El Patrón Feels Wronged
By Reinaldo Escobar
Translating Cuba - 14ymedio
November 18, 2018
The most significant thing about the statement from Cuba’s Ministry of Health (Minsap) announcing the withdrawal from Brazil’s Mais Medicos program is that it does not clearly mention the real causes of such a dramatic decision.
The angry reaction arose after Señor Bolsonaro, president-elect of the giant South American nation, announced that the new conditions for Cuba to remain in the collaborative program would be: first, that the Cuban doctors would have to revalidate their credentials according to Brazilian standards; second, that the collaborators would receive their full salary – that is the money that Brazil pays for their services would go entirely to them; and third, that they would have the right to bring their families with them to Brazil.
The official statement from Cuba’s Ministry of Health only mentions the need to revalidate the title, which is interpreted as disrespectful, as emphasized by the words: “It is not acceptable to question the dignity, professionalism and altruism of Cuban collaborators who, with the support of their families, currently provide services in 67 countries. ”
Another reason to terminate this collaboration which is not confessed in the Minsap statement, is that the Cuban government does not want a right-wing ruler to be able to show achievements in the health of his nation’s citizens. That was an advantage that Cuba was happy to offer to the Workers Party as part of the practices of political clientelism, which includes quotas for young Latin Americans to come to Cuba to study medicine.
Cuba today has about 8,300 doctors in Brazil for which Brazil pays a salary of 3,300 dollars a month, but in reality the doctors themselves receive only 25% of that because the rest goes into the coffers of the Cuban government. Hence, many doctors have been annoyed that Minsap’s statement announcing the withdrawal of the mission says, “Employees have been kept employed at all times and receive 100% of their salary in Cuba” without clarifying that the salary it is talking about is a monthly payment that seldom exceeds the equivalent of $60 US, insignificant when compared to the nearly $2,500 that the state receives for each doctor in Brazil.
On the national television midday news, where the statement was read in full, it was added that “Cuba’s medical collaboration in the world is used to pay for investments or programs that reach everyone on the Island, that generate income that contributes to the economic and social development and circumvents the United States blockade. ”
Since August 2013, when Dilma Rousseff organized this program in collaboration with the Pan American Health Organization, Cuban doctors were warned that they could not enter into contracts “freely” – that is on their own – and also since then they have been prohibited from taking revalidation exams.
Any “disobedients” caught in this “lack of discipline” were immediately returned to the island as punishment and if they dared to leave the mission they were defined as deserters and consequently were forbidden to return to Cuba for at least eight years.
In fact, the great offense that Bolsonaro has given the Cuban Government is to open the doors of his immense country to doctors who want to work there. Until now, the first reaction to the Cuban decision was a message on Mr. Bolsonaro’s Twitter account, where he lamented the withdrawal of Cuba from the Mais Medicos program; the second was his promise made at a press conference to give asylum to doctors who wanted to stay in Brazil.
In these critical moments for the Cuban economy, the annual 11.5 billion dollars that the country receives for the provision of professional services around the world, will be significantly reduced with the abrupt termination of the presence in Brazil, but in addition, the doctors who have to return to Cuba before their end of their “missions” in Brazil will be harmed.
Despite the difficult conditions that result from establishing themselves in places where no other medical professional wants to be and despite the burden of the low salary – from which the doctors had to cover their own living expenses – Brazil was one of the places most desired by Cuban doctors who, beyond their spirit of solidarity and altruism, wanted to fulfill a mission there to solve at least part that nation’s shortcomings in the provision of healthcare.
If something has been clear, it is that among the priorities of the Cuban government, rather than the humanitarian vocation to save lives, were to improve the image of a leftist party before its electorate and to earn money at the expense of the exploitation of professional work.
It is an indisputable sovereign right of Brazil to require any professional to revalidate their qualifications to practice in the country. It is a right of doctors to receive in full the salary that is being paid for them, and then pay the taxes on that salary that the law provides. It is also their right to be accompanied by family members if they wish.
Where is the offense?