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: 11/16/18; A 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).