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Preface For such a small nation, the number of doctors and nurses that Cuba is sending, as well as the speed with which the country has responded, is really extraordinary. Margaret Chan, director general, World Health Organization, September 12, 2014 In the fall of 2014, a deadly outbreak of Ebola swept through the West African countries of Liberia, Guinea-Conakry, and Sierra Leone. By midSeptember , 5,000 people had been infected, over half of whom died, and just four months later the number of patients had risen to over 20,000, with more than 8,000 deaths recorded. Predictions about the total number of cases ranged from 20,000 to hundreds of thousands. Faced with an impending disaster, Ban Ki-moon, secretary-general of the United Nations and Dr. Margaret Chan, director general of the World Health Organization (WHO), appealed to the international community for help and stressed the need for doctors and nurses above all else. The first country to offer support was Cuba. At that time the WHO had 170 medical staff working on this campaign but desperately needed more. (They had deployed some 500 specialists, but rotated them monthly due to the dangerous conditions, so that at any given time only about a third would be working in field.) Some international charities and NGOs had smaller numbers of medical staff working for short periods in West Africa, but others had withdrawn their members because of the dangers faced, and many healthcare workers had died as a result of infection. Some countries sent field hospitals and bedding, food, and medicine, while the United States provided extensive military support and others donated money. It was clear, though, that the greatest need was for medical personnel—a challenge ignored by most industrialized nations. Cuba responded to the appeal within days by offering to send to Sierra Leone 103 nurses and 62 doctors, all of whom had volunteered to help. This was the first contribution of healthcare personnel by any country, and it x · Preface is still the largest to date. Some context is appropriate here. At that time Cuba had more than 4,000 medical personnel already working in 32 African countries, and of these 2,400 were doctors. They chose Sierra Leone as the place to send the 165, since 23 Cuban medical personnel were already working there, and their program had been initiated several years earlier. The Cuban medical personnel who now arrived had an average of 15 years of professional experience, all had worked on missions in developing countries , and a quarter had worked in more than one. The Cuban commitment was to send their medical volunteers for a period of six months, after which they would reassess needs. Within a month the Cuban government had decided to increase the number of medical personnel, and it was announced that a further 296 would be sent to work in Guinea and Liberia. The Ebola crisis in West Africa struck a nerve in North America and Europe, since some of their citizens who had worked in the affected countries also became infected. A Cuban doctor, Félix Báez, became infected with Ebola and was treated in Switzerland, where he recovered. He subsequently volunteered to return to work in West Africa. Several died after returning to their home countries, and there was debate about whether the virus could spread there. Many governments overreacted, and a certain level of panic set in. Cuba responded in an organized fashion, training its volunteers in a fastidious, methodical approach at Havana’s prestigious Pedro Kourí Institute of Tropical Medicine in order to minimize the risks of infection. Together with the WHO and the Pan American Health Organization (PAHO), they also organized an international conference in Havana to which hundreds of medical personnel came in order to better understand the significance of the Ebola epidemic and how to treat it. Given the traditional approach of preventive healthcare, it was not surprising when they trained 240,000 people in Cuba about treating the disease and sent public health personnel to bordering countries, as well as to countries in Latin America and the Caribbean, in order to provide information about how to avoid being infected by Ebola and, where necessary, how to deal with it. In this way they trained almost 13,000 people in Africa, as well as 66,000 in Latin America and 620 in the Caribbean. Most important of all, they sent their doctors and nurses, selecting them from the 15,000 medical...


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