The Militant (logo)  
   Vol. 69/No. 45           November 21, 2005  
 
 
Cuban doctors help build
Equatorial Guinea’s health services
(feature article)
 
BY JONATHAN SILBERMAN  
MALABO, Equatorial Guinea—“We don’t just offer our medical services,” said Dr. Leonardo Ramírez, head of the Cuban internationalist medical personnel serving in this Central African country.

“Our goal is to strengthen Equatorial Guinea’s own health-care service, run by Guineans and for them. We collaborate in their training. This is a principle behind all our medical missions in countries around the world.”

Cuban volunteers, Ramírez said in an October 20 interview here, “work in health centers, clinics, and hospitals providing health services as well as training courses to raise the technical level of the medical personnel.” They also work to increase the health awareness of the population as a whole through activities in neighborhoods and radio broadcasts.

The Cuban medical mission is currently made up of 144 volunteers, 94 of whom are doctors. Around half are women. They work alongside Guineans in each of the country’s seven provinces and 18 districts—from the 200-bed hospital centers in the two largest cities, Malabo and Bata, to small practices in more remote rural areas.

Cuba’s medical collaboration in Africa started in the very first years of the revolution, when volunteer health brigades were sent to Algeria in 1963. At the end of 2004 there were some 1,200 Cuban doctors working in countries across the continent. In addition to Equatorial Guinea they are in Angola, Botswana, Cape Verde, Eritrea, Gambia, Ghana, Guinea-Conakry, Guinea-Bissau, Ivory Coast, Mali, Mozambique, Namibia, Seychelles, South Africa, Zambia, Zimbabwe, and areas in Western Sahara.

The current Cuban mission in Equatorial Guinea started its work in 2000. “Since then, more than 300 Cuban volunteers, mostly doctors, have practiced medicine here,” Ramírez said.

The Cuban medical brigades here are part of what is called the Comprehensive Health Program for Central America, the Caribbean, Africa, and Asia, an initiative the Cuban government launched in 1998 in wake of the social devastation following Hurricane Mitch.

Cuba’s collaboration stands in stark contrast to the theft by the imperialist powers of medical personnel from the semicolonial world. Dr. Agyeman Akosa, director general of Ghana’s health service, told the New York Times in an October 27 article that this “doctor drain” is leading to the virtual collapse of that country’s public health system. Ghana has lost 30 percent of its doctors to the United States, Britain, Canada, and Australia. It has only six doctors per 100,000 people.  
 
Guineans training as doctors
As part of Cuba’s international solidarity, some 200 medical students from Equatorial Guinea are currently studying in Cuba, and dozens more are being trained by Cuban teachers at the medical school of the National University in the city of Bata.

Twenty Guinean students flew to Cuba October 28 to spend their sixth and final year of medical studies doing practical work in hospitals in the western province of Pinar del Río. At the same time, 50 Guineans who studied for five years in Cuba returned home to complete their medical program working alongside the Cuban doctors in hospitals and clinics here. The 70 students will celebrate their graduation together next July.

Santiago Ndong from the town of Evinayong, one of the students preparing to leave for Cuba, described for the Militant what the first group of youth to enter medical school here felt they had conquered. “The first two years were very difficult for us,” he said. “For six months we didn’t even have textbooks, and we weren’t used to studying like that.

“But our Cuban teachers always treated us with respect,” he noted. “They called us compañeros.” Without them, “none of us would have made it,” Ndong said as the other students nodded in agreement.

“Next year there will be more than 70 students in the medical school,” Leonardo Ramírez said. “There are students in each year of study—so the number of doctors will continue to grow.”  
 
Main health problems
The biggest single health problem, we were told over and over, is malaria. But they also confront typhoid fever, intestinal parasites, AIDS, yellow fever, river blindness, and respiratory ailments, as well as violence against women and alcoholism, according to Nancy López Salas, who is one of the Cuban medical volunteers here.

In February there was a cholera epidemic that hit Malabo particularly hard, said López, who works at a provincial hospital in Malabo as an adviser in charge of nursing. The health ministry launched a campaign in which the Cuban volunteers participated, and the epidemic was contained fairly rapidly.

Vicente Nze, one of the Guinean medical students headed for Cuba, described for the Militant how they all left their classrooms and joined in this campaign alongside their teachers. They went house to house promoting better sanitation and testing the water quality. This not only helped combat the cholera but gave the students valuable experience and confidence.

“We approach problems like malaria in a comprehensive way,” Ramírez said. “We start with preventive medicine and simple health practices as well as treating people with the illness.”

Asked about a fumigation effort carried out with funding by Marathon Oil—one of the U.S. energy companies operating in this country—that helped reduce the incidence of malaria in recent weeks, Ramírez said, “Fumigation can be part of this, but in our opinion it’s not the best. It has bad side effects—toxins are emitted and the ecology is damaged. Children are particularly at risk. We favor biological controls and we’re working on the island of Annobón with a Cuban firm to develop a bacillus that destroys the mosquito larva’s digestive system. If the larva dies, there are no mosquitoes.”  
 
Cuban doctors win respect
Ramírez said the Cuban volunteers and the people of Equatorial Guinea have developed “excellent ties of friendship. Many bonds unite us. We were both colonized by the same colonial power, Spain. We speak the same language. There are many similarities in our customs, and there’s a deep mutual respect. This is reinforced by the understanding by Guineans that we’re not going to abandon them.”

What Ramírez described was confirmed in a visit with the Cuban medical brigade in Luba, the main port on the west coast of Bioko Island, a couple hours’ drive from the capital.

“If there was any initial suspicion about us, it was soon dispelled by the results of our work and how we work together with the people,” said Dr. Regla García, part of the Cuban team in Luba. The five-person brigade includes two general practitioners, a pediatrician, an analyst, and a nurse. They work in a small hospital of six medics with 14 beds, and see between 1,000 and 1,500 patients a year.

Being part of the mission “is the best experience of my life,” said Idalmis Gainza, the analyst. “Being here I really understand what the Cuban Revolution means to people far away from Cuba.”

“I’ve wanted to do something like this all my life, to learn more about the world,” García said. “But I had to wait until my children were old enough.” In some ways it’s been difficult, she said, spending two years away from family and co-workers. “But I’ve had tremendous support from my husband and my kids are 11 and 15, so they can manage without me.

“In fact,” she added, “my youngest wears my work as a badge of honor. He tells his schoolmates, ‘My mum’s an internationalist!’”

Ramírez said, “It has be en a tremendous thing for Cubans to participate in this internationalist mission. Here we have to deal with many illnesses—like malaria, river blindness, cholera—that have been eliminated in Cuba thanks to the revolution. At home we study them in books, while here we have to confront them as real-life challenges.

“But it’s not just this technical experience,” he added. “Our doctors also are highly motivated to learn about this country. We’ve learned a great deal about the Guinean people, how they live, their culture, their history. And this strengthens us. We’re not just working here, we’re also studying.”

Referring to Cuban president Fidel Castro, he noted, “Fidel once said the best ambassadors for the Cuban Revolution today are our internationalist doctors. And when we meet people and experience their solidarity, when we learn from them, as we do here, that strengthens the revolution.”

Arrin Hawkins, Martín Koppel, Brian Taylor, and Mary-Alice Waters contributed to this article.  
 
 
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