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Fears for Brazil's healthcare system

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Fears for Brazil's healthcare system as Bolsonaro sends Cuba's white coat diplomacy packing

 

Cuban doctors stop for a selfie as they return homeCuban doctors stop for a selfie as they return home following a row with the president-elect CREDIT:  ERALDO PERES/AP\

 Euan Marshallsão paulo

Angelita Santos cried when she heard the doctors were leaving. Health director in a town in the south-eastern state of São Paulo, she was aghast to hear that Cuba was pulling out the fleet of medical staff that kept facilities in Brazil's neediest regions afloat.

"We were rocked by the news. The doctors called us that morning in tears, and we were in tears too", Ms Santos said. Her town of Embu-Guaçu had had 19 doctors for its 70,000 residents only last week. Now, amid a diplomatic rupture between Havana and Brazil's new far-Right president-elect, it had been abruptly left with just two. 

"We're praying that replacements come soon. We can’t handle the demand of patients," she told The Sunday Telegraph.

Health centres in peripheral areas around Brazil have been left severely short-staffed after the Cuban decision, prompted by repeated verbal attacks on the More Doctors programme by Jair Bolsonaro ahead of his January 1 inauguration.The hard Right politician dubbed "the Trump of the Tropics" has upended relations between Brazil and the socialist island, which for much of the last two decades have been close allies under Leftist leaders in Brasilia.

Cuban doctors accounted for almost half of the medical personnel in the programme
Cuban doctors accounted for almost half of the medical personnel in the programme CREDIT: ERALDO PERES/AP

Luiz Inacio Lula da Silva and his Workers' Party successor, Dilma Rousseff, were bastions of the Latin American "pink tide", which saw Leftist governments in countries such as Venezuela, Ecuador, Bolivia, Argentina and Nicaragua form a strong regional alliance. Cuban aid, including in the form of doctors, played a key part in Havana's extended reach on the continent, with large medical missions in Venezuela and Bolivia in particular. 

But that tide is now turning, with the election of Mr Bolsonaro heralding the most dramatic reverse. Before even taking office, the populist politician is flexing his muscles and pushing Brazil further to the extreme Right. 

A staunch opponent of the Havana regime, Mr Bolsonaro promised to kick out Cuba's doctors at several campaign events, angering its government and causing the end of its white coat diplomacy in South America's largest nation.

The More Doctors programme employed 8,332 Cuban personnel, many of which have already flown out, leaving Brazil's primary healthcare system in a state of panic. The rest are expected to leave by December 10, amid what the Cuban health ministry has called a "lamentable situation".

The Cubans accounted for almost half of the 18,240 doctors brought in from overseas under the programme, launched in 2013 under Ms Rousseff with the aim of improving healthcare in the most impoverished and remote regions.

Brazil's then health minister, Alexandre Padilha, embraces Cuba's vice minister of health, Marcia Covas in 2013, when the More Doctors programme was launched

Brazil's then health minister, Alexandre Padilha, embraces Cuba's vice minister of health, Marcia Covas in 2013, when the More Doctors programme was launched
Brazil's then health minister, Alexandre Padilha, embraces Cuba's vice minister of health, Marcia Covas in 2013, when the More Doctors programme was launchedCREDIT: ERALDO PERES/AP

Posturing after his election, Mr Bolsonaro pledged he would force Cuban doctors to take proficiency tests to attest to their skills. 

Last week, he claimed that “there is no proof they are actually doctors,” despite the submission of a valid medical degree being a prerequisite for the programme.

"It’s a worrying situation," said Mauro Junqueira, president of the National Council of Municipal Health Departments. “The Cuban doctors were welcomed here, they did a great job," he said, adding that he hoped Brazilian replacements would fill the breach as effectively.

On Tuesday, the Brazilian government hurriedly released an emergency tender to replace the jobs vacated by the departed Cuban doctors. As of Friday morning, health ministry officials said 84 percent had been filled.

However, it remains to be seen whether these gaps will be properly plugged.

Last year, the health ministry posted 2,320 new vacancies within the programme, for which 6,285 Brazilian doctors applied. However, only 1,626 showed up to work, and one third resigned within their first year.

Many Cuban doctors in Brazil have already flown home, while the rest are expected to leave by December 10

Many Cuban doctors in Brazil have already flown home, while the rest are expected to leave by December 10
Many Cuban doctors in Brazil have already flown home, while the rest are expected to leave by December 10 CREDIT: ERALDO PERES/AP

Brazil's doctors are unequally distributed across the country, with an average of 5.07 doctors for every thousand residents in Brazil’s state capitals, but just 0.3 in towns of less than 5,000 inhabitants, according to official data.

"It’s not easy working in the most isolated parts of the country, for some health centres it can take over a day just for the doctors to get to work," Mr Junqueira said.

The perception is that the Cuban doctors filled the jobs that Brazilian professionals do not want, such as specialised indigenous health clinics. Of the 372 doctors working in 34 indigenous districts across the country, 301 are from Cuba.

The local health clinics staffed by the More Doctors programme are responsible for primary healthcare and vaccination campaigns, a crucial branch of Brazil’s public health system.

In July, Unicef warned that Brazil needed to step up its disease prevention programmes, citing data that the country’s vaccination coverage had decreased for diseases such as measles, polio and diphtheria. 

The country was also hit with successive yellow fever outbreaks in 2017 and 2018, causing hundreds of deaths.

It is not the only blow to those living in peripheral and rural regions of Mr Bolsonaro’s Brazil.

Recently, the president-elect backpedalled on his promise to scrap the environment ministry but is set to name agronomist Evaristo de Miranda as the new department head, intending to roll back protections against deforestation and loosen environmental licensing laws. His pick for foreign minister, Ernesto Fraga, declared last year that climate change was “a Marxist plot”.

Such moves could not come at a worse time for the Amazon rainforest, where deforestation has hit its highest rate in a decade, according to newly released government data. 

Deforestation grew by 13.7 percent with 3,050 sq miles of rainforest destroyed between August 2017 and July 2018 - an area roughly five times the size of London.

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Like I said in another thread, I thought this asshole would start killing people just in 01/01/2019 - when he will take Office - but no, it has already started.

He said, and truly believes, that many doctors are communist spies.

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The program is called "mais médicos" wich means more doctors, was planned by Cuba dictatorship so that Brazil would basically  give then money for something we don't need. In 10 days 97%of the Cubans already have replacement doctors for their jobs.

The doctors needed to come alone and 70% of the salary would go straight to Cuba, another 10% would go to another organization that were the mediator of the agreement and they weren't allowed to bring their families.

They were pretty much modern slaves working for the party.

the new president never asked the Cubans to leave, he said the program needed to change and the Cubans should keep their full salary, be able to bring their families and take a test to prove that they were able to perform their duty as physicians.

But this was immediately rejected by Cuba that determined the immediately return of the doctors, many of which said that wanna stay in brazil and the new government already said Will grant asylum.

Unfortunately many still defend a dictatorship that treat the people as merchandise.

 

 

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Cuba is the largest body hire company in the world. 

 

....it's a disgrace. 

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Just now, El Presidente said:

Cuba is the largest body hire company in the world. 

 

....it's a disgrace. 

Really?? I figured that would've been the Philippines. But then again, I suppose the Cuban people get screwed over more, even being overseas. Unless they denounce their citizenship I imagine.

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7 minutes ago, Derboesekoenig said:

Really?? I figured that would've been the Philippines. But then again, I suppose the Cuban people get screwed over more, even being overseas. Unless they denounce their citizenship I imagine.

The Cuban Government runs it as a business. 

Exported Doctors and Nurses are only one angle. 

Foreign business needing staff in Cuba? No problem. You hire them through the government at near your own countries wage rates......and then the government pays the worker 20-25 CUC. 

Construction, tourism, IT etc.   

 

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20 minutes ago, ORITO_SAMA said:

The program is called "mais médicos" wich means more doctors, was planned by Cuba dictatorship so that Brazil would basically  give then money for something we don't need. In 10 days 97%of the Cubans already have replacement doctors for their jobs.

The doctors needed to come alone and 70% of the salary would go straight to Cuba, another 10% would go to another organization that were the mediator of the agreement and they weren't allowed to bring their families.

They were pretty much modern slaves working for the party.

the new president never asked the Cubans to leave, he said the program needed to change and the Cubans should keep their full salary, be able to bring their families and take a test to prove that they were able to perform their duty as physicians.

But this was immediately rejected by Cuba that determined the immediately return of the doctors, many of which said that wanna stay in brazil and the new government already said Will grant asylum.

Unfortunately many still defend a dictatorship that treat the people as merchandise.

 

 

Are you kidding, right?

"for something we don't need." Whaaaaaat?!?!?!

"In 10 days 97%of the Cubans already have replacement doctors for their jobs." They applied, they didn't start working. Like in the past, before Mais Médicos, the few who showed up gave up before one year.

"The doctors needed to come alone". It was a program for 2-3 years period and most of them worked in poor places in Brazil, the family wasnt allowed to come simply because most of the places didn't have infrastructure to all of them. And, of course, anyone who wanted could go back to Cuba. Don't forget that the new president tried to forbid the family to come with the doctors. 

"70% of the salary would go straight to Cuba, another 10% would go to another organization that were the mediator of the agreement". Brazil didn't hire Cuban doctors. They hired doctors from all over the world, most of them being Cubans, Spanish and Brazilians. The Brazilian government paid to this organization and the organization paid the doctors. Like in many recent reports in Brazil media, all the doctors knew how much they would make coming to Brazil. Nobody was fooled.

I could go on but there is absolutely no point discussing with Bolsonaro fans.

Sorry, guys, I will not play his game. A fast Google search will show you what Bolsonaro fans are capable to do (I warn you: you will be terrified). Most of you know me and know that I always respect different opinions but with Minions (this is how Bolsonaro fans are called in Brazil) there is no discussion. Violent people don't have space in my life.

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It’s hilarious that they call it “extreme right” because you know, anything right of “communist””socialist” is extreme!

9 hours ago, oliverdst said:

Most of you know me and know that I always respect different opinions but with Minions (this is how Bolsonaro fans are called in Brazil) there is no discussion. Violent people don't have space in my life.

Wasn't Bolsonaro stabbed at a campaign event?

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Having no dog in this fight (except a general bias against communist states) I have found it interesting to read both sides here.

I was not going to mention it, but since someone else did, bias in media is nothing new to me. I too found the article writing style as supporting a bias.

Cheers! -tP

 

 

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Interesting read.

Hopefully those spots get filled quick.

I do hate hearing plans to roll back environmental protections. The Amazon has a gigantic impact on global weather. Scary to hear what deforestation does.

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Brazil wants to end the modern day slavery that Cuba had established...nothing wrong with that. Those doctors were miserable in Brazil making a mere portion of what doctors should make...I know because I have family on the island that said they would never ho to Brazil to work in medicine...horror stories

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3 hours ago, El Presidente said:

Cuba is the largest body hire company in the world. 

 

....it's a disgrace. 

North Korea may be even more disgraceful in this regard.

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9 hours ago, oliverdst said:

Are you kidding, right?

"for something we don't need." Whaaaaaat?!?!?!

"In 10 days 97%of the Cubans already have replacement doctors for their jobs." They applied, they didn't start working. Like in the past, before Mais Médicos, the few who showed up gave up before one year.

"The doctors needed to come alone". It was a program for 2-3 years period and most of them worked in poor places in Brazil, the family wasnt allowed to come simply because most of the places didn't have infrastructure to all of them. And, of course, anyone who wanted could go back to Cuba. Don't forget that the new president tried to forbid the family to come with the doctors. 

"70% of the salary would go straight to Cuba, another 10% would go to another organization that were the mediator of the agreement". Brazil didn't hire Cuban doctors. They hired doctors from all over the world, most of them being Cubans, Spanish and Brazilians. The Brazilian government paid to this organization and the organization paid the doctors. Like in many recent reports in Brazil media, all the doctors knew how much they would make coming to Brazil. Nobody was fooled.

I could go on but there is absolutely no point discussing with Bolsonaro fans.

Sorry, guys, I will not play his game. A fast Google search will show you what Bolsonaro fans are capable to do (I warn you: you will be terrified). Most of you know me and know that I always respect different opinions but with Minions (this is how Bolsonaro fans are called in Brazil) there is no discussion. Violent people don't have space in my life.

Of course you don't want to play this game you already throwed the fascist card, there's nothing left for you.

it's the good people slavery, so it's ok. what a shame.

These people wanted the country to be lead by a jailed man so we can expect honesty.

 

7 hours ago, MooseAMuffin said:

Interesting read.

Hopefully those spots get filled quick.

I do hate hearing plans to roll back environmental protections. The Amazon has a gigantic impact on global weather. Scary to hear what deforestation does.

sorry to inform but in the last 15 years the Amazon had the biggest increase in deforestation ever, the last government would go as far as accepting bribes from black market to let it cut tree's, so don't believethe ones that now are acusing, they are the same ones who made profits with this

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Play the ball, not the man, people. We have already had Moderator action today.

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11 hours ago, oliverdst said:

He said, and truly believes, that many doctors are communist spies.

Well.. I suppose that's not beyond the realms of possibility. I'd imagine it's possible that many doctors returning to Cuba get debriefed in a quiet room somewhere in Havana.

However the mother of a child with Yellow Fever in an isolated community in Brazil isn't going to care much about that.

Like many here, I'm a parent and like most parents I can remember nights lying in bed being afraid to fall asleep out of fear that my child would not wake up in the morning. Scary times, caused by simple, easily-treatable things, rotavirus, chest infections, vomiting bugs etc..

I can't imagine what that would be like without access to doctors/nurses.

Healthcare as a right is a thorny issue and I don't want to get into that.  Equally thorny is the practice of Cuba exporting bodies to foreign countries, however I can't imagine better training in the world than doctors working in tough conditions like that, isolated areas with limited to no budget.

In most of the world, including here, we're conditioned to the belief that poor people far away are less important. Look at the news any night, "30 people die in a bridge collapse in Genoa" then 5 segments later "350 drown in a ferry in India". While 30 people dying is a terrible thing, why is it so much more important than 350?

I'm not a fan of communism but what I do notice is that Cubans care more, on average, about poorer people everywhere. The Cubans I've talked to care more about homeless people in Ireland than most Irish people do. The older I get, the more I think about it.

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Horrible for the Brazilians left without care (and there will be no replacements soon) but in the end Cuba decided to recall them. 

Maybe they have a better deal lined up someplace else?

The Cuban doctors won’t be pleased either - they might get sent to Venezuela instead😈

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14 hours ago, Ryan said:

Well.. I suppose that's not beyond the realms of possibility. I'd imagine it's possible that many doctors returning to Cuba get debriefed in a quiet room somewhere in Havana.

However the mother of a child with Yellow Fever in an isolated community in Brazil isn't going to care much about that.

Like many here, I'm a parent and like most parents I can remember nights lying in bed being afraid to fall asleep out of fear that my child would not wake up in the morning. Scary times, caused by simple, easily-treatable things, rotavirus, chest infections, vomiting bugs etc..

I can't imagine what that would be like without access to doctors/nurses.

Healthcare as a right is a thorny issue and I don't want to get into that.  Equally thorny is the practice of Cuba exporting bodies to foreign countries, however I can't imagine better training in the world than doctors working in tough conditions like that, isolated areas with limited to no budget.

In most of the world, including here, we're conditioned to the belief that poor people far away are less important. Look at the news any night, "30 people die in a bridge collapse in Genoa" then 5 segments later "350 drown in a ferry in India". While 30 people dying is a terrible thing, why is it so much more important than 350?

I'm not a fan of communism but what I do notice is that Cubans care more, on average, about poorer people everywhere. The Cubans I've talked to care more about homeless people in Ireland than most Irish people do. The older I get, the more I think about it.

Believe me, they don't need to come as doctors to spy Brazil.

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30 minutes ago, oliverdst said:

Jair Bolsonaro launches assault on Amazon rainforest protections

Most strongly sharing this fear!

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