mercredi 1 janvier 2014

CUBA AND INTERNATIONAL HUMANITARIAN MEDICINE

Most westerners, americans of europeans, hardly know about the magnanimous Cuban efforts at Humanitarian Medicine. When people think of Humanitarian Medicine in the west, they think of flying out when there is a catastrophe in a poor city (by the time Miami team just minutes of flight away from Haiti arrived there after the earthquake, they were surprised to find a Cuban field hospital already in operation, and there was also an Israeli operation underway!. By the way the American team arrived in a private jet). They may equate it also with accompanying some church related charity for a week stay at some developing country. Few would also think of humanitarians who did much to improve the health in poorer countries, such as Dr Albert Shweitzer or Dr Paul Farmer. Very few humanitarian medical efforts exist organized by a state or a country on a large scale, affecting thousands of people, in many continents, all of which has continuity of care as a fundamental characteristic.
Cuba has a three pronged approach, began soon after the revolution, in 1961, when the first contingent of Cuban doctors arrived in Algeria.
The first is sending qualified Medical Doctors, who are well trained in the General Integrative Medicine to various parts of the world, especially to places where there are no doctors (Pemba Island in Zanzibar ) or Specialists (Funafuti in Tuvalu). I was happy to hear that 1500 Cuban doctors will be travelling to Brasil to improve the general medical care, including the prevention of diseases, spread over the entire country. For example, a friend of mine from Baracoa, with whom I spoke to over the telephone was in Carruese, in the interior of the state of Pernambuco, one and half hours by bus from Recife the state capital in the North Eastern Part of Brasil. Currently close to 80 000 (yes it is 80 000) cuban doctors and health professionals (I met an Cuban optometrist working in Curiapo, at the end of the delta Amacuro in Venezuelan Guyana) are engaged in 79 different countries around the world, such as specialists in Bhutan, Medical School Faculty at Dili in Timor L'este and in all countries of South and Central America and in many countries in Africa.  There are cuban doctors and specialists in Vanuatu, Nauru, Solomon Islands, Kiribati and Tuvalu. ( I felt a deep shame, as an Australian, that we had only exploited these islands for profit and not provided what Cuba has been providing them, Health and Education). If you wish to see the students from these Island nations in Cuba, please check the youtube videos. It is very touching.
The second approach is medical education. To my knowledge there are over 800 medical graduates from the Cuban Medical School at Dili, Timor L'Este.  When I was in Maputo, Mozambique, I was told that the majority of the teachers at the Eduardo Mondlane Medical University were Cubans.
The third is the more generous and everlasting legacy of Cuban solidarity with Poorer nations of this world and the indigenous populations in these countries.
After disaster struck Honduras, when Hurricane Mitch tore through a swathe of that poor country, Cuban medical contingent was there immediately. When it was time for them to return, Fidel Castro wanted a longer lasting help given to these poorer countries. Cuba itself is a poor country, economically but not intellectually. When the Cuban doctors leave,  who would look after the health of these poor people, now left destitute? he wondered.
That was the thought behind the birth of ELAM Escuela LatinoAmericana de Medicina, to bring deserving students from poorer countries to Cuba and offer them full scholarships (Lodging, Food and Education, allow them to return to their countries to finish their internships and become fully fledged doctors. Currently there are more than 20 000 students from all over the world!! 500 places are kept for poor Black, Latino and white students who would otherwise couldn't become doctors in the USA .(their stories are also on youtube)
(an Timor Leste doctor trained in Cuba on left. Nearly 1000 doctors in Timor Leste has been trained by Cubans!)
Rapa Nui or Easter Island or Isla de pascua is considered to be the most isolated inhabited place on earth, in distance from its nearest neighbours, Chile in South America to which it politically belong or Tahiti in French Polynesia to which it culturally belongs. This mysterious island has centuries old intrigue and oppression and freedom. It is the eastern most part of the Polynesian triangle (Aoatearoa to the west and Hawaii to the North). Medical care is provided by rotating doctors from the continental Chile, with little experience and no knowledge of the local culture.  Two local rap nui doctors have already graduated and awaiting validation of their diplomas and post graduate study ( Pediatrics and Anaesthesia), one will graduate in 2014, another two in 2015. Thus in 10 years time, all the doctors providing care for Rapa Nui people would be Rapa Nui themselves.

I couldnt help shedding a tear when I listened to a young woman from Tuvalu talking about her dream of becoming a doctor for her people. (see the youtube video). She said: I would like to say thanks and express my gratitude to the Cuban people and Fidel Castro for giving me this opportunity. I thought of the flat coral islands of her home, Tuvalu, where I was able to do some medical work soon after my graduation from Medical School, during the time of a typhoon.
(Medical students from Tuvalu in Cuba!)
In hundreds of thousands of villages all over this world, one can hear the deeply felt words of gratitude, Thank You, Cuba. and this is the legacy of Cuban International Humanitarian Medical Missions!