https://www.theguardian.com/global-development/2018/nov/23/brazil-fears-it-cant-fill-abrupt-vacancies-after-cuban-doctors-withdraw
Thousands of Cuban doctors leave Brazil after Bolsonaro's win Cuba has begun pulling out 8,300 doctors working in poor and remote regions of Brazil after far-right president-elect Jair Bolsonaro demanded contract changes to programme Global development is supported by Dom Phillips <https://www.theguardian.com/profile/dom-phillips> in Rio de Janeiro and Ed Augustin in Havana @domphillips <https://twitter.com/domphillips> Fri 23 Nov 2018 09.33 GMT First published on Fri 23 Nov 2018 08.00 GMT [image: Cuban doctors observe a dental procedure during a training session at a health clinic in Brasilia, Brazil.] <https://www.theguardian.com/global-development/2018/nov/23/brazil-fears-it-cant-fill-abrupt-vacancies-after-cuban-doctors-withdraw#img-1> Cuban doctors observe a dental procedure during a training session at a health clinic in Brasilia, Brazil. Photograph: Eraldo Peres/AP Cuba has begun withdrawing <https://www.theguardian.com/world/2018/nov/14/cuba-doctors-brazil-withdraw-jair-bolsonaro> 8,300 doctors working in some of the poorest regions of Brazil, prompting fears that indigenous villages, small towns and isolated rural communities could soon be left without medical care. The move came after Brazil’s far-right president-elect Jair Bolsonaro <https://www.theguardian.com/world/jair-bolsonaro> threatened to cut relations with Cuba and modify the conditions of a five-year-old agreement between the two countries and the World Health Organisation. The growing row offers a worrying sign of how the former army captain may handle diplomacy after assuming office on 1 January. On Tuesday, Brazil published an emergency tender for doctors trained in the country to replace the Cubans who were working under a programme called Mais Medicos, or More Doctors <https://www.theguardian.com/society/doctors>.. Chartered flights have begun carrying the Cuban doctors home, some carrying televisions and other goods, causing queues and cancelled appointments where they worked. Medical experts are worried the government will be unable to fill all the vacancies before they have all left by WHO’s expected final date of 12 December. Cuba to pull doctors out of Brazil after President-elect Bolsonaro comments Read more “I am extremely concerned about the potential health impact of this and how Brazil will be able to fill those positions,” said Albert Ko, a professor of epidemiology at the Yale School of Public Health <https://www.theguardian.com/society/health> who has worked in Brazil. The result will be “an abrupt fall in medical attention,” said Henrique Passos, a medical supervisor for Cuban doctors working in far-flung indigenous communities in the Amazon, many of which got their first doctor under More Doctors. Cuba announced it was pulling out of the programme <https://www.theguardian.com/world/2018/nov/14/cuba-doctors-brazil-withdraw-jair-bolsonaro> on 14 November, blaming Bolsonaro for declaring plans to modify the terms of the programme by insisting that Cuban doctors validate their diplomas and sign individual contracts. It also accused him of making “direct, contemptuous and threatening comments.” Earlier in the month, Bolsonaro, had questioned whether Brazil <https://www.theguardian.com/world/brazil> could maintain diplomatic relations with Cuba and said the More Doctors could only continue if Cuban doctors validated their diplomas and received their full pay. Currently, Cuba <https://www.theguardian.com/world/cuba> keeps around 75% of the doctors’ £2,400 allowance, though housing and food is paid by local authorities. [image: Cuban doctors Carlos Raul Lujos and Alioski Ramirez in Brasilia, Brazil. Leasing medical professionals is Cuba’s main export, bringing in more hard currency than tourism.] <https://www.theguardian.com/global-development/2018/nov/23/brazil-fears-it-cant-fill-abrupt-vacancies-after-cuban-doctors-withdraw#img-2> Facebook <https://www.facebook.com/dialog/share?app_id=180444840287&href=https%3A%2F%2Fwww.theguardian.com%2Fglobal-development%2F2018%2Fnov%2F23%2Fbrazil-fears-it-cant-fill-abrupt-vacancies-after-cuban-doctors-withdraw%3FCMP%3Dshare_btn_fb%26page%3Dwith%3Aimg-2%23img-2&picture=https%3A%2F%2Fmedia.guim..co.uk%2F25be68d4b77a8a9f66061cd614852a8b5a1678e8%2F0_171_3500_2100%2F3500.jpg>Twitter <https://twitter.com/intent/tweet?text=Thousands%20of%20Cuban%20doctors%20leave%20Brazil%20after%20Bolsonaro's%20win&url=https%3A%2F%2Fwww.theguardian.com%2Fglobal-development%2F2018%2Fnov%2F23%2Fbrazil-fears-it-cant-fill-abrupt-vacancies-after-cuban-doctors-withdraw%3FCMP%3Dshare_btn_tw%26page%3Dwith%3Aimg-2%23img-2> Pinterest <http://www.pinterest.com/pin/create/button/?description=Thousands%20of%20Cuban%20doctors%20leave%20Brazil%20after%20Bolsonaro%27s%20win&url=https%3A%2F%2Fwww.theguardian.com%2Fglobal-development%2F2018%2Fnov%2F23%2Fbrazil-fears-it-cant-fill-abrupt-vacancies-after-cuban-doctors-withdraw%3Fpage%3Dwith%3Aimg-2%23img-2&media=https%3A%2F%2Fmedia.guim.co.uk%2F25be68d4b77a8a9f66061cd614852a8b5a1678e8%2F0_171_3500_2100%2F3500.jpg> Cuban doctors Carlos Raul Lujos and Alioski Ramirez in Brasilia, Brazil. Leasing medical professionals is Cuba’s main export, bringing in more hard currency than tourism. Photograph: Adriano Machado/Reuters Even so, for Cuban doctors, the experience can be life-changing. Advertisement Yanet Rosales Rojas, 30, spent three years working in the Brazilian town of Poços de Caldas, where on average she earned more than 10 times her monthly salary in Cuba. She returned to the island last year, and was able to buy an apartment in Havana. “You earn much more than what you get in Cuba. I always wanted to travel and treat people in other countries. This was my chance,” she said. Leasing medical professionals is Cuba’s main export, bringing in more hard currency than tourism: last year professional services by doctors and nurse brought in $11bn , compared to $3bn in tourism. The chance to earn abroad is major incentive to study medicine, especially after a decade of private sector expansion where young Cubans have become less willing to work for the state. Sending doctors abroad also helps Cuba project soft power <https://www.theguardian.com/global-development/2014/oct/22/cuban-doctors-west-africa-fight-ebola>: Cuban doctors are currently working in 67 countries, and Cuban medical teams are often at the forefront of disaster relief efforts in the region (where they work free of charge.) In Brazil, more than 18,000 <http://maismedicos.gov.br/resultados-para-o-pais> doctors have taken part and 63 million people benefitted, according to the country’s health ministry.
