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8 Cuba’s Role in Haiti Hurricanes, an Earthquake, and Cholera First [in importance] is God, and then the Cuban doctors. Haitian president René Préval It is often mistakenly thought that Cuba first provided medical support for Haiti at the time of the massive earthquake of January 12, 2010, which leveled the capital, killing 230,000 people. In fact, Cuba has been providing medical support to the Haitian people for many years. Large-scale Cuban assistance began in 1998, and more than 6,000 Cuban medical personnel have worked in Haiti while over 1,000 Haitians from poor backgrounds have been trained as physicians in Cuba at no charge to the students.1 This chapter examines the evolving role of Cuban medical cooperation in Haiti, both in terms of emergency medical assistance—most clearly seen in natural disasters and in the 2011 cholera outbreak—and its contributions to sustainable public health in the poorest country in the Western Hemisphere. 1998: The Origins of Cuba’s Medical Cooperation Haiti has been plagued by natural disasters. In 1946 a tsunami killed 1,790 people, and hurricanes struck in 1954, 1963, 1994, and 1998. Floods killed 2,600 in 2004, and tropical storm Jeanne killed 1,900 more that same year. Tropical storm Noel triggered major mudslides and floods in 2007, and three hurricanes and a major tropical storm killed 800 Haitians in 2008. In September 1998, Hurricane Georges roared through the country, killing 230 people and destroying 80 percent of crops. More than 167,000 people were left homeless, and massive flooding resulted in unsanitary conditions throughout the country. In November of that year, an agreement was signed during the visit of Haitian president René Préval to Havana, the first accord since the breaking of diplomatic relations 36 years earlier. While the broad agreement called for Cuban support in education, agriculture, 190 · Healthcare without Borders tourism, and sports, the most important component was for the provision of medical cooperation. This involved 200 doctors being sent to work in Haiti and for 100 Haitian medical graduates to obtain specialized training in Cuba.2 On December 4, Cuba sent an emergency brigade to help the victims of Hurricane Georges, and in the following weeks 388 more emergency specialists arrived. Cuba adopted a dual approach to the disastrous public health situation in Haiti. First, they maintained a medical presence of between 300 and 500 personnel in the country for as long as they were needed, and second, they agreed to train hundreds of Haitians in Cuba as doctors, so that they could help their own people. The concept was to gradually withdraw Cuban medical staff as they were replaced by Haitians. That process has continued since 1998, and indeed at the time of the January 2010 earthquake there were 344 Cuban medical staff in Haiti as well as several hundred Haitian physicians trained in Cuba. The training of Haitians sought to develop a sustainable public health system. Cuba made the same offer for young Hondurans and Guatemalans, whose countries saw catastrophic loss of life caused by Hurricane Mitch during the same hurricane season, and since 2005 hundreds of young doctors from each of these countries have graduated from the Latin American School of Medicine in Havana, the world’s largest medical faculty. The first group of Haitian students was therefore selected, and they started at the Latin American Medical School in Havana in May 1999. The presence of Cuban medical personnel on the ground and the training of Haitian doctors continue to this day. Even major political developments in Haiti had little effect on the Cuban medical cooperation role. In late February 2004, for example, President Jean-Bertrand Aristide, who had been elected in 2000, was ousted in a violent rebellion and spirited out of the country, eventually being sent in exile to South Africa.3 Political turmoil had been swirling around the presidency of the former priest, who commanded popularity among the Haitian poor but had been accused of human rights abuses and corruption . Growing lawlessness, widespread instability, and spiraling violence (much of it politically motivated) became commonplace, particularly in the capital, Port-au-Prince. In February 2004, armed gangs took control of Gonaïves (Haiti’s third largest city), and groups opposed to Aristide carried out attacks in several cities. These ongoing political disturbances and the climate of uncertainty and fear that prevailed had a major impact on the health situation in the country. Cuba’s Role in Haiti: Hurricanes, an...


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