‘Doctor diplomacy’: Cuba seeks to make its mark in Europe amid Covid-19 crisis
They have jetted into some of the most horrifying calamities in recent history, clutching the red, white and blue flag of their small island home.
Earthquakes in Indonesia and Pakistan; a cholera outbreak in Haiti; and the Ebola epidemic in west Africa, where they won international plaudits for their hazardous, frontline work.
Now, as the world grapples with another era-shaping catastrophe, Cuban doctors and nurses are on the ground once again, only this time in a less common location: Europe.
“In Lombardy … everyone is grateful for their professionalism and their humbleness and availability to a country they hardly know,” said Marco Grimaldi, a politician from north-west Italy who helped to negotiate the arrival of a group of 39 Cuban healthcare workers with diplomats from Havana. “Imagine if Europe could manage to do the same.”
Cuba’s communist rulers have been sending medical teams overseas for decades in a bid to save lives and influence people.
Paul Hare, a former British ambassador to Havana, said Fidel Castro launched the “doctor diplomacy” policy soon after his 1959 takeover as a means of using the island’s highly trained professionals to export revolutionary ideas and make new friends.
“Fidel was very strategic. He saw they had a surplus of doctors and he saw it as a way of garnering diplomatic support initially. Cuba has not been like North Korea – they have always wanted international support,” Hare said.
The scheme has since become an essential economic lifeline: while some missions are provided free of charge, other countries pay Cuba for the medical services, bringing in $6.3bn (£4.8bn) annually and making it Havana’s largest source of foreign currency.
It is even more crucial now as Covid-19 obliterates Cuba’s tourist industry, another key source of income.
Today, an estimated 28,000 Cuban medical professionals ply their trade overseas, primarily in the developing world.
But the pandemic has seen a new trend emerge – with Cuba sending medical “brigades” to bolster struggling health services in developed European nations.
Since March teams have landed in Andorra, a small principality wedged between France and Spain, and two of Italy’s worst-hit regions, Lombardy and Piedmont, where a total of more than 17,000 people have died.
Local newspapers and politicians have celebrated the Cuban reinforcements.
“The arrival of these professionals will … give a respite to the healthcare structure,” the Diari d’Andorra newspaper commented in a recent editorial.
“This is excellent news,” agreed another newspaper, Bondia, claiming Cuban doctors would save Andorra’s health system from collapse.
Stéphanie Panichelli-Batalla, an academic at the University of Warwick who studies Cuba’s medical diplomacy, said the humanitarian deployments were partly about rebranding communist Cuba in the international press.
“They can’t miss out on this opportunity – especially now that it’s coming from Europe – because it gives even more visibility to the good that they do.”
Donald Trump’s White House – which has declared Cuba part of a Latin American “troika of tyranny” alongside Nicaragua and Venezuela and has sought to strangle its economy – is unimpressed.
The state department claims Cuban doctors and nurses are being abused and exploited in order to fill the coffers of an authoritarian regime.
“The Cuban ‘medical missions’ are exploitation: a for-profit front used to fund the regime’s repression and sow political discord,” the US secretary of state, Mike Pompeo, tweeted last week.
Panichelli-Batalla said there were legitimate concerns about Cuba’s authoritarian system and how those sent overseas were treated.
“Yes, of course there are big human rights problems in Cuba – there have been since the start [of the revolution] and there are still problems.
“But whatever their intentions are, and whatever they gain from those programmes, we need to recognise that they are doing a good job … It is having an impact,” said Panichelli-Batalla, who has interviewed Cuban medical workers who have served in countries including Guatemala, Ethiopia, East Timor, Ghana, Brazil and Tanzania.
“The work they do there is valued by the local people, it is valued by the local governments and it does make a difference.”
That seems to be the case in Italy, where the first Cuban “brigada” has been working since late March at a field hospital in Crema, a city in the northern region of Lombardy, where Covid-19 has killed more than 14,000 people.
The second team – 21 doctors and 16 nurses led by a kidney specialist who previously worked in the Venezuelan Amazon – touched down in Piedmont’s capital, Turin, on 12 April to replace overworked Italian professionals.
Other medical brigades have fanned out across the world to fight Covid-19 in 20 other countries, from South Africa to Suriname.
Grimaldi, the Piedmont councillor, said the Cubans were a lesson to Europe. “It’s incredible that a small island that will pay the consequences more than other countries because it lives mostly off tourism, and which has few inhabitants compared with big European countries, has managed to send 22 medical teams abroad,” he said.
“How wonderful it would be to see brigades from north or eastern Europe in Spain or Italy,” Grimaldi added. “But for this people need to work together.”