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Cuban doctors bring health and hope to Paraguay's poor
CubaNews / February 2005

By Larry Luxner

Cuban epidemiologist Gretza Sánchez Padrón holds on tightly as the Land Rover she’s riding in bounces along a dirt road south of Mariscal Estigarribia — the only town of any size in Paraguay’s vast Chaco.

Next to her is Mabel Lugo Santos, a young Paraguayan auxiliary nurse that often accompanies Sánchez on her rounds. Around 9 a.m., the vehicle grinds to a stop in Jotoishá, an indi-genous settlement where desperately poor people are already lined up at the local clinic to have their various ailments looked at.

One patient, a 72-year-old man with chest pains, is too weak to walk to the clinic, so Sánchez and Lugo visit him at home, which consists of little more than a shack with a zinc roof and dirt floors.

Half a dozen children, some of them naked, watch with a mixture of fear and fascination as a member of their tribe translates the doctor’s questions from Spanish into Nivaclé, an indigenous dialect, and the old man’s answers from Nivaclé back into Spanish.

“In every community, there’s a promotor de salud — a health facilitator who is trained in basic health techniques, for example, giving vaccinations or taking saliva samples to check for TB,” Sánchez explains.

Normally, the 34-year-old doctor from Santa Clara visits such remote communities two or three times a week as Lugo, her assistant, registers patients, checking their records and sometimes vaccinating children against diseases like diphtheria, polio and yellow fever.

Another epidemiologist, Elieser R. Delgado Torres, works in Dr. Pedro P. Peña, an even more remote town located near the Argentine border, 280 kms from Mariscal Estegarribia.

“I have a program on FM radio,” says Del-gado, also a Santa Clara native. “They give me radio time, which I use to explain to people how to prevent diseases such as diarrhea.”

Sánchez and Delgado are among 70 Cuban doctors currently on loan to Paraguay, an impoverished, landlocked South American nation that from 1954 to 1989 was ruled with an iron fist by Gen. Alfredo Stroessner.

A rabid anti-Communist, Stroessner broke relations with Cuba in 1962, shortly after Fidel Castro’s rise to power. Those relations were not fully restored until 1996 — seven years after Stroessner’s violent overthrow.

“During the Stroessner dictatorship, you could be imprisoned or tortured even for having a book about Fidel Castro,” said Irma González, Cuba’s top diplomat here and the only woman ambassador in Paraguay.

Her embassy, located in one of Asunción’s nicest neighborhoods, is cluttered with propaganda posters glorifying Cuba’s achievements in literacy and health care, and signs demanding the return of five Cuban men jailed in the United States for espionage.

“Here, there’s really very little information about Cuba,” González told us last month over a strong cup of Cuban coffee. “The Paraguayans don’t ask about dissent. They ask why Cubans are leaving Cuba, why aren’t there elections in Cuba, what’ll happen in Cuba after Fidel dies?”

The ambassador explains to such people that “in Cuba there are elections, but we have our own electoral system. We don’t have political parties. There is only one party and the people designate who will represent them. In the end, they understand me.”

There seems to be a great deal of sympathy for Castro and the Cuban revolution among ordinary Paraguayans — a sentiment that was particularly evident during Castro’s August 2003 visit to attend the inauguration of President Nicanor Duarte Frutos.

“It really was a great experience,” González said of Castro’s three-day stay in Asunción. “Thousands of people showed up to see him, even though it was very cold and raining.”

González acknowledges that the 70-member Cuban medical brigade in Paraguay pales in comparison to the 14,000 doctors, 3,000 dentists, 1,500 eye specialists and 7,000 sports trainers Cuba has sent to Venezuela — a group representing as much as 25% of Cuba’s entire medical establishment.

Even so, they’ve made a big impression.

“The Paraguayan people are marvelous,” said Mirta Quesada, a doctor from Las Tunas who arrived in September and is working in the department of Caaguazú. “They love us because Cuban doctors go to places where there are no Paraguayan doctors.”

Quesada adds that “if a doctor is alone in a place like that, he’s on call 24 hours a day.”

Besides the Cuban doctors in Paraguay, 523 young Paraguayans are studying medicine at the Escuela Latinoamericano de Medicina (ELAM) just outside Havana. This year, the Cuban government is offering an additional 100 scholarships in medicine, and 87 scholarships in engineering, forestry and agriculture.

“At this moment, our relations are in the field of collaboration, because trade is negligible,” said González. “There’s very little business except for a Casa de Habano in the Shopping del Sol that sells Cuban cigars and some pharmacies that sell Cuban medicines.”

The chief of Cuba’s medical mission in Paraguay is Guadalupe Linares, a pediatrician from Santiago de Cuba. She came here in May 2003 and runs the mission from a house located along Avenida Brasília, down the block from the Cuban Embassy.

“The professionalism of doctors in Cuba is very high. This is not debatable,” said Linares, who has also worked in the Spanish Sahara. “Here in Paraguay, the most urgent priority is primary care. They don’t have a good program of vigilance and prevention.”

For that reason, she said, 20 of the 70 Cuban doctors in Paraguay are epidemiologists. Eight are in Asunción; the rest are spread out among rural areas. Many are stationed in the Chaco, which contains 63% of Paraguay’s land area but only 4% of the California-size country’s 5.5 million inhabitants.

Sánchez, Quesada and the other doctors in Paraguay get 600,000 guaraníes (about $100) a month for basic living expenses.

According to Reuters, this is standard practice “under a generous Cuban program in which poor host countries such as Haiti and Mali pay Cuban doctors a small monthly stipend, but make no further payment to the Cuban government.”

Although the terms of the new agreement are hardly transparent, says Reuters, “it appears that Venezuela agreed to make separate payments for existing and increased medical help,” and that the prices the World Health Organization attaches to medical services might be used to calculate the value of Cuba’s assistance to such countries.

An unidentified Cuban economist quoted by Reuters predicts that earnings for the ex-port of medical, teaching and other professional services could hit $750 million this year — making it Cuba’s No. 4 foreign-exchange earner after tourism, remittances and nickel.

Although Paraguay is grateful for Cuba’s help, that generosity doesn’t always translate into political gains for the Castro regime.

“Last year, Bush personally called Presi-dent Duarte to vote against Cuba at the UN Human Rights Commission,” claimed Gonzá-lez. “In the end, he rejected this idea and decided to abstain.”

Leila Rachid, Paraguay’s foreign minister and the country’s former ambassador in Washington, denied such allegations.

“After our transition to democracy, during the Wasmosy presidency, we opened consular relations with Cuba. During the González Macchi administration, we re-established full diplomatic relations,” she told CubaNews. “We were never pressured by the United States. The U.S. respects our situation, and we have always had a very transparent relationship with the U.S. Embassy in Asunción.”

González insists that “we’re not against the American people, just the U.S. government. It’s not possible that we continue depending on what others are willing to give us.

“There must be greater solidarity among the peoples of Latin America and the Caribbean. What use is democracy if all people can do is vote, and not have the support of their government later? How can you talk about liberty when people cannot read and write?”

To that end, said González, Cuba is helping Paraguay wipe out illiteracy through a program called Yo Sí Puedo (Yes I Can). That program is already functioning in five departments throughout the country: Amambay, Caazapá, Central, Cordillera and Concepción.

“Paraguay aims to eliminate illiteracy by 2008, and Cuba is collaborating in this,” she said. “We have already taught thousands of Paraguayans how to read and write.”

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