News / Health

Cuban Doctors Tend to Brazil's Poor, Boost Rousseff's Popularity

A group of Cuban doctors attend a training session at a health clinic in a low-income neighborhood in Brasilia, Brazil, Friday, Aug. 30, 2013.
A group of Cuban doctors attend a training session at a health clinic in a low-income neighborhood in Brasilia, Brazil, Friday, Aug. 30, 2013.
TEXT SIZE - +
Reuters
— They were heckled and called slaves of a communist state when they first landed, but in the poorest corners of Brazil, the arrival of 5,400 Cuban doctors is being welcomed as a godsend.
 
The program to fill gaps in the national health system with foreign doctors, mainly from Cuba, could become a big vote-winner for President Dilma Rousseff as she eyes a second term in next year's election, despite fierce opposition from Brazil's medical class.
 
The move to tap Cuba's doctors-for-export program, begun by former leader Fidel Castro, became a priority for Rousseff after massive protests against corruption and shoddy public transport, education and healthcare services rocked Brazil in June.
 
Within weeks she launched a program known as “More Doctors” to hire foreign physicians. Brasilia signed a three-year contract to bring thousands of Cuban doctors to work in poor and remote areas where Brazilian physicians prefer not to practice.
 
Under an agreement that will earn cash-strapped Cuba some $225 million a year, Cuban doctors have been deployed to health centers in the slums of Brazilian cities and villages across the drought-stricken northeast that had no resident doctors. Bahia state is reopening rural health centers that were unstaffed.
 
Inhabitants of Jiquitaia, a hamlet surrounded by cacti, goats and famished cattle in Bahia's interior, no longer have to travel 30 miles on a dirt road to see a physician.
 
“This is a gift of God,” said farm worker Deusdete Bispo Pereira after he was seen for chest pains by Dania Alvero, a doctor from Santa Clara, Cuba. “Everyone is happy she is here. We're afraid she will be sent away,” he said.
 
Elderly residents and pregnant women crowded into the family health center waiting for a check up with Alvero, who like many Cuban doctors is an expert in preventive medicine.
 
“There are illnesses here that I had only read about in books, like leprosy, which no longer exists in Cuba,” she said, mixing Spanish and Portuguese words.
 
Doctors for Rent
 
Cuba has sent doctors abroad for decades to help developing countries for ideological reasons, using medical workers as revolutionary foot soldiers on the Cold War chessboard. Cuban MDs were sent near and far, in countries including Algeria, Ethiopia, Angola and Nicaragua.
 
Plunged into economic crisis after the Soviet Union collapsed, Castro devised a doctors-for-oil scheme with the late Venezuelan leader Hugo Chavez in 2000.
 
The so-called Barrio Adentro plan, in which more than 30,000 Cubans work in healthcare in dirt-poor shantytowns ringing Caracas and other cities, earned Chavez loads of political goodwill among the Venezuelan populace and was paid for with preferential oil shipments to Cuba.
 
Even though most of the income goes to the Cuban government, Cuban doctors are delighted to go abroad because they can earn much more than they are paid at home, where doctors' salaries max out at the equivalent of $50 a month.
 
“We don't get paid much, but we are not here for the money. We are here to help our country, which is poor,” said Lisset Brown, who works at a neighborhood health center in Ceilandia, the largest slum ringing the Brazilian capital of Brasilia.
 
The arrival of 12 Cuban physicians has relieved the overburdened Ceilandia hospital and improved the credibility of the public health system, said Brazilian nurse Tania Ribeiro Mendoneca. “People see the government is doing something.”
 
Today, Cuba has doctors to spare. According to the World Bank, it has the world's highest number of doctors in proportion to population: 6.7 per 1,000 people, compared to 1.8 in Brazil, though that ratio rises to 4 per 1,000 in cities where Brazilian doctors prefer to work, such as Sao Paulo and Rio de Janeiro.
 
Medical Uproar
 
Brazilian doctors initially tried to stop the arrival of foreign colleagues, which they saw as an attempt to undermine their professional interests and medical standards.
 
When an early contingent of Cubans arrived at Fortaleza airport in northern Brazil in August, angry Brazilian doctors shouted “Slaves!” at them.
 
However, they have been forced to tone down their criticism; opinion polls show that a vast majority of Brazilians favor hiring foreigners when local doctors are unavailable, even though doubts remain about the qualifications of the Cubans.
 
One poll in November showed that 84.3 percent of those surveyed backed the Mais MDedicos, as the program to hire Cuban doctors is known, though only 66 percent thought the foreign doctors were qualified to do the job.
 
“We are not opposed to foreign doctors working here. They can come from Russia, England, Cuba or Bolivia but their degrees must be evaluated and the government is not doing that,” said Florentino Cardoso, head of the Brazilian Medical Association.
 
Cardoso, a cancer surgeon, complained that Rousseff has “demonized” Brazilian doctors by associating them with the many shortcomings of Brazil's healthcare system. Putting more doctors in outlying areas, he said, will not end lines for underfunded medical services in the cities.
 
To allow foreign doctors to work in Brazil, Rousseff rushed through legislation allowing them to practice for three years without getting their degrees validated by local authorities, a cumbersome process that can take years. The law, however, says they can only work in basic healthcare services.
 
Meager Wages
 
Having lost that battle, Brazilian doctors are now focusing their criticism on what they call unfair treatment of their Cuban colleagues.
 
Unlike doctors of other nationalities, the Cubans cannot bring their families to Brazil, which opponents of the Cuban government say is to ensure that they return home.
 
The Cubans get only a fraction of the 10,000 reais (US$4,300) a month that Brazil pays for each physician in the program.
 
Municipal health officials in Bahia said they provide free board and lodging to the Cubans, who get paid 800 reais a month in cash. An additional 1,200 reais is paid to their families in Cuba, while 8,000 reais goes to the Cuban government through the Pan-American Health Organization.
 
While other foreign doctors can apply to work elsewhere in Brazil after their three years are up, the Cubans have to either go home or sign up for another stint with the program.
 
“We abolished slavery long ago, but this looks awfully similar. It's not the best way to go about improving healthcare in Brazil,” said Eleuses Paiva, a physician and congressman from a party that backs Rousseff's coalition government.
 
2014 Elections
 
Barely four months off the ground, the program is earning handy political kudos for Rousseff, who can point to the program as an example of her quick response to June's protests, when more than one million Brazilians took to the streets to vent their anger over inadequate public services that burn up taxpayer money and are infamous for long lines and waiting lists.
 
The program is a quick fix that might take time to show results in Brazil's health statistics, but Rousseff's campaign next year would receive a boost if she can, for example, tout a decline in infant mortality in the poorest parts of the country.
 
It could also help Health Minister Alexander Padilha, the program's chief architect, get elected governor of Sao Paulo, Brazil's wealthiest and most populous state.
 
“This is a big plus for her reelection. The polls show there is very high approval ratings for the program,” said David Fleischer, professor of politics at the University of Brasilia.
 
The program has been so successful that Rousseff's rivals are copying it. In Sao Paulo, a political stronghold of Brazil's main opposition party, the PSDB, the government is sending doctors to tend to the poor in the interior of the state.
 
For Dr. Paiva, the congressman, the program is an election campaign strategy more than a healthcare program. “The Cubans will inevitably work for Rousseff's reelection, funded with taxpayer money,” he complained.
 
In the northeast of Brazil, Cuban doctors are indeed winning hearts and votes for Rousseff.
 
“They are humble and look you in the eyes, which Brazilian doctors don't do,” said Angelo Ricardo, as he brought his ageing father to a health center in the Bahian town of Remanso. “Brazil needed this... I'll vote for her, no question.”

You May Like

Multimedia Anti-Keystone XL Protests Continue

Demonstrators are worried about pipeline's effect on climate change, their traditional way of life, health and safety More

Thailand's Political Power Struggle Continues

Court gave Prime Minister Yingluck Shinawatra until May 2 to prepare her defense over abuse of power charges but uncertainty remains over election timing More

Malaysia Plane Search Tests Limits of Ocean Mapping Technology

Expert tells VOA existing equipment’s maximum operating depth is around 6 kilometers as operation continues on ocean bed for any trace of MH370 More

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
Pet Kangaroo Helps Spread Environmental Messagei
X
Penelope Poulou
April 22, 2014 5:53 PM
Children’s author Julia Heckathorn travels the world to learn about different ecosystems and endangered animals. She pours her knowledge into children’s books, hoping the next generation will right the environmental wrongs of our times. As in many children's books, the main character in Heckathorn's stories is an animal. Unlike those other characters, though, this one is real - a kangaroo, that lives in the author’s backyard. VOA’s Penelope Poulou has more.
Video

Video Pet Kangaroo Helps Spread Environmental Message

Children’s author Julia Heckathorn travels the world to learn about different ecosystems and endangered animals. She pours her knowledge into children’s books, hoping the next generation will right the environmental wrongs of our times. As in many children's books, the main character in Heckathorn's stories is an animal. Unlike those other characters, though, this one is real - a kangaroo, that lives in the author’s backyard. VOA’s Penelope Poulou has more.
Video

Video Pro-Russian Separatists Plan 'Federalization Referendum' in Eastern Ukraine

Pro-Russian separatists in eastern Ukraine say they plan to move forward next month with a referendum vote for greater autonomy, despite the Geneva agreement reached with Russia, the U.S. and Ukraine to end the political conflict. VOA's Brian Padden reports from the city of Donetsk in Eastern Ukraine.
Video

Video Pope Francis Hopes Dual Canonizations Will Reconcile Church

On April 27, two popes - John the XXIII and John Paul II - will be made saints in a ceremony at St. Peter’s Square. VOA religion correspondent Jerome Socolovsky says the dual canonization is part of the current pope’s program to reconcile liberals and conservatives in the Roman Catholic Church.
Video

Video In Capturing Nature's Majesty, Film Makes Case for Its Survival

French filmmaker Luc Jacquet won worldwide acclaim for his 2005 Academy Award-winning documentary "March of the Penguins". Now Jacquet is back with a new film that takes movie-goers deep into the heart of a tropical rainforest - not only to celebrate its grandeur, but to make the case for its survival. VOA's Rosanne Skirble reports.
Video

Video Boston Marathon Bittersweet for Many Runners

Monday's running of the Boston Marathon was bittersweet for many of the 36,000 participants as they finished the run that was interrupted by a double bombing last year. Many gathered along the route paid respect to the four people killed as a result of two bombings near the finish line. VOA's Carolyn Presutti returned to Boston this year to follow two runners, forever changed because of the crimes.
Video

Video International Students Learn Film Production in World's Movie Capital

Hollywood - which is part of Los Angeles - is the movie capital of the world, and many aspiring filmmakers go there in hopes of breaking into the movie business. Mike O'Sullivan reports that regional universities are also a magnet for students who hope to become producers or directors.
Video

Video Pacific Rim Trade Deal Proves Elusive

With the U.S.-led war in Iraq ended and American military involvement in Afghanistan winding down, President Barack Obama has sought to pivot the country's foreign policy focus towards Asia. One aspect of that pivot is the negotiation of a free-trade agreement among 12 Pacific Rim nations. But as Obama leaves this week on a trip to four Asian countries he has found it very difficult to complete the trade pact. VOA's Ken Bredemeier has more from Washington.
Video

Video Autistic Adults Face Housing, Job Challenges

Many parents of children with disabilities fear for the future of their adult child. It can be difficult to find services to help adults with disabilities - physical, mental or emotional - find work or live on their own. The mother of an autistic boy set up a foundation to advocate for the estimated 1.2 million American adults with autism, a developmental disorder that causes communication difficulties and often social difficulties. VOA's Faiza Elmasry reports.
AppleAndroid