For more than a year, Yaime Acuna has been waiting tables at a restaurant in Belo Horizonte, the capital of Minas Gerais State. Before she turned to serving drinks and food to customers, the 30-year-old Cuban worked as a doctor at a healthcare unit in the interior of the Brazilian State, seeing more than 20 patients a day. In November 2018, Ms. Acuna lost her job as a pact between Brazil and Cuba ended abruptly with the election of Jair Bolsonaro as President. Deciding to stay in Brazil to earn a local diploma, she worked as a waitress to survive.
Ms. Acuna is one of 1,800 Cuban doctors who stayed back in Brazil after the programme, which brought them here was scrapped. Now, as COVID-19 spreads across this country of 210 million people, its healthcare system faces an unprecedented stress and the government is turning to the Cubans for help. “I am very excited to be able to work as a doctor again. The disease is growing here and I want to help,” said Ms. Acuna, as she heard about the federal government issuing a notification to “re-integrate the Cuban doctors” in the healthcare system.
The Cubans came to Brazil under a programme called ‘Mais Medicos’ (More Doctors), launched by then President Dilma Rousseff in 2013 with a plan to appoint doctors in the most remote and vulnerable places. In five years, 8,000 Cuban doctors were appointed in basic health units across 3,000 municipalities. With Mr. Bolsonaro, who constantly attacked the “communist” Cuba for “selling its doctors” during the 2018 election campaign, becoming President, Havana cancelled its arrangement with Brasilia and most doctors went home. But some, like Ms. Acuna, stayed back, doing odd jobs or studying. With more than 9,200 infections and 365 deaths till now, Brazil is desperate for more helping hands and looking at the Cubans, who are eager to chip in. “The anxiety for working and helping is very high,” says Niurka Perez, head of the Association of Cuban Doctors, who stayed on in Brazil. “The country is currently in an emergency but they have not told us when we are going to be called,” adds Ms. Perez.
Hiring more professionals
The Ministry of Health announced last week that it would hire 5,811 medical professionals to reinforce the fight against COVID-19, with local doctors getting the first preference. The Cubans are likely to be called for jobs next week or within 15 days. The news has given a ray of hope to people on the margins of Brazilian society who were badly affected when the Cubans left the health units in their communities. “The programme was essential to assist and guarantee healthcare to people who had hitherto been unassisted. With the abrupt disruption of the plan, several communities, especially the indigenous people, were left without any medical support and the situation continues to be so,” says Denise Pimenta, an anthropologist at University of Sao Paulo.
Ms. Pimenta, who works extensively with the marginalised people, says Brazil needed to invite doctors from Cuba, a country of just 11.5 million people, because of the elitist nature of medical studies in the country. As most doctors come from a privileged background, says Ms. Pimenta, the remote areas were left ignored. “Brazil has always had many doctors, being very well-paid compared to the rest of the population, but most of them never wanted to leave the big centres and their facilities to serve in peripheral and precarious regions,” says Ms. Pimenta, adding the Cubans went to work in locations that were considered “end of the world” for Brazilian doctors.
Now, as COVID-19 grows exponentially across the country, the private medical centres have already collapsed and all eyes are now on the hospitals run by the country’s Unified Healthcare System (SUS), which has faced massive cuts in resources since the impeachment of Ms. Rousseff in 2016. “It is still the best coordinated healthcare system that exists. The Cuban doctors are completely aligned with the SUS guidelines. If they come back, they can provide quality healthcare in the remote areas and peripheral regions such as slums,” says Ms. Pimenta.
As the SUS hospitals get filled with patients, many healthcare workers are in danger as they lack basic protective equipment. Just in Sao Paulo State, close to 600 professionals are suspected of having caught the virus. In the slums, entire communities have turned to making their own masks and hiring private services to survive the outbreak. With the peak of pandemic still weeks away, Brazilians can’t wait much longer for the Cubans to come back and support the creaking system.
(Shobhan Saxena is a journalist based in São Paulo)
