Cuba has 38,000 health professionals working in 77 countries worldwide

While the U.S. goes about the world like the proverbial gunslinger in a grade B western, and China makes its way with trade and diplomacy, Cuba leads the way with its long arm of medical care. From a medical institution that has won international acclaim it has graduated tens of thousands of doctors and nurses from poor countries and developed a global system for health care and rescue that is second to none. This international reach has literally saved the lives and restored the vision of millions. Here following is a backgrounder on this little known but remarkable achievement by a country with less than 12 million population.

From the Desk of Miguel Fraga

Third Secretary
Press and Cultural Attachê
Embassy of Cuba, Ottawa, Canada

The 1959 Cuban Revolution marked the single most important event in Cuban history. But the Cubans would not keep the gains of the revolution to themselves; they would share them with the world. In the very early years of the revolution, Cuba began the first of its legendary medical missions.  

On May 23, 1963, a team of 58 Cuban doctors, dentists, nurses, and technicians left for recently-independent Algeria at the request of the new government there. In 13 months, they performed 540 major surgeries in six sites throughout the country.

From Algeria in 1963 to earthquake devastated Haiti 2010, attention to the most vulnerable populations has underpinned our country’s health cooperation.

Over 45 years, Cuba’s health cooperation has evolved into a global clinical, educational and preventive program including a specialist disaster response team, a volunteer global health corps, a full scholarship medical school program, and a sight restoration initiative. Over 130,000 Cuban health professionals have volunteered abroad since 1963. Currently, there are 38,000 Cuban health professionals working in 77 countries under various modalities of cooperation.

Features of Cuba’s international program include:

• staffing public health systems, thus providing low or (more often) no cost services to patients;

• serving in the most remote, underserved areas usually for two years or more;

• building in sustainability by providing medical educational opportunities;

• volunteer service by health professionals based on bilateral government agreements; and

• technology transfer.

A Comprehensive Health Program (CHP) is designed to bolster a country’s public health infrastructure by staffing local clinics and hospitals - usually in remote and underserved areas - with Cuban medical teams. This cooperation is solicited by the host country, in many cases because it cannot entice its own health professionals to work in such isolated or poor regions. Often these Cuban volunteers are the first providers of physician services to rural and indigenous populations.

Since its founding 10 years ago, statistics kept by the Cuban medical teams indicate the CHP’s health professionals have saved more than 1.7 million lives around the world. Currently, there are some 3,400 Cubans working in the CHP in 37 participating countries.

Clearly, Cubans can’t stay abroad forever, nor are they a long-term solution to the human resources crisis facing most developing nations. A more sustainable Cuban contribution emerged in 1999: the Latin American Medical School (ELAM). ELAM’s mission is to train low-income, culturally-connected medical students from the same poor communities where they are encouraged to practice upon graduation. The six-year program, which involves a central basic sciences campus in Havana and extends to Cuba’s 21 medical schools for the clinical years, is a component of the CHP and contributes to Cuba’s goal of training 100,000 doctors for the developing world by 2015.

ELAM recruits a different kind of student and trains in a non-traditional model, which combines community-engaged population health with strong clinical skills, and prevention with disease management.

In 2004, Cuba and Venezuela launched the vision restoration program known as Operación Milagro (Operation Miracle) for low-income people in the region who suffer from blindness or vision loss due to cataracts and other reversible conditions. Originally, patients were flown to Cuba accompanied by a family member, received treatment and surgery at Havana’s Ramón Pando Ferrer Ophthalmology Institute, and were accommodated at a hotel for the immediate recovery and follow-up period. The surgery, related medicines, and logistical costs for the patient and their escort were covered by the Cuban government.

As more countries solicited participation, the program was expanded in number of patients and conditions treated. As of February 2010, the vision restoration program had treated over 1,8 million people, including 151,805 Cubans. Conditions treated now include cataracts, pterygium, diabetic retinopathy, retinopathy of prematurity, glaucoma, ptosis, strabismus, nyctalopia (night blindness), and retinitis pigmentosa.

Cuba’s most recent initiative in international health cooperation is the Henry Reeve Team of Medical Specialists in Disasters & Epidemics, named after a decorated U.S. soldier in Cuba’s First War of Independence. Established in the wake of Hurricane Katrina to provide emergency medical relief to the Gulf Coast an offer rejected by the US administration the Henry Reeve Team was first dispatched to Guatemala in October 2005 following Hurricane Stan.

Later that month, the team began arriving in Pakistan with 32 fully equipped field hospitals to aid earthquake victims. At the end of its 7-month stint, the team had grown to 2,378 members, including doctors, nurses, physical therapists and technicians, and had provided some 1.7 million patient consultations.

Since Pakistan, the Henry Reeve Team has served in the wake of natural disasters in Bolivia, Indonesia, Peru, Mexico, China and most recently Haiti.

The solidarity of the Cuban people did not arrive at Haiti at the time of the earthquake. Our cooperation with that brotherly country has been offered for more than a decade now. At the time the earthquake shook Haiti, around 400 Cuban cooperators were working in that brotherly country selflessly and free -of-charge.   

Cuban doctors started to offer their services right after the earthquake took place. It was the most important medical assistance received by the Haitian people in the first 72 hours. On January 13, more than 60 health cooperators reinforced the medical brigade in Port-au-Prince, among them there are specialists from the Henry Reeve Contingent for emergency situations with experience in similar disasters. This medical brigade carried medicines, provisioning, food, serum and plasma bags with them.

Until Thursday, January 14, at 20:00 hrs, 1 987 patients had been treated and 111 surgical interventions had been performed at 5 assistance locations in Port-au-Prince. Until April 15, more than 296 000 patients had been treated. About 400 Haitian youths, who were trained as doctors in Cuba, work today alongside the Cuban reinforcements to save lives in this critical situation.

The Cuban Revolution arrived last year at its first 50 years; this is the effort of an entire people to build a more just society every day. The same people who believe that a better world is not only possible but necessary.