Portal de Periódicos da CAPES

The USA and “Cuban doctors working abroad”

2007; Elsevier BV; Volume: 369; Issue: 9580 Linguagem: Inglês

10.1016/s0140-6736(07)61011-3

1474-547X

Patrick Van der Stuyft, Pol De Vos,

Diversity and Career in Medicine

Michael Ceaser's World Report (April 14, p 1247)1Ceaser M Cuban doctors working abroad defect to the USA.Lancet. 2007; 369: 1247-1248Summary Full Text Full Text PDF PubMed Scopus (2) Google Scholar is a nice mix of human-interest stories, juicy facts, and crusty background analysis. Unfortunately, these elements are hand-picked, imprecise, and flawed, respectively. First, testimonies of most Cuban doctors who work in Venezuela would have added grey shades to the picture. Readers who look for nuance further miss the position of the modal autochthonous medical personnel who mainly cater for urban elites. Fine journalism would even remind us of the plight of, for example, Canadian doctors who have “defected” to the USA.2Phillips Jr, RL Petterson S Fryer Jr, GE Rosser W The Canadian contribution to the US physician workforce.Can Med Assoc J. 2007; 176: 1083Crossref Scopus (21) Google Scholar Second, many assertions are not quantified. Scholars looking for numbers that support—or falsify—the report's claims might be interested in more precise sources.3Muntaner C Guerra-Salazar RM Benach J Armada F Venezuela's barrio adentro: an alternative to neoliberalism in health care.Int J Health Services. 2006; 36: 803-811Crossref PubMed Scopus (42) Google Scholar Finally, Ceaser's background analysis misses the point. The USA does not import foreign medical personnel to provide comprehensive care for its poor communities. Above all, it does not need to lure Cuban doctors away through tailored immigration rules to boost the yearly numbers of health workers already skimmed off all over the world.4Hagopian A Thompson MJ Fordyce M Johnson KE Hart LG The migration of physicians from sub-Saharan Africa to the United States of America: measures of the African brain drain.Hum Resources Health. 2004; 2: 17Crossref PubMed Scopus (260) Google Scholar The motives here—by contrast with what underlies brain drain in general5Mullan F The metrics of the physician brain drain.N Engl J Med. 2005; 353: 1810-1818Crossref PubMed Scopus (559) Google Scholar—are political: Cuba's health programme is part of an alternative, South-South collaboration model that pursues development on the basis of mutually beneficial exchanges. Whereas the doubtful benefits of the US-promoted free-trade agreements fail to trickle down to populations in developing countries, Cuban-Venezuelan cooperation has provided access to quality health care for millions of poor in a twinkling.3Muntaner C Guerra-Salazar RM Benach J Armada F Venezuela's barrio adentro: an alternative to neoliberalism in health care.Int J Health Services. 2006; 36: 803-811Crossref PubMed Scopus (42) Google Scholar This ensures growing popular support for the underlying novel path, and makes it increasingly attractive to the governments of other countries. US efforts to thwart Cuba's health cooperation aim, in fine, only at undermining a blossoming development model that constitutes a serious threat to the USA's hegemony. We declare that we have no conflict of interest.