'Castrocare' Divides Doctors In Cuba, Brazil

'Castrocare' Divides Doctors In Cuba, Brazil
by LOURDES GARCIA-NAVARRO
October 02, 2013 4:00 AM

Call it "Castrocare." Cuba's former leader Fidel Castro sent doctors
abroad for decades to work throughout Latin America and as far away as
Africa.

In some cases, like Haiti, the medical missions were seen as purely
humanitarian. In other places, like Venezuela, it was a form of barter
that provided Cuba with subsidized oil imports.

Cuba has long boasted of its program, which has generally been
well-received. So now Cuba is sending thousands of doctors to Brazil,
which badly needs the physicians in poor, rural areas and has the money
to pay for them. However, the program is meeting resistance in Brazil —
not from patients but from the medical establishment.

In the town of Pedreira, about 85 miles outside Sao Paulo, Luis Fernades
dos Santos is getting a broken tooth cared for at his local public
health clinic.

After the procedure, he says he's heard about the Cuban doctor who is to
be working here soon and thinks it's a good thing.

"Here in the city, you see people sleeping — sleeping — for a day, two
days waiting in line to see a doctor. And when it's their turn, there is
no doctor to see them," he says. "So that's why I think bringing people
in to help will make things better."

Over the summer, massive protests broke out in Brazil, decrying, among
other things, the state of the public health system. The problems
include aging equipment and a lack of medical facilities, things that
take time to fix. But the government moved quickly to address the lack
of doctors by bringing in Cuban physicians.

Opposition From The Medical Establishment

The patients may be in favor, but most of the Brazilian medical
community is not.

When Cuban physicians arrived in the city of Fortaleza in August,
Brazilian doctors shouted at them, "Slaves, slaves!"

"We are not slaves," says Tania Aguiar Sosa, one of the Cuban medical
workers with decades of experience. "We are health workers. We are
professionals that provide help to whatever country needs it."

She's worked in Venezuela and Haiti previously and was headed to Angola
before being rerouted to Brazil.

Brazilian medical unions are trying to mount a court challenge to the
use of Cuban doctors here.

Jose Roberto Murisset, the human rights secretary of the National
Doctors Federation, says that the Cuban government takes most of the
money that is paid for the doctors. The Brazilian government has also
decreed that the Cuban doctors have no right to ask for asylum in Brazil.

"Brazil has strong labor rights, but these Cuban doctors don't have
their rights guaranteed," he says.

The main bone of contention is that foreign doctors arriving under the
new program don't have to take the Brazilian medical exam to practice.
Murisset says that many of the doctors coming from abroad would fail the
test and are underqualified.

"Maybe the government thinks that these regions don't need a full
doctor. Maybe they think they need only a half doctor," he says.

Hospitals In Need

But Dr. Adriano Peres Lora, head of the Pedreira Municipal Hospital,
disagrees.

He says he has 50 beds at his facility serving 44,000 people in the
community. If he can get more doctors handling preventive care, then the
main hospital will feel less pressure, he says.

"What we need is basic attention. We lack doctors willing to work as
general practitioners in marginal communities," he says, adding that 80
percent or more of the health problems people face can be resolved by
seeing a doctor at an early stage.

He says most Brazilian doctors don't want to work in poor, rural
communities like his, though the need is great.

When the Brazilian government announced the program to bring in foreign
doctors, more than 4,000 towns and cities applied to the federal
government for extra help.

Back at the health clinic where a Cuban doctor will be working,
Brazilian doctor Flavio Blois de Mattos says he welcomes the help. He's
overwhelmed at the moment. But he also thinks the Brazilian program is
unethical.

He says the Cuban doctor agreed to come even though the Cuban government
gets the lion's share of her salary, paid by the Brazilian government.
Still, the Cuban physician will make more in Brazil than she would in
Cuba. And that will help her 15-year-old daughter.

"I don't think it's correct. We are a democracy. Why aren't we giving
them the same rights we have?" he says.

Source: "'Castrocare' Divides Doctors In Cuba, Brazil : Parallels : NPR"
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http://www.npr.org/blogs/parallels/2013/10/02/228376356/castro-care-divides-doctors-in-cuba-brazil