work in Brazil, but the lion’s share of their salaries are kept by Havana. Out of protest, one doctor has applied for asylum, putting Brazil in an embarrassing situation.

It is not exactly what Ramona Rodriguez had expected: In October of last year the Cuban doctor arrived in Brazil, a country with a severe shortage of physicians, to work in the far northeast state of Para, on the border to Suriname and Guyana.

There are very few doctors in this region of Brazil. Statistically, there is less than one physician for every 1,000 inhabitants. By comparison, Germany has a ratio of 1 to 233.

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Second Cuban doctor defects in Brazil

February 11, 2014

Loretta Chao & Paulo Trevisani – Wall Street Journal, 2/10/2014

A second Cuban doctor is confirmed to have defected from a controversial program to bring thousands of medical professionals to underserved regions of Brazil, according to Brazilian health officials.

“To all my friends on Facebook who sent me messages of concern about my absence, I thank you,” said a message posted to a Facebook profile under the doctor’s name, Ortelio Jaime Guerra.

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Cuban doctor defects in Brazil over pay, seeks asylum

February 6, 2014

Reuters, 2/5/2014

A Cuban doctor working in Brazil sought asylum on Wednesday complaining that Cuba’s communist government takes too big a slice of her pay, authorities said.

Ramona Rodriguez, 51, sought refuge on Tuesday in the office of Ronaldo Caiado, leader of the center-right Democratas party in the lower chamber of Brazil’s Congress, and slept the night on a sofa.

She is one of 7,378 Cubans who are in Brazil as part of a program that hires foreign doctors to tend the sick in slums and remote rural locations where there are no Brazilian physicians.

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Brazil’s president imports Cuban doctors to ease shortage

January 8, 2014

Vincent Bevins – Los Angeles Times, 01/06/2014

Dr. Alberto Asael Reyes speaks Portuguese carefully when talking to his patients. He arrived in the Amazon region only recently from Cuba, and his accent remains strong. But in an area where there has long been no available physician, he often needs to introduce residents to new words and concepts.

“Rheu-ma-to-lo-gist,” Vinicius, a thin, shy 11-year-old, utters slowly after meeting with Reyes. Though Vinicius has had severe fevers and heart problems since birth, no one had told him he needed to see one.

“No one would come here,” says Maria Elena Brito da Silva, a teacher at the school down the road here in the outskirts of the city. “All the doctors stayed in their private practices in the city [center] making money.”

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Cuban doctors tend to Brazil’s poor, giving Rousseff a boost

December 2, 2013

Anthony Boadle – Reuters, 12/01/2013

They were heckled and called slaves of a communist state when they first landed, but in the poorest corners of Brazil the arrival of 5,400 Cuban doctors is being welcomed as a godsend.

The program to fill gaps in the national health system with foreign doctors, mainly from Cuba, could become a big vote-winner for President Dilma Rousseff as she eyes a second term in next year’s election despite fierce opposition from Brazil’s medical class.

The move to tap Cuba’s doctors-for-export program begun by former leader Fidel Castro became a priority for Rousseff after massive protests against corruption and shoddy public transport, education and healthcare services rocked Brazil in June.

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“Castrocare” divides doctors in Cuba, Brazil

October 2, 2013

Lourdes Garcia-Navarro, NPR, 10/02/2013

Call it “Castrocare.” Cuba’s former leader Fidel Castro sent doctors abroad for decades to work throughout Latin America and as far away as Africa.

In some cases, like Haiti, the medical missions were seen as purely humanitarian. In other places, like Venezuela, it was a form of barter that provided Cuba with subsidized oil imports.

Cuba has long boasted of its program, which has generally been well-received. So now Cuba is sending thousands of doctors to Brazil, which badly needs the physicians in poor, rural areas and has the money to pay for them. However, the program is meeting resistance in Brazil — not from patients but from the medical establishment.

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Why they spy on Brazil

September 30, 2013

Carlos Alberto Montaner -The Miami Herald

President Dilma Rousseff of Brazil canceled her visit to President Obama. She was offended because the United States was peeking into her electronic mail. You don’t do that to a friendly country. The information, probably reliable, was provided by Edward Snowden from his refuge in Moscow.

Intrigued, I asked a former U.S. ambassador, “Why did they do it?” His explanation was starkly frank:

“From Washington’s perspective, the Brazilian government is not exactly friendly. By definition and history, Brazil is a friendly country that sided with us during World War II and Korea, but its present government is not.”

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Latin America’s doc deficit: Brazil, a continental giant, still needs to import Cuban medics

September 4, 2013

Tim Padgett – Time Magazine, 09/04/2013

A Brazilian prosecutor is investigating whether President Dilma Rousseff’s government violated federal labor laws by recruiting 4,000 Cuban physicians this month to work in remote areas like the Amazon. That’s just the latest wrinkle in Brazil’s acrimonious Cuban-doctors controversy, which has everyone from Brazilian physicians in Brasília to Cuban-American politicians in Washington, D.C., up in arms.

But there is a much larger problem involved here than Marxist medics — and it’s one that plagues not just Brazil but most of Latin America. Whether or not Brazilian judges eventually let the Cuban physicians stay or order them to leave, it won’t solve Brazil’s doctor shortage, especially in the medically deprived rural and favela (slum) zones the Cubans are headed to.

If you’re wondering why Brazil was the site of sometimes violent street protests this summer, this latest dustup offers one useful clue. Brazil is now the world’s sixth largest economy and considers itself on the doorstep of the developed world. Yet, as Brazilian demonstrators are all too aware, its education system is widely regarded as abysmal, especially science preparation. Brazilian physicians aren’t bad practitioners, though Rousseff has a point when she says many are too elitist to practice in the boonies. But while the medical community may share much of the blame, critics say Brazil’s notoriously corrupt and indifferent officialdom has done little to provide the infrastructure needed to create and support enough doctors to serve the nation’s 200 million people.

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