|Cuba has the highest primary care physician to population ratio|
in the world and Cuban doctors have volunteered to serve abroad
whenever needed since 1960
As President Obama makes his way to Colombia for the Summit of the Americas - "to tout his trade record and convince millions of Hispanic voters back home he cares about the region," as Reuters tartly reported - we found ourselves thinking back three years when he last attended this regional meeting. At a concluding press conference, the president recounted what he learned about the activities of Cuban doctors in the region thanks to their nation's commitment to "medical internationalism":
One thing that I thought was interesting -- and I knew this in a more abstract way but it was interesting in very specific terms -- hearing from these leaders who when they spoke about Cuba talked very specifically about the thousands of doctors from Cuba that are dispersed all throughout the region, and upon which many of these countries heavily depend.
The Cubans have been helping nations around the world react to crises and natural disasters, and to meet their people's primary care needs, since 1960. The achievements of this program -chronicled by scholars such as John Kirk, and non-governmental organizations like MEDICC-were well known outside the United States when President Obama heard about them in April 2009.
Following the earthquake in Haiti, however, when Cuban doctors already stationed there were the first to respond, became the backbone of the fight against cholera, and continued helping Haitians recover and build a new health care system long after many in the international community diverted their gaze, the full extent of Cuba's commitment to public health outside its own borders was hard to ignore even in the United States.
With the president attending the 2012 Summit of the Americas, we have to ask this: Who benefits from his decision to continue a Bush-era policy of coaxing Cuban doctors to leave their medical missions and defect to the United States?
In 2006, the Bush administration started the "Cuban Medical Professional Parole Program" to encourage Cuban medical personnel saving lives internationally, most often located in rural areas or slums of the world's poorest countries, to leave their posts. The Program promised special U.S. immigration rights for these Cuban doctors and health personnel, today numbering nearly 39,000. Although Cubans who reach the United States seeking asylum already enjoy preferential immigration status when they arrive, this program makes Cuban medical personnel eligible for parole abroad.
As Fox News Latino reported, the program was "the brainchild of Cuba-born diplomat Emilio González, director of the U.S. Citizen & Immigration Services from 2006 to 2008...a staunchly anti-Castro exile. He has characterized Cuba's policy of sending doctors and other health workers abroad as 'state-sponsored human trafficking'."
According to the Wall Street Journal, more than 1,500 Cuban doctors and health care personnel received visas under the program issued by U.S. consulates in 65 countries by the end of 2010. The promise to enter our country at the head of our long immigration line to practice medicine in the United States is a powerful inducement, as Cubans devoted to working in the medical system freely admit. "You'd go, too, if you could triple your pay," said Juan Bautista Palay, chief of physical therapy at Havana's 10 de Octubre Hospital.
It would be bad enough if this program simply functioned as its authors intended, to undermine an appealing, humanitarian feature of the Cuban system, no matter what it meant to patients in the developing world. But the story gets worse.
Once Cuban doctors arrive, many are prevented from practicing. Sometimes, records substantiating their credentials are withheld by Cuba's government. Others are disqualified
from gaining residency because they were once members of the Cuban communist party.
Yes, as the Miami Herald reported without a trace of irony, "Questions about party membership remain on residence and citizenship application forms, as relics from the Cold War, when the United States deemed communism its chief enemy."
For Cuban doctors lured here, it's Lucy and the football meets the "Red scare."
But most often, the reason Cuban doctors cannot hit the ground running as practicing physicians in the U.S. is because one piece of crucial information was withheld in the "parole promise": they cannot hang out their shingles until they pass the three-part US Medical Licensing Exam, for which many US medical students bone up for years, through special and costly preparatory courses...not to mention the several thousand dollars in exam fees themselves. Other health professionals face similar hurdles.
President Obama should have ended this nonsense unconditionally three years ago after encountering the region's reaction to Cuba's doctors; or two years ago after their heroic work in Haiti made such a decisive difference; or even this month before attending the Summit in Cartagena. He might have even laid out a program of medical cooperation with Cuba, as our friend Dr. Peter Bourne recommended, to make the most of what Cuban doctors have to offer for the medically-underserved in this hemisphere. But he didn't.
The next time the heads of government from the region gather at the Summit of the Americas, we expect Cuba's to be among them.
By then, our government should stop the shameful -and we think un-American- practice of plucking Cuban doctors from the world's poorest countries where they are serving patients and doing so much good.