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Thursday, January 15, 2009

Reflections on Medical Internationalism by John Kirk

Reflections on Medical Internationalism 
by John Kirk
John Kirk is Professor of Latin American Studies at Dalhousie University, where he specializes in Cuban political history. He has written/coedited several books on Cuba, including Redefining Cuban Foreign Policy: The Impact of the “Special Period” (2006), and Culture and the Cuban Revolution: Conversations in Havana (2001). Together with Michael Erisman he is writing a monograph on Cuban medical internationalism. 

Patria es humanidad. —José Martí

José Martí’s assertion that the Cuban homeland is all of humanity sums up elegantly the extraordinary generosity of spirit visible in Cuba’s medical internationalism program.
I am constantly surprised by Cuba’s ability to punch above its weight, and nowhere is this more visible than in Cuba’s health contribution in the developing and underdeveloped world. The facts themselves are simply mind-boggling: 23,000 children, victims of the Chernobyl nuclear meltdown, have been treated in Cuba to date; some 1.3 million patients with eye problems in Latin America and the Caribbean have been operated on under Operation Miracle (including the Bolivian soldier who had executed Che Guevara in 1967, an impressive act of symbolic revenge by Cuba); emergency medical brigades have operated since 1960, and in the past three years alone over 4,000 medical staff have saved tens of thousands of lives from Peru to Pakistan (Gorry, 2008); and the largest medical school in the world, the Latin American School of Medicine, with 10,000 students from 30 countries registered, is on its way to training 100,000 doctors for Latin America and the Caribbean within a decade (Field, 2006). In all, some 6,693 doctors have already graduated, while 40,000 are currently being trained (Lage, 2008).

Since I first traveled to Cuba in 1976, I have met scores of medical people, almost all of whom have participated in medical missions abroad, and am always impressed by their commitment to serve and to view medical service as a basic human right. By contrast, their North American counterparts usually cannot see past the profit motive in public health. In particular I am astonished at the Cuban approach to low-cost primary health care, with an emphasis on preventive medicine. Since 1959 some 113,000 health professionals have worked in 103 countries, and in 2008 some 41,000 of them are working in 31 countries. A microcosm of this is the comprehensive health program in effect since Hurricane Mitch devastated Central America, killing some 30,000. Since then the results of Cuban collaboration have been staggering: 96 million medical consultations, 834,000 births attended, 2.4 million surgeries, and 1.7 million lives saved. By contrast I look at the contribution of the G-8 countries, and I am embarrassed.

If we leave aside the mind-numbing data and reflect upon the positive impact caused in dozens of countries around the globe, I am not surprised at the popularity of the Cuban government. The elected leader of the Non- Aligned Movement (of 118 nations), Cuba has long struggled against the U.S. blockade (in 2008, 185 countries at the UN condemned it, with only 3 voting in favor). In addition, Cuba was elected to the UN Human Rights Council with the support of 135 countries. Cuban medical internationalism represents good diplomacy. I am also convinced that, for Cuba, it represents a moral obligation to less fortunate countries, a debt to be paid to humanity, as the Cuban constitution outlines.

In sum, Cuba’s medical internationalism, providing more medical aid than all of the industrialized countries combined, was aptly summed up by Cuban Foreign Minister Pérez Roque in June 2007: “We don’t give out our leftovers; instead we share what we have” (Forteza, 2007). Martí would agree. 

REFERENCES
Field, Connie 2006 ¡Salud! http://www.saludthefilm.net/ns/elam/html.
Forteza, Francisco 2007 “Canciller cubano: No damos lo que nos sobra. Compartimos lo que tenemos.” World Data Service Report, June 27. Cuba-L@list.unm.edu (accessed June 23, 2008).
Gorry, Conner 2008 “Cuban health cooperation turns 45,” MEDICC Review 10: 44-46.
Lage Dávila, Carlos 2008 “El ALBA fue una inspiración, luego un proyecto, hoy es una esperanza.” Granma, August 26.

LATIN AMERICAN PERSPECTIVES,
Issue 164, Vol. 36 No. 1,
January 2009 139-140
DOI: 10.1177/0094582X08329183
© 2009 Latin American Perspectives