Cuban doctors arrive in Kenya on June 5, 2018. PHOTO |MARTIN MUKANGU | NMG
Summary
- Despite a level of economic stagnation, Cuba has managed to maintain a universal health care system viewed as a model for other countries.
- Current data shows the doctor to patient ratio in Cuba is well above the United Nation’s target of 1:1000, at 7.5:1000 in 2014.
- By comparison, Kenya has a ratio of 0.204 doctors per 1000 patients
Cuban medical missions abroad are perhaps one of the most
significant legacies of the 1959 Cuban Revolution. The programme
involves Cuban doctors offering health care services in host countries,
often in impoverished rural communities where there’s little access.
The
programme stemmed from Cuba’s foreign policy objectives of
anti-colonialism and humanitarianism in the 1960s. It became one way in
which Cuba could avoid the isolation intended by the trade embargo
imposed by the US and its expulsion from the Organisation of American
States (OAS).
Well over 131,993 Cuban doctors have
taken part in international missions in 107 countries. Kenya is the
latest. The first 50 specialists arrived in the country recently, with
50 more to follow. All are expected to work in under served rural areas.
But
their arrival has been met with a storm of protest. Some Kenyan health
professionals have strongly opposed their arrival on the grounds that
they’ll be taking away local jobs.
My understanding of the work of Cuban doctors has been greatly
influenced by the fact that I spent seven years studying medicine in
Cuba, one of thousands of students from all over the globe who have had
the opportunity to study medicine on the island. The experience gave me a
keen understanding of how the Cuban health system works. It also helped
me understand what lies behind the medical missions programme.
I
accept that the way the programme is implemented in countries like
Kenya leaves a lot to be desired. But I would also argue that the
services being provided by Cuban doctors is invaluable and the reasons
for not wanting them in Kenya are not justified.
The national benefit is paramount
The current fears of the Kenyan medical fraternity are understandable. But their fears may be based on misinformation. Prior consultations between Kenyan government officials and the medical fraternity would have gone a long way to allaying these.
The current fears of the Kenyan medical fraternity are understandable. But their fears may be based on misinformation. Prior consultations between Kenyan government officials and the medical fraternity would have gone a long way to allaying these.
Nevertheless, I believe
that Kenyan doctors should focus on the national benefits of the
programme. Cuban doctors are sent to rural, under-served areas – areas
that local doctors often refuse to work in. In these communities, the
mere presence of a doctor can make a tremendous difference in health
outcomes.
In addition, the Cuban doctors being sent to
Kenya are highly specialised in areas such as oncology and nephrology,
areas of medicine which are in demand the world over. Their presence can
only improve access to specialised medical care while reducing
congestion in referral hospitals.
Cuba’s healthcare missions
Despite a level of economic stagnation, Cuba has managed to maintain a universal health care system viewed as a model for other countries. Current data shows the doctor to patient ratio in Cuba is well above the United Nation’s target of 1:1000, at 7.5:1000 in 2014. By comparison, Kenya has a ratio of 0.204 doctors per 1000 patients.
Despite a level of economic stagnation, Cuba has managed to maintain a universal health care system viewed as a model for other countries. Current data shows the doctor to patient ratio in Cuba is well above the United Nation’s target of 1:1000, at 7.5:1000 in 2014. By comparison, Kenya has a ratio of 0.204 doctors per 1000 patients.
Cuban
trained doctors have been praised the world over for the level of
service and compassion they offer. There are numerous examples of work
that they’ve done. For example, Cuba were sent doctors to South Africa
during a brain-drain in the post-apartheid era as white medical doctors
left that country in droves.
They also helped develop
medical faculties in Ghana, Guinea-Bissau, The Gambia and Haiti between
1963-2004. And they showed tremendous humanitarian spirit during the
Haitian Earthquake in 2010, the Ebola outbreak of 2014 and even offered
the US assistance in the aftermath of Hurricane Katrina. The offer was
rejected.
ALSO READ: Cuban doctors get Sh1bn budget
The
argument that Kenya should invest in its own citizens rather than sign a
multi-million dollar deal with the Cuban government is a fair one and
should be addressed. But I don’t believe that it’s simply a question of
one or the other.
Studying medicine is costly and
requires training for between six to seven years. This excludes
specialisation. But what happens in the interim to sick, impoverished
individuals in rural communities while doctors are being trained? Cuban
doctors should be seen as a temporary reinforcement offering a level of
service every Kenyan should demand.
Why Cuban doctors?
Is a Cuban doctor better than a Kenyan one? No. But Cuban doctors have specific expertise in dealing with tropical diseases such as malaria. This remains a major problem in Kenya even though it was eradicated in Cuba more than three decades ago.
Is a Cuban doctor better than a Kenyan one? No. But Cuban doctors have specific expertise in dealing with tropical diseases such as malaria. This remains a major problem in Kenya even though it was eradicated in Cuba more than three decades ago.
It’s also important
to keep some perspective when it comes to the numbers. Foreign
physicians make up below 10 per cent of all doctors in Kenya. There are
939 foreign doctors in the country’s register – but the majority (358)
are from the US. Only 100 are from Cuba. This is a tiny number.
The
presence of these foreign doctors should be seen as a benefit to the
country’s health care service. It offers the opportunity for Kenyan
physicians to learn from the Cubans’ experiences working in a universal
health care system with emphasis on preventative medicine. They could
also learn from their integrated community medicine approach, how
they’ve managed to eradicate various diseases as well as policies and
guidelines in place in Cuba that could be implemented in Kenya.
Cuban
physicians will also be able to learn from their Kenyan counterparts
how their system operates, difficulties and challenges of working as a
physician in Kenya as well as the cultural norms that Cuban physicians
would have to consider when offering services to Kenyans.
Ultimately, the Kenyan health care system and its people will reap the rewards of the presence of Cuban doctors.
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