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Debt-Free Doctors Part of Cuba’s Foreign Policy Strategy

December 22, 2010 at 12:00 AM EDT
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Ray Suarez wraps up his series on Cuba with a look at a "medical diplomacy" program that offers medical school education to low-income students from around the world.
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GWEN IFILL: Next: Cuba’s medical diplomacy.

Ray Suarez and our Global Health Unit wrap up their three-part series with this story.

RAY SUAREZ: A 28-year-old American, Pasha Jackson is in his second year of medical school. But his medical career actually started a year earlier, when he had to begin a crash course in Spanish, because Jackson is learning to be a doctor in Cuba, and his entire six years of medical education is being paid for by the Cuban government.

He is one of about 10,000 students from 29 countries now enrolled in Havana’s Latin American Medical School, including more than 100 Americans.

PASHA JACKSON, American Student: I have always had the interest in medicine. Medicine, biology anything that has to deal with how things work, especially if you are talking about organisms, that was my deal.

RAY SUAREZ: The school offers full scholarships to foreign students, mostly from low-income families, with good academic records, six years of medical education and room and board, and it is all free.

How can one of the poorest countries in the Western Hemisphere give away something so precious to so many and expect nothing in return?

The Latin American Medical School is the brainchild of Cuba’s Fidel Castro. The school’s aim is to create a pool of physicians for public service in disadvantaged rural and urban areas around the world.

Dr. Maritza Gonzalez Bravo is one of the school’s directors.

DR. MARITZA GONZALEZ BRAVO, Latin American Medical School (through translator): Our rationale, the training, the values that we have here are a way of continuing the revolutionary process, the eternal ideology of our leader, Fidel Castro, which is to always help out poor countries, not with what we have left over, but what we have.

RAY SUAREZ: The school is an outgrowth of what has become known as Cuba’s medical diplomacy. When these students graduate:

DR. MARITZA GONZALEZ BRAVO (through translator): They become health ambassadors, capable of taking home the principles of Cuban values and solidarity.

RAY SUAREZ: This place has unusual prerequisites for med school. The students must have high school diplomas, be under 25, and come from the poorest parts of their home countries.

DR. MARITZA GONZALEZ BRAVO (through translator): This assures that they are committed to return to their communities, so they can make change in their own villages and neighborhoods.

RAY SUAREZ: Pasha Jackson is from Oakland, California. A standout student and athlete, Jackson went to the University of Oklahoma on a football scholarship, even making it to the NFL. When an injury put his football career in doubt, he turned to medicine and to Cuba.

PASHA JACKSON: Receiving this gift from a country who already doesn’t have a lot, there is no way that I’m going to return to back to the United States and just take any job. You know, I want to be able to give myself to the very communities who are underserved and be able to serve them, and provide these services for people who normally wouldn’t have such access.

RAY SUAREZ: Since it opened in 1999, the medical school has graduated more than 7,000 physicians from 45 countries. Cuba doesn’t ask these students to practice here, because the island already has more doctors per capita than any country in the world.

Cuba’s own medical professionals have become a big part of the Havana government’s outreach to the world. Cuban doctors are rushed to natural disasters across the globe, like last year’s devastating earthquake in Haiti, where Cuba dispatched more than 600 medical workers.

Over the last 20 years, exporting Cuban doctors has become part of the country’s foreign policy strategy. Many Cuban doctors will at some point in their career go on overseas missions, most to developing countries with severe doctor shortages.

Dr. Jorge Delgado of the Cuban Health Ministry spent almost a decade practicing in Africa, and now directs overseas missions.

DR. JORGE DELGADO, Cuban Ministry of Public Health (through translator): As of now, we have more than 350,000 health care personnel, doctors, technicians, nurses, and other specialists, sent out to support 105 countries around the world.

RAY SUAREZ: Gail Reed is an American who lives in Cuba and edits the medical journal “MEDICC.”

GAIL REED, editor, “MEDICC Review”: It’s a foreign policy to the extent that, what can a small country do? You don’t have foreign aid and big dollars sums to give, so what can you give? You have your human resources.

RAY SUAREZ: The medical missions have also been described as a way for Cuba to get around a negative world view of its human rights record. Cuba’s Ministry of Health describes the international medical aid as a natural outgrowth of Cuba’s educated population and revolutionary vision.

DR. JORGE DELGADO (through translator): Our main source of wealth is human resources. Everyone knows we are a poor country, but providing Cuban doctors to other countries grew out of the ideas of our commander in chief, Fidel Castro, who said, we are paying our debt of humanity to our brother countries who support our revolutionary causes and who need our vast human resources.

RAY SUAREZ: One young Cuban doctor, Orisloriam Morales, says she volunteered because she wanted to help families learn to prevent illness, something Cuban doctors are known for. She was sent to rural Bolivia.

DR. ORISLORIAM MORALES, Cuba (through translator): We took with us our experiences, our preventive health care model. We took to places where conditions were pretty bad. But, in turn, we learned a lot from them.

KATRIN HANSING, City University of New York: It’s a wonderful way of keeping very, very good diplomatic relations with very many countries.

RAY SUAREZ: Katrin Hansing is Cuba scholar at City University of New York and is writing a book about Cuba’s medical diplomacy.

KATRIN HANSING: If you have ever been to any developing countries where there — where there are a lot of Cuban doctors or other professionals, Cuban doctors are loved, and, by extension, Cuba is loved in those countries.

RAY SUAREZ: Cuba’s doctor programs have also become a boon to the country’s faltering economy. Money is flowing in from countries with growing economies, but less educated work forces, giving Cuba, and the doctors, precious hard currency.

Venezuela pays for exported Cuban doctors with vital supplies of oil.

KATRIN HANSING: This is one way Cuba is actually making fairly large amounts of hard currency.

RAY SUAREZ: But a small number of doctors have used the missions as a way to escape the poverty and politics of Cuba.

Ruber Rodriguez was sent to Africa and Guatemala on medical missions, and decided to defect to the United States during a stint in Bolivia. We met in Miami.

DR. RUBER RODRIGUEZ, Cuban defector (through translator): During this time that I had outside of the country, I was able to realize that, for example, in Africa, despite the extreme poverty, they had freedom — same in Guatemala, same in Bolivia, the freedom they had in expressing themselves.

And this really opened my eyes to the immense suffering caused by the lack of freedom in Cuba. This was really the main thing that prevented my return to Cuba.

DR. JORGE DELGADO (through translator): We send out doctors and put our trust in them. If, along the way, they abandon our ship made up of solidarity and humanity, let them follow their path as they see fit. We do not fear that.

RAY SUAREZ: Meanwhile, Pasha Jackson says a free medical education is great, but just as important is the Cuban approach to medicine: a hands-on, high-touch ethic. He will carry that with him, back home to Oakland, in another four years.