In the wake of Cuba’s withdrawal from Brazil’s More Doctors program, estimates indicate that 29 million Brazilians will be left without medical assistance.
Boticario is a town lost in the vast northeast of Brazil, in the municipality of Santo Amaro de Brotas, close to the Aracaju coast in the State of Sergipe, more than 1,600 kilometers from the capital, Brasilia.
It is hard to say if the President-elect of the country, Jair Bolsonaro, has been here, or if he knows where this town is located on the map. It is even more unlikely that he knows the story of María, a humble, young woman, 29 years of age, to whom a Cuban doctor provided relief.
Without the diagnosis of Dr. Reymeri Valderrama Pimentel, she would never have been able to fight the lymphatic filariasisshe suffered, a chronic, very debilitating disease also known as elephantiasis.
“We Cuban doctors who work in this municipality, will never forget María’s face, before and after the diagnosis, and those of her family and neighbors, who everyday placed their confidence in us and allowed us to enter their lives, despite the language and cultural barriers, that only love, professionalism, and humility can overcome,” said specialist Dr. Valderrama, who gave this testimony at the Central Medical Cooperation Unit in Havana, on the occasion of the 55th anniversary of Cuba’s international medical cooperation.
It was in 2012 that the Brazilian Institute of Applied Economic Research (IPEA) announced terrifying findings: doctors were in short supply; waiting times for appointments were long; and the quality of assistance was poor. At that time, the ratio of doctors per inhabitant was 1.8 per 1,000, according to the Brazilian Institute of Geography and Statistics (IBEG), far below other countries on the continent and around the world. Thus the analysis concluded with the proposal to raise this ratio to 2.7 doctors per 1,000 inhabitants.
Considering these statistics, it is evident that the More Doctors program, launched in August of 2013, was an urgent necessity. According to former President Dilma Rousseff, initiator of the effort, the goal was not to bring more foreign doctors to Brazil, but to take health care to the country’s interior.
The declaration released by the Cuban Ministry of Public Health, announcing its exit from the program, stated, “The work of Cuban doctors in places of extreme poverty, in the favelas of Río de Janeiro, Sao Paulo, Salvador de Bahía, in the 34 Special Indigenous Districts, especially in Amazonía, was widely recognized by federal, state, and municipal governments of the country, and by the population, who supported their presence at a level of 95%, according to a study which the Brazilian Ministry of Health requested of the Federal University of Minas Gerais.”
This reality was emphasized during the 2015 International Health Convention in Cuba, when Arthur Chioro, Brazilian Health Minister at the time, said, “Brazil has an official history of more than 500 years, and this is the first time we have doctors in all indigenous villages. This people, some 800,000 brothers, were never guaranteed access to a health team.”
The More Doctors program reached populations in Amazonia, in semi-arid regions, remote rural areas, and the outskirts of large cities, Chioro noted, adding, “Millions of people live in Sao Pablo, and in its periphery, thousands of them have no medical assistance.”
Brazilian authorities, the Pan American Health Organization (PAHO), and the population expressed their satisfaction with the program many times.
“We are very satisfied because 90% of the Brazilian doctors participating in this experience tell their Brazilian colleagues to come to the program, that it is worthwhile. This environment of success, credibility, and quality, we are morally obliged to share with the Cuban government, the PAHO, and with doctors from 30 countries who also responded to our call and make a contribution to allow Brazil to provide universal health coverage,” Chioro said at the gathering.
At the same time, he expressed the necessity of strengthening primary care with the opening of more medical schools and scholarships for residencies, “We are transforming the structure of our health system so that in ten years we have the capacity to provide this program more Brazilian doctors. We always count on the cooperation of Cuba, because we know that this sister people takes a position of great solidarity and commitment with Brazil,” he said.