Friday, September 17, 2010

DC Mayoral Primary, Facebook, Obama Keeps Cuba Embargo, Fidel’s Surprise, Cuban Doctors

We’ve had our Democratic mayoral primary in DC, after which the November election is usually just a formality, since well over 90% of DC voters are registered Democrats. Unfortunately (in my opinion), incumbent Mayor Adrian Fenty lost to City Council Chair Vincent Gray. Fenty was a no-nonsense guy who plowed ahead, usually without consulting others, but a reformer who got a lot a done. He was of bi-racial heritage, like Obama, and appointed many non-blacks to high positions, including a white woman as chief of police and, the most controversial and nationally well-known, an Asian woman, Michelle Rie, as education chancellor. Rie dared to get rid of non-performing or even harmful teachers. Gray, a long-time council member, is a pretty traditional political type who had the backing of most African American voters, still a majority in the city, though a slightly shrinking percentage; the vote was pretty much divided along racial lines. I think it’s a step backward to have elected Gray, a sign of the anti-incumbent fever or fervor sweeping much of the nation in the wake of the economic recession. People seem to be thinking: let’s go back to the way things were; it was better then. An ironic wrinkle in the mayoral primary is that among the miniscule number of registered Republicans who voted, Fenty won as a write-in candidate, so, theoretically, he could run as a Republican to challenge Gray, a risky strategy that could well backfire and forever ex-communicate him from the Democratic Party.

Someone told me about a Peace Corps volunteer in her 60s working in Africa more than 20 years ago who was murdered by a radio thief. It happened in Zimbabwe, no longer a PC country, but something like that, regrettably, could happen elsewhere. I can’t help remembering with a shudder the robber who came in through my roof in La Esperanza while I was sleeping and planned to steal my radio, among the loot he’d assembled on the floor before I woke up screaming and scared him away.

Not surprised to read in the Washington Post (Sept. 13, 2010) an article headlined “South Sudan sovereignty at risk.” Sounds like Khartoum is trying to raise issues about the dividing line between north and south in order to delay (and undermine) the vote, since it’s obvious that southerners will want to secede.

Facebook can be a fun way to connect with friends old and new, but I got a jolt recently when someone posted a message, supposedly from me, saying that I had gotten a coupon for a free laptop from some promotion or other and they should do the same. Well, I never posted that message and never got a free laptop. How was my system invaded? Who knows? I reported it to Facebook, changed my password, and dumped a few iffy names from my “friends” list. Still, I was shaken, as my previous password was rather esoteric. However, these invaders apparently can read keystrokes, so no matter how convoluted the password, they can copy it. Kind of scary. Electronic communication is a two-edged sword, so easy to use, so easy to have your privacy invaded and your system hijacked.

You may already know that Obama signed a renewal of the Trading with the Enemy Act regarding Cuba, despite our best efforts in Amnesty International. Apparently in this mid-term election year and with all the other problems, that was an issue he wasn't willing to tackle. However, HR4645, to effectively lift the full US travel ban to Cuba, is still in play and probably would not be vetoed by the president.

Below from AP, Sept. 8, 2010, is a remark heard round the world.

Jeffrey Goldberg, a national correspondent for The Atlantic magazine, asked if Cuba's economic system was still worth exporting to other countries, and Castro replied: "The Cuban model doesn't even work for us anymore" Goldberg wrote Wednesday in a post on his Atlantic blog.

What did Castro mean? He said later that he was misunderstood, that he meant that capitalism doesn’t work anymore. Is the guy senile, sending a signal, or what?
Sept. 9 — At least 10 of the political prisoners out of the odd 20 still in prison refuse to accept traveling to Spain because they wish to remain in the island or want to go to the United States, Elizardo Sánchez, president of the opposition’s Cuban Commission of Human Rights and National Reconciliation, affirmed. That group forms part of the 52 dissidents included in the agreement between the Catholic Church, Madrid and the Cuban government, reported IPS.
Cuba's Cash-for-Doctors Program
Thousands of its health-care missionaries flee mistreatment.
Wall Street Journal, AUGUST 16, 2010

For decades, Cuba has "exported" doctors, nurses and health technicians to earn diplomatic influence in poor countries and hard cash for its floundering economy. According to Cuba's official media, an estimated 38,544 Cuban health professionals were serving abroad in 2008, 17,697 of them doctors. (Cuba reports having 70,000 doctors in all.)

These "missionaries of the revolution" are well-received in host countries from Algeria to South Africa to Venezuela. Yet those who hail Cuba's generosity overlook the uglier aspects of Cuba's health diplomacy.

The regime stands accused of violating various international agreements such as the Trafficking in Persons Protocol and ILO Convention on the Protection of Wages because of the way these health-care providers are treated. In February, for example, seven Cuban doctors who formerly served in Venezuela and later defected filed a lawsuit in Florida federal court against Cuba, Venezuela and the Venezuelan state oil company for holding them in conditions akin to "modern slavery."
They claim the Cuban regime held the funds Venezuela remitted for their services and then paid them—an arrangement they say is a form of "debt bondage." They also say they were forced to work extremely long hours in dangerous areas, including urban zones with high crime rates and the jungle. (The Venezuelan government and its oil company are challenging the court's jurisdiction to hear the case; Cuba hasn't responded.)

Starting in 2002, Hugo Chávez agreed to pay—mostly with subsidized, cheap Venezuelan oil—for Cuba to provide health care to marginalized populations in Venezuela at no cost to patients. But in the past several years he has expanded the effort to other countries, helping to build support for his regional Marxist agenda while keeping the Cuban economy afloat.

Cuba won't release its agreements with host countries, but details have emerged in open sources, including in Cuba's official media. These show that typically the host country pays Cuba hard currency for each health worker and provides accommodations, food and a monthly stipend generally between $150 and $350. Cuba covers airfare and logistical support, and it pays salaries to the health-care workers out of the funds it holds.

Cuba's global health projects also receive support from the developed world. In 2005, at least $27 million was donated to Cuba's Haiti mission, including from France and Japan. International goodwill also translates into direct aid. In 2008, Cuba received $127 million from OECD countries. These transfers explain the recent rise in Cuba's export of services, to $8.6 billion in 2008 from $2.8 billion in 2003. Representing 75% of GDP, they generate far more income than any other industry.
Cuban doctors go abroad because at home they earn a scant $22-$25 a month. When they work in other countries, they typically get a small stipend in local currency while their families back home receive their usual salary plus a payment in hard currency—from $50 to $325 per month.

But with the state as sole employer and the citizens forbidden from leaving the country without permission, the system is tailor-made for exploitation. Several Cuban doctors who have served abroad tell me that in addition to very long hours they may not drive a car, leave their dwellings after a certain hour, or speak to the media. In some countries they are only allowed to associate with "revolutionaries." Thousands of Cuban health professionals have deserted world-wide. Almost 1,500 have made it to the U.S. alone since 2006, according to a Department of Homeland Security report in March.

Cuba's profitable global business has ramifications for its own health-care system. It's been extensively reported, by Cuba's independent journalists as well as by the occasional Westerner who ends up in a hospital for the common people, that Cubans face a chronic shortage of doctors and dilapidated health facilities. Patients or their families must even bring their own food and linens to the hospital.
Meanwhile, the mass production of Cuban doctors for export has led medical associations in host countries such as Bolivia, Paraguay, Uruguay, Brazil and Portugal to question their experience and credentials. Some Venezuelan doctors have complained of being fired and replaced by Cuban missionary physicians. And a few years ago the Bolivian press reported that the country's medical association was complaining about thousands of unemployed health professionals who were earning considerably less than what Mr. Chávez was paying for Cubans.

Humanitarianism cannot be selective. Cuba's health workers deserve full protection of local and international laws, its citizens deserve access to adequate health care, and patients everywhere deserve accountability from their health-care providers.

Ms. Werlau is executive director of nonprofit Cuba Archive, a human rights organization

1 comment:

Jenni said...

MD247 doctors and telemedicine program members are legitimately given the opportunity to connect, allowing a patient the chance to talk to a doctor without that doctor worrying about time and overhead.
ask a doctor