HAVANA, Cuba.- Since 2017, when he was a Senator, Jair Bolsonaro, Brazil’s President-elect, has had the More Doctors Program at the center of his ultra-right-wing discourse, vilifying the training of the Cuban medical staff and classifying them of modern slaves.

After its election last October, Bolsonaro has opened a permanent fire against Cuba and the More Doctors Program in an aggressive and offensive language. In addition to reiterating their questioning of the quality and training of Cuban professionals and requiring them to pass a questioned revalidation exam, Bolsonaro attacks the PAHO-Brazil-Cuba triangular agreements talking about Cuba appropriating the salaries of physicians and that does not allow the presence of their relatives in Brazil.

In his eagerness to be well aligned with the Trump Administration and his friends of the Anticuban ultra right, led by Senator Marco Rubio, Bolsonaro is able to shatter a collaborative program that has provided health care to millions of Brazilians, especially the poorest people in that country, not a few of whom had never had primary health care. It is not surprising then the public complacency of the Undersecretary of State for Western Hemisphere Affairs in the U.S., Kimberly Breier, with the anti-Cuban actions of Bolsonaro.

Since the pronouncement of the Cuban Ministry of Health, the President-elect of Brazil, the far-right of that country and its fellows of Miami repeat again and again their speech of snare and try to reverse the guilt of the deadly blow that have given to medical assistance of a significant part of the Brazilian people.

Let’s do a review of truths that undress wicked snares:

Does Cuba take the salaries of doctors in Brazil?

The Ministry of Public Health (MINSAP) pays in Cuba 100% of the collaborators´ salaries. Although they are not in Cuba their positions and all labor and social guarantees they are creditors as workers of the national Health system are preserved, as well as the protection and attentions necessary for their families.

The collaborators in Brazil do not receive salaries, because they are not employees of the health system, but scholarships providing services specializing in primary services of Brazil, that is allowed by the Federal Law on the More Doctors Program.

The Government of Brazil does not pay salaries to the Pan American Health Organization but pays for the services the organization has contracted to the Ministry of Public Health.
The collaborators who by personal choice decide to participate in the More Doctors Program under the auspices of PAHO sign a contract with the Ministry of Public Health of Cuba by which they voluntarily decide to share income to strengthen the Cuban health system.

The collaborators in Brazil receive a stipend for personal expenses and the program finances their food, housing, transportation and health insurance, which is part of their income.

The Cuban collaborators have a solidarity vocation and prefer to share benefits for the common good of their country, rather than defending a selfish and individualistic vision. They do so not only in Brazil, but in other countries that pay for the provision of Cuban health services.

The voluntary contributions of the collaborators to the health system have helped to financing the repair and rehabilitation of polyclinics, several provincial hospitals and supplies of inputs, medicines and equipment for important programs such as that of fight against cancer.

Until the closing of 2017, more than 2 700 clinics and 327 polyclinics were intervened with repair and maintenance actions.

Thirty-one new technologies and advanced techniques were introduced, mainly in the development lines of the specialties responding to the solution of prioritized health problems, as well as those requiring treatment abroad.

As part of acquiring new technologies and renewing others, more than 5 000 medical equipment were imported, with a value exceeding 32.5 million dollars, prioritizing anesthesia, surgical activity and maternal and child care programs and that to care critical ill patients, among others.

These resources are reverted to the universal, free and quality services the health system provides to all the people of Cuba, including collaborators on their return and their families, all victims of the economic, commercial and financial blockade of the United States that precludes access to such resources in any other way.

In 2017 they were reported 96 361 152 medical consultations, 6 480 369 more than the previous year, while the hospital activity achieved, for the seventh consecutive year, more than one million surgeries, reaching the highest figure in history with 1 085 623 operations. Of the major elective surgeries, 14% were made by minimum access.

Collaborators’ contributions have helped to get the material needs of free training in Cuba of physicians from other much poorer countries, which in these 55 years amount to almost 36000.

Does Cuba prohibits doctors’ contact with their families?

The Ministry of Health of Cuba does not prohibit collaborators from associating with their families and in fact, most of them have received a visit to their relatives at different times of their stay in Brazil; besides they maintain permanent communication with them by different ways. Thousands of relatives have traveled to Brazil in these years and more than 300 are currently there accompanying the collaborators.

The Program rules established by the Government of Brazil regulate the access and coexistence of people outside the collaboration with the cooperating physicians.

Not everyone invites family members for different personal reasons nor all relatives are willing to travel.

Aren’t Cuban doctors qualified? Have they not been examined by the authorities? What do you want with revalids?

The More Doctors Program Law is clear as to how doctor ‘ titles are credited and the role played by the Pan American Health Organization, the Ministry of Public Health and the Cuban universities of medical sciences in their accreditation.

Our collaborators have to undergo prior exams before traveling to Brazil and to pass periodic exams during their stay. All these tests are conducted by the Ministry of Health of Brazil.

The offers of revalidation of titles are misleading because the Medical College is opposed to it: in Brazil there are thousands of graduate doctors whose titles have not been revalidated. Out of every 100 doctors who take tests, only 8 pass.
That is the way to keep the private health market regulated in order to ensure its enormous income: less doctors and more money. That’s why they were opposed from the beginning to the More Doctors Program.

With these aggressive pronouncements will the safety of Cuban doctors be guaranteed?

Our collaborators provide services in places where Brazilian doctors and from other countries do not want to go. They assume dangers for their vocation to save lives.

That is why they are in the most risky places, in the communities of extreme poverty, in favelas and violent neighborhoods where even the police cannot enter. They are in the 34 special indigenous districts and in 700 municipalities that have never met a doctor before in the history of Brazil.

Until today the people and the government have protected them, but that protection is going to be withdrawn by the new government

Bolsonaro´s pronouncements and his conditions are “for the good of the collaborators”?

It’s a fake he looks for a good. We know well the new President’s insidious proposals seek to discredit doctors, humiliate them in their dignity, to lead them to violate a contract, abandon their companions and the mission.

If he look for a good, why don´t he solve the revalidation of the titles of the thousands of Brazilian doctors who cannot work and who have to leave the country because positions are denied to them?

If he sought a good he would confront the Medical College to allow his own compatriots, graduates of Medicine in Cuba, to pass the exam and access to jobs in the Brazilian health system.

If he really looked for the good of collaborators he would not invite them to separate themselves from their families and their country under the pretext of joining them with their families here. That invitation has a name: Brain drain.
The only thing the President-elect has proposed is a great operation of Cuban brain drain, similar to the parole.

The best response to Bolsonaro’s snare was given to the AP news agency by the former Minister of Health of Brazil, Alexandre Padilha: “Bolsonaro does not understand that a doctor does not practice medicine only for money. Doctors working in the poorest areas do not think only of money. ”

Taken from Cubadebate