Cuban medicine not a tonic for SA

IT is puzzling that our authorities see fit to send hundreds of young South Africans — at heavy cost to taxpayers — to study medicine in that communist backwater, Cuba, in an otherwise laudable effort to increase the declining supply of doctors in South Africa.

To start with, these youngsters first have to spend a year learning Spanish, in itself quite a desirable objective, but then they must study a complicated subject like medicine in what remains, even after a year of study, a foreign language.

It can be accepted that, given the paucity of places in our medical schools, it is reasonable to seek other means of qualifying young people as doctors.

But Cuba, at first blush, would seem to be an unlikely venue to which one would voluntarily go to learn how to practise modern medicine.

As has been reported, Elma de Vries, a former chairwoman of the Rural Doctors Association of Southern Africa, who is based in Mitchells Plain now, agrees with this view.

“The burden of disease in Cuba is very different,” she said. According to her, when the freshly trained doctors return to South Africa from Cuba, they do so without having been trained in how to deal with tuberculosis, HIV or the complications of diabetes.

In addition, according to De Vries, they have not been trained in how to deal with women in labour, which, given South Africa’s burgeoning incidence of childbirth among juveniles — aside from adults — does not augur well for outcomes in maternity wards serviced by Cubantrained South African obstetricians.

On the other hand, Cuba has an extremely low infant mortality rate of 4.2 deaths per 1 000 live births, one 10th of that of South Africa, at 42, which is the world average. Such statistics should, however, be treated with caution because they can be doctored (forgive the pun) by, among other tweaking, aborting foetuses that do not look promising (a Cuban habit, according to the literature). Cuban life expectancy ranks high at 78, equal to that of the US and streets ahead of South Africa, at below 60.

Errol Holland, chairman of the South African Committee of Medical Deans, which represents all eight medical schools in the country, agreed with De Vries.

“They have a preventative healthcare system and we are not there yet,” he said. “Students going to Cuba are trained in the needs of the Cuban healthcare system.”

Our diligent health minister, Aaron Motsoaledi, advocates sending more medical students to Cuba for training and increasing enrolment in South Africa. This year, the government sent 1 000 students to Cuba.

In Cuba, medicine is treated as an industry vital, for example, to the nation’s balance of payments. There is a high degree of medical tourism and the island “exports” 50 000 doctors a year — including 30 000 to Venezuela — in return for almost R40-billion in oil, according to Granma, the state newspaper.

We pay for the children we send there. Limpopo recently committed R24-million to sending 100 students to the island. Meanwhile, Cuba has also opened up its economy to foreigners and offers an eight-year tax holiday, a 15% rate thereafter and guaranteed 100% ownership.

Aside from upper management, all employees must be Cubans. We go in the other direction.

Of course, Cuba is not the only option for medical students seeking foreign degrees. Google reveals that the US, Australia, the UK and Canada — to mention only major English-speaking democracies — offer scholarship benefits to the foreign needy.

Further, the Commonwealth countries have special plans for fellow members. Perhaps the minister might usefully explore these avenues. Although their benchmarks might be higher than the Cubans’, many offer bridging courses to the underprivileged.