A photographic exhibition at the TUC in London documents the extraordinary role being played by thousands of Cuban health professionals in Haiti, Honduras and Venezuela. This is how it came about...

'The stars in the sky'

WORKERS, APR 2007 ISSUE

Salud International's Phil Lenton tells the story behind the photographic exhibition being shown at the TUC between 30 March and 14 April, and in Leeds on 12 May.

It was December 2003 and we had been invited by the Cuban Health Workers Union to travel to Haiti to see the work of the Cuban doctors at work in that country. At that time, Cuba could publicly claim that around 4,000 Cuban doctors and health professionals, all trade union members, were working in 50 poor countries providing free health care. (Privately we were told that there were an additional 12,000 at this time in Venezuela.)

This was a huge programme by any stretch of the imagination, but soon to be dwarfed by the almost superhuman efforts made by this Caribbean island besieged for 40 years by its northern neighbour.

The situation in Haiti itself was grim and dangerous. US backed forces were trying to overthrow the elected government of President Aristides, and our Cuban hosts told us it was not safe to venture onto the streets. Most striking was the level of poverty in this, the world's poorest country outside of Africa.

The Cubans declared that they did not take sides in the near civil war in the country, regarding it as an internal Haitian affair. The Haitians on both sides treated the Cubans with absolute love and respect. President Aristides described them as being "the stars in the sky".

However, the 650 mainly young doctors and support workers showed a heroic commitment to improve the health of the Haitian working class who, they told us, had been neglected since they first arrived as slaves.

Their work as doctors, always in the poorest areas, started with house visits to assess health risks to family members, organising local 'circles' to work together to tackle health problems. So elderly circles would organise exercise or change diet to eliminate high levels of salt in their staple porridge, young people would learn about hygiene or sexually transmitted diseases, and pregnant women about how to ensure a safe delivery and the health of their child. The Cubans would organise work to improve sanitation and build latrines in a country where raw sewage often flowed through the streets.

Because of the lack of medicines, they often used herbal medicines and taught the Haitians how to grow and use them. They also staffed the emergency unit at hospitals and undertook a range of surgery including neurosurgery, providing the only neurosurgeon in the country. Infant and maternal mortality rates were dramatically reduced where there were Cuban doctors.

Free medical training
Hundreds of young Haitians were receiving free medical training by Cuban teachers in both Cuba and Haiti so that they could replace the Cuban doctors. It was obvious that no other country could do what the Cubans were doing: their doctors were unique in their revolutionary professionalism. Yet the world knew nothing about this (other than the poor of Latin America and Africa!). So we knew we had to make a record of their work.

Cuban doctors in Gonaives, Haiti: class solidarity in action Photo: Cuban Medical Brigade

With the agreement of the Cuban Health Workers Union, we took a photographer, Ailie Hodgson, to Honduras next to record the story of the Cuban Medical Brigade in that country.

In Honduras, the Cuban doctors were in the most inaccessible areas, often alone or with a Cuban trained Honduran nurse. Again, the respect for the Cubans was everywhere. Many of the families had sons or daughters studying in Havana who would return as fully qualified doctors. It was difficult to encapsulate this in photography. Yet along with the pictures from Haiti, we were beginning to tell the story.

The Cubans then suggested that if we really wanted to see and photograph what was possible, we should go to Venezuela. There, a modern free health service was being built by Cuba, with some 24,000 Cuban doctors and state of the art medical equipment in brand new "diagnostic centres", in reality ultra modern cottage hospitals with intensive care and A&E facilities. With Venezuelan doctors being trained both in Cuba and in Venezuela by Cubans, we were told that eventually Venezuela would significantly exceed its requirement for doctors so that it, alongside Cuba, could provide 100,000 doctors to provide free health care across the American continent and Africa.

At the time of Hurricane Katrina, Cuba created overnight the Henry Reeves Medical Brigade and offered to send 1,500 doctors to New Orleans. This was refused by the US government. This same brigade received disaster training and was sent to Pakistan after the earthquake, and stayed there for many months, and then to Indonesia to tend to the victims of another earthquake. Cuba now has more than 31,000 doctors in 70 countries.

In Cuba itself, 8,000 young people from 24 countries were studying free of charge at the Latin American School of Medicine in Havana. On graduation, they would return to their home countries to replace the Cuban doctors. In Santiago de Cuba, there were another 6,000 young people from English and French speaking countries in Africa and the Caribbean. These numbers were additional to those being trained by Cubans in their own countries.

Just when the sheer scale of this project began to overwhelm us, there was Operation Miracle, a vast project designed to restore sight to 250,000 low income patients from Latin America and the Caribbean. Although the referral centre is in Havana, this surgery is being undertaken across the whole of Cuba in the second phase of a joint Cuban Venezuelan project. The third stage is seeing surgical units set up and staff trained by Cubans in home countries and the fourth stage will see this project extended to Africa.

We have tried to tell this story in pictures but there is more to tell. How does the Cuban health system cope with more than half its doctors working on such missions? And plans are in hand to photograph a Brigade in Africa. This really is a story of the working class looking after its own, of heroism, selflessness and solidarity. As the Cuban Minister of Health recently said – "It's all a matter of class."

• For details of the exhibition, see Meetings from the menu to the left.

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