Tuesday, October 25, 2011

Unchartered Cuba: A "Sister-Country" in “Globalized Times”

 (Dr. Balseiro with members of NSCuba and presenting at Dalhousie)

Dr. Jorge T. Balseiro Estevez visited Halifax as part of a 14 city Canada wide tour including also Montreal, Quebec City, Ottawa, Gatineau, Toronto, Kingston, Calgary, Edmonton, Vancouver, Nanaimo, Victoria, Winnipeg and Windsor. 
During his presentation at Dalhousie University in Halifax on October 19th, Dr. Balseiro talked about some stepping stones on the history of the Cuban Missions. He said they started with the Cuban experience in helping Chileans affected by the earthquake of 1960, and also benefitted from what they learned while helping Argelians in the aftermath of the 1963 earthquake, and from what they learned during the many helping missions to Africa and Central America during the 1970s and 1980s. Today, medical solidarity and cooperation is Cuba´s way of providing health care and it is very much rooted in who they are as a nation. Cubans have projects with 48 countries and more than a fifth (22%) of Cuban doctors work outside of Cuba and in projects of medical solidarity and cooperation like the one implemented in Haiti.  

Dr. Balseiro, a psychiatrist by training, explained that at the time of the arrival of Cubans in Haiti in 1998, right after hurricane Georges caused 230 deaths, the destruction of 80% of the crops and left 167 000 people homeless, Cubans had nothing in place and had to start from scratch. They were so busy with the project that they survived their first month on canned sardines and tuna. They could not trust the food supply which was probably contaminated, but also they had no time to cook for themselves.

At one point, he remembered, Canadian and American military offered the Cuban Mission protection thinking that they needed it. We Cubans did not accept it, he said, because we felt protected by the people of Haiti who made us feel safe and at home. What many people outside of Haiti and Cuba do not know is that Cuban doctors have been so crucial to Haiti that Haiti’s President René Preval had referred to them as “second only to God.” Cuban doctors know this, feel value; they know Haitians welcome their efforts and appreciate the work they do now for more than 10 years.

On the aftermath of the earthquake that caused so much destruction in Haiti in 2010, Cubans already had much experience in Haiti and have developed strong links with the Haitian people. Dr. Balseiro was part of the emergency response and remembers how people were in shock after the earthquake. Helpers had to be creative, he said, find ways to deal with a traumatized population even with very limited resources. Shock, he explained, is a normal response to traumatic events and providing supports for children, adolescents and adults to help them overcome the trauma experienced became a big part of the work Cubans did. The worse, he remembers, was the cholera epidemic that followed; they had to face it with limited supplies of oxygen bottles which forced them to rationing oxygen among patients if they were to ensure everybody a chance at survival. He shared proudly that they managed so well these challenges that they did not lose a single patient.

Despite the valuable work that for more than a decade Cubans are doing in Haiti many people ignores their presence there. It is not common knowledge. Most people ignore the work Cubans have done or their dedication. The work of Cubans helping Haiti continues to be a very well kept secret, and one that most of us are unlikely to learn as long as we read the international press. The same press that often highlights the role Americans, Canadians and MSF (Doctors Without Borders) have played in Haiti, fails to mention the Cuban presence there. And yet, Cuban effectiveness is difficult to hide when you go through the data which proves their work unmatched by anyone else and their help not only more extensive in time and effort but also more efficient in resource management.

“In general, international news reports ignored Cuba’s efforts. By March 24, CNN for example, had 601 reports on their news website regarding the earthquake in Haiti — of which only 18 (briefly) referenced Cuban assistance. Similarly, between them the New York Times and the Washington Post had 750 posts regarding the earthquake and relief efforts, though not a single one discusses in any detail any Cuban support.” [1]

Nevertheless, Cuba continues working in Haiti as it has been doing since 1998, implementing a very effective approach in dealing with the public health issue Haiti faces. Cuba provides not only hundreds of doctors to attend to Haiti’s medical needs, and it has committed to do so for as long as Haiti needs it, but it also provides medical training through ELAM (Latin America School of Medicine) which ensures that in the future Haiti will have its own medical personnel. In fact, the first group of medical students started their training in May 1999, and these days graduates and students from ELAM are part of the effort and work together with other medical personnel in Haiti. [2]

The table below [3] points to the effectiveness of the Cuban effort. Cubans have managed with almost half the personnel to treat more than 4 times the number of patients and to perform almost twice the number of surgeries that MSF (Doctors Without Borders) had  –not mentioning the greater amount of resources available to MSF.

Comparative Medical Contributions in Haiti by March 23, 2010. 
No. of Staff
No. of Patients Treated
No. of Surgeries

Important statistics about the specifics of the Cuban medical mission in Haiti include number of visits to the doctor, doctors visits to patients, attended births, surgeries, vaccinations, and lives saved, as in the table below.[4] These numbers are an eye opener as it puts in perspective the size of the service provided by Cuban medical personnel and helps see more clearly how Haitians benefit. 

Selected Statistics on Cuban Medical Cooperation, Dec. 1998-May 2007 [5]
Visits to the doctor
Doctor visits to patients
Attended births
Major and minor surgeries
Lives saved (emergency)

Data [5] on health indicators for improvements in public health also highlight the success Cubans have Haiti; there are marked improvements in infant, child and maternal mortality as well as on life expectancy since Cuban arrived in 1998.  

Improvements in Public Health in Haiti, 1999-2007 
Health Indicator
Infant Mortality, per 1,000 live births
Child Mortality Under 5 per 1,000
Maternal Mortality per 100,000 live births
Life Expectancy (years)

Furthermore, Cuba, together with ALBA (Alianza Bolivariana para los pueblos de Nuestra America), has presented a project to the World Health Organization focusing on the reconstruction of health care in Haiti. This project counts with the support of Brazil while it is run by Cubans; it includes hospitals, polyclinics, medical schools and a comprehensive approach to health and yet, it has not been reported by the media.  

Thus, although Cubans have worked hard and well in Haiti, their approach has been successful, Haitians value the work they do and Haitian authorities have recognized their success publicly and internationally, we rarely learn about it from the Media. Why is it that the press ignores the relevant role Cuba plays in Haiti? Why do we rarely heard for example that the President of Haiti and its Prime Minister publicly acknowledge Cuban help as “second” to none. Why is it that there is no mention, nor recognition for the support and solidarity Cuba and members of the ALBA coalition have provided to Haiti? Why is it that most people know nothing, or next to nothing, about how Cubans have helped since 1998, and continue to help, in the reconstruction of health care in Haiti? 

I am not about to post the answers to these questions, but I believe it is crucial to ask them –as they need to be considered and explored. Is there any reason why we should not know about the Cuban role in Haiti? Is there anything problematic about us knowing how Cuba helps?

I have my theory and believe that Cuba, although a small country, has selected its own path: it has chosen to establish relationships with others based on solidarity and support rather than on self-interest and revenue. Now, a small country like Cuba, facing so many challenges to its survival, and not allowing these challenges to define. or limit how it defines, its identity and instead chooses to struggle and find creative ways to overcome whatever limitations, it is a noteworthy country. Cuba works at "making it" without losing sight of the vision it has built for itself, without forgetting “the country it aspires to become.”  Now, a country like that can no longer be considered "small;" it can certainly become an example to others.

I believe, that a country with big dreams can be perceived as dangerous particularly at times like these we live, times were “globalizing is everything." Worse, a country proud enough to be different, unique even, and in the process of becoming more, rather than less, in tune with its own uniqueness, can be problematic for those who rule, or aspire to rule, the world. Global tyrants of today and the future have plans for turning us all into “more of the same;” they would not want, or allow, us to aspire to be “different.”  Maybe, because of this Cuba has to be omitted, ignored, left unknown to many of us. Maybe this is why Cuba has to be presented as “bad” or the "enemy" whenever possible. We are not allowed to have big dreams, to dream big projects for a unifying humanity working for the well being of all its members. We are only allowed their “nightmares of a global nature," their visions of a world working only for a few and leaving the majority of us behind.

Nora Fernández

[1] Cuban Medical Aid to Haiti: One of the World’s Best Kept Secrets, EJ Kirk & JM Kirk, http://www.globalresearch.ca/index.php?aid=18614&context=va
[2] Cuban Medical Aid to Haiti: One of the World’s Best Kept Secrets, EJ Kirk & JM Kirk, http://www.globalresearch.ca/index.php?aid=18614&context=va,. 
[3] Cuban Medical Aid to Haiti: One of the World’s Best Kept Secrets, EJ Kirk & JM Kirk,   http://www.globalresearch.ca/index.php?aid=18614&context=va. 
[4]  Anna Kovac, “Cuba Trains Hundred of Haitian Doctors to Make a Difference,” August 6, 2007. Located on the MEDICC website athttp:www.medicc.org/cubahealthreports/chr-article.php?&a=1035. (February 2, 2010). In: Cuban Medical Aid to Haiti: One of the World’s Best Kept Secrets, EJ Kirk & JM Kirk, http://www.globalresearch.ca/index.php?aid=18614&context=va.   .
[5]  Cuban Medical Aid to Haiti: One of the World’s Best Kept Secrets, EJ Kirk & JM Kirk, http://www.globalresearch.ca/index.php?aid=18614&context=va -See entry for “Haiti” on the Pan American Health Organization website, found at http://www.paho.org/english/dd/ais/cp_332.htm, accessed February 2 2010.

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