Disruption in Cuban Medical Mission to Brazil

On November 14,  Cuba’s Ministry of Public Health stated that the island was ‘discontinuing’ its participation in the Program Mais Médicos, or More Doctors, in Brazil. [1]

In response to this Cuban move, a well-known Brazilian lawyer presented an appeal to Brazil’s Supreme Court requesting a “habeas corpus” so that the 8,332 Cuban doctors currently working in  Brazil and were summoned back to their country can remain in their positions as asylees or as permanent residents. The attorney also asserted that even though the Brazil-Cuba agreement for this program barred Brazil from granting the Cuban doctors political asylum or permanent visas, Cuba’s unilateral termination of the program also terminated the ban on granting such relief to the Cuban doctors.

Cuba has received more than $249.5 million a year for its doctors in Brazil, according to a researcher interviewed by the Miami Herald. The elimination of this revenue for Cuba will have a huge negative impact on Cuba’s economy and finances. Just one such problem is Brazil’s demand for Cuba to pay the arrears it owes Brazil for the $680 million loan it provided for the development of the port of Mariel near Havana. Cuba already is $71.2 million in arrears, according to Brazil’s National Bank for Economic and Social Development.

This current set of disputes was predicted by Brazil’s recent presidential campaign when then-candidate Jair Bolsonaro raised questions about the quality of the Cuban doctors’ training and said the doctors would have to prove their medical credentials by getting their diplomas validated in Brazil, a process that has previously been waived for Cuban doctors. He also criticized the Cuban government’s keeping around 75 percent of their salaries paid by Brazil even though the doctors earn more in Brazil than they did on the island. [2]

Another criticism by Bolsonaro was the employment contract between Cuba’s Ministry of Public Health and the Cuban doctors, in which the doctors are banned from having family accompanying them during their mission. In addition, Bolsonaro said his government would offer asylum to Cuban doctors who wished to stay in Brazil.

The Program was launched by former Brazilian President Dilma Rousseff to send Cuban physicians to underserved regions in the South American country and was arranged by the Pan American Health Organization (PAHO). the New York Times reports. Around 20,000 Cuban doctors have worked in Brazil in the span of five years. By the end of 2017 there were Cuban health workers in 64 countries, with Brazil and Venezuela as the main destinations.

The current horrible living conditions in Venezuela has caused many of the Cuban doctors serving there to try to escape to other countries.[3]

Impact on Cuban Health Care[4]

Meanwhile back in Cuba there are reports that its “export” of medical doctors to other countries, including Brazil and Venezuela, has caused a significant reduction in the number of health professionals providing primary care on the island. For example, In 2010 the number of doctors assigned to Family Clinics was 36,478, while in 2017 there were only 13,131; that is, a 64% drop in less than a decade. The result of this imbalance is a sharp decrease in health personnel in Cuba, the closure of infrastructures, a reduction in the number of hospital beds, shortages at pharmacies, and an increase in diseases related to deficient health conditions.

Conclusion

Those of us in the U.S. who want to see both Cuba and Brazil succeed will need to keep watch on this situation and try to assess the merits of the two countries’ arguments and claims.

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[1] Center for Democracy in Americas, Cuba Central News Brief: 11/16/18A lawyer asks the Supreme [Court of Brazil] for guarantees of permanence for Cuban doctors, Diario de Cuba (Nov. 18, 2018).

[2] The U.S. has alleged that the Cuban medical professionals on foreign missions are engaged in illegal forced labor due to their not receiving the total payments by foreign governments for their services. This blog, however, has rejected that U.S. claim for various reasons. (See U.S. State Department Unjustly Continues To Allege That Cuba’s Foreign Medical Missions Engage in Forced Labor, dwkcommentaries.com (Aug. 17, 2017).

[3] See  Cuban Medical Professionals Continue To Escape from Foreign Medical Missions, dwkcommentaries.com (Mar. 15, 2018).

[4] Fernández & Diaz Ezpí,  23,000 Fewer Doctors: A Raw Deal for Cubans, Diario de Cuba (Nov. 12, 2018); More doctors for Maduro: bleeding into the Cuban primary health system continues, Diario de Cuba (Nov. 12, 2018).

The Non-Aligned Movement Holds Summit in Venezuela

On September 17 in Venezuela Raúl Castro addressed the Summit of the Non-Aligned Movement (NAM), an organization of 120 states that advocates for solutions to global economic and other problems.[1] We will review that speech and the Summit’s concluding Declaration before making observations about this event.

Castro’s Speech

For Cuba, he said, “non – alignment means the struggle to radically change the international economic order imposed by the great powers, which has led to 360 people possessing a higher income than 45% of the world population annual wealth. The gap between rich and poor countries is growing. Technology transfer from North to South is an elusive aspiration.”

“Globalization mainly favors a select group of industrialized countries. The debt of southern countries multiplies. . . . [Mamy] people are pushed into unemployment and extreme poverty; millions [of] children die each year from hunger and preventable diseases; almost 800 million people cannot read or write, while more than 1.7 [billion] dollars are devoted to military spending.”

Castro reported that it has been “21 months since we announced simultaneously with President Barack Obama, the decision to restore diplomatic relations between Cuba and the United States.”

“There has been some progress, especially in the diplomatic arena and cooperation on issues of mutual interest, but has not been the same in the economic and commercial sphere, due to the limited scope, while positive, of the measures taken so far by the American government.”

“Cuba will continue to demand the lifting of the economic, commercial and financial blockade that [had caused] much damage and deprivation to Cuba and that also affects many countries for its extraterritorial scope.” Cuba also “will continue to demand that our sovereignty is returned to the territory illegally occupied by the US Naval Base in Guantanamo. Without [these and other changes by the U.S.] there can be no normal relations [between the two countries].”

Nevertheless, “we reaffirm the will to sustain civilized coexistence relations with the United States, but Cuba will not give up one of its principles, or . . . make concessions inherent in its sovereignty and independence. It will not relent in defending their revolutionary and anti-imperialist ideals, [or] in supporting self-determination of peoples.”

Castro also rejected any attempts to “regime change” and reaffirmed rejection of any country’s “resorting to aggression and use of force,” and “commitment to the principles of the United Nations Charter and International law; [to peaceful resolution of disputes] and full respect for the inalienable right of every state to choose its political, economic, social and cultural system as an essential condition to ensure coexistence among nations.”

More specifically Castro reaffirmed (a) Cuba’s “unconditional support for the government and Venezuelan people, the civil-military union and the constitutional President Nicolas Maduro Moros;” (b) Cuba’s rejection of the parliamentary “coup” in Brazil against President Dilma Rousseff; (c) Cuba’s support of Colombia’s “implementing the Agreement” with the FARQ; (d) Cuba’s support of “the people of the Syrian Arab Republic resolving their “without external interference aimed at promoting regime change, . . . “the creation of an independent Palestinian state with East Jerusalem as its capital, . . . the self-determination of the Saharawi people, . . . the historical demand of the Puerto Rican people towards self-determination and independence, . . . [and] the claim of Argentina over the Falkland Islands, South Sandwich and South Georgia;” and (e) Cuba’s congratulations to “the Islamic Republic of Iran for his work in the recently concluded mandate.”

Castro’s concluded with this assertion: “The only alternative to the enormous dangers and challenges ahead is unity and solidarity in defense of our common goals and interests.”

Summit’s Declaration[2]

The Summit’s Declaration concluded with a 21-point statement of NAM objectives: (1) consolidate and revitalize NAM; (2) consolidation of the international order; (3) the right to self-determination; (4) disarmament and international security; (5) human rights; (6) condemnation of unilateral sanctions; (7) condemnation of terrorism; (8) dialogue among civilizations; (9) support for Palestine; (10) reform of the U.N. Security Council and General assembly; (11) selection and appointment of new U.N. Secretary-General; (12) U.N. peace-keeping operations; (13) sustainable development goals; (14) promotion of education, science and technology for development; (15) climate change; (16) reforming the international economic governance; (17) South-South cooperation (18) international solidarity in combatting pandemics; (19) support for refugees and migrants; (20) young women, peace and security; and (21) new world order of information and communication.

Conclusion

These words of Raúl Castro were nothing new.

The real news from the NAM Summit was the low turn-out. Of the 120 NAM members only 13 attended, including the leaders of Cuba, Iran, Palestine, Ecuador, Bolivia and Zimbabwe and the Venezuelan host.

Venezuela’s President Nicolas Maduro called the meeting as an opportunity to increase international solidarity for his socialist government as the oil-dependent economy reels from widespread food shortages and triple digit inflation. However, according to observers, the low attendance indicates that almost all of the NAM members were not interested in engaging in such solidarity with this country under these circumstances.[3]

Nevertheless, Maduro spoke defiantly at the Summit about Venezuela’s problems, blaming them on the country’s foreign enemies. “Venezuela is facing a global attack, which is against all of Latin America and Caribbean. An attack that aims to impose a political, economic and cultural reorganization of our countries with the old oligarchy.”

As repeatedly stated, this blog concurs that the U.S. should end its embargo (blockade) of Cuba and that the peace agreement between the government of Colombia and the FARQ is to be applauded and hopefully will be approved in the October 2 referendum in that country. I also agree that Cuba and the other NAM members have the right to organize and advocate their many other positions.This blog, however, disagrees with Cuba’s allegation that the U.S. is illegally occupying Guantanamo Bay.

Finally soon after the NAM Summit,  President Maduro met with U.S. Secretary of State John Kerry when both were in Cartagena Colombia for the signing of the Colombia-FARQ peace agreement. The next day on his regular television show in his country, Maduro, mentioning his 40-minute meeting with Kerry, said, “I ask that God bless the results of the meeting [with Kerry] and that Venezuela opens a new era of relations with the United States.” He also said that veteran U.S. diplomat Tom Shannon, who has been the U.S. point man for the troubled relationship, will visit Caracas again soon and that an invitation was open to Kerry.[4]

The U.S. State Department, acknowledging the meeting, said, “The Secretary expressed our commitment to the well-being of the Venezuelan people, and our willingness to work with all sectors of Venezuelan society to enhance our relationship. He also spoke of our concern about the economic and political challenges that have affected millions of Venezuelans, and he urged President Maduro to work constructively with opposition leaders to address these challenges.” In addition, the Department said that “Kerry stressed our support for democratic solutions reached through dialogue and compromise” and that the two men “agreed to continue the bilateral discussions begun in recent months.”[5]

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[1] Castro, The only alternatives to the enormous dangers and challenges is unity and solidarity, Granma (Sept. 17, 2016).

[2] Declaration of the XVII Summit of Heads of State and Government of the Non-Aligned Movement (NAM), Granma (Sept. 18, 2016).

[3] Assoc. Press, Venezuela’s Crisis Keeps Non-Aligned Summit Turnout Low, N.Y. Times (Sept. 17, 2016); Reuters, Venezuela Summit Draws Few Leaders in Blow to Maduro, N.Y. Times (Sept. 17, 2016); Reuters, Maduro Revels in Support From Zimbabwe, Iran as Critics Decry Failed Summit, N.Y. Times (Sept. 19, 2016);  Castro, Venezuela closes the summit of non-aligned countries amid criticism, El Pais (Sept. 18, 2016).

[4] Reuters, Venezuela’s Maduro Calls for New Era of Relations With U.S., N.Y.Times (Sept. 27, 2016).

[5] U.S. State Dep’t, Secretary Kerry’s Meeting with Venezuelan President Maduro (Sept. 26, 2016).