BY CHRISTOPHER MARQUIS
Herald Washington Bureau
HAVANA -- After relying for decades on guerrillas and guns to
export his Marxist
model, Cuban President Fidel Castro has found another tool: ``doctor diplomacy.''
The Castro regime, which claims high quality health care as a
pillar of the
41-year-old Cuban Revolution, has long sent its doctors abroad, welcomed health
``tourists'' to the island and developed drugs to attack some of the most stubborn
blights of the developing world.
Now, even though the country's medical system is so hard-pressed
must show up for surgery with their own sheets and soap, Castro has opened a
medical school exclusively for students from across Latin America. Free of
charge, Havana plans to train thousands of new doctors from neglected,
impoverished populations of the region.
In a white-washed former naval academy by the sea, the gleaming
provided Castro with a needed burst of goodwill from his Latin and Caribbean
neighbors. At the Ibero-American summit in Havana last November, Latin leaders
who strongly criticized Castro's human rights record were dazzled by the school
and clamored for more spaces for their students.
Castro obliged, expanding plans to teach as many as 7,500 Latin
medical students over five years, 10 times the original number, school officials
said. In so doing, the Cuban leader may hope to inoculate himself from further
regional attacks and play the humanitarian in a part of the world where
Washington has slashed economic aid in recent years.
Officials deny that the school has a political purpose, even though
it siphons off
resources from a struggling health system that has long waiting lists for elective
surgery, shortages of basic medicines, and outmoded and broken equipment.
``We don't teach politics, just medicine,'' said Nancy Nuñez,
director of the
school's foreign affairs department. But she added: ``We hope they come out of
this course with the same human sensibility as the Cubans who spend time in
other countries. We hope they don't see medicine as merchandise, but as
With one doctor for every 170 Cubans -- one of the highest ratios
in the world --
the country has exported its medical talent for decades, usually in the service of
Socialist ``solidarity'' with nations such as Nicaragua under Sandinista rule during
But after Hurricane Mitch in 1998 wiped out entire towns in Central
deployed medical brigades across the region. Cuban doctors now work for free in
some of the region's most remote hamlets, some of which have never had regular
medical attention. Cuba has more than a thousand doctors in Guatemala,
Nicaragua, Belize, Honduras and Haiti.
The Latin American School of Medical Sciences opened last year,
after 18 Latin
American governments selected and sent 1,929 of their most promising students
-- evenly divided between men and women -- from mostly rural, disadvantaged
Most came from Central America, which has been tormented in recent
by ideological proxy wars fueled by the United States on one side and the Soviet
Union and Cuba on the other. Nicaragua sent 325 students, Honduras sent 279
and Guatemala 252. Even El Salvador, a nation that doesn't have diplomatic
relations with Cuba, sent students.
Sandra Mercado, 25, with dimples and a white coat, came from Cochabamba,
Bolivia. Books that would have been out of reach at $300 are given to her free.
She gets up at 4 a.m. to study. She misses her family and her native food. But,
sounding like the doctor she hopes to become, she adds: ``The organism adapts
Students live at the school, which has a theater, dormitories,
laboratories and a post office. They get uniforms, food and a small stipend for
expenses on weekends. They will remain there for 2 1/2 years, then be integrated
into the Cuban system for the rest of their medical education.
School officials say they don't know yet how much all this is
cash-strapped Cuban government. No one has even calculated teachers' salaries,
materials and school upkeep, even though costs elsewhere are curbing basic
The largest hospital in Cardenas, a city of 150,000 in the Matanzas
example, closed its operating room to all but emergency surgery for a year
because it did not have the proper equipment to provide general anesthesia,
doctors there said. It suffers shortages of everything from antibiotics to medication
for ulcers and asthma, syringes, X-ray equipment, even sterile water. More than
200 patients await operations, the doctors said.
Cuban doctors, moreover, earn as little as a dollar a day, and
many are forced to
moonlight by selling trinkets or homemade rum to make ends meet.
Yet, on paper, Cuba's health record remains impressive, with infant
that rival those of the United States. It has eradicated diseases such as malaria
that continue to plague the region.
Indeed, Cuba's reputation for capable doctors, experimental treatments
personal therapy draws people from around the world. Dubbed ``health tourists,''
these patients -- some of them desperate for cures -- shell out dollars to stay in
clinics designed for foreigners or on designated floors of general hospitals.
One of the most prominent health tourists in Cuba today is Diego
legendary Argentine soccer player, who is being treated for cocaine addiction.
Maradona, an idol of many Latin American children, checked himself in after
expressing admiration for the Cuban Revolution.
With so much medical talent, Cuba turned to its doctors and researchers
when its economy crashed after the Soviet Union withdrew its support a decade
ago. Cuba pumped more than $1 billion into developing new medicines using
biotechnology, and charted some successes. They include the use of interferon
to combat hemorrhagic dengue and a therapeutic vaccine for certain cancers. Its
meningitis B vaccine is so promising that SmithKline Beecham, which is partly
based in the United States, obtained approval from the Clinton administration to
test the drug, despite a U.S. ban on trade with Cuba.
Copyright 2000 Miami Herald