After seven years in Venezuela, Dr. Jorge Humberto decided not to be away from his wife and daughter. Only the program Mais Brazil Doctors would make him think of leaving Cuba to meet the material needs not fully covered in his previous trips. In Brazil, they allowed him to take his family with for the duration of the work.
When in Havana he was offered the opportunity, he said yes and signed the six-page contract , where he handed over 70 percent of his salary to the authorities in Cuba. He passed a course on Portuguese and Brazilian traditions, boarded the plane and in just a week, started the paperwork to bring his people.
After considerable economic cost (more than two thousand dollars) and a bureaucracy which at times seemed endless in both countries (about fifteen steps between each side), Humberto got his family, protected by a visa granted by Brazil for 36 months, they were beside him.
However, the peace did not last long: in early February 2015, a Cuban official warned him that due to indications of the Ministry of Public Health, relatives should return to Cuba within a maximum period of two months or measures would be taken including, ultimately, the interruption of stay in Brazil.
Humberto Jorge is not his name. The team that has led this investigation changed the name to protect his identity. The reason: no Cuban doctor is authorized to disclose inside information about its work, pursuant to subsection r in the second paragraph of the contract.
“R) Keeping strictly confidential any non-public information received in such condition that accesses or by any means, in compliance with the work performed or performed under this Agreement, in Cuba and Brazil. Such confidentiality is from the signing of this Agreement and for one year after its termination for any reason “.
However, many of them use anonymity to report on the social networks and the Internet what they consider a serious violation of their rights as citizens: the threats by the Ministry of Public Health to withdraw their qualifications and suspend their stay in Brazil to every physician to prolong the stay of their families for longer than directed.
The outrage has even led to the collaboration of Cuban doctors with the Brazilian press to make the decision public, as evidenced by a recent article published by the Folha de Sao Paulo.
Another article, also published by the Folha relates the strong criticisms made by the president of the Brazilian Medical Association, Florentino Cardoso, and the presidents of the Regional Councils of Medicine of the states of Sao Paulo and Minas Gerais. In all cases make mention of the inadmissibility of this attitude, “because it is a contrary proceed to labor standards and family life established in Brazil.”
The conflict becomes more apparent when Brazilian authorities reiterate the validity of visas granted to relatives of Cuban doctors for a period of 36 months, a position that stress by exposing their intentions to remain unaltered the delivery of visas. Meanwhile, Cuba immigration laws allow their natural residents up to two years out of the country without losing residency. No immigration provision prevents the establishment of family in the South American country.
The only clause in contracts issued by Cuban authorities and signed by doctors, referring to the possibility of a family reunion in Brazil is done, use only the term “visit”, without specifying the time or conditions thereof.
“Q) Informing the Department of the Cuban Medical Brigade in the Federative Republic of Brazil, prior, his intention to receive visits from relatives or friends in the town where he provides his services under this Agreement; if the visit occurs, he will be totally responsible and shall take all measures to not occur any involvement in fulfilling their duties and obligations corresponding to the subscribed LEGAL INSTRUMENT and with this contract.”
The legal void on the right of families to be with the doctor in Brazil for as how long as they wish has implied the absence of an endorsement to counter via the right, the measure of the Cuban authorities. Doctors are literally disarmed.
Copy of the individual contract issued by the authorities of the island and signed by Cuban doctors enrolled in the Mais Doctors program. None of its pages state that family stay in Brazil is prohibited.
Nobody could believe that this measure was issued…
Since its inception in 2012, sending doctors to Brazil by the Cuban government, occurred abnormally compared to other medical collaborations that the island has established more than 60 countries. The negotiations were carried discreetly with the Pan American Health Organization as an intermediary. But apparently the Cuban and Brazilian authorities have lacked communication, since in many respects the lack of coordination has prevailed, as evidenced by the avalanche of shipments from Brazil by Cuban doctors, who collapsed services Cuba, a situation aggravated by the absence of agreements between postal companies of both countries.
With regard to the situation with the family, Laura S., a young doctor who at 32 has not yet had any children and saw in this mission the possibility to stabilize emotionally with her partner, told OnCuba: “Nobody could believe that after much effort a measure contrary to Brazil´s initial authorization would be issued. A measure that leaves us uncomfortable, outraged to reviewers and stain vision that authorities and patients here have on Cuba, on our mission. It is a blow to Mais Medical Program. A blow that paradoxically comes from Cuba “.
According to testimony from several doctors, mission coordinators in each state called personally for dates back to the families and small gatherings for groups warn them that there is a long list of staff wishing to join the mission “on the island, so there are no major setbacks to unlink them from the program if not complying with the order “.
The only institutional response so far is in CubaBras Blog in a post of the National Coordination of the Cuban Medical Brigade:
“To all of our employees, the issue related to the family in Brazil is of interest that everyone knows defined for it: The state coordinators have the argument on this issue, which will contenting with each of you, in addition to them they tell you how to be held this process for anyone wishing to bring family to Brazil or already have a family here. ”
OnCuba tried for over a month to get a statement from the Cuban Ministry of Public Health on the matter, which was denied flatly.
Brazil, another South Africa?
At present, the work of Cuban doctors abroad represents a major source of revenues for Cuba, and still no public data on gains in other activities, many define the export of medical services as the current support of the Cuban economy. Only in 2014, more than eight billion dollars in revenue was anticipated by the work of Cuban doctors abroad. Hence the importance that the Cuban government gives the sector and the precautions taken to avoid a massive emigration.
A notorious example and that there are no further references, was the one in South Africa during the nineties, when nearly three thousand doctors left with their families the collaboration program. Although this year announced the increase of shipping doctors in this country are evident efforts of the Cuban authorities to avoid South Africa’s experience with nearly 12,000 Cuban doctors in Brazil.
The comprehensive general medical Raunel Lugo, who has a wife in Campinas, Sao Paulo, explains on South Africa that “the mission was smaller, were specialists, ie oncologists, surgeons, clinicians receiving a huge salary, almost 12 000 dollars a month, plus car, house and other privileges. Errors were also committed, they did not let them bring cars to Cuba, had to give the embassy over half the salary, not allow the import of container, “adding that” conditions were in different historical moments “.
For the South American giant, dozens of Cubans (there are no official figures, nor published, only estimates) have left the Mais Medical Program. In these cases, the Cuban authorities immediately considered “deserters” and cancel their permits to practice medicine by Cuban procurement. One of the most notorious cases was that of Dr. Ramona Matos, who raised controversy for months after leaving the program Mais Doctors and speak negatively of Cuban participation in the Brazilian initiative.
But not all think or act like Dr. Matos. Published data show the Cubans as the group with the lowest dropout rate of Mais Doctors. While in Brazil there is a program designed to provide working facilities and revalidation of degree for those that leave the program or the existence of the visa system Parole designated for Cuban doctors abroad, which are granted by the government United States upon request at the US embassies.
Jorge Humberto explains that “most doctors who work here are older than 40 years, have deep roots in our communities in Cuba, we also have other family members who need our support, elderly parents, which import more than money. We have shown that we will always return, with the problems of our society but aims to help improve it.
“That’s part of our consciousness work, none of us, though there are exceptions, has protested Cuba getting 73 percent of our salary. We understand that this is to help our society and our people, but our sacrifices are not enough, they want our pain, humiliation and our shame. And that, my brother, I do not think that we will ever deliver “.
Meetings of the Antillean surrealism
Recently, sources in Brazil of this research reported that following reactions, the main responsible for the Cuban part of Mais Doctors Program, under instructions of the Cuban Ministry of Health, met with several groups of collaborators. In Sao Paulo, these meetings took place in several municipalities in the state. OnCuba talked about these meetings with Dr. Rigoberto Pereira, comprehensive general practitioner.
Where was the meeting held specifically?
We initially thought that the meetings would be conducted at the Consulate of Cuba in Brazil. Later we knew it would not be there because as these attitudes are not part of the immigration policy of Cuba, and is legislated by the Cuban state, as it doesn’t have to do with indications of the Ministry of Foreign Affairs and should not be performed there. The meeting ended up in a premise of the municipality.
Who directed these meetings? Who were called?
The meetings are led by Dr. Maria Cristina Luna, Head of the Mission here in Brazil; there are consular officials, and in the State of Sao Paulo, participated Dr. Roilder Romero, Coordinator of Mission of the State. At the meeting are summoned all physicians in the municipality to which previously were shown discipline and methodologies for information to be sent. In some cases after individual meetings occur.
What did they say about the measure? What were the arguments this time?
The move is dictated by the Ministry (Health) without conclusive arguments. This time they raised the Cuban missions have a separate Government of Cuba legislation and Medical Services Company which was put in the contract that the family could only come to visit and not to live with the doctors. At this point the discussions are intense because nobody knew that part of the contract, that “visits” is a broad term without time limits and especially the fact that if you knew about the existence of that clause ( which they didn’t show) Why did they let us incur in all costs of paperwork and passage and then apply the measure?
Did they mention who is responsible for the measure?
No, as in other times they did not say who is responsible. No names.
Was some Brazilian representative present? How did they react?
To my knowledge, they avoid the presence of representatives from the Brazilian side. They know that Brazilians do not understand that our institution deprive us of a law and constitution they have given us. They do not understand this measure, which is illogical. If we do not understand neither can you imagine Brazilians?
What options were you given if you refuse to return the family?
They did not give us options, just told us we are to give a solution. We had to abide by what was “established” and that they would wait for the response. Otherwise, they would interrupt the mission.
Did you notice any differences between the positions of those who were in charge of the meeting?
I do not know whether to call them divergences. I cannot be sure of that. Although I can tell you that it seemed that the representatives of the Ministry of Foreign Affairs do not agree with this and were there only to fulfill a protocol. They can do nothing with the provisions of another Ministry (the Health), but agree that this measure goes completely against Cuba immigration policy recently adopted by the National Assembly.
How do you feel after these meetings? Do you anticipate any change in the current situation?
The truth is I didn’t take any positive expectation for this meeting and the result is confirmed. It is lamentable. Feeling helpless for your own authorities, by those who should look after us. To feel that one has wanted to do for his country while having to live with the discomfort that transforms into rage and ends in great pain. Hopefully we can do something. I believe they are still time. It cannot be that we give this vision, so inhumane to a program that aims precisely the opposite note: the union and the health of all families.