INTERNATIONAL COOPERATION REPORT

Cuban Disaster Doctors in Guatemala, Pakistan

By Conner Gorry

Mothers swing pick axes and claw at the mud, searching for loved ones buried in the rubble. Rotting corpses and shortages of food, water and medicine threaten survivors, while relief efforts are hampered by impassable roads or inclement weather. This same, desperate scene is repeating itself from Guatemala to Pakistan, where catastrophic natural disasters have shaken these nations to the core.

Volunteers for the Henry Reeve Brigade at the Havana ceremony constituting the volunteer disaster team.

The aftermath is horrific, with entire communities entombed in Guatemala and Pakistan, while nearly 1,000,000 are displaced in Mexico and a dengue outbreak grips El Salvador in separate post-disaster scenarios. To help save survivors of such events is the goal of Cuba’s Henry Reeve International Team of Medical Specialists in Disasters & Epidemics. 

Units of this specialized, rapid response volunteer team of health professionals are now serving in Guatemala and Pakistan, their expenses assumed by the Cuban government.

Conceived during Hurricane Katrina as a mobile team staffed with doctors trained in disaster response and epidemic intervention, the 1,586 medical professionals-  each equipped with  50 pounds of medicines - pledged to serve anywhere in the world they were needed (see MEDICC Review, Vol. VII, No. 8, 2005)

In a ceremony on September 19, Cuba formally constituted the International Team, the founding members of which collectively possess an average of 10 years clinical experience and service in 43 countries. Ultimately, the United States rejected Cuba’s offer to send these medical professionals to the Gulf States during the ongoing post-Katrina relief effort.
Now 3,000 strong, the team’s members are required to speak at least two languages, take post-graduate courses in epidemiology, and be physically fit. They also receive specialized training in medical assistance during epidemics and pandemics and HIV prevention methods and treatment for people suffering from HIV/AIDS.

“We’re ready and willing to go anywhere we’re needed,” said Dr. Dayane González, “whether it’s Cuba, the United States, wherever.”  Dr. Gonzalez’ colleague and fellow team member Dr. Alexander Martínez echoed this sentiment when asked to which country he preferred to travel. “We’re trained to serve and help save lives; wherever that’s necessary, I’m willing to go.”  

Henry Reeve Team In Action

And what a need there is: several hundred specialists are currently serving alongside local and other international health workers in post-earthquake Pakistan, and in Central America in the wake of Hurricanes Stan and Wilma.  While each disaster scenario provides particular challenges, the circumstances in which the Henry Reeve Teams are working to save lives are both tragic and trying.

Guatemala, with over 840 missing and 650 dead following Hurricane Stan, was the first country to accept the Henry Reeve doctors, and 300 began arriving on October 8th., each carrying medicine-filled backpacks to treat acute diarrhea, respiratory illnesses, skin afflictions, malaria, dengue, and other illnesses. By the end of October, the Cuban Henry Reeve volunteers in Guatemala numbered 600. 

Among their ranks are surgeons, pediatricians, internists, vector specialists and epidemiologists. These professionals supplement the 235 Cuban doctors on long-term stints in Guatemala, providing rural primary health care services as part of the ongoing Comprehensive Health Program (CHP).  The CHP was established between Cuba and several Central American countries following Hurricane Mitch in 1998, as a more sustainable way to address these country’s underlying health problems.

Speaking from Guatemala, Dr. Yoandra Muro, head of the Cuban CHP team there said, “the situation is very difficult and our main goal now is to prevent epidemics, which we have done, despite outbreaks.” The Cuban doctors have also been going house to house in a prevention campaign where they inquire about general health – particularly fevers and diarrhea - and talk to families about measures such as the need to boil drinking water. The strategy has paid off according to Muro, who believes basics like this have saved many lives, especially among children.      

As new Cuban volunteers arrived in Guatemala on October 8, a 7.6 earthquake ripped across northern Pakistan, killing upwards of 73,000 people and seriously injuring another 69,000, according to Pakistan’s chief of disaster response. The death toll was predicted to rise as relief teams made their way into previously inaccessible areas.

As many as 3 million people were made instantly homeless – three times the number of Asia’s December tsunami - as the bitter winter approached. Relief officials announced recently that there are not enough winter-weather tents in the world to house these people. Into this situation arrived 200 Cuban doctors - including surgeons, anesthesiologists, internists and trauma specialists - one of the largest groups of foreign doctors to come to Pakistan’s aid.   

Later planeloads of physicians have dramatically increased the original number, so that by press time, there were over 900 Cuban doctors serving in Pakistan. Further supplies pledged by Cuba to the Pakistan relief effort include three field hospitals and hundreds of winterized tents.

At this writing, the Cuban team is divided among three hospitals, one in central Islamabad, which is receiving patients airlifted to the capital for care. “We’re working very intensely in 12-hour shifts,” said one Cuban volunteer at the hospital. “It’s astonishing the number of children we’re treating, especially for trauma.”

International Track Record

Cuban medical teams have been providing international disaster aid for 45 years, beginning in 1960 when the 20th Century’s most violent earthquake struck Chile, killing 5,000. Since then, Cuba has provided post-disaster medical and technical assistance to nearly a dozen countries.

Recognition of Cuban expertise in disaster preparedness and response prompted the UN Development Program (UNDP) and Association of Caribbean States to select Havana as headquarters for the new Cross Cultural Network for Disaster Risk Reduction to facilitate regional cooperation in disaster management (see MEDICC Review Vol. VII, No. 7, 2005).

Keeping a universal public health system with such international solidarity underpinnings such as Cuba’s well staffed in both quantity and quality is an ongoing challenge. On September 19th, in the same ceremony officially constituting the international disaster and epidemics team, Cuban medical schools graduated 1,905 new doctors from across the country.

Increased opportunities to study health science careers have also boosted enrollment.  In the 2005-2006 academic year, 95,595 Cuban students are matriculated in medicine, nursing, dentistry, clinical psychology and university-level allied health sciences.