About 8,000 Cuban doctors are leaving Brazil
When you think of Cuba’s exports , you might think sugar or tobacco . But in fact , its biggest export is health care. But the Cuban health care industry will take a hit after 8,000 of its doctors are being withdrawn from Brazil.
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Cuba is withdrawing 8,000 doctors from Brazil after a verbal sparring match with president-elect Jair Bolsonaro.
At this point, you might be wondering why Cuba has 8,000 doctors in Brazil to begin with . Cuba actually has a program called More Doctors, in which it sends 50,000 trained physicians to work in over 60 other countries, most of them developing and in need of medical expertise . Cuba calls them an army of white coats , and it’s big business. Through this program, health care is actually the country’s biggest export—meaning, Cuba makes more money off its doctors working on other countries than it makes from tobacco, sugar, or tourism industries. Brazil alone pays Cuba about $400 to $500 million a year for health care services. Many of the Cuban doctors have worked in parts of Brazil that are under-served by the medical community, where the only doctors available in whole towns are these Cuban doctors.
Cuba sends tens of thousands of doctors to needy countries to administer checkups , deliver babies , cure illnesses , and tend to injuries . What’s not to like? Well, plenty. For starters , the host countries —the ones receiving the medical help from Cuban doctors—don’t pay the doctors directly . Instead, they pay the Cuban government—and the government keeps 80 percent of their wages . Second, doctors are not allowed to bring their families with them. Since many Cubans have historically tried to defect —or seek asylum in the United States and Europe—when given the chance, the Cuban government doesn’t allow them to bring their families along, supposedly to deter them from defecting.
One doctor who did defect, though, was a Cuban radiologist who had been working in Venezuela. He is Carlos Hernandez and he is now living in the United States, helping Cuban doctors defect to the United States, and here’s what he had to say about Cuba’s More Doctors program. He said the program was a violation of his dignity as a human being, and that he was paid just $50 a month.
The president-elect of Brazil, Jair Bolsonaro, sees things similarly . He called this arrangement “ slave labor .” He demanded that the Cuban government let the doctors working in Brazil bring their families and insisted that the government let the doctors keep more of what they earn for their services . He also wanted them to be trained and certified to practice medicine in Brazil.
Unsurprisingly , these conditions were unacceptable to the Cuban government, which promptly recalled the 8,000 doctors currently working in Brazil. What at first seemed like a win for Bolsonaro’s agenda , and a win for human rights , might easily have turned to disaster , since Bolsonaro didn’t appear to have a backup plan to fill those 8,000 jobs in over 2,800 towns. But after a massive recruitment effort , the government said within days that it had already filled 97 percent of the vacancies that will result from the Cuban doctors leaving.
Even so , it’s not clear whether all 8,000 are willing to work in the dangerous urban areas or the remote villages that the Cuban doctors served . Even with these particular jobs filled, there is still a shortage of medical expertise in Brazil. And the shortage is particularly acute in areas far from large cities. There is a legitimate fear that Brazil doesn’t have enough trained doctors to take care of its own population—or that they don’t live in the right places—and that Bolsonaro’s war of words with Cuba will actually deprive people in his country of the care they need. One typical example is the state of Pernambuco. The capital, Recife, has three-quarters of the state’s doctors, but less than 20 percent of the state’s population . That means there are a lot of people in smaller towns and cities that don’t have access to the medical care they need without traveling to the capital .
As difficult as this will be for Brazil, though, it will be worse for Cuba. While the island nation boasts over 60 client governments for its More Doctors program, the vast majority of the doctors are working in just two countries: Brazil and Venezuela. Venezuela has long been able to pay for its doctors by providing Cuba with cheap oil and loans . Over 21,000 doctors are currently working there. But Venezuela’s economy is collapsing , and the amount of oil that’s being produced is falling rapidly .
That puts the biggest source of revenue for Cuba’s government at serious risk . The Cuban economy has opened up a little bit to tourism, but its relations with the United States and Canada have cooled , and the hoped-for tourism boom has not yet materialized . The Cuban economy does not produce a wide enough variety of goods and services to make up for the losses from its More Doctors program.
If you liked this week’s topic, then you have a fellow listener to thank: Stéfano from the state of Maranhão in Brazil. At first, I wasn’t quite sure about this topic , if I thought it would be interesting. But he wrote me a nice summary of the topic and it really captured my interest . As Stéfano says, it’s a complex issue and there are a lot of people who need medical care in Brazil. I hope the new recruits the government found can fill the holes left by the departing Cuban doctors.
JR and I do a lot of the work here at Plain English, and I love it when the listeners chip in a little by suggesting topics and sending me some information. So if there’s a big story near where you’re living, and if you think it would be interesting to people around the world, send me a note to [email protected] and I’d be happy to consider it for a future episode. Thanks again to Stéfano for this story idea.
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