The Sunday Telegraph

Diplomatic row leads to Brazil medical crisis

Cuba withdraws thousands of doctors amid souring relations with Brazil’s far-Right president-elect

- By Euan Marshall

in São Paulo ANGELITA SANTOS cried when she heard the doctors were leaving. The health director in a town in the southeaste­rn state of São Paulo, she was aghast to hear Cuba was pulling out medical staff that kept facilities in Brazil’s neediest regions afloat.

“We were rocked by the news. The doctors called us that morning in tears, and we were in tears too,” Ms Santos said. Her town of Embu-Guaçu had 19 doctors for its 70,000 residents only last week. Now, amid a diplomatic rupture between Havana and Brazil’s new far-Right president-elect, it had been abruptly left with just two.

“We’re praying that replacemen­ts come soon. We can’t handle the demand of patients,” she told The Sunday Telegraph.

Health centres in peripheral areas around Brazil have been left severely short-staffed after the Cuban decision, prompted by repeated verbal attacks on the More Doctors programme by Jair Bolsonaro ahead of his Jan 1 inaugurati­on.

The hard-Right politician, dubbed “the Trump of the Tropics”, has upended relations between Brazil and the socialist island, which for much of the last two decades have been close allies under Leftist leaders in Brasilia.

Luiz Inacio Lula da Silva and his Workers’ Party successor, Dilma Rousseff, were bastions of the Latin American “pink tide”, which saw Leftist government­s in countries such as Venezuela, Ecuador, Bolivia, Argentina and Nicaragua form a strong regional alliance.

But that tide is now turning, with Mr Bolsonaro flexing his muscles before even taking office. A staunch opponent of the Havana regime, Mr Bolsonaro promised to kick out Cuba’s doctors at several campaign events.

The More Doctors programme employed 8,332 Cuban personnel, many of which have already flown out, leaving Brazil’s primary healthcare system in a state of panic. The rest are expected to leave by Dec 10, amid what the Cuban health ministry has called a “lamentable situation”.

Cubans accounted for almost half of the 18,240 doctors brought in from overseas under the programme, launched in 2013 under Ms Rousseff to improve healthcare in poor regions.

Mr Bolsonaro last week claimed that “there is no proof they are actually doctors”, despite the submission of a valid medical degree being a prerequisi­te for the programme.

“It’s a worrying situation,” said Mauro Junqueira, president of the National Council of Municipal Health Department­s. “The Cuban doctors were welcomed here, they did a great job,” he said, adding that he hoped Brazilian replacemen­ts would fill the breach. On Tuesday, the Brazilian government hurriedly released an emergency tender to fill the jobs. As of Friday morning, health ministry officials said 84 per cent had been filled.

Last year, the health ministry posted 2,320 new vacancies within the programme, for which 6,285 Brazilian doctors applied. However, only 1,626 showed up to work, and one third resigned within their first year.

The perception is that the Cuban doctors filled the jobs that Brazilian profession­als did not want.

There is an average of 5.07 doctors for every thousand residents in Brazil’s state capitals, but just 0.3 in towns of less than 5,000 inhabitant­s, according to official data. It is not the only blow to those living in Brazil’s rural regions.

The president-elect has back-pedalled on his promise to scrap the environmen­t ministry but is set to name agronomist Evaristo de Miranda as its department head, intending to roll back protection­s against deforestat­ion and loosen environmen­tal laws. Ernesto Fraga Araujo, his pick for foreign minister, declared last year that climate change was “a Marxist plot”.

Such moves could not come at a worse time for the Amazon rainforest, where deforestat­ion has hit its highest rate in a decade, according to newly released government data. Deforestat­ion grew by 13.7per cent with 3,050 sq miles of rainforest destroyed between August 2017 and July 2018 – an area roughly five times the size of London.

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