The Cuban Doctor Pays a Visit
St. Augustine's Catholic Church in Barrio Temporal is a pretty odd place for a Cuban outpost in Bolivia. But so it goes.
It is midday here in my neighborhood and the sun is brutal hot. A short line of local women, most looking to be in their mid to late 50s, is waiting at a small side door to one of the church's tiny classrooms. I know this classroom. It is where both my older kids prepared for their first communion (We're in Bolivia, someone in the family has to be Catholic).
Today the room is occupied by a visiting doctor from Cuba, Doctora Maita, a serious woman who I guessed to be in me late 30s. She tells me that she's been here eight months and likes Bolivia.
All through the weekend the local neighborhood organization was passing out flyers for "Operation Miracle" which at this moment is focused on offering free eye exams and free surgeries for anyone diagnosed with either cataracts or certain other operable eye problems. Judging from the line yesterday, and a stream of visits that lasted from 8am to 6pm, local interest was high.
"If you need an operation it will be free," Christian Cruz, head of the local neighborhood association, tells the women and men who come by. "If you need glasses it will be free."
There is one catch however, to get the surgeries my neighbors will need to travel four hours by bus to Villa Tunari, a small town in the middle of Cochabamba's Chapare jungle region. Operation Miracle tried to get clinic space in Cochabamba, but to no avail. The project needed a loan of three rooms for three years – one for reception, one for doctor visits, and one to set up for operations.
"The doctors here just want to make money," Cruz complains. I also expect it was just easer for the Cubans to set up in one place and Villa Tunari – a tourist destination that is also hub to a region of rural poverty – probably wasn't a bad pick. It also, coincidently, is the political hometown of Evo Morales' MAS party and the government is a key backer of the Cuban doctor program.
"I have a problem in this eye," a young Bolivian soldier tells Cruz and I through a chain link fence as he passes by. "It keeps looking at all the girls."
"Be careful," I warn him, "I think the Cubans might spread it to the other eye as well."
Much uproar has been made in Bolivia and in the foreign press, these past few months, over Cuban doctors coming here to offer free care. Medical quality isn't the issue. A lot of Bolivian doctors have studied in Cuba and the island of Fidel is also a popular destination for members of the Bolivian middle class seeking high quality care.
But up on the hillside near my home, politics was not an issue. "I have had two surgeries on this eye and neither of them worked," a woman with cataracts tells us. She took a number and joined the line, hoping that maybe Doctora Maita might help her do better.
It is midday here in my neighborhood and the sun is brutal hot. A short line of local women, most looking to be in their mid to late 50s, is waiting at a small side door to one of the church's tiny classrooms. I know this classroom. It is where both my older kids prepared for their first communion (We're in Bolivia, someone in the family has to be Catholic).
Today the room is occupied by a visiting doctor from Cuba, Doctora Maita, a serious woman who I guessed to be in me late 30s. She tells me that she's been here eight months and likes Bolivia.
All through the weekend the local neighborhood organization was passing out flyers for "Operation Miracle" which at this moment is focused on offering free eye exams and free surgeries for anyone diagnosed with either cataracts or certain other operable eye problems. Judging from the line yesterday, and a stream of visits that lasted from 8am to 6pm, local interest was high.
"If you need an operation it will be free," Christian Cruz, head of the local neighborhood association, tells the women and men who come by. "If you need glasses it will be free."
There is one catch however, to get the surgeries my neighbors will need to travel four hours by bus to Villa Tunari, a small town in the middle of Cochabamba's Chapare jungle region. Operation Miracle tried to get clinic space in Cochabamba, but to no avail. The project needed a loan of three rooms for three years – one for reception, one for doctor visits, and one to set up for operations.
"The doctors here just want to make money," Cruz complains. I also expect it was just easer for the Cubans to set up in one place and Villa Tunari – a tourist destination that is also hub to a region of rural poverty – probably wasn't a bad pick. It also, coincidently, is the political hometown of Evo Morales' MAS party and the government is a key backer of the Cuban doctor program.
"I have a problem in this eye," a young Bolivian soldier tells Cruz and I through a chain link fence as he passes by. "It keeps looking at all the girls."
"Be careful," I warn him, "I think the Cubans might spread it to the other eye as well."
Much uproar has been made in Bolivia and in the foreign press, these past few months, over Cuban doctors coming here to offer free care. Medical quality isn't the issue. A lot of Bolivian doctors have studied in Cuba and the island of Fidel is also a popular destination for members of the Bolivian middle class seeking high quality care.
But up on the hillside near my home, politics was not an issue. "I have had two surgeries on this eye and neither of them worked," a woman with cataracts tells us. She took a number and joined the line, hoping that maybe Doctora Maita might help her do better.
45 Comments:
I think some tougher questions about the "quality" of the Cuban medical care might be in order. Yes, the Cuban medical system has a solid reputation -- particularly overseas. But there's been enough reports lately about the stark differences between "local" care (for Cubans) and "medical tourism" care (not for Cubans), as well as complaints that Cuban medical students (I've heard this from Bolivians who've spent time in Cuba as medical students as well) not having proper equipment w/ which to study. So there's growing concern that many of the Cuban doctors sent overseas (especially) aren't as well trained as they were, say, 10-15 years ago.
I'm also curious on any new news about the 30+ Cuban doctors who recently defected to Bolivia.
As for where the Bolivian middle class goes for treatment is, partly, a matter of ideological principle. Many leftists middle class members do prefer Cuba, for political reasons. So it all depends on which members of the middle class one is most familiar with. But many others in the middle class prefer medical treatment in Peru (I've an aunt who specifically did her oncology studies in Lima, because the Cuban system at the time wasn't up to her standards), Chile, or Brazil (similarly, many Brazilian come to do medical studies in Santa Cruz). Of course, if they can afford it, they tend to go to the US or even Europe.
this concept of cubans "defecting" always makes me wonder. how far are we taken by the mere use of terminology? why does noone ever say that the Bolivians in Argentina, or in D.C. have "defected" from Bolivia? have I, and the other "elite Bolivians" who studied in the United States, "defected" from Bolivia? did Jim "defect" from California?
If Jim defected from California it was a good move and I'd have much more respect for him...
I would assume that the term "defecting" implies that one left a country where that country would not normally authorize you to leave. My understanding is that Cuba prevents its citizens from leaving. The doctors are not permanently stationed in Bolivia; Cuba expects them to return. The other countries you cited (I like to imagine that Califirnia is a separate country) do not forbid their citizens from staying abroad.
In the past months I also encountered and talked, even befriended some of these doctors, and no, as fare as I know, none of them “defected” because of me or my help. From the ones I spoke to, I notice that most have in common that are young, married and have little experience in their work. One of them in La Paz, after several shots of cheap singani, told me that in Cuba he did not worked as a doctor because he made more money selling under the counter cigars to tourists. Other, in Santa Cruz, told me that her brother in law made more money in tips from tourists working as a taxi driver that her as a doctor, all of them told me they make more money now; no wander they like Bolivia. Most off them also explained to me that the majority of the work they perform in Bolivia doesn’t need too much knowledge or technology. I said most, because I also found a few doctors that didn’t want to talk about their work or life in Cuba and seemed to know an iota about medicine, I figured out they where agents from their obscure police and stayed away from them.
Jim says that politics is not an issue here, its funny to how people see what they want to see when is convenient for them; he try to make this Cuban doctors a blessing to Bolivians and want to make Bolivian doctors look like some greedy bastards, because that is the policy of the MAS Regime with this issue. He quotes the head of local neighborhood association, what a long name for a MAS Partisan, saying, "If you need an operation it will be free," ……. "If you need glasses it will be free." ………….."The doctors here just want to make money,". As I mentioned before the Cuban Doctors are also here for the money, let’s be clear on how “free” this “free” service is. Somebody is paying these doctors salaries, I could not get a solid number because most of them refuse to talk about it, but from the drunk one and a couple of others I it is between US$ 350.- and US$ 500.- a month; plus other US$ 50.- their families directly received in Cuba. They have “free” housing, “free” offices, “free” transportation, “free” food, “free” entertainment, they pay “no” taxes, they have to take “no” exam to practice medicine in Bolivia; they just do not have “free of will”. At the end, these caring Cuban Doctors end up with clean US$ 400 to 550 in their pocket at the end of the month. Most of the Bolivian doctors with their capacity are happy to get US$50 to save for an emergency at the end of the month because when they charge for their services they are paying all those “frees”.
The Democracy Center, having Jim as their badass, infallible economist expert from Harvard, have being vicious at denouncing Free Trade Agreement and World Bank globalization policies as the worst that can ever happen in a Country like Bolivia, because these policies supposedly bring goods from abroad in diminish of local goods, import more money then exported, can make people to loose their jobs and only a few “rich”, entrepreneurs, will make most of the money. Medicine is a commodity, a good for the people, we might not have too many doctors to export but we did not need them to be import, we are spending more money in this Cuban Doctors that any money coming from Cuba, since only the MAS hard cores believe that money coming from Chavez is free. Bolivian young doctors are out of a job and most of the benefit, in political currency, is going to the MAS Regime. So, I will have to re phrase a saying I first heard during the Clinton era, and I will say, “Is not the economy, it is politics stupid”.
Jim Schultz: defector, or badass?
cuban anti-cancer drug defects to Usamerica
hasta la vista, Baby.
cuban rum brand defects to the us as well
For me, the test of defection is simple:
What percentage of the population, per year, risks their life (e.g. on rubber rafts) to leave the country?
Norman has it right: the question of "defection" or not is a matter of whether you have the right to leave. Those in the US who dislike their government, their society, or their economic system are free to leave. They're even free to leave to places like Cuba. But are people living in Cuba allowed to leave, freely, if they don't like their goverment, their society, ro their economic system? Or do they have to sneak out at night on unstable rafts and pray they reach another country?
The US Committee for Refugees and Immigrants estimates that 28,200 Cubans sought refuge abroad in 2003. 17,500 arrived in Mexico; 6,600 in Miami; 1,200 in Costa Rica; and then the numbers go down including Canada, Argentina, and Brazil.
http://www.refugees.org/countryreports.aspx?area=investigate&subm=19&ssm=29&cid=88
With an estimated population of 11.4 million, about a quarter of one percent of the population sought assylum. That figures seems like very little, but for comparison: The rate of US deaths in World War II was 0.32% of the total population.
Just to reiterate: the percentage of the Cuban population that fled Cuba in one year (2003) is only slightly lower than the total percentage of the US population that died in five years of war (1941-1945). If we do the math, it looks as if about twice as many (in terms of per capita percentage) Cubans fled their country in one year than the number of American servicemen/women who died in a single year of World War II.
If the figures for Cuba 2003 are roughly consistent (and they've gone up in years like the Mariel boatlift), then Cuba is steadily losing a share of its population roughly comparable to the casualty rate of a country engaged in a major world war every year for the last five decades. The cold hard numbers take my breath away and make me think about Cuba.
..Following Miguel's thoughts on Cuba, it might be interesting to keep an eye out for any noticebale trends/changes in trends regarding out migration from Bolivia in the midst of the changes going on there. Note that I don't say, "as a result of" changes there, since that'd be a bit premature/presumptuous. The idea also assumes that some sort of reliable data is available on these sorts of trends... T
Miguel: Facts don't matter to someone like Jim...you're dealing with a belief system, a religion...Evo good, anti-Evo bad. Socialist-good, capitalist-bad. Colla-good, camba-bad. You could show him video evidence of Evo eating live children and it wouldn't shake his beliefs. As Churchill said, 'Men occasionally stumble over the truth, but most of them pick themselves up and hurry off as if nothing ever happened.'
Something to Ponder you all:
Even with out Evo in power, do you think that an Aymara would be given a Visa to come to the USA? Doubt it. If so how long could they stay anyways without being deported? My spanish teacher from Columbia, who teaches at the university level must leave the country for at least two years. On the other hand our government allows thousands(millions ?) of illegal's from mexico into the country to work all the slave jobs, the bottom feeder jobs, fast food joints, migrant labor, ect. I will not over generalize and say that they are all bottom feeder workers, but large percentiles of them are. A funny Paradox, here a teacher with a Master of Arts in Communication must leave while the migrants working at MCdonalds get to stay.
Jonathan
My father (who was born in Oruro) was an accountant (head of accounting, actually) in Bolivia, and for a very large company at the time: Cambagras (it made soaps and other related products; it was state-owned). We moved to the US in winter of 84/85, fleeing the hyperinflation (it reached well over 20,000%) caused by growing fiscal deficits as the UDP Siles Zuazo government kept printing money to pay salaries for workers in state-owned industries that were unproductive.
Anyhow. We came to America (Saginaw, Michigan). My father didn't speak any English. So despite his education, he worked as a manual laborer for a while. His first job was selling newspapers, then he moved up to working as a roofer & other light construction. In the meanwhile, we lived on charity (both private & governmental), including all the various "welfare" services provided in the US -- we qualified because my mother & us kids were citizens (my mother worked running a government-sponsored day care program for other poor families while raising our newborn sister). We lived five blocks from a GM factory (Stearing Gear III).
In time, my father learned English, took his CPA exam, and we slowly crawled our way up to the lower middle class. He took a job at a non profit company that helped other immigrant families learn English, get job skills, and find work. We never had much money, but we did OK. All the kids went to public school; all (but one) went to college, and all got post-graduate degrees (all from public state colleges, we couldn't afford anything else).
What's the point of all this? Imagine that kind of social mobility in Bolivia, or most anyplace else. And think of what my father (an intelligent, hard-working man) could've accomplished in Bolivia had there been a halfway rational economic system. Instead, my father (and his sons) became part of the Third World "brain drain" and left to take our productive abilities elsewhere.
My father retired six months ago and moved back to Bolivia, to Santa Cruz (where he lived before we migrated to the US; he'd migrated to Santa Cruz in the 1970s because of better opportunities there). He took his US money back w/ him, and he wants to start a construction company in Santa Cruz that can generate jobs, income, and material goods to more people. He still believes in Bolivia. My father, whose parents spoke Quechua at home, is (in many ways) a typical example. He's intelligent, he wants to work, and look what he had to do: he moved to Santa Cruz to find opportunities, had to leave the country in the 1980s, and has returned, again to Santa Cruz. The idea of moving to La Paz (where he grew up in the 1950s-1960s) never crossed his mind. And my dad's a proud kolla.
Well, there you go... Most of the able, skilled, creative, and courageous people are leaving... Bolivians that could bring progress into this country think its better to leave, and its true, its better to leave... Why attached yourself to a country that gives you nothing? Miguel, your story is the story of over 110,000 people that leave Bolivia a year...
This is the only country in the world where progress, where successfull citizens are enemies of the state... Where honest and dignified growth is bad, where as illegal growth is perfectly fine... (check up Minister Ric) I am planning to leave in a year or so, and so are most of my peers and my siblings... It is toooo hard to work here... WAY TOO HARD... To be honest its not worth it. I work for the people, but if they don't want any help what can you do about it?
...The last two comments go toward (and answer, to some extent) my earlier question about what's happening with emigration in Bolivia. It seems that some people, 110,000/yr, if the last anonymous is correct, are giving up on Bolivia and bailing out. to be objective, Bolivia is not alone here in LA in that respect.
I've lived in several countries in LA in the last 30 years and every/every one of them loses thousands of its best/brighest/hardest working to the U.S. or Europe.
I live in Ecuador which is reasonably peaceful (notwithstanding frequent changes in government; not a lot of people have gotten hurt, fortunately) but continues to lose tens of thousand of its folks each year to the north because they simply can't work/prosper like you can in the States. According to contacts I have in the U.S. Department of Homeland security, Ecuador in number two, behind Mexico, in terms of illegal immigrants entering, or trying to enter the States. This is not meant to ameliorate the gravity of the situation in Bolivia, nor much less, say the political/economic situation of Ecuador is worse than that of Bolivia because more people leave; far from it.
I am saying though, that there are more endemic/deeper social/political malaises that affect LA countries than just Morales, Chavez or crumby polical leadership here in Ecuador - and those malaises need to be recognized addressed (FYI: a MAS approach will not/not do the trick), if we hope to keep Bolivians or whoever, in their home countries down here... T
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Good assessment of Cuban doctors in Bolivia, by foreign medical student.
http://www.thelancetstudent.com/2007/12/13/cuban-doctors-in-bolivia-help-or-hindrance/
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