Re: Hospital ship departs S. Florida for 12-nation medical mission

On Jun 18, 1:09 pm, PL <pl.nos...@xxxxxxxxxx> wrote:
Hospital ship departs S. Florida for 12-nation medical mission
By Sallie James
South Florida Sun-Sentinel
Posted June 18 2007

ABOARD THE USNS COMFORT · As the gigantic white U.S. Navy ship adorned
with bold red crosses slipped past Florida on Sunday headed toward
Belize, Lt. Jamesetta Johnson wistfully recalled how she explained her
upcoming 120-day absence to her two young children.

"I told them Mommy's going away to help people who can't get medical
care," said the urology clinic nurse from Frederick, Md., who is part of
a large-scale humanitarian deployment of civilian and military
health-care providers sailing to Central and South America and the
Caribbean.


12 countries in 120 days? 10 days in each country? Better than
nothing, I guess.

Instead of patch-work approach like this, which, I'm sorry, does smack
a bit of a propaganda effort, it would be nice if the US made a
somewhat longer term commitment to the health of the people in the
region (or even in their own country, as Tony points out here). This
is precisely what Cuba has done. Following is an excerpt from an
excellent paper by C. William Keck, MD, "Cuba's contribution to global
health diplomacy." Full text at http://igcc.ucsd.edu/pdf/keck.pdf
includes useful tables of statistics on Cuban internationalist
programs.

Notice that the ultimate aim of the Cuban internationalist program --
even in oil-rich Venezuela -- is not to create dependency, but to
eliminate the need for foreign (Cuban or US) doctors in these
countries. In addition to direct medical aid in the short term, they
are training promising locals as doctors in Cuba to serve the longer
term needs of the people in impoverished and remote communities in
their own countries.

Dan
Visit my CUBA: Issues & Answers website at http://www.netcom.ca/~dchris/CubaFAQ.html



A Model for Hope

Cuba's experience is practical proof of population health principles
long shared by visionaries in global health. Cuban health authorities
and government didn't discover these principles, they simply applied
them. Their results are a source of encouragement, especially for
people in resource scarce settings. As Dr. Paul Farmer says, The most
important contribution that Cuba has given to global health has been
its example. The idea that you can introduce the notion of a right to
health care and wipe out the diseases of poverty. Cuba has offered a
very stirring example, especially to poor countries, that they could
do it: that they could really put in place a comprehensive public
health and medical system. (Paul Farmer, MD, in the film Salud!)

Assistance in Medical Education

From early on in the development of the Cuban system, Cuba has offered
international assistance in health consisting of training health
professionals and sending Cuban health professionals abroad to provide
medical care assistance when requested. During the 1960's, in spite
of severe shortages at home, Cuba began to train students from
developing countries alongside their own. From 1966 through 2004,
nearly 4,000 international students graduated from Cuban medical
schools. Some of these graduates are found today among the developing
world's health ministers and secretaries of health. Cuba also provided
assistance to medical education efforts within other developing
countries. In 1976 a medical school in Yemen was founded by Cuban
professors, and under bilateral agreements in later years, Cuban
faculty would go on to found another eight schools of medicine in
Africa, Latin America and the Caribbean, and rescue struggling schools
in other countries of the Global South, such as Angola and South
Africa.

Assistance in Health Services

The first Cuban medical contingent to serve abroad went to earthquake
devastated Chile in 1960 when the two governments had no formal
relations. Similar disaster relief missions traveled to 16 other
countries over the next several decades, but these somewhat ad-hoc aid
efforts were eventually augmented by government to government
agreements that saw Cuban health professionals (mostly physicians)
providing medical care, Cuban style, to underserved populations and
regions in Latin America, Africa, the Caribbean and Asia. Since the
1963 request from the Algerian government, bereft of physicians at the
end of the French occupation, another 100 governments have initiated
pacts with Cuba for a sustained presence of Cuban health professionals
in their countries' health care delivery programs; six in the 1960's,
22 in the 70's, 11 in the 80's 47 in the 90's and 15 since 2000. The
significant expansion of this effort in the 90's speaks to the growing
capacity of Cuba's own health system, which made large numbers of
physicians available for international service and reinforced Cuba's
commitment to bolster public health infrastructures by providing
personnel to deliver primary care services (combining population-based
public health principles and prevention with clinical medicine) as the
key to improving health status.

External factors also contributed to the increase in Cuban
international assistance during the 90's. Cuban medical teams deployed
in emergency response in Central America to the devastation of
hurricanes Georges and Mitch stayed on at the request of several
governments under Cuba's Comprehensive Health Program (CHP). The CHP
was created in response to the region's crisis and later expanded to
include a total of 27 countries in Latin America, the Caribbean,
Africa and Asia. Under these agreements, the host country provides
accommodations and food, domestic transportation, a locale for work,
and a monthly stipend (usually US$150-200), while Cuban personnel
receive their regular salaries, airfare and other logistical support
from the Cuban health ministry. In arrangements outside the CHP, so-
called Compensated Cooperation, wealthier countries such as South
Africa pay additional hard currency salary, part of which is kept by
the professionals and part of which is remitted to the Cuban health
ministry. Currently 1,042 health professionals (principally physicians
and technicians) are serving in 28 countries under the Comprehensive
Health Program, and 3,198 are woring in 373 countries under the
Compensated Cooperation Program. Cuban presence is consistently
associated with large increases in services delivered and often
dramatic improvements in population health status.

Ramping Up - Health Services

Since 2000 Cuba has launched four new special international
collaborative initiatives. The first focuses on HIV/AIDS in 19
countries; Botswana, Honduras, Mali and Haiti among them. Joint
projects in prevention and treatment were developed, and in 2001 Cuba
offered African countries 4,000 physicians and other health
professionals, medical school professors, a stock of anti-retroviral
drugs and diagnostic equipment to help combat the epidemic.
The second began in 2003 when Cuba made a major commitment to
Venezuela, a country with great discrepancies between rich and poor,
to bolster health services. About 20,000 Cuban family physicians moved
to Venezuela to provide health services and health education in
medically underserved communities ranging from the shantytowns of
Caracas to the jungle riverbanks of the Amazonas State. This
arrangement exemplifies a new type of South-South cooperation where
each involved country brings the resources at its disposal to the
table to be used for social programs bilaterally and throughout the
Caribbean and the rest of Latin America. In the case of Venezuela,
this is often described as "oil for doctors".

The third is a vision restoration program that began in mid-2004. An
estimated 6 million people in Latin America and the Caribbean have
reversible blindness or vision loss due to surgically correctable
conditions and are too poor to pay for surgeries in their own
countries. Centers in Cuba equipped with the latest in ophthalmologic
operating microscopes along with similar ophthalmology centers in
Ecuador, Bolivia and Mali, have so far operated on almost ½ million
people from 27 different countries.

The fourth is the Henry Reeve Disaster Response Contingent established
as a permanent volunteer corps of health professionals given special
training in disaster response, and named for an American who fought
and died on the Cuban side during their war for independence from
Spain in 1898 - an example of self sacrifice for others. Members of
this group are ready to be dispatched to disaster areas with just 24
hour notice, and were first mobilized in October 2005 when 2500
traveled with 32 field hospitals for a five month stay in earthquake-
stricken Pakistan. President Bush did not respond to an offer to send
the contingent to areas hit by Hurricane Katrina in the US, but since
Pakistan the Contingent has been dispatched to Guatemala, Indonesia
and Bolivia.


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