Cuba’s Health Ministry Desperate over Doctor Exodus

Cuba's Health Ministry Desperate over Doctor Exodus
April 11, 2015
Francisco Aburto

HAVANA TIMES — Any entity making good profits and sensing dangers that
threaten its very existence would have good cause for concern.

Currently, the incomes generated by medical services offered abroad
constitute the most important source of hard currency revenue for Cuba's
State budget – and this sector is facing a serious threat, in the form
of a mass exodus of the medical professionals responsible for offering
such services.

The interests of Cuban physicians are well known. Salaries in Cuba are a
bad joke. Health professionals earn a little over 50 dollars a month –
an inadequate sum from any conceivable point of view, despite
compensation through some subsidized services in other areas.

When these professionals sign a contract for work abroad, they receive
one fourth (or less) what the foreign counterpart pays. When one deducts
what they spend on living expenses in this foreign country, far from
their homes and families, one gets a sense of the meager takings they
end up with. One of the most demanding jobs in society, the one
involving the highest degree of responsibility, does not allow these
people to live in decorous material conditions.

After decades of a life based on political rallying calls and principles
of sacrifice, we are now witnessing the exhaustion of the ideological
tools wielded by the authorities. People have begun to look for concrete
solutions to their vital problems whichever way they can, and this leads
them away from the medical profession or towards private employers
within the field in other countries, away from Cuban authorities.

Cuba's Ministry of Public Health (MINSAP), true to the totalitarian
tradition, is very much upset because those who work for the ministry
don't like living like slaves. News of frantic meetings and measures
aimed at tightening the screws on "its" personnel are leaked regularly.
People have even reported an attempt to take reprisals against health
workers who have "dared" invite their spouses to stay with them, at
their own expense.

I recently got my hands on a document which appears to contain a list of
reprisals conceived to punish this unruly bunch. The apparent document
details the measures considered, the personnel responsible for
implementing them and other things. Fake or real, it is perfectly in
step with what we know these authorities to be capable of, and one or
two comments in this connection are worth making.

The document opens with a number of internal restructuring policies.
These reflect the new logic of rationalization being adopted following
the failure of the so-called "Battle of Ideas." There's nothing
irrational about them, from a mathematical and objective point of view.
The terrible stuff comes after, with the measures conceived to revert
the exodus of professionals.

The list includes furious lobbying by the Cuban health officials with
their foreign counterparts, so that they will take measures against the
individual, private contracting of Cuban medical doctors. Here, they are
to apply all imaginable pressures, to the point of halting or hampering
current hiring processes if foreign institutions do not abide by the
will of the Cuban agency. These pressures are to be taken to the level
of foreign ministers in the countries with the largest numbers of Cuban
health professionals.

Other measures are aimed at Cuban personnel that step out of line,
demanding more restrictive commitments, tighter discipline and fuller
submission from potential candidates.

In the event of disobedience, they plan on stepping up repressive
measures, such as demoting workers to lower positions or invalidating
their degrees. The ministry hopes to improve coordination with
immigration authorities to control the lives of these people more
efficiently.

In short, the document is congruous with the policies we face in our
jobs on a daily basis as medical professionals. As I see it, these
measures do not really stand a chance to revert the phenomenon, as it is
a repressive policy that attacks the surface of the problem and does not
aim at the well-known roots of the issue.

It also goes against the current of the political, social and economic
policies being implemented elsewhere in the country, which promote
greater openness. What they are likely to do, rather, is make doctors
more upset, give the young more reservations about pursuing a medical
career and make those who are already studying medicine think twice
about continuing.

Source: Cuba's Health Ministry Desperate over Doctor Exodus - Havana
Times.org - http://www.havanatimes.org/?p=110574