More doctors for
It is 2:00pm and doesn’t appear to
be a Sunday, a day of rest and recreation. Groups of
men and women wearing white coats come and go, at
the speed of someone about to miss a train. The
usually tranquil Medical Collaboration Center (UCCM)
is abuzz with activity.
President Dilma Rousseff meets Cuban
doctors in Brazil.
Dr. Yvonne Rodríguez García, with
eight years as the Unit’s deputy director for
analysis, management and medical services, is aware
of every move, many involving her directly. She
remains unflappable, a characteristic undoubtedly
acquired over the years during which she has worked
at every level of health services in Cuba and during
her missions to Pakistan and Honduras. With aplomb
and common sense, she is dealing with a major
priority, explaining, "This week, all the doctors
still lacking must leave for Brazil." This group
will complete the contingent of 11,430 Cuban doctors
participating in Brazil’s Más Médicos program, who
began arriving in early 2013.
The departure of such a large number
of professionals will not affect the quality of
services provided by the public health system in
Cuba, undergoing a re-organization to better and
more efficiently meet the needs of the population, a
healthy one as a variety of indicators show.
By April, some 13,225 Cuban doctors will
be working in Brazil, serving 46 million
Doctors participating in the
collaboration program in Brazil come from all
regions of Cuba, as is the case with all
international brigades from the country, for which
participants are chosen on the basis of proposals
made by hospitals and clinics. Candidates’
willingness to serve and availability is essential,
since, as indicated above, no doctor is released to
serve abroad if services in Cuba might be affected.
More than 80% of those selected for
the Brazilian program have a minimum of 15 years
experience and all have previously participated in
at least one other international mission, while some
30% have participated in more than one other
The Cuban doctors in this program
will be working exclusively in primary care, in
4,070 municipalities, in 26 states, plus the
Brasilia Federal District and 32 special indigenous
In July, 2013, President Dilma
Rousseff launched the program "More hospitals and
health centers, more doctors and more training" in
response to popular demands across the country. To
expand public healthcare system’s services,
contracting of foreign doctors was prioritized.
The international appeal to cover
vacant positions in rural areas was an
understandable solution, since the country faced a
deficit of some 54,000 doctors, with many locations
lacking a single health professional.
The Brazilian President affirmed, on
March 21, that results of the program thus far
indicate that the government decision to contract
doctors abroad, to guarantee health care to citizens
throughout the country, was the correct one. She
said, according to Prensa Latina, "I knew I was
going to receive a lot of criticism, but I was sure
that the Brazilian people would understand that we
were on the right track," sending Brazilian doctors
and others from abroad to municipalities in the
interior of the country and to peripheral areas
surrounding large cities. She announced that, by
April, some 13,225 doctors will be in place serving
46 million Brazilians.
SERVICES AVAILABLE THROUGHOUT THE
Cuban doctors enjoy prestige
internationally, recognized not only for the quality
of their professional training, but for their
humanity as well.
Any community served by a Cuban
doctor can rest assured that inhabitants will be
treated regardless of the circumstances, in any
location where assistance is needed, be it in an
inhospitable or remote area, even under life-threatening
"There are hostile people who
attempt to take advantage of insignificant
situations, distorting or exaggerating them," Dr.
Rodríguez said, "What are two or three cases
compared to more than 11,000 doctors who are there?
… The population has recognized us. This has always
been the case, because Cuban collaborators are even
changing the style of medical attention in Brazil."
Cuba’s medical personnel is
distributed throughout the country, not in large
cities, but in the periphery of these metropolitan
areas. This has been a basic principle of
collaboration – providing services in remote and
"Brazil is not only what we see in
the soap operas we like so much, it is much more, a
country as big as a continent and full of
contrasts," Dr. Rodríguez continued, "and our
doctors go where the poorest and most needy are,
from across Amazonia to the periphery of cities like
Brasilia, San Pablo, Bello Horizonte, Vitoria,
Fortaleza, Bahía and others."
Daniel Carvalho, special
correspondent for Folha de Sao Paulo, reporting from
remote areas in Pernambuco, in an article about the
lack of medical services in the region, wrote that
Cuban doctor Teresa Rosales was surprised by the
reception she was afforded by her patients in Brejo
da Madre de Deus, in São Domingos, a poor region in
the interior of Perambuco facing a severe drought.
She noted that people were accustomed to getting
down on their knees to thank god and the doctor. She
saw 231 patients during her first month on the job
as part of the federal government’s Mas Médicos
Something as natural for a Cuban
doctor as performing a physical examination to make
an adequate diagnosis is a wonder for some patients,
as the reporter recounts.
"Over the last four years, the post
did not even have the most basic element: doctors.
Whoever walked kilometers through the mud to reach
the clinic would always return home without
treatment… the lines to see someone were long. It
was god who sent this man, said 69-year-old Maria
Inácia Silva, who had last seen a doctor in 2005.
She was impressed by the way she was treated by the
44-year-old Cuban doctor Nelson López, new to the
settlement of Capivara, in Frei Miguelinho."
Carvalho noted, "The difference in
treatment begins with the way furniture is arranged.
The patient sits on a chair beside the doctor’s
table, so that the furniture is not a barrier
It is no surprise that Brazil’s
President herself has recommended, on her Facebook
page, an article published by the newspaper G1 in
the state of Bahía, which details the work of Cuban
doctors in the country.
WE WILL NEVER RENOUNCE SOLIDARITY
Cuban President Raúl Castro,
speaking during the recent Federation of Cuban
Workers Congress, emphasized the importance of
medical services provided abroad given the income
they generate for the economy and announced a salary
increase for all health care workers, effective June
Dr. Rodriguez commented, "I have repeated many times
that, if medical collaboration abroad is the
greatest source of income for the country, it is the
result of the great vision held by our Comandante
Fidel. I remember when he said that we didn’t have
gold or oil, but that what we had was well-trained,
well-educated personnel, with the capacity to help
others. In reality, what a Cuban doctor does is not
paid with anything, more so when we help in a very
direct way, which I consider very just, although
today we are living in another time, we will never
• With a surface area of more than
8.5 million square kilometers and more than 200
million inhabitants, Brazil has the world’s fifth
• There are 1.72 doctors and 2.4
hospital beds per 1000 inhabitants, according to the
World Health Organization.
• Brazil’s extensive territory
includes a great variety of ecosystems, including
the Amazon tropical jungle, renowned as possessing
great biodiversity and valuable resources.
• According to UNICEF, the infant
mortality rate in Brazil has been reduced from 62
per 100 live births, in 1990, to 14 in 2012,
although this rate is still considered high.
WE WILL WORK AS WE ALWAYS HAVE
DIOSVANY JUNCO BRINGA. 43 years of
age, from Santa Clara, Comprehensive Family Medicine
specialist with 20 years of experience. Former
director of the XX Aniversario Polyclinic in his
native city. Participated in medical missions to
Belize and Venezuela.
"What I miss most is my family," the
doctor said in the brief moment available after the
departure ceremony, during which he was presented a
Cuban flag as head of the contingent leaving for
He has indelible memories of his
previous two missions, equally significant, but very
different. In Belize, he worked in the capital’s
main hospital and said that learning the language
was the greatest challenge, although he did manage,
rising to the occasion.
"Venezuela was a great school for
me," Diosvany said, " I began as a doctor in a
community clinic in Maracaibo, in Zulia, then I was
an advisor for the people’s doctors’ clinics and
later I assumed other positions, including mission
director in that state."
His expectations for Brazil? "This
South American giant, like Venezuela, is a country
of great contrasts, with an immense population, from
the medical point of view, very underserved. There
are a significant number of health professionals in
the country but they are concentrated in the
capitals, and don’t go to peripheral neighborhoods.
That’s where we are going. We will do so, just as we
I KNOW THE PEOLE WILL LOVE US
and Diosvany have been married for seven
years, and are undertaking this mission
to Brazil together, saying they will
postpone starting a family, for the time
BELSYS ACOSTA CABRERA. Comprehensive
Family Medicine specialist from Santa Clara, 32
years of age, doctor at XX Aniversario Polyclinic.
Participated in Cuba’s medical mission to Venezuela
for more than five years, with a focus on community
When Diosvany and I returned, we
intended to start a family, since we don’t have
children, but we postponed that for three more years.
We’re young and we love each other; we have time.
We are preparing ourselves well with
the language, although I don’t know where we’ll go,
but, yes, that we will be working with people in the
community and when we arrive, after the medical
Portuguese course, they will evaluate us.
We’re not going to cities, but
rather to rural areas and as always, I know the
people are going to love us.
What I miss most is my family and
everything else, too, the customs, everything… the
experience of having a mission to fulfill
strengthens us and gives us more confidence.