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Cuba's Medical Diplomacy - a winner

The Cuban people are quite remarkable.  They have survived almost 50 years of a formal trade embargo by successive governments of the United States, the abandonment of Russia and many years of economic deprivation.

 They have endured decades of suffering including food rationing, no access to goods that their Caribbean neighbours might consider ordinary, and few washing machines and dryers so as to conserve on electricity. 
During the so-called ‘special period’ after Russia pulled out of Cuba, hundreds of thousands of Cubans walked to work, rode on vastly overcrowded buses, or reverted to horse-and-cart for transportation.
But, while all this was going on, the Cuban government provided assistance to other countries in Africa, in Latin America and the Caribbean. 
Cuba could hardly afford it, yet the government’s programmes of assistance continued.
Even when Cuba is hit by savage hurricanes causing considerable damage to its agriculture and infrastructure, it continued to provide help to Central American and Caribbean countries that were also affected.  Many of the countries to which it provided help enjoy much higher per capita incomes than Cuba and their standard of living is higher.
Little wonder that Caribbean countries have strongly upheld their support for Cuba despite urgings from US government officials to criticise, if not abandon the Cuban government, over its internal human rights record.
The Cuban government’s strategy of medical diplomacy has worked; it has won friends and supporters in the smallest villages in nations in Central America and the Caribbean.  What Caribbean governments and people appreciate is not just that Cuba has been a consistent friend in time of need, but Cuba has given assistance at great sacrifice to itself.   It is the quality of the assistance, and the knowledge that it is given despite hardship within Cuba, that has left a lasting impression on Caribbean people, and increasingly now people in Central America.
Recently, I saw two large Central American aircraft parked outside the terminal at the Cheddie Jagan International Airport in Guyana.  Knowing that there were no scheduled flights between Central America and Guyana, I inquired about them.  An airport official explained that the two airplanes had been chartered by the Cuban government to come to Guyana to take over 150 people to Cuba for eye operations. 
This is not unique to Guyana in the Caribbean.  It has happened in the Bahamas, Belize, Jamaica, Antigua and Barbuda, St Kitts-Nevis and Grenada. Cuba paid the entire cost for transportation to and from these Caribbean nations, accommodation in Cuba and the cost of the medical treatment.
This programme called “Operation Miracle” by the Cubans was started in 2004 and its purpose is to save hundreds of thousands of relatively poor people from blindness by undergoing surgery to remove cataracts, transplant corneas, and treat glaucoma.  Since the programme started over 750,000 people have been treated, and while there has not been success in every case, hundreds of thousands of people from Central America and the Caribbean now see where once their vision was severely blurred or they have been saved from a loss of eyesight in the future.  In effect, where once they faced the threat of being permanently handicapped, they can now live productive lives.
And, the important thing about the Cuban programme of medical assistance is that it is consistent. 
Earlier this year, the US administration sent a ship with medical personnel and facilities around the Caribbean to treat people in need.  While the US effort was fully appreciated, it suffered from both the perception that it was a knee-jerk response to the successful Cuban programme, and the fact that it is not continuous.  
Josefina Vidal, the director of the North American division of the Cuban foreign ministry put it well in a recent visit to Canada when she said, “Cuba is respected for the aid it provides to many countries in Latin America and the Caribbean.  Cuba sends delegations of doctors and teachers throughout many of the poorest areas of the hemisphere.  It also provides scholarships to other nations so students can attend high-quality Cuban medical and other programmes”.  
It is significant that while hospitals in Canada and the United States are populated with doctors and nurses from the Caribbean, the health services of many Caribbean countries are being maintained by Cuban medical personnel without whom their health services would be in dire conditions.
This Cuban policy of sending teams of medical personnel abroad is not without deleterious effects within Cuba itself.
There was a time Cuban communities could enjoy access to a dedicated doctor who lived within their “block” and had intimate knowledge of their medical history.  This is beginning to change.  For, although Cuba continues to produce doctors and specialist nurses, it was recently reported that “the corps of doctors and nurses left in Cuba are stretched thin and overworked, resulting in a decline in the quality of care for Cubans”.
Understandably, this is beginning to cause some resentment within Cuba, and the Cuban authorities will have to fine tune the balance between continuing to give their own people the health care to which they have become accustomed, and the assistance they provide overseas. But, there are enormous benefits to Cuba.  The most obvious one is support for the Cuban government in international organisations such as the UN where apart from three countries led by the US, the trade embargo has been routinely and regularly condemned.
Cuba now sends medical personnel, or provides medical assistance, to more than 70 countries, and recent reports put the number of medical students in Cuba at more than 10,000 from 27 countries, more than 90% of them were enrolled in medicine.  In money terms, Cuba is also doing well. The Economist Intelligence Unit estimates that non-tourism services exports in 2005 (mostly medical services) was around US$2.4 billion, putting it ahead of gross tourism earnings of US$2.3 billion in 2005.
The Council on Hemispheric Affairs also reports that official data for export earnings from medical products (medicines and equipment) were below US$100 million in 2004, but there are now press reports citing a figure of US$300 million for such products. To this has to be added, considerable income from Venezuela under the scheme to swap oil for medical services.
Cuba’s medical diplomacy has been a success both economically and as a foreign policy tool.  In the process, hundreds of thousands of poor people have benefited – a winner for all.

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