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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.

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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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Massive Displacement in DR Congo’s Ebola-Affected Ituri Province Poses Serious Health Hazard

At least 160 people were killed during renewed clashes early last month between Lendu farmers and Hema herders

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FILE - A woman and her children wait to receive Ebola vaccinations, in the village of Mabalako, in eastern Congo Monday, June 17, 2019. VOA

The International Organization for Migration warns massive displacement from renewed inter-ethnic fighting in DR Congo’s Ebola-affected Ituri province poses a serious health hazard.

At least 160 people were killed during renewed clashes early last month between Lendu farmers and Hema herders in Ituri province.  U.N. agencies report the violence has displaced hundreds of thousands of people and sent more than 7,500 refugees fleeing for their lives into neighboring Uganda.

The International Organization for Migration reports people who have fled the frontline of the conflict are living in abysmal conditions that create a fertile ground for the spread of disease, most worryingly Ebola.

The latest World Health Organization figures put the number of Ebola cases at 2,382, including 1,606 deaths.  The bulk of these cases and deaths are in conflict-ridden North Kivu province   About 10 percent are in Ituri.

DR Congo, Ebola, Health
The International Organization for Migration warns massive displacement from renewed inter-ethnic fighting. Pixabay

The inter-communal fighting has displaced an estimated 400,000 people.  IOM spokesman, Joel Millman, says his agency manages 12 displacement sites in Ituri’s Djugu Territory.  Thousands of people unable to cram into these overcrowded camps, he says, are sheltering in spontaneous sites.

“Poor hygiene conditions in displacement sites severely increase the risk that Ebola, as well as cholera, measles and acute respiratory diseases, will spread,” Millman said. “Many of these people are seeking assistance in Ebola-affected Bunia, where the displacement site officially called “General Hospital Site” has received more than 5,000 new Internally Displaced Persons, increasing the site’s population to 10,000 or twice its capacity.”

Millman says plans are underway to relocate many of the IDPs to a new improved settlement on land owned by Bunia’s Catholic Diocese.

He says IOM also is reinforcing its Ebola surveillance and disease prevention activities at Ituri’s Points of Entry at International borders.  Measures include hand washing, hygiene promotion, and screening travelers for possible Ebola infections.

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On June 11, the first case of Ebola spread across the border from DRC to Uganda.  A five-year old boy and his grandmother subsequently died from the deadly virus.

Millman says IOM is working to reduce disease transmission to new areas and across borders by expanding its preparedness measures to include Uganda, South Sudan and Burundi. (VOA)