Why Cuban doctors are on the coronavirus front line globally
It is a rarity these days for Cuba to receive much attention in the news. The days of the island being at the heart, even a symbol, of revolutionary fervor and superpower rivalry have long gone. However, every time there is a health crisis, this small Caribbean island distinguishes itself with selfless readiness to heed the call to arms, and sends its brigades of doctors and nurses to help those most in need, while the wealthiest countries can barely look after the health of their own people.
For those of us who regularly visit Cuba and have become familiar with the legacy of the revolution, the Cuban government’s decision to send hundreds of doctors to combat coronavirus not only to its neighbors, but to a total of 14 countries, including Italy and Andorra in Europe, came as no surprise. Neither did the country’s decision to allow a British cruise ship with five confirmed cases of coronavirus on board to dock near Havana after it had been turned away from multiple ports in the Caribbean and the US. Since the early 1960s, when Cuba sent its first medical mission to Algeria to replace French doctors who had left the North African country after it gained independence from France, medical help and humanitarian aid for the less fortunate have become part of Cuba’s DNA.
From the very early days of the “Barbudos” (the bearded) seizing power in 1959, Cuba’s two main paths to achieving social justice have been through investing in its education and health care systems. This comes from a deep conviction that a successful society requires universal education and health services, instead of these benefits being available only to those privileged enough to be able to pay for them. And, through the years, the expansion of medical internationalism has evolved from a universalist humanitarian ideology to also being a source of influential soft power — what became known as “doctor diplomacy” — and a major source of income for the country; bigger even than tourism or agriculture.
In its drive to improve the human condition, Cuba followed the thinking of one of the leaders of its revolution, Ernesto “Che” Guevara, an Argentinian physician who declared in the early days of the revolution that, “we must strive every day so that this love of living humanity is transformed into actual deeds, into acts that serve as examples, as a moving force.” In a speech to Cuban militiamen in 1960, Guevara reminisced about his travels throughout Latin America after his graduation (immortalized in “The Motorcycle Diaries”), when, as a young middle-class doctor, he became acquainted with “poverty, hunger and disease; with the inability to treat a child because of lack of money; with the stupefaction provoked by the continual hunger and punishment, to the point that a father can accept the loss of a son as an unimportant accident, as occurs often in the downtrodden classes of our American homeland.” This led him to leave the medical profession and become a revolutionary and, on reaching a position of power, to advance the cause of medical internationalism together with Fidel and Raul Castro and his other comrades.
Cuba currently has about 50,000 doctors operating in 67 countries — many in Latin America and Africa. This is a staggering number and means there are more Cuban doctors working abroad than from all G7 nations combined, even though the country’s population is only 11.4 million. This comes with a financial reward, which, according to some estimates, is about $6 billion a year. For a country on the receiving end of harsh punitive sanctions from the US, such an income stream, especially of hard currency, is a lifeline. But it is far from the sole reason for Cuba maintaining its international brigades in white. Moreover, from a diplomatic perspective, providing medical help to the developing world has helped to ease years of pressure by consecutive US administrations that have attempted to destroy Cuba’s revolution. There has always been an element of defiance of the US in Cuba’s medical diplomacy, while its domestic health care system stands diametrically opposed to the American model that neglects those who can’t afford to pay for medical insurance.
Cuba’s drive to improve the health of the world’s underprivileged is complemented by its provision of free training for medical students — including their accommodation and subsistence. Students come from more than 100 countries, chiefly in Africa, Asia and Latin America, as well as from disadvantaged neighborhoods in the US. Two years ago, during a visit to a hospital in Santa Clara, I met, among others, two Palestinian medical students, one from Ramallah in the West Bank and one from the Gaza Strip. They had arrived in Cuba with no Spanish but soon became fluent, and were by then preparing to return to the Occupied Territories to serve their people.
Part of the current US campaign to reverse the rapprochement between Washington and Havana that took place during the Obama administration involves vehemently criticizing what the Trump White House calls the “exploitation” of Cuban medical workers by their government. The State Department tweeted last month that the Cuban government “keeps most of the salary its doctors and nurses earn while serving in its international medical missions while exposing them to egregious labor conditions.” It is legitimate to question how much of what the Cuban government receives from its medical missions finds its way into the pockets of the doctors and nurses themselves, but the US tweet reflects both the hypocrisy and the ignorance of an administration that is making a complete shambles of containing the coronavirus in its own country, while doing nothing to help others.
There has always been an element of defiance of the US in Cuba’s medical diplomacy.
In Cuba, unlike the US, there are no tuition fees for locals at any level of education, and virtually no homelessness, even if living conditions are very modest. And, as for the working conditions, Cuban health workers are certainly prepared to work in the most remote and difficult conditions because that is exactly what Cuba’s revolution has taught them. Hence, it was Cuban medical teams that led the relief mission in Haiti after the 2010 earthquake, and were later in West Africa dealing with the 2014 Ebola crisis.
If the late Fidel Castro were able to witness the US criticism of Cuba’s medical internationalism, he would probably repeat what he said to the judges in his 1953 trial before being sentenced to 15 years’ jail: “History will absolve me.”
- Yossi Mekelberg is professor of international relations at Regent’s University London, where he is head of the International Relations and Social Sciences Program. He is also an associate fellow of the MENA Program at Chatham House. He is a regular contributor to the international written and electronic media. Twitter: @YMekelberg