Thousands of Cuban doctors headed to Brazil

Facing a physician shortage, Brazil plans to import 4,000 doctors from Cuba to work mostly in poor, rural areas at a cost of more than $200 million.

The first installment of 400 Cubans to participate in Brazil’s Mais Médicos (More Doctors) program will begin arriving this weekend and will undergo three weeks of orientation along with other doctors who have earned their diplomas abroad, said Brazil’s Ministry of Health.

All 400 doctors in the first wave have participated in other international missions for Cuba, which sends healthcare professionals to more than 50 countries from South Africa to Bolivia.

The best known of Cuba’s medical exchanges is the so-called doctors-for-oil program in Venezuela. As many as 35,000 Cuban healthcare professionals, security advisors, teachers and sports trainers work in Venezuela in exchange for some 96,000 barrels of Venezuelan oil daily at subsidized prices.

Brazil, meanwhile, suffers from a serious shortage of doctors. In 2009, it had 15.1 physicians per 10,000 population, while Cuba had 66.3 doctors to serve 10,000 people, according to the Pan American Health Organization. The United States physician ratio was 26 for every 10,000 people.

Inadequate public healthcare in Brazil was one of the complaints that touched off massive street demonstrations in more than 100 cities this summer.

After millions of Brazilians took to the streets in June to protest a bus fare increase, political corruption, high crime, poor education and inadequate healthcare, among other issues, President Dilma Rousseff pledged a “grand pact” to improve public services in Latin America’s largest country.

She repeated previous calls to send thousands of doctors to rural areas and devote 100 percent of petroleum revenue to education. This summer, the National Congress voted to designate 75 percent of future oil royalties from its new deep-water oil fields to education and 25 percent to improving healthcare.

The Cuban doctors will come via a technical cooperation agreement that Brazil signed Wednesday with the Pan American Health Organization. The Brazilian government plans to spend nearly $209 million through next February to bring in the Cuban doctors. The money will be channeled to Cuba through PAHO, the Americas office of the World Health Organization, and it will be up to Cuba to decide how to parcel it out.

Under the Mais Médicos program, which Rousseff launched July 8, Brazil pays doctors a monthly salary of $4,098 and a cost-of-living stipend to work in poor rural areas and urban slums.

Brazilian Minister of Health Alexandre Padilha said the Cuban doctors will be sent to 701 communities — most in the North and Northeast — that were not selected by Brazilian doctors or other foreign physicians who signed up for the program. After the first registration period that ended Aug. 13, only 1,096 Brazilian doctors and a few hundred foreign doctors, many from Spain and Argentina, had applied. Mais Médicos needs 15,000 doctors.

The Cuban doctors “are experienced physicians who have already worked in Portuguese-speaking countries and that have a specialty as family doctors. We are certainly bringing a very prepared group to Brazil,’’ said Joaquin Molina, the PAHO representative in Brazil.

Still, there has been resistance among Brazilian medical professionals to importing Cuban doctors. Some have questioned the Cubans’ training and language abilities.

Jorge R. Piñón, interim director of the Center for International Energy & Environmental Policy at the University of Texas at Austin, said even though Brazil potentially has billions of barrels of deep-water crude, he doesn’t see the doctor program in Brazil having the same implications it does in Venezuela.

“I think Brazil’s interest in Cuba is purely political,’’ he said. “There is oil in Brazil but technology will have to catch up with the finds. The play in Brazil is no longer oil, but ethanol and sugarcane. What Brazil has an eye on in the future is Cuba’s sugar industry.’’

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