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Cuban Medical Internationalism: The Ebola Campaign of 2014–15
Abstract
This article examines the Cuban response to Ebola in West Africa, specifically in the three countries where the Cuban medical personnel focused their efforts – Guinea, Liberia and Sierra Leone. It analyses the situation in West Africa as the disease rapidly spread, the international response and the Cuban reaction. In particular, it assesses the impact of Cuba's contribution and concludes with some thoughts about what can be learned from this short (6-month) campaign of the Henry Reeve Contingent, which specialises in responding to natural disasters and medical emergencies. The article finds that there are important lessons for the international community regarding responses to future outbreaks. Diseases such as Ebola do not respect international borders and cannot be overcome with promises of resources or money. In this case, Cuba's response – of a highly trained healthcare workforce of doctors, nurses, technicians and others – remains unique.
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Notes
World Health Organization, ‘Cuban Medical Team Heading for Sierra Leone’, September 2014. Available at http://www.who.int/features/2014/cuban-ebola-team/en/. (Accessed 30 March 2015.)
World Health Organization, ‘Ebola Situation Report – 1 April 2015’. Available at http://apps.who.int/ebola/current-situation/ebola-situation-report-1-april-2015-0. (Accessed 1 April 2015.) See also André Picard, ‘WHO Declares Liberia Free of Ebola’, The Globe and Mail , 11 May, 2015, p. A3.
‘“Es increíble lo que Cuba puede hacer,” dice la OMS sobre ayuda frente al Ébola’, Solidaridad Cubana , 24 October 2014. Available at http://www.cubadebate.cu/noticias/2014/10/24/es-increible-lo-que-cuba-puede-hacer-dice-la-oms-sobre-ayuda-frente-al-ebola/. (Accessed 24 October 2015.)
The Henry Reeve Brigade (named after an American volunteer who fought with Cuba against Spain in the first war for independence) was formed in 2005 with the mission of responding to natural emergencies and epidemics. The first mission (in October of that year) was to Kashmir, where a major earthquake occurred. Cuba responded with 2,400 medical personnel, who stayed there several months. Since then the Henry Reeve Brigade has participated in numerous missions to assist local communities from around the world – from Chile to China, Peru to Nepal. After their mission in Kashmir, the largest Cuban delegation was sent to Haiti following the 2010 earthquake. They stayed there long afterwards to lead the struggle against the outbreak of cholera.
See John M. Kirk and H. Michael Erisman, Cuban Medical Internationalism: Origins, Evolution, and Goals (New York, NY: Palgrave Macmillan, 2009); John M. Kirk and Chris Walker, ‘From Cooperation to Capacitation: Cuban Medical Internationalism in the South Pacific’, International Journal of Cuban Studies 5(1) Spring 2013: 10–25; John M. Kirk and Chris Walker, ‘Moral Medicine – The Cuban Way’, New Internationalist , no. 457, November 2012: 24–27; and John M. Kirk, Healthcare without Borders: Understanding Cuban Medical Internationalism (Gainesville, FL: University Press of Florida, 2015).
See the press conference held at the WHO on September 12, 2014. Available at www.who.int/mediacentre/news/statements/2014/cuban-ebola-doctors/en. (Accessed 17 May 2015.)
David A. Bluemke and Carolyn C. Meltzer, ‘Ebola Virus Disease: Radiology Preparedness’, Radiology 274(2) February 2014: 527–531.
All data from Karen A. Grépin, ‘International Donations to the Ebola Virus Outbreak: Too Little, Too Late?’, The BMJ , 3 February 2015. Available at http://www.bmj.com/content/350/bmj.h376?etoc. (Accessed 30 March 2015.)
As noted in a recent New York Times article – ‘How Many Ebola Patients Have Been Treated outside of Africa?’, The New York Times , 26 January 2015. Available at http://www.nytimes.com/interactive/2014/07/31/world/africa/ebola-virus-outbreak-qa.html. (Accessed 20 May 2015.) Approximately ten Americans have been infected and two have died since the outbreak. Approximately fourteen people in Europe have been infected and five have died (with one in treatment at the time of the article).
‘How Many Ebola Patients Have Been Treated outside of Africa?’.
John Kerry, ‘Remarks on the U.S. Response to Ebola for Members of the Diplomatic Corps’, US Department of State, 17 October 2014. Available at http://www.state.gov/secretary/remarks/2014/10/233091.htm. (Accessed 30 March 2015.)
Joe Sutton and Holly Yan, ‘Second American Infected with Ebola’, CNN , 22 August 2014. Available at http://www.cnn.com/2014/07/27/world/africa/ebola-american-doctor-infected/. (Accessed 20 May 2015.)
Examples taken from Alan Yuhas, ‘Panic: The Dangerous Epidemic Sweeping an Ebola-fearing US’, The Guardian , 20 October 2014. Available at http://www.the-guardian.com/world/2014/oct/20/panic-epidemic-ebola-us. (Accessed 11 April 2015.)
The Editorial Board, ‘Cuba's Impressive Role on Ebola’, The New York Times , 19 October 2014. Available at www.nytimes.com/2014/10/20/opinion/cubas-impressive-role-on-ebola.html?_r=0. (Accessed 28 May 2016.)
William Mauldin, ‘World Bank Calls for Emergency Fund for Disease Outbreaks: World Bank President Jim Yong Kim Criticizes Global Response to Ebola Outbreak, Suggests International Fund’, The Wall Street Journal , 10 October 2014. Available at http://www.wsj.com/articles/world-bank-calls-for-emergency-fund-for-disease-outbreaks-1412963186. (Accessed 20 May 2015.)
‘France Says Will Build More Ebola Treatment Centers in Guinea’, Reuters , 13 October 2014. Available at http://uk.reuters.com/article/2014/10/13/us-health-ebola-france-idUKKCN0I224W20141013. (Accessed 20 May 2015.)
‘Canadian Contribution to Ebola Fight Not Enough, Critics Say’, Toronto Sun , 16 September 2014. Available at http://www.torontosun.com/2014/09/16/us-to-send-3000-troops-to-tackle-ebola. (Accessed 11 April 2015.)
Drew Hinshaw and Betsy McKay, ‘Cuban Doctors at the Forefront of Ebola Battle in Africa’, The Wall Street Journal , 9 October 2014. Available at http://www.wsj.com/articles/cuba-stands-at-forefront-of-ebola-battle-in-africa-1412904212. (Accessed 30 March 2015.)
Kirk and Walker, ‘From Cooperation to Capacitation’.
Andy Weber, ‘Robust Responses from the Asia-Pacific Region to the Ebola Outbreak in West Africa’, DIPNote – U.S. Department of State Official Blog, 23 December 2014. Available at https://blogs.state.gov/stories/2014/12/23/robust-responses-asia-pacific-region-ebola-outbreak-west-africa. (Accessed 20 May 2014.)
See ‘Remarks at a Press Conference: Cuban Government Announces Substantial Support to WHO Ebola Response’, Statement by WHO Director-General, Dr Margaret Chan, 12 September 2014. Available at http://www.who.int/mediacentre/news/statements/2014/cuban-government-support/en/. (Accessed 11 April 2015.)
Salim Lamrani, Cuba, the Media, and the Challenge of Impartiality (New York, NY: Monthly Review Press, 2015).
For a general overview of Cuba's approach to medical cooperation, see John M. Kirk and H. Michael Erisman, Cuban Medical Internationalism: Origins, Evolution and Goals (New York, NY: Palgrave Macmillan, 2009) and John M. Kirk, Healthcare without Borders: Understanding Cuban Medical Internationalism (Gainesville, FL: University Press of Florida, 2015).
Glen Ford, ‘For Moment, the World Embraces the Cuba Model – and Slaps the Empire’, Common Dreams , 2 November 2014. Available at http://www.common-dreams.org/views/2014/11/02/moment-world-embraces-cuba-model-and-slaps-empire. (Accessed 11 April 2015.)
See ‘Ebola’. Available at http://www.doctorswithoutborders.org/our-work/medical-issues/ebola. (Accessed 28 May 2016.)
See ‘WHO Welcomes Cuban Doctors for Ebola Response in West Africa’, WHO Statement. Available at http://www.who.int/mediacentre/news/statements/2014/cuban-ebola-doctors/en/. (Accessed 11 April 2015.)
Data taken from Lisandro Fariñas Acosta, ‘En África por la humanidad’, Granma , 4 January 2015. Available at http://www.granma.cu/cuba/2015-01-04/en-africa-porla-humanidad. (Accessed 5 January 2015.)
Colin Freeman, ‘Cuban Doctors Take Leading Role in Fighting Ebola’, Daily Telegraph , 29 January 2015. Available at http://www.telegraph.co.uk/news/worldnews/ebola/11375422/Cuban-doctors-take-leading-role-in-fighting-Ebola.html. (Accessed 30 March 2015.)
WHO, ‘Cuban Medical Team Heading for Sierra Leone’. Available at http://www.who.int/features/2014/cuban-ebola-team/en/. (Accessed 19 May 2015.)
Gail Reed, ‘Meet Cuban Ebola Fighters: Interview with Félix Báez and Jorge Pérez’, MEDICC Review 17(1) January 2015: 6.
Ibid., p. 7.
Baéz noted the challenges that resulted from the protective clothing that they had to wear: ‘You could only wear the suit for up to an hour, maximum, sometimes less; and you only went into the patient-care unit twice during your shift … For suiting up and removing our suits, we used a buddy system, our decontamination supervised by local hygienists, who were very strict.’ Reed, ‘Meet Cuban Ebola Fighters’, p. 7.
Dr Leonardo Fernández quoted in Enrique Ubieta Gómez, ‘Doctors Fighting Ebola’, Granma International , 23 March 2015. Available at www.en.granma.cu/cuba/2015-03-23/doctors-fighting-ebola. (Accessed 11 April 2015.)
Two other Cuban medical personnel did die, however, both of malaria – Jorge Juan Guerra Rodríguez in Guinea, and Reinaldo Villfranca in Sierra Leone.
‘Regresan a Cuba médicos que combatieron el Ébola en África’, Cubadebate , 22 March 2015. Available at http://www.cubadebate.cu/noticias/2015/03/22/regresan-a-cuba-medicos-que-combatieron-el-ebola-en-africa/. (Accessed 1 April 2015.) The same article cites the grateful words of Liberian president Ernest Bai Koroma: ‘I knew that Cuba would not leave us alone. You are true to your lineage, your African roots – as Fidel has taught you.’
Yordanis Rodríguez Laurencio, ‘Presidente de Guinea, Señor Alpha Conde: “Los mejores médicos en África son los cubanos”’, Granma , 1 April 2015. Available at www.granma.cu/mundo/2015-04-01/los-mejores-medicos-en-africa-son-los-cubanos. (Accessed 28 May 2016.)
‘Médicos cubanos curan a 260 enfermos de ébola en Sierra leona y logran frenar avance del virus,’ Cubadebate , 18 February 2015. Available at http://www.cubadebate.cu/noticias/2015/02/18/medicos-cubanos-curan-a-260-enfermos-de-ebola-en-sierra-leona-y-logran-frenar-avance-del-virus/. (Accessed 30 March 2015.)
See John M. Kirk, ‘Cuban Medical Internationalism: Development and Rationale’, Bulletin of Latin American Research 28(3) 2009: 497–511.
Enrique Ubieta Gómez, ‘Doctors Fighting Ebola’, Granma , 23 March 2015.
Hinshaw and McKay, ‘Cuban Doctors at the Forefront of Ebola Battle in Africa’.
Chris Walker, Venezuela's Health Care Revolution (Halifax, NS, Canada: Fernwood Publishing, 2015).
'Intervención de la delegación de Cuba en la sesión especial del 136 Consejo Ejecutivo de la OMS sobre el combate al virus del ébola, 25 de enero de 2015.
Rep. Mario Díaz-Balart, a Republican House representative noted ‘It is a disgrace that the United States sent a representative to an ALBA meeting in Havana and praised the Cuban dictatorship for sending forced medical labor to Western Africa … That the US would send a representative to such a meeting is by itself ludicrous … Cuban doctors are hastily trained, poorly equipped, and forced to work in dangerous conditions while most of their pay is siphoned to the Castro dictatorship. That a U.S. official would condone their overt exploitation is outrageous.’ Cristina Marcos, ‘House Republican Blasts U.S. Attendance at Ebola Meeting in Cuba’, The Hill , 30 October 2014. Available at http://thehill.com/blogs/floor-action/house/222349-house-republican-blasts-us-attendance-at-ebola-meeting-in-cuba. (Accessed 11 April 2015.)
Reed, ‘Meet Cuban Ebola Fighters’, p. 10.
Sheri Fink and Pam Belluck, ‘One Year Later, Ebola Outbreak Offers Lessons for Next Epidemic’, The New York Times , 22 March 2015. Available at http://www.nytimes.com/2015/03/23/world/one-year-later-ebola-outbreak-offers-lessons-for-next-epidemic.html?_r=0. (Accessed 30 March 2015.)
See Yordanis Rodríguez Laurencio, ‘Los mejores médicos en África son los cubanos’, Granma , 1 April 2015 and ‘Regresan médicos cubanos que lucharon contra el ébola en Guinea,’ Cubadebate , 22 April 2015. Available at www.cubadebate.cu/noticias/2015/04/22/regresan-medicos-cubanos-de-guinea/#.Vzx00-RcBc8. (Accessed 8 May 2015.)
Monica Mark, ‘Cuba Is Totally Showing Up the US with Its Tremendous Ebola Response’, The Guardian , 14 October 2014. Available at http://www.businessinsider.com/cuba-is-showing-up-the-us-with-tremendous-ebola-response-2014-10. (Accessed 30 March 2015.)
Ibid.
Reed, ‘Meet Cuban Ebola Fighters’, p. 10.
Tamar Khan, ‘SA Signs Deal with Cuba for More Doctors’, Business Day Live , 8 August 2012. Available at http://www.bdlive.co.za/articles/2012/05/28/sa-signs-deal-with-cuba-for-more-doctors;jsessionid=9DA7B75C4346A3C31D3F9E78DB3C7393.present1.bdfm. (Accessed 20 May 2015.)
Available at www.telesurtv.net/english/news/Guinea-President-Thanks-Cuba-as-Medics-Prepare-to-Return-Home-20150521-0026.html. (Accessed 22 May 2015.)
Hinshaw and McKay, ‘Cuban Doctors at the Forefront of Ebola Battle in Africa’.