Tag Archives: Health

CUBA AND COVID-19: WHY IS THEIR MODEL SO SUCCESSFUL?

Original Article: Cuba and Covid-19

McLeod Group guest blog by John M. Kirk, October 29, 2020 

Original Article: Cuba and Covid-19

As the cold winter looms, along with the dreaded “second wave” of COVID-19, Canadians are faced with some alarming facts. While pleased that our infection and death rates are only half those found in the United States, we are doing poorly compared with one country barely mentioned in our media: Cuba. Their death rate (adjusted to population differences) is roughly 1/25 what ours is, while Canadians are ten times more likely to become infected by the virus than Cubans.

How did they manage to do this? Is there anything that we can learn from them?

The world is in a parlous state. There is the possibility that 500,000 Americans might die by February. The intensive care wards are rapidly filling up in Europe. In Canada, we are now hitting almost 1,000 new cases daily in the two most populous provinces of the country, Ontario and Quebec.

Yet, Cuba has managed to control the situation there, with fewer than 7,000 people infected and 128 dead. It has also faced, and curbed, a second wave of infections. Cubans are also over 40 times less likely to contract the virus than people in the United States. Countries of a similar size to Cuba offer interesting data in terms of fatalities. As of October 25, Cuba has experienced 128 deaths, compared with 10,737 in Belgium, 2,081 in Switzerland, 2,297 in Portugal, 5,933 in Sweden, and 1,390 in Hungary.

While there are some aspects of the Cuban model that are not transferable to Canada – largely because of radically different political systems – there are things that we can learn from them.

Cuba is fortunate that it is a small country, with 11.2 million people in an island about twice the surface area of Nova Scotia. It also has an excellent healthcare system, with three times the number of physicians per capita as Canada – the highest rate in the world. Its system emphasizes preventive medicine, as opposed to the curative approach used here. The Cubans moved with enormous speed to limit COVID-19, in part because of a finely tuned system to respond to natural disasters.

When COVID arrived in the island in March, brought by Italian tourists, the government decided to forego the funds derived from the tourism industry, and closed the island to tourists. Healthcare for all was deemed far more important than economic growth.

Continue Reading: Cuba and Covid-19

John M. Kirk is Professor of Latin American Studies at Dalhousie University, and the author/co-editor of 17 books on Cuba, including two on its healthcare system.

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THE WORLD REDISCOVERS CUBAN MEDICAL INTERNATIONALISM

The world rediscovers Cuban medical internationalism

Helen Yaffe,April 8th, 2020, 

 

As coronavirus has spread around the world, the global public has been surprised to see Cuban medicines being used in China and Cuban doctors disembarking in northern Italy. But Cuba’s solidarity-based medical internationalism has been going strong since the 1960s, writes Helen Yaffe (University of Glasgow).

Just weeks ago, in late February 2020, US Democratic Senator Bernie Sanders was vilified by the US establishment for acknowledging education and healthcare achievements in revolutionary Cuba. Now, as the SARS-CoV-2 pandemic sweeps the globe, the island’s medical prowess is back in the spotlight, first because the Chinese National Health Commission listed the Cuban anti-viral drug Interferon alfa-2b amongst the treatments it is using for Covid-19 patients.

Effective and and safe in the therapy of viral diseases including hepatitis B and C, shingles, HIV-Aids, and dengue, the Cuban anti-viral drug has shown some promise in China and the island has now received requests for the product from 45 countries.

Then, on 21 March a 53-strong Cuban medical brigade arrived in Lombardy, Italy, at that time the epicentre of the pandemic, to assist local healthcare authorities. While images spilled out over social media, little was said in mainstream outlets. The medics were members of Cuba’s Henry Reeve Contingent, which received a World Health Organisation (WHO) Public Health Prize in 2017 in recognition of its provision of free emergency medical aid. In addition to Italy, Cuba sent medical specialists to treat Covid-19 cases in 14 of the 59 countries in which their healthcare workers were already operating.

Continue Reading: THE WORLD REDISCOVERS CUBAN MEDICAL INTERNATIONALISM

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CUBA’S REPUTATION AS MEDICAL POWERHOUSE TESTED

Marc Frank, Financial Times, April 5 2020

Cuba has long been proud of sending thousands of its doctors to work around the world as icons of socialist solidarity — and important sources of dollars.

But the coronavirus pandemic has given a communist government with a reputation as a medical power one of its toughest domestic challenges since Fidel Castro seized power six decades ago.

All but bankrupted by US economic sanctions, the Caribbean island nation is grappling with the threat posed to the oldest population in the Americas, where more than 20 per cent are aged over 60.

A severe outbreak of Covid-19 could also potentially threaten the domestic authority of a government whose comprehensive free healthcare system has been a pillar of the revolution’s success.

But the global outbreak has also created diplomatic opportunities, say analysts. The government has stepped up its overseas medical programme, sending doctors and nurses to help fight the virus in the Chinese city of Wuhan, where the pandemic began, as well as Italy, Andorra and elsewhere.

The strategy had long been a soft power play for the island, said Nicholas Watson, Latin America director at the consultancy Teneo, in a note. “[President Miguel] Díaz-Canel is not just looking to restore revenues that the program used to provide but to drive a wedge between the US and Europe over the medical assistance program.”

Cuba has so far reported close to 250 cases of Covid-19, mostly related to foreign visitors, and six deaths — an Italian and a Russian tourist and four Cubans. On March 20 it shut its borders, banned tourism and began implementing measures to curb the virus. This year’s May Day parade has been cancelled for only the third time since the 1959 revolution. Schools, bars and public transport between provinces have been shut down. Restaurants and stores remain open but with new rules on social distancing and hygiene, and all outside gatherings for festive purposes are banned.

Mr Díaz-Canel has appeared daily in the state-run media since the restrictions were rolled out, co-ordinating measures and urging citizens to take the threat seriously. “We have in our favour a public health system for all, a dedicated scientific community and an effective civil defence system, a party and a government that put Cubans at the centre of their attention,” he said in a nationwide address last month as he announced preliminary measures to contain the pandemic. “Serenity, discipline and collaboration, values ​​that every Cuban has incorporated, can prevent the spread of the virus,” he added.

Paul Hare, a former UK ambassador to Cuba who lectures at Boston University’s Pardee School of Global Studies, said the country’s tight social control over its population would also aid the effort. But, he added, “the strains on the Cuban health service will show in equipment and resources”.

While Cuba still boasts the best health statistics in the region, including number of doctors and nurses per capita, many health facilities are in disrepair and there are scattered pharmaceutical shortages.

Cuba initially did little Covid-19 testing but is now conducting more than 500 a day — a fivefold increase since last month — after a donation of kit from China. The government has not said how many ventilators are available. Community-based doctors and nurses, as well as medical students, have been going door to door asking about recent travel, contacts with visitors from abroad and possible symptoms.

Suspected cases are swiftly quarantined in state facilities. Confirmed cases have been hospitalised and their primary contacts quarantined.

The measures appear to have drawn near unanimous support.

“I approve of the measures, though the government should have taken them earlier, especially closing the border like other countries did,” said Anaida González, a retired nurse from central Camagüey province.

The government is, meanwhile, continuing to promote its narrative of global solidarity. As well as sending personnel to virus-stricken nations, state media have broadcast extensive footage of passengers being rescued from the Braemar, a cruise ship that docked in Havana after being refused entry by other Caribbean nations, and images of a Cuban-run hospital in Qatar and nurses marching into hospitals in seven other Caribbean island nations.

Cuba earned $6.3bn from medical services exports in 2018, its biggest source of foreign exchange and twice as much as tourism, its second biggest export earner. It needs the money more than ever given the tourism shutdown.

“Tourism generates $3bn annually in desperately needed hard currency and keeps most of the nascent private sector in business,” said William LeoGrande, a professor and Cuba expert at American University in Washington.

“A prolonged closure will reverberate across the entire economy, producing a recession not quite on the order of the 1990s Special Period [following the collapse of Cuban ally the Soviet Union], but a close second,” he warned.

“The photos of the Cuban medical brigade arriving in Italy are an icon of the revolution’s epic of international solidarity,” said Bert Hoffman, a Latin America expert at the German Institute of Global and Area Studies.

“But this narrative will only function as long as Cuba can control the coronavirus situation on the island itself.”

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CUBA: U.S. EMBARGO BLOCKS CORONAVIRUS AID SHIPMENT FROM ASIA

Michael Weissenstein The Associated Press, Friday, April 3, 2020

HAVANA — Cuban officials say a shipment of coronavirus aid from Asia’s richest man, Jack Ma, has been blocked by the six-decade U.S. embargo on the island.

Carlos M. Pereira, Cuba’s ambassador to China, said on his blog this week that Ma’s foundation tried to send Cuba 100,000 facemasks and 10 COVID-19 diagnostic kits last month, along with other aid including ventilators and gloves.

Cuba was one of 24 countries in the region meant to receive the donations announced on March. 21 by the Jack Ma Foundation, which is sending similar aid to countries around the world, including the United States.

Cuban officials say the cargo carrier of Colombia-based Avianca Airlines declined to carry the aid to Cuba because its major shareholder is a U.S.-based company subject to the trade embargo on Cuba. The embargo has exceptions for food and medical aid but companies are often afraid to carry out related financing or transportation due to the risk of fines or prosecution under the embargo.

Human-rights groups have been calling for the U.S. to lift sanctions on Venezuela, Cuba and Iran during the coronavirus epidemic in order to permit the flow of more aid. The Trump administration has argued that only the countries’ government would benefit from the sanctions relief.

An Avianca spokeswoman referred a query to a spokeswoman for Ma’s company, Alibaba, who did not return an email seeking comment.

Cuba has closed all air and sea connections, with the exception of essential cargo and government flights, in an attempt to prevent the further introduction of coronavirus to the island.As of Friday morning, Cuba had 269 confirmed cases, 3,241 people in quarantine, 15 patients recovered from the infection and six who have died of it.

A town in western Cuba and a relatively well-off section of Havana have both been completely isolated to prevent the spread of the disease.

Cuba has free universal health care and a high ratio of medical workers, 95,000, for a population of 11 million but operates without much of the equipment and testing generally available in developed countries.

The blocking of the aid should be “an action inconceivable in a global crisis,” but “it doesn’t surprise us,” said Carlos Fernando de Cossio, Cuba’s head of U.S. affairs. “It’s the type of obstacle that Cuba confronts daily in order to take care of the country’s basic necessities.”

 

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Public and Private, Market and Plan: Some Lessons from Cuba and the United States.

Attached is the PDF of a P.Pt. presentation delivered at Kennesaw State University on October 24, 2019 entitled Public and Private, Market and Plan:Some Lessons from Cuba and the United State: 

    Public and Private, Market and Plan, Kennesaw, Oct. 24, 2019

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CHALLENGES AND REALITIES OF CUBA’S HEALTH CARE SYSTEM

Fernando Ravsberg, enero 25, 2018

Artículos de Fernando Ravsberg, English Version, Política, Salud, Sociales

Last November, “Maria de la Caridad” was admitted into one of the best hospitals in the country, waiting for her knee replacement prosthesis, when she slipped in a puddle of water out in the hospital’s corridor and broke both her arms. Now, she’s back at home in a worse state than before.

It’s hard to explain to someone who isn’t Cuban, how a hospital with such high professional standards and so much modern equipment can be lacking in personnel to collect dirty dishes or keep the floor which orthopedic patients walk along, dry.

It’s just as hard as understanding the fact that pharmaceutical employees are dedicating themselves to counterfeit medicines for children so they can be sold secretly via the illicit pharmacy network, as Cuban press reported a few days ago.

How can there be medicine shortages and a black market in a country with scientists capable of inventing innovative vaccines to treat different types of cancer or medicines that prevent diabetes patients from having to be amputated?

There is so much chaos that you can buy any medicine without needing a medical prescription at many pharmacies, as long as you are willing to pay extra on the side. However, all lines are crossed when medicines for children are tampered with.

During the crisis of the ‘90s, I saw a black market seller offering powdered milk to a mother with two small children. She said that it was top quality because it was stolen from the school for children with disabilities. The mother was appalled and refused to buy it.

There are many Cubans like her who clearly know where their boundaries lie, but even they cross these lines when a son is having an asthma attack or their grandfather needs to monitor their heartrate. So they go looking for the medicines they need wherever they may be and they pay whatever is being asked for them.

The black market in Cuba’s public health sector is a death trap. Let’s remember how thirty patients died of cold and hunger at Havana’s psychiatric hospital, when the people who were responsible for protecting them, stole their food and blankets.

We could spend hours talking about how morally bankrupt those who make a business out people’s health are but we can’t explain how these people, who were once young and had the vocation to protect and help others, a pharmacist, a nurse or a doctor, can stoop so low.

Among the causes for this situation, the chronic shortages of medicines and low wages particularly stand out. The combination of both these factors leads to the black market, which we have all been responsible for, some as sellers and others as buyers.

 A few years ago, the government promised that wages would improve in correlation with an increase in productivity. Today, the health sector brings in 70% of the country’s revenue in hard currency but wages continue to be way below what the basic foods costs.

Public health sector workers aren’t even given any perks that wouldn’t cost the State’s coffers a single cent, such as being able to purchase a property for its cost price and in hard currency or being able to freely import a car, after having completed their mission abroad.

And the reality is that if wages of medical personnel don’t increase, the wages of cleaning staff can’t get any better either. Patients will continue to receive “stem-cell” therapy for free while they continue to slip and fall in puddles of water that nobody is cleaning up.’

Many cleaning and technical employees leave the health system looking for a more dignified income in the private sector, that is to say an income that allows them to get to the end of the month without having to steal. Official press “kick the bucket” blaming self-employment for this exodus.

The real problem lies in stagnant reforms, in using the health sector and pharmaceutical industry’s incredible earnings to finance the State’s shortfall companies instead of using them to feed the “hen that lays the golden eggs.”

There are morally bankrupt criminals in the black market but many other people (maybe most of them) only take part so as to meet their family’s basic needs or are forced to because of pressing needs, like the medicines only available from illicit sources.

Ideology awareness classes aren’t enough to stop this loss of values. The answer could once again lie in Jose Marti’s insightful way of seeing things when he explained that “given human nature, one needs to be prosperous to be good.”

In 2017, Cuba reached its record child mortality rate of only 4 per 1000 newborns. Public health needs the financial resources it brings in so as to keep up these levels of efficiency.

Translation: Havana Times

About Fernando Ravsberg: Nacido en Uruguay, corresponsal de Público en Cuba y profesor del post grado de “Información internacional y países del Sur” de la Universidad Complutense de Madrid. Fue periodista de BBC Mundo, Telemundo de EEUU, Radio Nacional de Suecia y TV Azteca de México. Autor de 3 libros, El Rompecabezas Cubano, Reportajes de Guerra y Retratos.

 

 

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HOW DOES CUBA MANAGE TO ACHIEVE FIRST-WORLD HEALTH STATISTICS?

The island’s medical system is envied throughout the region and is a major foreign revenue earner

ÁLVARO FUENTE; EL PAÍS, Havana 10 FEB 2017

Original Article: Cuba’s Medical System

Cuba’s healthcare system is a source of pride for its communist government. The country has well-trained, capable doctors, the sector has become an important export earner and gives Cuba valuable soft power – yet the real picture is less rosy. A lot of health infrastructure is deteriorating and there is a de facto two-tier system that favors those with money.

Cuba’s child mortality rate is on par with some of the world’s richest countries. With six deaths for every 1,000 births, according to World Bank data from 2015, Cuba is level with New Zealand. In 2015, the global average was 42.5 deaths for every 1,000 births. Despite more than half a century of a US economic embargo, Cuba’s average life expectancy matches that in the US: 79.1 years, just a few months shorter than Americans who, on average, live to 79.3 years, according to 2015 data from the World Health Organization (WHO).

Much of Cuba’s success in these areas is due to its primary healthcare system, which is one of the most proactive in the world. Cuba’s population of 11.27 million has 452 out-patient clinics and the government gives priority to disease prevention, universal coverage and access to treatment.

Cuba has also produced innovations in medical research. In 1985 the country pioneered the first and only vaccine against meningitis B. The country’s scientists developed new treatments for hepatitis B, diabetic foot, vitiligo and psoriasis. They also developed a lung cancer vaccine that is currently being tested in the United States. Cuba was also the first country on earth to eliminate the transmission of HIV and syphilis from mother to child, a feat recognized by the WHO in 2015.

In 2015, Cuba spent 10.57% of its GDP on health, slightly higher than the global average. According to the World Bank in 2014, the European average spending GDP spending was 10%, compared to 17.1% in the United States.

TWO-TIER SYSTEM

A lesser-known characteristic of Cuba’s healthcare system is the existence of special clinics, reserved for tourists, politicians and VIPs. The state reserves the best hospitals and doctors for the national elite and foreigners, while ordinary Cubans sometimes must turn to the black market or ask expatriate friends or family to send medicine.

“Cuba’s health service is divided in two: one for Cubans and the other for foreigners, who receive better quality care, while the national population has to be satisfied with dilapidated facilities and a lack of medicines and specialists, who are sent abroad to make money for Cuba,” says Dr. Julio César Alfonzo, a Cuban exile in Miami and director of the NGO Solidaridad Sin Fronteras.

In 2015, Cuba spent 10.57% of its GDP on health, slightly higher than the global average

In 1959, the country had only 6,000 doctors, half of whom emigrated after the Cuban revolution. By 2014, Cuba had 67.2 doctors for every 10,000 inhabitants, with only Qatar and Monaco ahead of it.

However, despite these impressive statistics, the quality of primary healthcare, which has been fundamental to Cuba’s success, has been declining in recent years. Between 2009 and 2014 there was a 62% fall in the number of family doctors, from 34,261 to 12,842, according to Cuba’s National Statistics Office (ONEI).

AN ARMY OF WHITE COATS

In the words of Fidel Castro, Cuba’s “army of white coats” was formed in 1960, when a medical brigade was sent to Chile after an earthquake left thousands dead. Since then, Cuba has sent more than 300,000 healthcare workers to 158 countries in Latin America, Africa and Asia, according to Cuba’s state news agency. Today, around 50,000 Cuban medical workers are present in 67 countries.

“Cuban doctors are rooted in solidarity and in the Hippocratic Oath. Our job would be unthinkable without foreign missions,” says Salvador Silva, a doctor specializing in infectious diseases who has worked in Haiti and Liberia.   “Yes, our salary is low and maybe that pushes us to go abroad, but it also makes us proud when we see our work recognized throughout the world, on top of just helping in our own country,” he adds.

Doctors are arguably Cuba’s most profitable resource and the country’s medical missions have proved to be a lucrative diplomatic tool. The healthcare industry is also one of the country’s main sources of income. In 2014, Cuban authorities estimated overseas healthcare services would bring in $8.2 billion, putting it ahead of tourism.

Cuba has a different deal with each country it works with. For example, in exchange for sending 3,500 health care workers to work in and provide training in Venezuela, a close Cuban ally, Venezuela sends oil.

With such a high demand for personnel, some suspect that the Cuban government has been reducing educational requirements to hasten students’ entry into the work force.  “They are giving doctors licenses in record time to meet the need to export them, and this has been detrimental to the quality of training and medicine, which used to be the best. This has been happening since they started the program in Venezuela, between 2003 and 2004,” says Dr Alfonzo.

Doctors are also eager to be sent abroad, not only to help the less fortunate, but also for money. Salaries are higher – depending on the location, with doctors abroad reportedly making up to $1,000 per month (minus taxes), whereas those in Cuba make around $50. On the island, it isn’t rare to find taxi drivers, shopkeepers or construction workers with medical degrees.

Juan drives a 1950s Chevrolet he bought with his brother and he uses it as a taxi from 6pm to midnight. He’s also a doctor in the clinic Hermanos Ameijeiras. “The wage is a pittance. We find ourselves obligated to make a living doing other things. I have coworkers who sell prescriptions to pharmacies, who work in unlicensed clinics or help their families in shops. It’s frustrating,” he says. “It’s like they’re pushing us to enlist in international missions, the business of Cuba.”

The country’s medical missions abroad have been an important escape route for Cubans looking to defect. Before migratory reforms were passed in January 2013 allowing Cubans with passports and visas to travel abroad, the preferred way to abandon Cuba was via Venezuela. In 2013 and 2014, more than 3,000 doctors deserted the island to go to the United States through a special visa program called Cuban Medical Professional Parole, a program started by George W. Bush to help healthcare workers who had escaped while working abroad.

Lucia Newman, a former CNN correspondent in Habana, said Cuban doctors complain that travel restrictions prevent them from attending conferences or keeping abreast of the latest medical advances. The US trade embargo on Cuba includes some textbooks, but the major problem is that Cuban doctors cannot buy medical equipment from the United States or from any US subsidiaries.

For Odalys, a young patient waiting at the Hospital Salvador Allende, “the situation is becoming unsustainable in this country and it’s not because of a lack of specialists, it’s because we have to bring everything ourselves. I just bought a light bulb for the hospital room. I’ve called home so that they can bring me bedding, towels and even toilet paper. There aren’t even stretchers, I saw a family carrying their sick son into a room. Free and universal health care, yes, but it’s a bit of a mess and very informal,” she says.

English version: Alyssa McMurtry.

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CRISIS IN VENEZUELA MAKES LIFE HELL FOR CUBAN MEDICAL PROFESSIONALS

A growing number of Cuban health professionals working in Venezuela are fleeing or seeking second jobs as a result of the economic and political crisis in the South American country.

By MARIO J. PENTÓN

In Cuba Today, June 22, 2016

Original Article: Cuban Doctors in Venezuela

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Cuban Doctors in Venezuela in More Promising Times

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Tania Tamara Rodríguez never thought she would escape from the Cuban medical teams in Venezuela and become a “deserter,” now blocked by her government from returning to her country for eight years.

But the many difficulties that Cuban health professionals face in Venezuela as a result of the economic and political crisis in the South American country are leading a growing number to seek refuge in neighboring countries or obtain other jobs to make ends meet.

“Conditions for the doctors and other health professionals are horrible. You live all the time under the threat of being returned to Cuba, losing the job. You’re afraid they will take all the money – which is in Cuban government accounts – and revoke your assignment (to Venezuela) if they want to discipline you,” said Rodríguez, who now lives in Tampa.

While she worked in a medical laboratory in Venezuela as part of Cuba’s “Mission to the Neighborhood” medical aid program, the government deposited Rodríguez’s salary of 700 pesos per month (about $29) to an account in Cuba and gave her access to $280 dollars (U.S.) per month and a card for 25 percent off at the TRD shops in Cuba, which offer hard-to-find imported goods at dollar prices.

In 2014, after acknowledging that its “export of health services” was earning the island more than $8.2 billion a year, the Cuban government increased salaries in the domestic health sector. Even with the increases, which took effect after the public health sector had dismissed 109,000 employees, Cuban doctors are still not earning even close to the international median.

Rodríguez went to Venezuela in early 2015 from the eastern city of Holguín where she worked in the laboratory of the Máximo Gómez Báez. She agreed to join one of Cuba’s many medical teams in foreign countries in hopes of providing better opportunities for her 13-year-old daughter.

Cuba currently has about 28,810 medical personnel in Venezuela working in public health programs that, according to President Nicolás Maduro, represent a priority sector for his government and has cost Venezuela more than $250 billion since 1999.

The payment arrangement, essentially trading Venezuelan oil for Cuban medical personnel, has been repeatedly denounced by critics as a way for the Venezuelan government to cover up its subsidies to Cuba. Cuba then resells part of the refined oil products on the international market.

Rodríguez, who arrived in the United States after a few months in Venezuela under the U.S. government’s special parole program for Cuban medical personnel who defect, saved the money needed to buy her daughter a plane ticket to the United States from Cuba. But when her family took the girl to an Interior Ministry office to apply for a passport, she was denied because the mother was still listed as working in Venezuela.

“I don’t understand how I can be listed as working when I have been in the United States for more than a year. Someone must be pocketing the money the Venezuelan government is paying for me,” Rodríguez said.

According to the U.S. Citizenship and Immigration Service (USCIS) agency, 2,335 petitions were received in Fiscal Year 2015 under the Cuban Medical Professional Parole (CMPP) program, an initiative by the George W. Bush administration that offers visas to Cuban medical personnel “recruited by the (Cuban) government to study or work in a third country. Since its start in 2006, more than 8,000 medical professionals have been admitted under the program.  Solidarity Without Borders, a Hialeah non-profit that helps the arriving Cuban medical professionals, told el Nuevo Herald that the number of Cubans applying for the CMPP has risen in recent years. Not everyone is accepted, and 367 were rejected in fiscal year 2015, according to official data.

Rodríguez said that when she arrived in Venezuela in 2015, she was assigned to work with other Cuban medical personnel in the north central state of Falcon.

 “Everything in Venezuela is a lie,” she complained. “We were forced to throw away the reactive for CKMB (a type of blood test), a product that is scarce in Cuba. But we had to throw it away so that it would be marked in the books as having been used and Cuba could sell more. The same happened with the alcohol, bandage, medicines …  “Everything was produced in Cuba and paid for by the Venezuelan government,” Rodríguez said. “We faked lists of patients and were forced to live on nothing, while Cuba took all the money.”

During the time she worked in Venezuela, Cuban officials paid each medical professional about 3,000 bolivares (about $3) per month — an amount that has increased substantially recently because of an inflationary crisis and the relentless devaluation of the Venezuelan currency.

“Sometimes I had to do little jobs on the side to make ends meet,” she said. “Thank God that many Venezuelans take pity on the Cubans and help us.”  “Maybe what happened in my case was that when I decided to escape, I went to the municipality and told them everything about the disaster” at her clinic, she said. “And now they want to take revenge because I denounced them.”

Another Cuban doctor who works in the northeastern state of Anzoategui spoke on the condition of not being identified because of fear of being punished for speaking with a journalist.

“We started earning 3,000 bolivares and we’re now up to 15,000,” he said, or about $15 on the black market. “What’s interesting is that it makes no difference if they give us more bolivares because they are worthless in real life.”   “Our working conditions are horrible. We are salaried slaves of Cuba,” the doctor said. “They keep us in groups. Since I arrived, I live with three doctors from other parts of the island, so I have to share my room with someone I don’t know, and every day at 6 p.m. I have to ‘report’ that I am home.”

Officials of the Cuban medical teams in Venezuela justify the daily check-ins as a security measure due to the high levels of violence in the neighborhoods where they work. The doctors, however, see it as part of an effort to keep a close watch on them.

“There are many (Cuban) state security agents. Their job is to keep us from escaping,” said the doctor working in Anzoategui. “When you arrive in Venezuela, they ask you if you have relatives abroad, especially in the United States. We all say no, even if we do, because the surveillance is even worse then.”

The economy in Venezuela is so poor, he added, that returning from his last vacation in Cuba he had to carry back laundry and bathroom soap and toothpaste.

“When we first got here, this was paradise. They had everything we did not have in Cuba. Today it’s exactly the opposite,” he said. “We came thinking we would help our families, and it turns out they are the ones helping us. If it were not for the money that my brother in Miami sends me, I don’t know what I would do.”

Several other medical professionals in Venezuela also said that authorities try to hide cases when the Cubans become the victims of crimes, even when they are killed.

“You can’t avoid being robbed, because everyone gets robbed here. A stray bullet, a thug who doesn’t like you, we run all those risks,” said another Cuban doctor who also asked for anonymity. “One day I was mugged by two children, no more than 12 years old. I had to give them all my money because the pistols they were playing with were real.”

The personal relations of the Cuban medical personnel are also watched.

“They warn you that it can go badly for you if you have relations with Venezuelan government critics,” the female doctor said. And although intimate relations with Venezuelans are formally forbidden, “people find a way.”

During the 13 years that Cuba has been sending medical personnel to Venezuela, more than 124,000 have served in the South American country. Thousands have escaped to the United States and other countries, searching for better lives.

For many years, like Rodríguez, the medical defectors were banned from returning to Cuba for eight years. Last year, Cuba announced the defectors could return and would be guaranteed “a job similar to what they had before.”

But there was a catch: Those who returned would need a special permit to travel abroad again.

Venezuela's President Maduro speaks with Cuba's President Castro during their meeting in Havana

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Cuba: Ministerio de Salud Publica, ANUARIO ESTADISTICO DE SALUD, 2015

Below is a link to Cuba’s newly published Anuario Estadistico de Salud, a comprehensive statistical picture of Cuba’s health record.

Anuario_Estadistico de Salud, Cuba, 2015

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CUBA REPORTS FIRST CASE OF ZIKA TRANSMITTED ON THE ISLAND

By MICHAEL WEISSENSTEIN, Associated Press, March 16, 2016

zzzzz2A female Aedes aegypti mosquito in the process of acquiring a blood meal from a human host.  Photo from the Center for Disease Control and Prevention (AP)

(AP) — Cuban officials announced Tuesday night that they have detected the first case of the Zika virus transmitted inside the country, ending Cuba’s status as one of the last nations in the hemisphere without domestic cases of the disease that has been linked to birth defects.

State media said a 21-year-old Havana woman who had not traveled outside Cuba was diagnosed with the virus after suffering headaches, fatigue and other symptoms. On Monday, her blood tested positive for Zika. She remains hospitalized.

Cuba had previously reported a handful of cases of the disease in people who had traveled to countries with outbreaks of the mosquito-borne virus, particularly Venezuela, and appeared to have contracted it there.

Cuba has close ties to Venezuela, a fellow socialist country that sends hundreds of millions of dollars a year in subsidized oil in exchange for Cuban medical assistance that sees many thousands of people travel between the two countries annually.

Zika is being investigated as a possible agent in cases of microcephaly, a condition in which babies are born with unusually small heads and brain damage, and also in cases of Guillain-Barre, a rare condition that sometimes results in temporary paralysis.

Cuba has thrown more than 9,000 soldiers, police and university students into an effort to fumigate for mosquitoes, wipe out the standing water where they breed and prevent a Zika epidemic.

President Raul Castro has called on the nation to battle lax fumigation and trash collection, turning the Zika fight into a test of the communist government’s once-legendary ability to marshal the entire country behind efforts ranging from civil defense to bigger sugar harvests to disease prevention.

In recent days the streets of Havana have been crisscrossed by teams of green-clad soldiers fumigating houses with mosquito-killing fog. Residents of the capital say fumigators no longer accept excuses of allergies or requests to spray some other day, as frequently happened in the past.

Still, neighborhoods like Central Havana, where the patient in Tuesday’s case lives, are filled with decaying buildings, piles of uncollected trash and pools of standing water.

The Zika announcement comes at a moment of intense international attention on Cuba: President Barack Obama arrives on Sunday as the first sitting U.S. president to visit in nearly 90 years. The Obama administration on Tuesday announced that it was carving a series of broad new exceptions into the U.S. trade embargo on Cuba, removing limits on individual travel that experts predicted would lead to a boom in U.S. visitors.

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