In The Diaspora: Cuba’s humanitarian imagination

Alissa Trotz is editor of the In the Diaspora column
On Saturday the Stabroek News carried a small report on a Guyanese doctor trained in Cuba (one of a larger group of 64) who had been posted to the Lethem Hospital. This is Cuba’s medical internationalism at work (the subject of an excellent book by Canadian professor John Kirk), and something we have been accustomed to in Guyana since the 1970s. Last year I brought a small group of Caribbean Studies students from the University of Toronto to Guyana, and one of the places we visited was the Mahaicony Cottage Hospital, a small and immaculately kept health centre, that was staffed primarily by Cuban and Cuban trained doctors; even the nurses were Cuban. The garden out front was carefully tended with rows of lovely flowers, and we were told that the doctors and nurses looked after not just the patients, but the building and its environs as well. Having read about this in a sterile classroom, the students found the trip deeply inspiring and an example of solidarity that fundamentally begins with the needs of working people. As the Stabroek article reminds us, Cuba is not just sending its medical workers abroad. It is deeply interested in offering sustainable alternatives by investing in people, the region’s most valuable and most overlooked resource. To this end, Cuba also trains students from across the world, preparing them to return to their countries with the skills so desperately needed. Nor are these scholarships for the privileged, for the investment is in students who would not otherwise have the opportunity, and who can return to their communities after they have finished. I believe some 10,000 such scholarships have been offered by the Cuban Government to students from over 25 Caribbean, Latin America and African countries, and even the United States, to attend the Latin American School of Medicine (ELAM). I was privileged to witness some of this in December of last year, when I attended a conference at the University of Havana. In fact I was there for the celebration of Cuba-Caricom Day, hosted by the University’s Caribbean Centre, and I remember being struck by the fact that at least one of the ambassadors from the Anglophone Caribbean began his remarks by commenting that he was a graduate from the University of Havana.

The title of today’s column comes from Keith Ellis, a retired Professor of Spanish and Portuguese at the University of Toronto, well known for his work on Hispanic literature, and the first Jamaican scholar to receive a doctor honoris causa (honorary doctorate) from the University of Havana. He is a member of the Canada-Cuba Friendship Committee, and actively involved in a Cuba for Haiti fundraising campaign. I was a participant in a teach-in on Haiti two weeks ago, when Keith shared with the audience Cuba’s medical support for the Haitian people in the aftermath of the devastating January earthquake.  A recent article in the online journal Counterpunch reminds us that this is not new. After the island was hit by Hurricane Georges in 1998, Cuba offered support, the most important element of which was medical cooperation (sending Cuban doctors to Haiti and training Haitian students at medical schools in Cuba who would eventually replace the need for overseas medical assistance on such a large scale), and this despite an absence of diplomatic relations between the two countries for more than 36 years. Between then and 2010, over 1000 Haitian doctors were either trained or are currently in schools in Cuba. According to Keith Ellis, the Cubans had even established a medical school in Haiti. Following the coup in 2004 that deposed democratically elected President Jean-Bertrand Aristide, the US army was billeted at the site and shut it down; the Cubans made the decision not to interrupt the training and took some 300 Haitian students back to Cuba to complete their programme. As the Counterpunch article and Keith Ellis’ presentation made clear, the results are nothing short of astonishing, as measured by such organizations like the Pan American Health Organisation. Between 1999 and 2007, the infant mortality rate per 1,000 live births dropped from 80 to 33, maternal mortality per 100,000 live births fell from 523 to 285, and life expectancy increased from 54 to 61 years. It is useful to note that Cuba’s infant mortality rate, 4.8 per 1000 live births, is the lowest in this hemisphere. Canada is second best. The rate for the United States of America is somewhere in the vicinity of 6.7 per 1,000 live births.

What this means is that Cuban and Cuban trained doctors were already on the ground when the earthquake hit, working in communities across the country, and able to spring into action immediately. The Cuban teams have to date been able to treat far more than all of the other countries and organisations offering medical support, including Partners in Health, Médecins Sans Frontières, the Canadian and US military medical support personnel. Within the first 24 hours, the 400 Cuban and Cuban-trained medical personnel (most of whom were doctors) had treated some 1000 Haitian patients, setting up field hospitals, running 12 hour shifts, and staying with their patients overnight at a time when we were seeing television reports of doctors with other relief organizations returning to base in the evening for fear of personal safety. By the end of March over 200,000 patients were treated and six and a half thousand surgeries carried out. More doctors and advanced medical students have continued to arrive on the island, including ELAM trained personnel from other Latin American countries. Compare this with the US Naval ship Comfort, now safely back in Baltimore as of mid-March, and which treated less than 900 patients in its two months in Haiti.

It is sinister that the international mainstream media spent such an inordinate amount of attention on how much international aid was being raised, but comprehensively failed to reckon with the realities of Cuban support and presence (it is also deeply unfortunate that the Caribbean regional media has not addressed this in the detail it deserves). As the Counterpunch article points out, Haitian president René Préval said to the Cubans, “you did not wait for an earthquake to help us”, and Prime Minister Jean-Max Bellerive has specifically identified Cuba, Venezuela and the Dominican Republic as the first three countries on the scene. Yet all we heard about in the days following the earthquake was Western support, and US troops arriving in the country. The Cuban government immediately opened its airspace to American and other flights travelling to Haiti; this was no time to be playing geopolitics when faced with such a humanitarian tragedy. On the other side, however, there has been silence on the Cuban presence, and willful misrecognition as well, with the corporate media playing no small role – in one television report the CNN reporter described a Cuban doctor as Spanish! It reminded me of 2005, in the aftermath of Hurricane Katrina, when Cuban doctors and medical relief workers packed up their supplies and were ready to travel. Of course George W. Bush would not let them in, playing deadly politics with people’s lives at a time when it was patently clear that that country’s disaster relief efforts were not nearly co-ordinated enough to prevent the devastation that unfolded before our eyes.

There is a lesson here on what a people-centred approach looks like, a point I remember being forcefully made by grassroots Guyanese women at the speakout organized by Red Thread and held in Georgetown in 2005 after the January floods that destroyed lives and livelihoods on our coast. And for all of us who call ourselves Caribbean, there is a lesson here on what regional solidarity looks like and what it can do.  People across the Caribbean know so little about Caricom, what it does, how it involves them, the difference it can and should make. But I am sure that Haitians on the ground today can tell us about Cuba, because they see relations unfolding before their eyes, relations that are based on equality and dignity and with consequences for their lives that are clear for all to see and measure. This is what a regional movement needs to look like. In his remarks at the teach-in I attended, Keith Ellis mentioned hearing an interview in which the Haitian ambassador to Cuba said that the Cubans had thought of things the Haitians were in no position to even imagine in the first awful days following the earthquake. Artists, clowns and stilt walkers have travelled to Haiti to work with children to restore to their lives some joy and pleasure which are so necessary to cope with the trauma. This is not a country that is giving from surplus. This is not a country that is sending materials it has no use for. Cuba is sharing what little it has. A colleague of mine here in Toronto said to me some months ago that we should judge countries and institutions not by what they do in the good times, but by their priorities and what they cut in the lean times. It’s a good point with which to reflect on the Cuban-Haitian relationship. Cuba’s humanitarian imagination, Keith said, and it is a beautiful and apt phrase indeed.

Thanks to Keith Ellis. For the full Counterpunch article, see http://counterpunch.org/kirk04012010.html