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By                     Tom Fawthrop in Havana 
After the quake struck, Haiti's first medical aid came from Cuba
Among the many donor nations helping Haiti, Cuba and its medical teams  have played a major role in treating earthquake victims.
Public health experts say the Cubans were the first to set up medical  facilities among the debris and to revamp hospitals immediately after  the earthquake struck.
However, their pivotal work in the health sector has received scant  media coverage.
"It is striking that there has been virtually no mention in the media of  the fact that Cuba had several hundred health personnel on the ground  before any other country," said David Sanders, a professor of public  health from Western Cape University in South Africa.
The Cuban team coordinator in Haiti, Dr Carlos Alberto Garcia, says  the Cuban doctors, nurses and other health personnel have been working  non-stop, day and night, with operating rooms open 18 hours a day.
During  a visit to La Paz hospital in the Haitian capital Port-au-Prince, Dr  Mirta Roses, the director of the Pan American Health Organisation (PAHO)  which is in charge of medical coordination between the Cuban doctors,  the International Committee of the Red Cross (ICRC) and a host of health  sector NGOs, described the aid provided by Cuban doctors as "excellent  and marvellous".
La Paz is one of five hospitals in Haiti that is largely staffed by  health professionals from Havana. 
History of cooperation
Haiti and Cuba signed a medical cooperation agreement in 1998.
Before  the earthquake struck, 344 Cuban health professionals were already  present in Haiti, providing primary care and obstetrical services as  well as operating to restore the sight of Haitians blinded by eye  diseases.
More doctors were flown in shortly after the earthquake, as part of  the rapid response Henry Reeve Medical Brigade of disaster specialists.  The brigade has extensive experience in dealing with the aftermath of  earthquakes, having responded to such disasters in China, Indonesia and  Pakistan.
"In the case of Cuban doctors, they are rapid responders to  disasters, because disaster management is an integral part of their  training," explains Maria a Hamlin Zúniga, a public health  specialist from Nicaragua.
"They are fully aware of the need to  reduce risks by having people prepared to act in any disaster  situation."
Cuban doctors have been organising medical facilities in three  revamped and five field hospitals, five diagnostic centres, with a total  of 22 different care posts aided by financial support from Venezuela.
They are also operating nine rehabilitation centres staffed by nearly 70  Cuban physical therapists and rehab specialists, in addition to the  Haitian medical personnel.
The Cuban team has been assisted by 100 specialists from Venezuela,  Chile, Spain, Mexico, Colombia and Canada and 17 nuns.
Havana has also sent 400,000 tetanus vaccines for the wounded.
Eduardo  Nuñez Valdes, a Cuban epidemiologist who is currently in  Port-au-Prince, has stressed that the current unsanitary conditions  could lead to an epidemic of parasitic and infectious diseases if not  acted upon quickly. 
Media silence
However, in reporting on the international aid effort, Western media  have generally not ranked Cuba high on the list of donor nations.
One  major international news agency's list of donor nations credited Cuba  with sending over 30 doctors to Haiti, whereas the real figure stands at  more than 350, including 280 young Haitian doctors who graduated from  Cuba. The final figure accounts for a combined total of 930 health  professionals in all Cuban medical teams making it the largest medical  contingent on the ground.
Another batch if 200 Cuban-trained doctors from 24 countries in  Africa and Latin American, and a dozen American doctors who graduated  from Havana are currently en route to Haiti and will provide  reinforcement to existing Cuban medical teams.
By comparison the internationally-renowned Médecins Sans Frontières  (MSF or Doctors without Borders) has approximately 269 health  professionals working in Haiti. MSF is much better funded and has far  more extensive medical supplies than the Cuban team. 
Left  out
But while representatives from MSF and the ICRC are frequently in  front of television cameras discussing health priorities and medical  needs, the Cuban medical teams are missing in the media coverage.
Richard Gott, the Guardian newspaper's former foreign editor  and a Latin America specialist, explains: "Western media are programmed  to be indifferent to aid that comes from unexpected places. In the  Haitian case, the media have ignored not just the Cuban contribution,  but also the efforts made by other Latin American countries." 
Brazil is providing $70mn in funding for 10 urgent care units, 50  mobile units for emergency care, a laboratory and a hospital, among  other health services.
Venezuela has cancelled all Haiti debt and  has promised to supply oil free of charge until the country has  recovered from the disaster.
Western NGOs employ media officers to ensure that the world knows  what they are doing.
According to Gott, the Western media has  grown accustomed to dealing with such NGOs, enabling a relationship of  mutual assistance to develop.
Cuban medical teams, however, are  outside this predominantly Western humanitarian-media loop and are  therefore only likely to receive attention from Latin American media and  Spanish language broadcasters and print media.
There have, however, been notable exceptions to this reporting  syndrome. On January 19, a CNN reporter broke the silence on the Cuban  role in Haiti with a report on Cuban doctors at La Paz hospital. 
Cuba/US cooperation
When the US requested that their military planes be allowed to  fly through Cuban airspace for the purpose of evacuating Haitians to  hospitals in Florida, Cuba immediately agreed despite almost 50 years of  animosity between the two countries.
Josefina Vidal, the director of the Cuban foreign ministry's North  America department, issued a statement declaring that: "Cuba is ready to  cooperate with all the nations on the ground, including the US, to help  the Haitian people and save more lives."
This deal cut the flight time of medical evacuation flights from the  US naval base at Guantanamo Bay on Cuba's southern tip to Miami by 90  minutes.
According to Darby Holladay, the US state department's  spokesperson, the US has also communicated its readiness to make medical  relief supplies available to Cuban doctors in Haiti.
"Potential US-Cuban cooperation could go a long way toward meeting  Haiti's needs," says Dr Julie Feinsilver, the author of Healing the  Masses - a book about Cuban health diplomacy, who argues that  maximum cooperation is urgently needed.
Rich in human  resources
  
Although Cuba is a poor developing country,  their wealth of human resources - doctors, engineers and disaster  management experts - has enabled this small Caribbean nation to play a  global role in health care and humanitarian aid alongside the far richer  nations of the west.
Cuban medical teams played a key role in the wake of the Indian Ocean  Tsunami and provided the largest contingent of doctors after the 2005  Pakistan earthquake.
They also stayed the longest among international  medical teams treating the victims of the 2006 Indonesian earthquake.
In the Pakistan relief operation the US and Europe dispatched medical  teams. Each had a base camp with most doctors deployed for a month.
The  Cubans, however, deployed seven major base camps, operated 32 field  hospitals and stayed for six months.
Bruno Rodriguez, who is now Cuba's foreign minister, headed the  mission - living in the mountains of Pakistan for more than six months.
Just  after the Indonesian earthquake a year later, I met with Indonesia's  then regional health co-coordinator, Dr Ronny Rockito.
Cuba had  sent 135 health workers and two field hospitals. Rockito said that while  the medical teams from other countries departed after just one month,  he asked the Cuban medical team to extend their stay.
"I appreciate the Cuban medical team. Their style is very friendly." 
Their medical standard is very high," he told me.
"The Cuban  [field] hospitals are fully complete and it's free, with no financial  support from our government."
Rockito says he never expected to see Cuban doctors coming to his  country's rescue."We felt very surprised about doctors coming  from a poor country, a country so far away that we know little about.
"We can learn from the Cuban health system. They are very fast to  handle injuries and fractures. They x-ray, then they operate straight  away." 
A 'new dawn'?
The Montreal summit, the first gathering of 20 donor nations, agreed  to hold a major conference on Haiti's future at the United Nations in  March.
Some analysts see Haiti's rehabilitation as a potential opportunity  for the US and Cuba to bypass their ideological differences and combine  their resources - the US has the logistics while Cuba has the human  resources - to help Haiti.
Feinsilver is convinced that "Cuba should be given a seat at the  table with all other nations and multilateral organisations and agencies  in any and all meetings to discuss, plan and coordinate aid efforts for  Haiti's reconstruction".
"This would be in recognition of Cuba's  long-standing policy and practise of medical diplomacy, as well as its  general development aid to Haiti," she says.
But, will Haiti  offer the US administration, which has Cuba on its list of nations that  allegedly "support terrorism", a "new dawn" in its relations with Cuba?
In late January, Hillary Clinton, the US secretary of state, thanked  Cuba for its efforts in Haiti and welcomed further assistance and  co-operation.
In Haiti's grand reconstruction plan, Feinsilver  argues, "there can be no imposition of systems from any country, agency  or institution.
The Haitian people themselves, through what remains of  their government and NGOs, must provide the policy direction, and Cuba  has been and should continue to be a key player in the health sector in  Haiti".
Thursday, February 18, 2010
Cuba's aid ignored by the media?
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