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AFRICA: South Africa Welcomes Cuban Doctors

Stephanie Nieuwoudt

CAPE TOWN, Apr 28 2008 (IPS) - For more than a decade, Cuban doctors have filled part of a gap left by South African doctors who in large numbers leave the country looking for better salaries and employment opportunities.

According to Fidel Radebe, director of communications for South Africa’s department of health, there are currently 134 Cuban doctors in the country working under a government-to-government agreement between Cuba and South Africa.

The first Cuban doctors who came to the country under this agreement arrived in 1996 – two years after the African National Congress (ANC) came to power.

Socialist Cuba was a firm supporter of the anti-apartheid struggle in South Africa, and the ANC and other leftwing movements in South Africa always had a natural affinity for Cuba’s stated struggle against “neo imperialism.”

Fast forward to 2008 – Radebe could not confirm rumours that negotiations were underway to bring a new batch of doctors to the country. “The department may in future consider the further recruitment of Cuban doctors as provided for in the government-to-government agreement, but details have not yet been finalised,” he said.

IPS asked Radebe about how Cuban doctors have been received in South Africa. Some of their patients and colleagues have been harsh in their criticism. Patients have complained that some of the doctors are not properly trained and that they do not converse fluently in any of South Africa’s 11 official languages, including English.

This kind of response, however, stands in sharp contrast to a number of papers and articles written by academics and journalists that praise the Cuban government for its accessible medical system and the high standards of training in that country. According to some figures there is one doctor for every 170 Cubans – something South Africa has no hope of achieving in the near future with only 74 doctors per 100,000 citizens.

Whatever the criticism, it cannot be denied – some commentators say – that Cuban doctors have brought invaluable resources to far-flung areas of the country where many South African doctors refuse to work due to insecurity, remoteness of the area, and a lack of proper salaries.

“These doctors provide an important service in places where only one doctor is often on call 24 hours a day, seven days a week,” says Mike Waters, spokesperson for the opposition Democratic Alliance (DA).

Harald Pakendorf, a former newspaper editor and currently an independent political analyst, concurs that Cuban doctors play an important role in primary health care in South Africa. He also adds that the government should retain doctors, all of whom were trained at great cost to South African taxpayers.

“The government should appoint competent hospital administrators who can see to things like funding and the purchasing of equipment. Doctors should care for their patients. They should not have to worry about the availability of things like needles, sutures, swabs and medicines,” Pakendorf said.

Regarding the criticism that Cuban doctors often lack the necessary skills, Radebe says that all doctors have to register with the Health Professions Council of South Africa and therefore have to meet certain professional standards.

According to Waters, the vacancy rates for medical specialists range from 51 percent in the central province of the Free State to a massive 86 percent in the northern Limpopo Province, near Zimbabwe. And it is in these empty spaces that the Cuban doctors are eagerly welcomed.

The situation in the Eastern Cape, South Africa’s poorest province, is also desperate. Not only is there a lack of general practitioners, but there is also a demand for teaching staff at the medical school of the Walter Sisulu University in Mthatha. A total of 32 Cuban specialists are currently attached to the medical school.

Karuna Krihanlal-Gopal, the acting director of marketing, communications and development at the university, says that the Cuban doctor-trainers “certainly bring a wealth of experience [to South Africa], having worked in similarly challenging circumstances prior to arriving in the country. They are also very dedicated teachers.”

In 2007 Cuban doctors with 10 years experience or more who work in South African government hospitals and institutions were paid about 3,800 to 4,400 dollars per month, according to figures released by the DA. Relatively speaking, this might seem like a lot, compared to salaries in Cuba, but South African doctors emigrating to work in Europe, North America or the Antipodes could often treble their salaries by practicing overseas.

According to Radebe, several doctors have in the past opted to obtain permanent residency and citizenship in South Africa.

According to the government-to-government agreement, South Africa has also sent hundreds of medical students to Cuba to be trained there. From 1996 to 2007, 470 South Africans had been trained there.

Radebe says that there are many programmes to retain doctors in the South African public health system – “revitalising of hospitals to provide a better clinical environment for health professionals, improving their conditions of service within the allocated budgets, providing better career progression and remuneration dispensations, providing specialist training, investing in new technologies and improving clinical management.”

There are many suggestions on the table. But implementing them is another matter. Meanwhile, Cuban doctors are fulfilling a crucial role in plugging the hole left by South African doctors who are either unwilling to work in far- flung areas or who are themselves seeking greener pastures overseas.