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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
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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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Green Groups In Brazil Prepare A Climate Change Plan

A Brazilian version would draw on linkages between about 150 civil society groups who worked closely over the last year to oppose Bolsonaro's campaign

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Brazil, rainforests
This photo released by the Brazilian Environmental and Renewable Natural Resources Institute (Ibama) shows an illegally deforested area on Pirititi indigenous lands as Ibama agents inspect Roraima state in Brazil's Amazon basin. VOA

With its wooden walls and posters on protecting forests and fauna, Brazil’s pavilion at the U.N. climate talks in Poland offers no hint of the angst at home and abroad over mixed messages on global warming from its president-elect.

But campaign promises made by Jair Bolsonaro that could weaken protection for the Amazon rainforest are a hot topic of conversation among visitors, said Caio Henrique Scarmocin, one of three hosts on the stand.

At the conference, whose outcome will be key to implementing the landmark 2015 Paris Agreement on climate change, scientists and environmental activists said they were laying the groundwork should calls for Bolsonaro to protect Brazil’s forests fail.

Campaign statements from Bolsonaro, who takes power in January, suggested indigenous lands could be opened up to economic exploitation, including agribusiness and mining, and environmental fines eased.

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Brazil’s President-elect Jair Bolsonaro arrives for a meeting in Brasilia. VOA

The ability of Ibama, Brazil’s environmental protection agency, to fine those who break environmental laws is one of the government’s best defenses against the destruction of forests, stoking fears of a deforestation spike under the new government.

Bolsonaro, who campaigned on a far-right platform, also pushed the Brazilian government to withdraw its offer to host next year’s U.N. climate conference.

“He has a hostile approach over environmental issues,” said Paulo Barreto, a researcher with Imazon, a Brazilian institute monitoring deforestation in the Amazon.

Brazil is home to about 60 percent of the Amazon rainforest, considered by many as nature’s best weapon against global warming, because trees absorb and store carbon from the air.

Alfredo Sirkis, executive secretary of the Brazilian Forum on Climate Change, said he thought dialogue with the incoming government was still possible.

Rainforest, Brazil
In this May 4, 2018 photo released by Ibama, the Brazilian Environmental and Renewable Natural Resources Institute, members of a specialized inspection group of Ibama walk with their weapons up through an area affected by illegal mining, after landing in helicopters in Munduruku indigenous lands in Para state in Brazil’s Amazon basin. VOA

But if environmental roll-backs proceed, there was a “contingency plan,” he told journalists.

A coalition would assemble regional governments committed to respecting Brazil’s emissions reduction goals set under the Paris pact, said Sirkis.

Governors in as many as seven Brazilian states, including Amazonas, Pernambuco, the Federal District, Espirito Santo, Parana and Rio Grande do Sul, had already expressed interest in joining, he said.

“This is for starters,” said the former congressman.

A spokesman for the presidency of Brazil at the climate talks declined to comment.

U.S. shows the way

The plan has similarities with “We Are Still In,” a U.S. group of more than 3,500 mayors, governors and business leaders who have promised they will not retreat from the Paris deal.

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

Last year, U.S. President Donald Trump gave notice the United States would leave the accord — although it cannot formally withdraw until 2020 — arguing it was bad for the economy.

Mauricio Voivodic, executive director of WWF-Brazil, said his group had been in touch with the U.S. campaign through WWF-US, which is part of the “We Are Still In” secretariat.

The American coalition has its own pavilion at the U.N. climate talks.

“We are learning from ‘We Are Still In’ the importance of sub-national (governments) and companies enhancing commitments for the implementation of the Paris Agreement,” Voivodic said.

But WWF-Brazil is not yet trying to emulate the model because it wants to prioritize dialogue already under way with the transition government, he added.

“It could be an option, but we are not going in the direction of starting planning this,” said Voivodic.

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Brazil Surpasses 2020 Target to Cut Deforestation Emissions. Flickr

Brazil’s future environment minister told Reuters on Monday his “inclination” was not to leave the Paris Agreement, after Bolsonaro said on the campaign trail he might quit the deal, under which countries set their own targets to cut emissions.

Marcio Astrini, public policy coordinator for Greenpeace Brazil, said he also looked to the United States as a vague blueprint to build a similar “resistance movement.”

A Brazilian version would draw on linkages between about 150 civil society groups who worked closely over the last year to oppose Bolsonaro’s campaign, he said.

Also Read: Many Countries Refused To Endorse Landmark Study as Climate Conference Enters Second Week

Also mirroring tactics used in the United States, his group does not exclude filing lawsuits to push back against potential weakening of environmental and climate regulations in Brazil.

“It’s on the table,” he said, adding that it was still a last-resort option. (VOA)