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Will Arce bring Cuban doctors back to Bolivia?

By Lucas Leiroz | December 12, 2020

For the supporters of Evo Morales and MAS, the election of Luis Arce in Bolivia was a great victory. But the challenges for the new president are enormous and opposition to his plans is strong. One of the most recent challenges is to decide about the future of medical cooperation between Bolivians and Cubans. Arce, in the midst of his country’s political chaos, must choose the future of Bolivian health cooperation with Cuba.

For 13 years, thousands of Cuban doctors have been in Bolivia and helped to make up for the shortage of health professionals in this South American country. Altogether, more than 70 million medical consultations were carried out by Cubans in Bolivia. A real dependency relationship was created. Without Cubans, thousands of Bolivians are unable to receive any medical treatment and entire regions of the country are excluded from the national health system, mainly the urban peripheries and rural zones. Even so, shortly after the coup that overthrew Morales, one of the first attitudes of the government of Jeanine Áñez was to expel the brigade of Cuban doctors from Bolivia, as part of the alignment measures with the US planned by the opponents of Morales.

Despite the undeniable benefits of the Cuban presence, Bolivia’s departmental medical schools vehemently reject the Cuban brigade’s presence in the national territory. According to representatives of such departments, the members of the Cuban medical brigades are “supposed doctors” who perform secret activities for the Communist government of Cuba. Another widely used argument is that Cubans “take jobs” that would be for Bolivian doctors. In this regard, the Doctors’ Union announced that health professionals will soon go on strike against the Arce government and that services will only resume if the president maintains the veto against Cubans.

In addition, the La Paz Faculty of Medicine recently stated that it sent a letter to the Ministry of Health addressing the issue of Cuban doctors. The Faculty, like the Union, is directly opposed to the presence of foreign doctors in the country, however, it assumes a more “peaceful” posture, trying to negotiate with the government instead of starting a national strike.

This rivalry between Bolivian and Cuban doctors is not new. During the government of Evo Morales, Bolivian doctors carried out repeated strikes, which lasted for months, resulting in leaving a large percentage of the population dependent on the public health system without an adequate care. There was no statistical study on the case, but it is known that many Bolivians became ill, died, or had serious consequences due to the resistance of doctors to assist them – which is a crime. That is precisely why Arce is acting so cautiously: his goal is to prevent further strikes in the midst of the pandemic.

However, the idea of replacing Cuban doctors with unemployed Bolivian professionals seems to be nonviable. At the time of the expulsion, the Áñez government had declared that it would immediately fill these positions with Bolivian doctors, which never really happened, showing that Bolivia really has no structure to supply the absence of Cuban doctors.

There are a number of factors that must be considered when analyzing this case. First, it deals with a question of quality over quantity. Regardless of the numbers and whether or not there are enough Bolivian doctors to replace the brigades, Cuban medical training is noticeably more appropriate, with the Caribbean country being recognized worldwide for its medical quality. During the pandemic, Cuba sent humanitarian aid to several countries, including developed nations, such as Italy. It is impossible to deny the ability of Cuban professionals – which is usually done only based on ideological assumptions. Still, the numbers of Cuban actions in Bolivia are impressive: more than 70 million consultations, 47,000 laboratory tests and 253,000 surgeries. The main merit of these professionals serving remote regions, where the Bolivian public system has difficulty reaching. Bolivia is a country marked by mountainous and desert regions, where access by health professionals is often difficult. Bolivian doctors most of the time do not arrive in such regions as large urban centers are treated with priority. Cooperation with Cuba met this need.

It is also important to demystify the discourse of Bolivian health professionals that Cubans are “taking their jobs”. This is not true. It is important to remember that Bolivia is the poorest country in South America, with poor education conditions for most of the population. In general, Bolivians who graduate in medicine are part of the country’s economic elite and are, therefore, interested in guaranteeing their own interests, and not those of the population, when they criticize the government and promote strikes and stoppages.

Still, what to expect from professionals who refuse to treat their own countrymen, promoting stoppages of essential services only for political reasons? Apparently, the close links between the Bolivian opposition and the medical centers have reached intolerable levels. In any case, the scenario only tends to get worse.

Lucas Leiroz is a research fellow in international law at the Federal University of Rio de Janeiro.

December 12, 2020 - Posted by | Economics | ,

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