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Brazillians at a Disadvantage Due To Loss Of Cuban Doctors

The former health minister said the doctors were not only highly qualified, but specialists in rural medicine, something that Brazil's health system badly lacks.

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Brazil, cuban doctors
Foreign physicians — mainly Cuban — arrive at the University of Brasilia for a meeting with the Brazilian Health Minister, in Brasilia on Aug. 26, 2013. The Brazilian government hired thousands of foreign doctors due to the lack of medical professionals. VOA

Millions of Brazilians may be left without access to doctors due to the end of a program that brought Cuban physicians to rural and dangerous areas in Brazil, the former health minister who helped create the initiative said Thursday.

The Cuban government on Wednesday said it would end the program after Brazilian President-elect Jair Bolsonaro said it could only continue if several conditions were met

Bolsonaro, a former army captain, campaigned in part on promises to take a hard line against left-leaning governments. As a congressman, the far-right leader often complained about the Cuban doctors’ program and tried to end it.

In a phone interview, former Health Minister Alexandre Padilha said the decision to pull out would leave millions of Brazilians without access to doctors.

Padilha said Cuban doctors were in 2,800 cities and towns — and they were the only doctors in 1,700 of those towns. Padilha said the initiative was launched in 2013 because local doctors could not be found for many positions.

Brazil, cuban doctors
Brazil’s President-elect Jair Bolsonaro talks to the media, in Brasilia, Brazil. VOA

“This will have an immediate and terrible impact on the health care system,” said Padilha. “Cuban doctors are in the most vulnerable areas. They are in the Amazon, rural towns and in slums.”

Brazil, which includes the largest portion of the Amazon basin, is a vast country, a little bit larger than the continental United States. Many areas, particularly in the Amazon and historically poor Northeast region, are sparsely populated and lacking basic infrastructure.

After Cuba’s announcement Wednesday, Bolsonaro made a blistering critique of the program. Frequently referring to the Cuban government as a “dictatorship,” he said the program was “slave work” because the Cuban government keeps 70 percent of doctors’ salaries. He also said Brazil had no way to verify if the doctors were truly qualified.

Neither Bolsonaro nor the Cuban government has said when the estimated 8,500 Cuban doctors currently in Brazil would be leaving. Bolsonaro said Cuban doctors who asked for asylum would get it, though he stopped short of saying Brazil would provide that to any Cuban who asked.

Brazil, Cuban doctors
In this Aug. 30, 2013 file photo, Cuban doctors observe a dental procedure during a a training session at a health clinic in Brasilia, Brazil. VOA

Bolsonaro, who takes office Jan. 1, said he had signaled the program could only continue if doctors directly received their salaries from Brazil, were able to bring their families during their assignments and had their credentials verified.

“We have no proof that they are really doctors and able to take on these functions,” Bolsonaro said.

Padilha said the program, passed by Congress, already includes an evaluation of the doctors’ credentials and language training; Brazil’s national language is Portuguese and Cuba’s is Spanish.

Also Read: Spix’s Macaw Parrot from Brazil Is Now Extinct

The former health minister said the doctors were not only highly qualified, but specialists in rural medicine, something that Brazil’s health system badly lacks. He said the salary structure was something the Cuban government had worked out with more than 60 countries that participate in the program, and not something specific to Brazil.

“Bolsonaro doesn’t understand that a doctor doesn’t just practice medicine for money,” said Padilha. “Doctors who work in the poorest areas are not just thinking about money.” (VOA)

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New York City’s Mandatory Measles Vaccination Order Stands Still

The health department's lawyers argued that quarantining was ineffective because people carrying the virus can be contagious before symptoms appear.

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Materials are seen left at demonstration by people opposed to childhood vaccination after officials in Rockland County, a New York City suburb, banned children not vaccinated against measles from public spaces. VOA

Brooklyn judge on Thursday ruled against a group of parents who challenged New York City’s recently imposed mandatory measles vaccination order, rejecting their arguments that the city’s public health authority exceeded its authority.

In a six-page decision rendered hours after a hearing on the matter, Judge Lawrence Knipel denied the parents’ petition seeking to lift the vaccination order, imposed last week to stem the worst measles outbreak to hit the city since 1991.

The judge sided with municipal health officials who defended the order as a rare but necessary step to contain a surge in the highly contagious disease that has infected at least 329 people so far, most of them children from Orthodox Jewish communities in the borough of Brooklyn.

Another 222 cases have been diagnosed elsewhere in New York state, mostly in a predominantly ultra-Orthodox Jewish neighborhood of Rockland County, northwest of Manhattan.

The New York outbreaks are part of a larger resurgence of measles across the country, with at least 555 cases confirmed in 20 states, according to the U.S. Centers for Disease Control and Prevention.

Health experts say the virus, which can cause severe complications and even death, has spread mostly among school-age children whose parents declined to get them vaccinated. Most profess philosophical or religious reasons, or cite concerns — debunked by medical science — that the three-way measles-mumps-rubella (MMR) vaccine may cause autism.

The judge rejected the parents’ contention that the vaccination order was excessive or coercive, noting it does not call for forcibly administering the vaccine to those who refuse it.

He also dismissed assertions in the petition disputing the “clear and present danger” of the outbreak. “Vaccination is known to extinguish the fire of contagion,” the judge said.

FILE PHOTO: A sign warning people of measles in the ultra-Orthodox Jewish community of Williamsburg in New York City, April 11, 2019.
A sign warning people of measles in the ultra-Orthodox Jewish community of Williamsburg in New York City, April 11, 2019. VOA

Secret identities

The vaccination order, which was extended this week, requires residents of certain affected Brooklyn neighborhoods to obtain the MMR vaccine unless they can otherwise demonstrate immunity to measles, or face a fine.

The court challenge was brought in Brooklyn’s Supreme Court by five people identified only as parents living in the affected neighborhoods. Their identities were kept confidential to protect their children’s’ privacy, their lawyers said.

In court on Thursday, they told Knipel the city had overstepped its authority and that quarantining the infected would be a preferable approach.

Robert Krakow, an attorney for the parents, estimated that just 0.0006 percent of the population of Brooklyn and Queens had measles. “That’s not an epidemic,” he said. “It’s not Ebola. It’s not smallpox.”

The health department’s lawyers argued that quarantining was ineffective because people carrying the virus can be contagious before symptoms appear.

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The vaccination order, which was extended this week, requires residents of certain affected Brooklyn neighborhoods to obtain the MMR vaccine unless they can otherwise demonstrate immunity to measles, or face a fine. Pixabay

The judge cited 39 cases diagnosed in Michigan that have been traced to an individual traveling from the Williamsburg community at the epicenter of Brooklyn’s outbreak.

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The surge in measles there originated with an unvaccinated child who became infected on a visit to Israel, where the highly contagious virus is also running rampant.

The number of measles cases worldwide nearly quadrupled in the first quarter of 2019 to 112,163 compared with the same period last year, the World Health Organization said this week. (VOA)