How Cuba's solidarity makes a difference

Issue 

On August 15, the cities of Ica and Pisco located in the southern region of Peru were hit by a massive earthquake registering 7.9 on the Richter scale. This was the first quake recorded in living history in this area. It resulted in the loss of 540 lives, and immense physical destruction; 80% of buildings within the heart of Pisco collapsed, and more than 16000 people were left without housing and basic services.

The terror was magnified by it occurring the quake happening at 6.40pm, so victims were left, many crushed under rubble, for the entire night. In total darkness people tried to find relatives and seek medical attention for the injured.

When the quake hit I had finished some volunteer nursing in Bolivia, and had been touring around the country. So after gathering some supplies, I made my way up by bus arriving five days after the event to lend a hand. At this time, although many national and international rescue groups had arrived, there was still bodies yet to be recovered and drastic food and water shortages. Many elderly people with significant injuries were still left in their houses, or crammed in under tarpaulins with many others.

In addition, new injuries were being sustained during the recovery operation as unstable supports of buildings collapsed on people attempting to recover their belongings. All the district hospitals, government buildings and schools had suffered the same fate as the houses of the area.

A significant contingent from different nations and NGOs had arrived to lend support, including a small but highly effective team from France, and also great teams from South Korea, Mexico, Venezuela; some support from the US air force was on the ground assisting with the operation.

However, it was the Cuban trauma team that from a medical perspective provided by far the most support to the rescue operation. I encountered the Cuban team many times through work as we sent patients to them for surgical and diagnostic procedures, and after meetings I was able to speak briefly with the leader of the team, Dr Juan Carlos Dupuy. He informed me that within three days of the quake they had deployed 60 personal of varying specialties — seven surgeons, including four orthopaedic surgeons, two anaesthetists, one gynaecologist, one paediatrician, two epidemiologists and 23 general practitioners all with a masters degree in community family medicine, along with 10 nurses and 14 technical assistance staff.

Throughout the mission they have maintained two hospitals, each located in the areas assessed to have the greatest need and both with fully equipped operating theatres able to perform complex surgeries. They also brought in vital diagnostic equipment, including an electrocardiogram, X-rays, and a complete pathology laboratory.

In the initial days, I was working alongside an international Christian organisation that had links in Peru. As they left after two weeks, I began work under the ministry of health with a small team of Peruvian and US doctors.

I was present in the daily assessment meetings of the ministry of health, where the different international groups and NGOs would register the areas where they had worked, and the number of people seen and the types of injuries and illnesses encountered during the day. It was obvious from the start that none of these groups could compete with the Cubans, in the number of patients seen, procedures completed and the strategic experience offered.

Dr Carlos Dupuy recorded within these meetings that within three weeks they had seen more than 15,500 patients, and performed 115 surgical procedures, 40% being repairs of complex upper- and lower-limb fractures. Others included surgical amputations and appendix removals. The level of stress on the health-care system that was absorbed by the Cuban team would have had the already overflowing hospitals of Ica and Lima in a greater crisis than experienced.

In an interesting paradox, the right-wing government of President Alan Garcia has gained much support for their handling of the crisis. One could argue that the government's handling of the emergency would be viewed very differently without the support of Cuba. Though it must be said that at least the government of Peru has seen beyond politics to assist their own people, which was not the case in the US when the Bush administration refused Cuban assistance during the rescue disaster that followed the actual disaster in New Orleans after Hurricane Katrina hit in 2005.

After three weeks, as the other international teams, including my own, began leaving the area with much work still required, Carlos Dupuy stated that his team would be staying at least until the end of October — but actually that was just an estimate, and the team would be staying until the people of Pisco no longer required its assistance.

Cuban medical teams have earned a well-deserved reputation for disaster relief, as seen in Pakistan in October 2005, and more recently following the quake in Indonesia. They have also gained the more admirable reputation for staying on and filling the service vacuum when other international teams leave.

Many people when told of these achievements respond with surprise, and/or scepticism, suggesting that Cuba sends these missions as propaganda to increase their standing in the world. They then fail to compare this strategy to the manner in which the US increases its standing in the globe, and the manner in which it intervenes in the business of smaller countries in Latin America, and especially in the Middle East.

For me, I can be easily won over by the brigades of free medical assistance, when the alternative from the north is political assassinations, support for undemocratic governments and illegal military interventions. These Cuban missions also go further to shame our health-care system, the benevolence of our aid projects and the structure of medical education in the country. As Australia seeks medical personnel from Africa and Asia (continents that incidentally need as many as they can get), we fail to fund positions in our own universities and colleges, while Cuba boasts more medical staff per capita than any other nation.

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