The Southeast Asian Times

Cuba’s gift to East Timor - good health

By John Loizou
November 26, 2006

Dili, November 26: The contrast between the physical presence of Cuba and the rest of the world in East Timor is as stark as the difference in the philosophies that divide them.

Most of the grand embassies and their subsidiaries, such as the ubiquitous USAid, built for the countries that have rushed to recognise newly-independent East Timor — Australia, New Zealand, Thailand, the former occupier, Indonesia, and the former colonialist, Portugal — dot the elegant esplanade that borders Dili harbour, the Avenida dos Martires da Patria, where centuries-old tropical trees provide shade and in less-troubled-times, tranquillity.

In the morning, middle-aged diplomats, accompanied by their security guards, jog the beach.
By day, fishermen hawk their catch from beneath the shade while women — many dressed in traditional sarongs — offer tomato, garlic and bananas or play cards in the dust while they await customers.

Before sunset, their more affluent sisters from the spacious houses used first by colonial administrators and then the commanders of the Indonesian army sit by a lighthouse that I’m told was built immediately after World War II and watch the sprinkling of cargo vessels, wooden fishing smacks and inter-island ferries riding at anchor or look out to the massive statue of Christ installed by Jakarta that dominates the far skyline or the barren island of Atauro.

Portuguese East Timor was a place of exile for opponents of Antanio de Oliveira Salazar who was overseer of the authoritarian right-wing regime that controlled his country’s social, economic, cultural and political life from 1933 to 1974. Atauro served as a prison — a place of exile for the exiles.

But the embassy for the Republic of Cuba stands amid the hot dusty, busy streets of the overcrowded — and now sometimes violent city — in the lee of the rugged mountains that are so essential to life in the most eastern of the sparsely-populated Lesser Sunda Islands.

Here, in this unexpected concrete jungle, the only shade is that provided by the darkened windows.

But if the Cubans lack grandeur, they do not lack generosity.

At last count, the defiantly Socialist Caribbean country had 302 volunteers working in East Timor.

They began arriving in April 2004 and their two-year tour of duty has them working throughout the republic, including five hospitals and its most remote villages.

There are: 228 physicians, 23 nurses, 40 health technicians and 11 teachers of Portuguese and Spanish who help prepare young East Timorese to study medicine in Cuba.

Another 12 member of the team work with the East Timorese students in Cuba.
Almost 500 young East Timorese study medicine in Cuba with the first 20 now in their third year.

When he first saw the emaciated new arrivals from far off Southeast Asia, President Fidel Castro quipped that they would have to be first “fattened” before they could be expected to study successfully.

The programme was initiated by East Timor’s former Prime Minister, Mari Alkatiri, and his successor, Jose Ramos Horta, told a meeting with relatives of the students in Dili earlier this month that the cooperation and solidarity symbolised by the Cuban health workers was a beautiful gesture of friendship with the people of East Timor.

“Cuba has given the opportunity to these youth to prepare themselves, be better men and women, and return to their homeland in 2012 to work for the welfare and health of the people of Timor Leste,” he said.

Cuuba has physicians working in 68 countries, says a member of his country’s management team for the East Timor programme, anaesthetist Dr. Eries Ramirez Salomon.
“We will stay as long as the people of the country need us.

“But our programme will ensure that in ten to 12 years most of the doctors will be from East Timor.

“Our plan is to stay here until the East Timor Government says we are no longer required and our goal is to provide medical treatment for all of the people of East Timor and to prevent disease.”

Dr Salomon and three of his senior colleagues, programme — deputy co-ordinator, Dr Roberto Fernandez, the dean of the Medical Science Faculty at East Timor’s National University, Dr Marcia Cuervo Calvino, with co-ordinator of the Cuban nurses in East Timor, Javier Garrido Guerraro, who previously served in Botswana, as interpreter — and I have met at the small, neat house in the grounds of the Dili Hospital occupied by the Cubans where they proudly explain their programme to me.

In keeping with the portraits of revolutionary Che Guevara that look down from the walls, a computer linked to the internet via broadband in the corner and sipping excellent coffee — “a present from Cuba” — they provide “collective” response to my questions.

Were they shocked by the primitiveness of medical facilities in East Timor, I ask.
After 45 years of the United States economic blockade we are accustomed to hardship, they reply.

They also explain that the principal threats to the health of East Timor’s mostly rural and slum-dwelling population are malaria, dengue fever, respiratory infection, tuberculosis and malnutrition.

Data about the severity of these maladies is not available but the Cubans are developing a variety of programmes to reduce the prevalence of these common diseases in East Timor, says Dr Roberto Fernandez.

But the most important task is eradication of the mosquito habitat.
The Cubans also teach the action needed for preventative health — information now crucial to the thousands still living in the capital’s refugee camps — where many of the Cubans are now working.

Cuban medicine throughout the world has two major objectives, they say.
To prevent disease and pay particular attention to the patients.

“We are doing both in East Timor and all the members of our group have the same tasks,” says Dr Salomon.

The team a comprehensive collection of statistics as proof of their success.
For example, the child mortality rate where members of the Cuban team work is 27.5 for each 1,000 live births — more than 50 percent less than elsewhere .

Maternity mortality is 175/100,000; elsewhere the figure is between 600 and 800 for each 100,000.

But myriad specialist services ranging from essential gynaecology to orthopedics and pathological anatomy to forensic medicine and dermatology to psychiatry and dentistry are also being provided.

The team has done more than 4000 surgeries in East Timor and these includes the first Caesarean delivery at Oecusse — the first such operation in the district.

The Cuban government pays all the team’s living costs, including travel despite the blockade by successive United States administrations.

The Southeast Asian Times
November 26, 2006