14ymedio, Yoani Sánchez, Generation Y, Havana, 1 April 2020 — The applause was felt everywhere. This Sunday at nine o’clock in the evening, an ovation crossed Cuba, in tribute to the health personnel who are on the front line of confrontation with Covid-19. As in other countries affected by the pandemic, people have wanted to acknowledge the sacrifice of doctors, who in Cuba must not only deal with the risk of becoming infected, but also with the material deterioration of the hospitals and low wages.
For decades, the Cuban health system has been highly praised by official propaganda and has become almost a myth at an international level. The fact that healthcare is free of cost to all and available to all is presented as one of the great “achievements of the Revolution,” and, for many, the health of the Island is a benchmark of how the sector should be managed. However, discontent grows among Cubans about the dire state of the hospitals, where the patients themselves must bring everything from sheets to food.
As the coronavirus spreads throughout the country – where according to official figures there are already 170 people who have tested positive for the disease and six who have died— our entire health network is being tested. In support of the Cuban doctors, they have been trained in contingency and working with few resources, so they have a special capacity to deal with the shortage of supplies that is becoming even more acute right now. Many of them are “graduates” in the harsh school of chronic crisis.
This ability to do a lot with little is one of the strengths that Cuban doctors have exhibited in recent days to countries where the coronavirus is taking hundreds or thousands of lives. More than 40 nations have requested the support of the island’s health professionals, as reported by the Ministry of Public Health. A necessary request and, without a doubt, a wise decision, because they will receive doctors experienced in emergency situations.
However, it must be said that the fine print of these agreements between the Cuban Government and the countries that call for health personnel almost never makes headlines anywhere. Those doctors will provide their services in semi-slavery conditions because, of the money the hosts pay, only a tiny part will end up in their pockets.
Our self-sacrificing doctors will work, sweat, and risk their lives, but the biggest beneficiary will be a government that doesn’t show transparency about what is done with every centavo earned from medical missions. Although official voices repeat that this money is invested in improving national health facilities and services, there is no clear record and the same could go to save lives rather than to sustain the repression.
On the other hand, although the desire to heal is the main motivation of their work, these doctors will have to accept that their work is publicly dressed up in the robes of ideology. It is enough to see the images of the Cuban doctors before leaving for Italy, posing next to a portrait of Fidel Castro, to understand that their trip is also being used by the Plaza of the Revolution as a marketing operation. The authorities want to extract ideological revenue from the pandemic and spread the idea that an authoritarian model cuts freedoms but saves lives. In other words, in these regimes, it is not possible to behave oneself as a citizen, but rather as an eternal patient.
The official discourse is disrupted when one of those doctors decides not to return to the Island. From the smiling photo and the epithet “hero of the country” they will come to suffer the stigma of being considered a “deserter.” It is enough that a doctor fails to return from a mission for them to be forbidden to enter Island to be reunited with their family for eight long years and, in addition, they will lose the salary in national currency that they have already earned, which had been accumulating in a bank account in Cuba.
So why do they go to these missions where they risk their lives and where they earn so little, many will wonder. The answer is complex but worth exploring. The humanitarian vocation is part of the motivations, but there is more: Getting out of the island prison is a respite in the midst of such a hard daily life. Despite being in an emergency zone, over there they will have access to many more services and products, so they will be able to bring merchandise to Cuba that will relieve their situation and that of their family.
A few years ago I met a doctor, epidemiologist, and university professor, who accepted a medical mission in Venezuela because it was the only possibility of obtaining the resources to repair the roof of her house. On this island we have the harsh contrasts of running into a neurosurgeon who is going to operate on a brain without having had breakfast, because his salary is not enough to have a glass of milk each day, and of a nephrologist who asks his patients to buy him a snack to cope with the workday.
Despite the fact that some years ago the salary of health professionals became the highest pay in all of Cuba, right now it is very difficult to find any of them who earn more than the equivalent of 70 dollars a month, and this in a country where a liter of vegetable oil costs over $2.50 and in state stores a liter of milk costs more than $1.50. Our doctors live, practically, in penury.
All this and much more influences why they get on a plane to provide their professional services outside the country, even if they risk their lives and even though they know that the Government is going to keep most of their income. They also do it because they love their profession and one day they swore to face illness and death, because they are magnificent human beings, like all the doctors on the planet, and not because they profess an ideology or because they are members of a certain party.
They, our doctors, are the true heroes of these days and not because of what the official press says. So tonight, when the clock strikes nine, I will clap wildly for them on my balcony. I will do so to acknowledge their effort, but it will not be an ovation for the system that has condemned them to wage poverty and political docility. Come clap your hands for our white-coat heroes.