Hasta la victoria siempre. Friday Cuban embassy attache would be in Nelson Mandela Medical School as part of this commemoration. Sent from my BlackBerry® wireless device
-----Original Message----- From: Ndinisa Maviyo <[email protected]> Sender: [email protected] Date: Tue, 12 Jul 2011 23:14:32 To: ycl<[email protected]>; tom<[email protected]> Reply-To: [email protected] Subject: [YCLSA Discussion] 15TH ANNIVERSARY THE 15TH ANNIVERSARY OF CUBA AND SOUTH AFRICA HEALTH COLLABORATION This year 2011 will mark the 15th anniversary of the Cuba and South Africa collaboration on health related matters. The official government to government agreement was signed in 1996 and exactly on the 10th of January 1997 the first group of students departed to Cuba for training as medical doctors and a number of Cuban doctors and professors arrived in South Africa to work in our public hospitals and institution of higher learning. Cuba has been educating and training young South African and other young Africans prior 1994, there were medical students and engineering students who came through the liberation movement. The collaboration has contributed in training young people from the poor families to enter a field which has been always considered a career of the rich and the middle class due to the cost of the training. The ruling party and the government of the day showed a lot of interest in this programme hence you had a direct interest from the then minister of health Dr NK Dlamini Zuma and the then MEC for Health in Mpumalanga Candith Mashego Dlamini there was a political will from both side of Cuba and South Africa to see this programme becoming a success. Not for getting the role played by the Ambassador John Nkadimeng and all the embassy staff in ensuring that there is a smooth transition and adaptation to a new country with a different culture, as it was for the first for the students to leave South Africa and for others they were leaving their parents for the first time. The programme benefitted our people, rural hospitals were staffed with highly qualified specialist who performed procedures and saved many lives or have helped people who will be still waiting to be operated today or died still on the waiting list. The programme was surrounded by controversies, first after the minister was removed from the portfolio there was no political direction and vision in terms of the programme. Secondly, the South African officials from the HPCSA and professors from SA medical institutions went to Cuba to recruit Cuban doctors with 5 years or more experience in their field of speciality but here in South Africa they were registered as medical officers and their immediate supervisors in the hospitals were not informed about their capacity or they just ignored and preferred to frustrate their colleagues in other to prove a misinformed perception about the Cuban quality of training. In other institutions specialist like orthopaedic surgeons were allocated to work in the outpatient department. A question can be asked why the Cuban doctors were treated differently from other foreign specialist and doctors in terms of their registration. When the Cubans were still around we did not have such a bag log in orthopaedics, general surgery, obstetrics and gynaecology. SA medical graduates wanted to work in the rural areas because they receiving hand on training and exposure in different specialities. Thirdly, the programme of training student in Cuba started to lose its reason for existence, children from privileged middle class and the upper class (ruling class) of our society started to dominate the programme. In other insistences South Africa sent student without any back ground in basic science making it difficult for the Cuban professors and the student to understand each other which forced the Cuban to introduce basic science together with Spanish during the preparatory course. The commitment of some student to the course was questionable. Lastly the knowledge of the government advisers in these programme objectives is questionable. ANALYSIS ON THE TRAINING OF SA STUDENT IN CUBA The programme had the first group which left South Africa in 1997, towards their completion there was a confusion whether to complete their training in Cuba or to come back and complete in south Africa and another issue what which skills were needed by the South African Cuban trained medical students in order to adapt to the South African environment of working as a doctor and nobody was available to advice but our little knowledge we had of the reality of the working environment of a doctor in South Africa and the help of Cuban doctors who worked in South Africa a programme was drafted specifically for South African student from their 4th year of studies. The special programme included training / skills in obstetrics and gynaecology, trauma and emergency medicine, basic skills in general surgery, basic anaesthesia and tropical medicine. South African student were expected to attend extra classes, calls and to days from their holidays to attend to the programme. It was tough and rough but there was commitment from both the student and the Cuban tutors to realise this programme. The course in tropical medicine was interesting because it was the first time to see HIV patients in Cuba on treatment and few others as treatment failures, to be taught about ARV combination and ARV”S resistance during those years South Africa was still grumbling about the ARV prices and the affordability of the state not to mention the politics surrounding HIV-AIDS. Only few amongst the student complained about importance of the special programme. The success of the special training led to the training of the Cuban graduates who were going to Haiti to do their internship and for exposure (it was before the earth quake) and it was further appreciated by the student when they returned, they find it easier to adapt and work as student doctors and to match with their peers in South Africa except for differences in approach. The first group studied in Sancti Spiritus, every South African in Cuba is being told about the dedication of the first group in realising the objectives of the programme and back in South Africa those who knew and work with the first group as student and junior doctors do miss them and the majority of their SA colleagues were denying that they were Cuban graduates because they were so different from what they have been told and their imaginary perception. On the side of the South African government there was no evaluation of the special programme of skilling, it was just abandoned and now it depends to an individual interest to be attached to a particular speciality as a student assistant ( extra normal programme for the Cuban training in general) and I believe that contributed to the problems encountered by the majority of the student from the subsequent groups to adapt and to know what is expected from them especially as Cuban graduates because are treated as foreigners in their own country or stand to humiliated by the professors or senior doctors in demonstrating their disapproval of the Cuban SA programme through humiliation of the student or undermining Cuban consultants working with them. Remember South African medical institution are still competing among themselves instead of complementing each other, the graduate from white institution are perceived as better doctors than those from the black institution and now at least the black graduate through their imaginary and misinformed perception they feel better than the Cuban graduates. THE WITHDRAWAL OR NON RECRUITEMENT OF THE CUBAN DOCTORS There was no proper assessment in stopping the recruitment of the Cuban doctors in of the impact, there was back up to the void when they left, we did not have enough specialist even willing to work where the Cuban specialist were working, to do the numbers of cases a Cuban specialist was prepared to do a day in order to deal with the back log and the lack of access to specialised services. WHAT SHOULD BE DONE? The training of South African student in Cuba should continue including the special skilling programme for the South African which will produce doctors who can work in our abnormal health environment especially in our rural communities. Remember the Cuban curriculum for medical training produce a graduate who can fit to work in Cape Town because of the advanced system of heath and the availability of specialist as a pillar of support. THE RECRUITEMENT OF CUBAN SPECIALIST The Cuban doctors can still make a serious contribution in strengthening our public health system, in provinces like Mpumalanga are in dire need of these internationalist to come and provide their expertise, the availability of specialist will help to assist and easier the system of referral for specialised services, they will remove the stress faced by medical officers in the public service to get a specialised service for their patients especially in the rural areas. They will train SA graduates during their internship and community service and they must be placed where they can perform their specific specialities instead of being turn medical officers in terms allocations and depriving our people due to narrow egos of our clinical manager. The only speciality which is doubtful from Cuban trained doctor is the family physician if is practised properly in south Africa because I think it needs a person who has worked in South Africa as a medical officer. Another recruitment which can help to address the shortage is to recruit Cuban graduate of African origin who cannot return to their countries due political instability in their countries, being rejected by their government, (e.g. Ethiopians and the Congolese) they are stranded and redundant in Cuba and majority of them are specialist in their field, one time in a meeting on Africa, they raised their interest to come back to Africa and serve any where as long as they are in Africa. The proposal was raised with some officials from the SA embassy but did not show any interest until some of them were recruited to work in Canada. The political interest from the political head will provide leadership to the success of this programme because the lack of interest from the minister or MEC from the provinces gives the officials to mess up the programme. The collaboration can teach us a lesson on how Cuba manages to produce more than 100 000 doctors from only less 20000 when they took over the government. It can teach us to understand the concept of business that you only have a choice to chose when there is a surplus in production, the Afrikaners through their political will were able to produce a quantity of doctors from white graduates and they had a surplus to send them to black communities to work and defend apartheid as the only hope for the health of black people. Therefore the current government needs to use its political power to produce a quantity of health workers with clear programme of changing that quantity into quality through a compulsory continued development programme and the cap in terms of the years of practice before a doctor can become a private medical practitioner, as long as the medical profession is termed a scare skill the public service will continue to suffer and the blow will always hitting directly to the poor and the working class who cannot afford the private service. Let me conclude by thanking all the people who have made sure that the programme is a success, especially the people of Cuba and their Revolutionary state, the South African student training in Cuba, all the ambassadors who followed to the steps of Mr J Nkadimeng, the government officials who continued to do a good job in supporting the programme. Thanks to all the South African institution who opened their doors to orientate the students to the South African disease pattern than to demonstrate their disproval of the programme, all the health professionals who made sure that the students feel a sense of belonging to the system, starting from professors, consultants, registers, doctors, medical managers, nurses and the general workers in the health system. Special appreciation to professor Mazwayi for showing interest in this programme from the beginning up to date. A special thanks to all the South African medical students in South Africa who showed patriotism by making sure that their patriots adapt fast, have all the notes and prepare them to the system of examination. Thanks to everyone who sacrificed his or her time to help us, their contribution is noted. BY Dr M.W. NDINISA IS A CUBAN GRADUATE, WAS PART OF THE 1997 GROUP -- You are subscribed. This footer can help you. 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