♠ Posted by Emmanuel in
Health,
Latin America,
Socialism
at 9/04/2013 01:29:00 PM
A longstanding fixture of Cuba's outreach has been sending physicians to fellow Latin American nations. Witness the still-ongoing Venezuela-Cuba oil-for-doctors
scheme: 90,000 barrels per day for 30,000 doctors. Despite its proto-communist economy being in shambles for decades now, Cuba still retains a reputation for training physicians--in quantity if not necessarily in quality. With a surplus of them at home and a perpetual shortage of foreign exchange, it was perhaps inevitable that they became one of the island nation's top exports. TIME talks about the current
controversies over Cuban doctor exports to Brazil and the differentials in terms of physicians to population:
According to the World Health Organization (WHO), Brazil — despite its
recent economic boom and constitutional guarantee of universal health care
— has only 1.8 doctors per 1,000 people. (Cuba, despite its endless
economic bust, has 6.7.) Almost two-thirds of all health care spending
in Brazil is private, even though three-fourths of the population
depends on public medical services.
Coming from a self-styled worker's paradise, what exactly is in it for the Cuban physicians working in Brazil? Unfortunately, it appears the ratio of wages paid to these doctors relative to Cuba's remuneration from host states is very low:
But Cuba’s medical-diplomacy mission, which currently has 40,000 doctors
serving abroad and brings the Cuban government some $6 billion a year
(of which the doctors themselves get only a tiny fraction), is a fixture
in the third world, and was generally praised for its work in Haiti
after the 2010 earthquake. And it points up the fact that Brazil’s
problems are hardly unique. In fact, six of Latin America’s seven
largest economies have two or fewer doctors per 1,000 people. (The
exception is Argentina, which has 3.2.)
The
Havana Times complains about this opaqueness over how much Cuba receives relative to what the physicians do:
In different comments, we read of “new slaves”, that the Cuban State
is a kind of “foreman” and that Cuban doctors are “sheep” denied the
right to demand their rights, individuals subjected to that which Jose
Marti, when writing of a certain form of socialism much spoken of in his
time, called “modern slavery.” Unfortunately, I do not know how much money will be paid directly to
the doctors under the agreement entered into with the pertinent agencies
of Cuba’s Ministry of Public Health. Our local and biased press has not
published this detail, and we will have to find out from the doctors
themselves [...]
It is both just and necessary for the Cuban State to take in a
reasonable part of the money paid by Brazil, in order to re-invest it in
Cuba’s public health programs. This money represents investments in
many areas, including the country’s educational system, capable of
creating a highly qualified labor force. It is also both just and necessary to respect the individual rights
of our medical professionals, to pay them a percentage of the earnings
that will guarantee their professional and personal dignity, as well as
that of their families (without which they will not be able to practice
their profession adequately).
What we need is transparency, on the basis of broader democratic,
socialist concepts, throughout the selection, hiring and other processes
related to the work of our professionals beyond Cuban borders. If Cuban doctors working in Brazil, for instance, were entitled to
openly discuss their payment conditions and to arrive at an agreement
with public health authorities that isn’t simply imposed on them, then
we would be wrong to speak of any kind of slavery.
Call it Transparency, ah,
Internationale. I too would love to know exactly what these Cuban physicians earn relative to the amount of treatment they give to better calculate the
rate of exploitation, but alas, the Cuban government is perhaps not the best model of public transparency [!?] Rest assured though that economic necessity drives this increasingly controversial trade.
