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    South Africa: Country Welcomes Cuban Doctors

    South Africa: Country Welcomes Cuban Doctors

    Inter Press Service (Johannesburg)

    28 April 2008
    Posted to the web 29 April 2008

    Stephanie Nieuwoudt
    Cape Town

    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

    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

    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.


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