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Over the past 45 years, Cuba’s conduct of medical diplomacy has improved the health of the less privileged in developing countries while improving relations with their governments. By the close of 2005, Cuban medical personnel were collaborating in 68 countries across the globe. Consequently, Cuban medical aid has affected the lives of millions of people in developing countries each year.

Medical diplomacy has been a cornerstone of Cuban foreign policy and its foreign aid strategy since shortly after the triumph of the 1959 revolution.

Despite Cuba’s own economic difficulties and the exodus of half of its doctors, Cuba began conducting medical diplomacy in 1960 by sending a medical team to Chile to provide disaster relief aid after an earthquake. Three years later, and with the U.S. embargo in place, Cuba began its first long-term medical diplomacy initiative by sending a group of 56 doctors and other health workers to provide aid in Algeria on a 14-month assignment. Since then, Cuba has provided medical assistance to scores of developing countries throughout the world both on a long-term basis and for short-term emergencies.

And now, with help from his friend, Venezuelan President Hugo Chávez, who is awash in oil wealth, Cuban President Fidel Castro is threatening to provide massive amounts of medical aid to improve the health of poor Latin Americans. Rather than a fifth column promoting socialist ideology, these doctors provide a serious threat to the status quo by their example of serving the poor in areas in which no local doctor would work, by making house calls a routine part of their medical practice and by being available free of charge 24/7, thus changing the nature of doctor-patient relations.

As a result, they have forced the re-examination of societal values and the structure and functioning of the health systems and the medical profession within the countries to which they were sent and where they continue to practice. This is the current Cuban threat.

Over the past 45 years, Cuba’s conduct of medical diplomacy has improved the health of the less privileged in developing countries while improving relations with their governments. By the close of 2005, Cuban medical personnel were collaborating in 68 countries across the globe. Consequently, Cuban medical aid has affected the lives of millions of people in developing countries each year. And to make this effort more sustainable, over the years, thousands of developing country medical personnel have received free education and training either in Cuba or by Cuban specialists engaged in on-the-job training courses and/or medical schools in their own countries. Today, over 10,000 developing country scholarship students are studying in Cuban medical schools.

Furthermore, Cuba has not missed a single opportunity to offer and supply disaster relief assistance irrespective of whether Cuba had good relations with that government. This includes an offer to send over 1,000 doctors and medical supplies to the United States in the immediate aftermath of Hurricane Katrina. Although the Bush administration chose not to accept the offer, the symbolism of this offer of help by a small, developing country that has suffered 45 years of U.S. hostilities, including an economic embargo, is quite important.

Because good health is necessary for personal wellbeing as well as societal development, the positive impact of Cuba’s medical aid to other countries has greatly improved both its bilateral relations with those countries as well as its standing and support in a number of multilateral forums. Therefore, as a consequence of its medical diplomacy Cuba has accumulated considerable symbolic capital (goodwill, prestige, influence, credit and power).

Eventually, symbolic capital can be converted into material capital, which in Cuba’s case has meant both bilateral and multilateral aid as well as trade, credit and investment. This is one of the rewards for the conduct of medical diplomacy.

From the outset of the revolution, Fidel Castro has made the health of the individual a metaphor for the health of the body politic. Rather than compare Cuban health indicators with those of other countries at a similar level of development, he began to compare them to those of the United States. This was particularly true for the infant mortality and life expectancy rates. Both are considered to be proxy indicators for socioeconomic development because they include a number of other indicators as inputs. Among the most important are sanitation, nutrition, medical services, education, housing, employment, equitable distribution of resources, and economic growth. It is, therefore, symbolically important for Cuba to compare favorably with the U.S. in an effort to demonstrate what Fidel Castro sees as the moral superiority of Cuba’s social development policies.

The latest data indicate that Cuba’s infant mortality rate was 5.6 per 1,000 live births, a figure less than that of the United States, which was 7.0 per 1,000 live births according to the latest published data (NCHS 2005, data are for 2002). Life expectancy at birth in Cuba today is the same as for U.S. citizens, 77 years. These achievements make Cuba a model and therefore, make possible its medical diplomacy.

In the past 35 years, Cuba has tripled its number of healthcare workers. Even more striking is the change in the ratio of doctors to population. This went from one doctor for every 1,393 people in 1970 to one doctor for every 159 people in 2005. This was part of Pres. Castro’s 1984 family doctor plan to put a doctor on every block. Having accomplished this in both urban and rural areas, even isolated ones, Cuba is now exporting this model through its medical diplomacy initiatives.

There was also a simultaneous development of high tech medicine and biotechnology as well. Cuba shares its expertise through numerous international medical conferences that it holds every year and through scientific exchanges. Because research is also an important part of the operation of the health system, in the medical and public health field alone, Cuba publishes 54 professional journals.

As early as 1982, the U.S. government recognized Cuba’s success in the health sphere in a report that affirmed that the Cuban health system was superior to those of other developing countries and rivaled that of many developed countries.

Source: Internet