The Army of White Coats: Cuba's Medical Offensive
Por: Aslam Hossain*
*Md. Aslam Hossain is a Senior Editor of The Geopolitics (https://thegeopolitics.com). He is a Dhaka based policy analyst and political commentator. One of his areas of interest is U.S.-China security competition.
Although Cuba is a small, isolated and developing country, it has achieved much progress in healthcare. Cuban constitution guarantees the right to have equal and free access to medical services. The estimated average life expectancy of the Cuban people was 78.9 years (CIA, 2019) in 2018 which is comparable to the developed countries of the West. Castro's communist revolution was instrumental in improving medical services and healthcare in the country. As a communist, Castro believed in free education and universal healthcare. His vision of turning Cuba into a major medical power was also influenced by Ché Guevara; a doctor, fellow communist and friend of Fidel Castro. However, Cuba's healthcare is not only designed to meet domestic needs but also a viable foreign policy tool to achieve its international goals and objectives. As Havana was mostly isolated from the Western World during the Cold War, the government decided to export Guevara's legacy to end political isolation and gain recognition of the international community.
Cuba's exporting of its doctors has facilitated medical services in developing and underdeveloped countries, especially in Africa and Latin America. Havana earns $11 billion[i] each year from medical services which makes it the biggest source of revenue for the communist government. It is a big achievement for a country which has been facing American embargo for six decades. The country has 50,000 doctors and nurses working in 67 countries around the world (Nugent, 2018); Cuban officials call them as an "army of white coats". Till November 2018, 8517 Cuban doctors worked in the poor and remote areas in Brazil, but Cuba's government recalled them following Bolsonaro's hostile and derogatory comments towards the country's communist regime (Sánchez-Vallejo, 2018).
In 1963, Castro sent his first medical team abroad to Algeria with 56 doctors following its independence from France in 1962[ii]. The medical mission was a success as it ushered in a new era of cooperation and close relations between the two countries. As of 2018, more than 1000 doctors worked in medical facilities across Algeria. In the 1960s and 1970s, Cuba sent medical practitioners to countries like Angola and Guinea Bissau which were fighting colonialism at that time.
Cuba still enjoys the benefits of exporting its doctors to developing countries. The communist country uses doctors to project its soft power abroad. The country sent 2000 doctors to Pakistan[iii] after the devastating earthquake which hit the country in 2005. Cuban medical personnel received appreciation and recognition from international media due to their professionalism and services after the earthquake in Haiti in 2010 and during the Ebola outbreak in West Africa in 2014. The policymakers in Havana have leveraged the country's medical capabilities to win the hearts and minds of millions of people around the world.
With the dissolution of the Soviet Union in 1991, many thought the communist regime in Cuba would crumble as it had lost its primary security guarantor and the largest trading partner. But the regime survived due to its good relations with the developing countries in Asia, Africa and Latin America. In 1999 Cuba signed “oil for doctors” deal with oil-rich Venezuela. Under the deal, Cuba received 100,000 barrels of oil per day in exchange for 31,000 doctors and dentists (Fawthrop, 2006). The partnership with Caracas deepened further during the presidency of Hugo Chavez. More than five decades of medical expertise has enabled Cuba to establish strong relations with NGOs and international agencies like World Health Organization (WHO) which in turn helped it to overcome international isolation in a certain degree.
Though Cuba has punched above its weight, it lacks modern medical instruments, drugs and advanced medical facilities due to longstanding U.S. sanctions. However, the country has more medical practitioners working around the world than the World Health Organization and the G7 countries combined. Besides, Cuba has been operating the largest medical school in the world since 1999. The school enrolls 8000 students each year (Hurley, 2017), most of them are from developing countries. So, Havana has managed to put itself in a special place in the world when it comes to healthcare. Cuba's deft medical diplomacy has injected billions of dollars of remittance into its cash-starved economy, brought prestige and recognition as well as overcome international isolation and generated soft power in the world, especially in the global South.
Central Intelligence Agency (2019). The world Fact Book. Retrived from https://www.cia.gov/library/publications/the-world-factbook/fields/355rank.html#CU August 4th 2019.
Fawthrop, T. (2006). Cuba doctors popular in quake-stricken Java. BBC. Retrived from http://news.bbc.co.uk/2/hi/americas/4792071.stm August 3rd 2019.
Hurley, G. (2017). Punching above its weight: Cuba’s medical internationalism. Sheffield Political Research Institute. The University of Sheffield.
Nugent, C. (2018). How Doctors Became Cuba's Biggest Export. Time. Retrived from https://time.com/5467742/cuba-doctors-export-brazil/ August 3rd 2019.
Sánchez-Vallejo, M. (2018). “Diplomacia branca” com médicos rende 42 bilhões de reais a Cuba por ano. El Pais. Retrived from https://brasil.elpais.com/brasil/2018/11/24/internacional/1543042730_806992.html August 4th 2019.