Unsung heroes quietly helping sick Haitians

They are heroes of the Haitian earthquake disaster, the human catastrophe on America's doorstep which President Barack Obama pledged a monumental United States humanitarian mission to alleviate. Except these heroes are from the US' arch-enemy, Cuba, whose doctors and nurses have put US efforts to shame.

A medical brigade of 1200 Cubans is operating all over earthquake-torn and cholera-infected Haiti, as part of Fidel Castro's international medical mission which has won the socialist state many friends but little international recognition.

Observers of the Haiti earthquake could be forgiven for thinking international aid agencies were alone in tackling the devastation that killed 250,000 people and left nearly 1.5 million homeless. Cuban healthcare workers have been in Haiti since 1998, so when the earthquake struck the 350-strong team jumped into action.

Hundreds more Cuban doctors, nurses and therapists later arrived. Most countries were gone within two months, again leaving the Cubans and Medecins Sans Frontieres as the principal healthcare providers.

Figures show that Cuban medical personnel, working in 40 centres across Haiti, have treated more than 30,000 cholera patients since October. They are the largest foreign contingent, treating about 40 per cent of all cholera patients.

Another batch of medics from the Cuban Henry Reeve Brigade, a disaster and emergency specialist team, arrived recently as it became clear that Haiti was struggling to cope with the epidemic that has already killed hundreds.

Since 1998, Cuba has trained 550 Haitian doctors for free at the Escuela Latinoamericana de Medicina en Cuba (Elam), one of the country's most radical medical ventures. Another 400 are currently being trained at the school, which offers free education to those who cannot afford to study medicine in their own country.

John Kirk is a professor of Latin American studies at Dalhousie University in Canada who researches Cuba's international medical teams. He said: "Cuba's contribution in Haiti is like the world's greatest secret. They are barely mentioned, even though they are doing much of the heavy lifting."

This tradition can be traced back to 1960, when Cuba sent a handful of doctors to Chile, hit by a powerful earthquake, followed by a team of 50 to Algeria in 1963. This was four years after the revolution, which saw nearly half the country's 7000 doctors voting with their feet and leaving for the US.

The travelling doctors have served as a useful arm of the Government's foreign and economic policy. The best-known programme is Operation Miracle, which began with ophthalmologists treating cataract sufferers in impoverished Venezuelan villages in exchange for oil. This initiative has restored the eyesight of 1.8 million people in 35 countries. The Henry Reeve Brigade, rebuffed by the Americans after Hurricane Katrina, was the first team to arrive in Pakistan after the 2005 earthquake, and the last to leave six months later. Cuba's constitution lays out an obligation to help the worst-off countries when possible, but international solidarity isn't the only reason, according to Kirk.

"It allows Cuban doctors, who are frightfully underpaid, to earn extra money abroad and learn about diseases and conditions they have only read about. It is also an obsession of Fidel's and it wins him votes in the UN."

A third of Cuba's 75,000 doctors, along with 10,000 other health workers, are currently working in 77 poor countries. This still leaves one doctor for every 220 people at home, one of the highest ratios in the world, compared with one for every 370 in England.

Every medical graduate in Cuba works as a family doctor for three years minimum. The family doctor looks after 150 to 200 families in their community. This model has helped Cuba to achieve some of the world's most enviable health improvements, despite spending only US$400 per person last year compared with US$3000 in the United Kingdom and US$7500 in the US, according to Organisation for Economic Co-operation and Development.

Infant mortality rates, one of the most reliable measures of a nation's healthcare, are 4.8 per 1000 live births - comparable with Britain and lower than the US.

Politics, inevitably, penetrates many aspects of Cuban healthcare. Every year hospitals produce a list of drugs and equipment they have been unable to access because of the US embargo, which prevents many American companies from trading with Cuba. Antonio Fernandez, from the Ministry of Public Health, said: "We make 80 per cent of the drugs we use. The rest we import from China, former Soviet countries, Europe - anyone who will sell to us - but this makes it very expensive because of the distances."

Cuba's international ventures in healthcare are becoming increasingly strategic. Last month, officials held talks with Brazil about developing Haiti's public health system, which Brazil and Venezuela have both agreed to help finance.

- Independent