Emily Beam: Medical diplomacy

BY EMILY BEAM: LOOKING FOR AMERICA

Published September 8, 2005

With the help of its white-coated ambassadors, Cuban President Fidel Castro has found a new way to gain leverage in Latin America. On Aug. 22, the first class of 1,610 students from 28 countries graduated from the Latin American School of Medicine in Havana, founded in 1998 as a response to the destruction wrought by Hurricanes George and Mitch. Each year the Cuban government admits roughly 1,500 students, mainly from Latin American countries, and pays their tuition and living expenses for the duration of their training provided they return home to practice medicine upon graduation. Castro has also teamed up with Venezuelan President Hugo Chavez, to open a similar school in Venezuela, and the two expect to train 200,000 doctors within the next decade.

Angela Cesere

But while Cuba turns its attention abroad, it is still haunted by the tensions with the United States that threaten its work. Following the graduation ceremony, Honduran authorities announced that they would reject future Cuban scholarships to train Honduran doctors. According to the Honduran newspaper El Heraldo, they cited that Honduras’s needs have changed, and the country no longer needs doctors but medical technicians and nurses. It is highly improbable, however, that so much has changed in Honduras since the hurricane that a few hundred doctors each year could not be put to good use. Indeed, when the Honduran government also discussed halving the number of Cuban doctors working in the country, public outcry forced them to let the 300 doctors stay at least another year.

A more believable explanation for Honduran wariness toward Cuban help is pressure from the United States. There is a very realistic fear that accepting help from Castro might have severe consequences should it be determined that Honduras is leaning a bit too far to the left for the United States’s liking. But it is hard to justify that hundreds of would-be Honduran doctors must be denied an otherwise unaffordable education and the opportunity to serve their people with a stale feud more that 40 years old between Cuba and a nation that exploited Honduras for years as a military base and Contra-training ground.

Is Cuba acting with political considerations in mind? Almost certainly. But if thousands of people can be helped while Castro tries to make friends, that might not be such a bad thing. Doctors are doctors, and it is unfair for nations in which more than half the population lives in poverty to be forced to refuse aid because of a Cold War-era grudge.

The new graduates are hardly Castro’s first attempt to open the doors to its medical schools and share its own doctors worldwide. Cuba has more doctors per citizen than even the United States, and it has shipped off more than 50,000 doctors to work abroad during the past 40 years. In 2001, Cuba even began offering scholarships to the Latin American Medical School to low-income minority students from the United States, again provided they return to America to practice upon graduating. After recently negotiating an oil-for-doctors swap with Venezuela, the number of Cuban doctors abroad is beginning to spark concerns about doctor shortages within the country. At a time when nations have reached out to the United States following Hurricane Katrina, Castro also offered medical supplies and the services of 1,500 of its own doctors.

As always, the United States ignored the offer. Or rather, the Bush administration remained silent for nearly a week before finally rejecting the offer, making the hardly profound statement that they hoped “Castro would offer freedom to his people.” This is nothing new; Cuba rejected U.S. aid as recently as July, when America offered to help out following Hurricane Dennis, and the United States refused Cuban help following the Sept. 11 attacks. But in the case of Hurricane Katrina, there is little shame in putting the lives of Gulf Coast residents before political considerations. The scale of the disaster trumps concerns about how it might look to accept help from Castro, but the needs of hurricane victims have shamefully been pushed aside by politics.

Despite U.S. accusations that Cuba is attempting to destabilize Latin America, Castro is having some success in showing off his country’s good side thanks to its army of doctors. Once the United States recovers from the absolute devastation of Hurricane Katrina, it will once again turn its energies outward. Attention will have to eventually make its way back to the Castro-Chavez alliance and growing anti-Americanism in many parts of Latin America. Countering these factors will require a better strategy than threatening sanctions and meddling in elections. And if the United States is concerned with issues of human rights in Cuba, it will have to find a better way to handle Castro than sitting on its hands waiting for the 79-year-old leader to die. As America figures out how to improve its approach to Latin America diplomacy, it might stand to learn from Cuba’s example and use humanitarian aid as a tool to reach out to its southern neighbors — at least some people would be helped in the process.

Beam can be reached at ebeam@umich.edu.