Cuban doctors in Haiti: `The worst tragedy is not being able to do more'

January 18, 2010 -- Since 1998, Cuba's health cooperation with Haiti has made it possible for 6000 doctors, paramedics and health technicians to work there. Besides, 450 young Haitians have graduated as doctors from Cuban colleges, free of charge, in the past 12 years. More than 400 Cuban specialists, 344 of them doctors and paramedics, have been in Haiti, jointly sponsored by the United Nations and the Cuban government. But in the wake of last Tuesday's disaster, the largest earthquake ever to hit the Caribbean Basin, Cuba dispatched another team of 60 doctors, health technicians and medications to join the doctors on the ground in Haiti. Cuba has also sent ten tons of medications.

* * *

By Leticia Martínez Hernández, photos by Juvenal Balán

Port-au-Prince, Haiti — January 18, 2010 — Granma — The little boy, with a drip attached to his hand — although at that stage it wasn’t helping him very much — couldn’t stop trembling. The fluid that perhaps in other circumstances would give him some strength was not passing through his collapsed veins. Lying on a piece of cardboard, his life was ebbing away, while, at his feet, a Cuban doctor lamented not being able to do more.

"They brought this little angel in this morning. He was buried under the rubble for three days. A rescue team member brought him; he has no family and he’s unlikely to survive. We’ve given him everything, we’ve cleaned him up, we’ve treated his injuries, and I don’t know what else to do to help him. This tragedy has been merciless on the children, the pain is unbearable."

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Cuban doctors are working continuously and amputations are the most frequent operations.

Aged 28, Sergio is already familiar with the face of death. These last few days have been terrible for this doctor from Santiago de Cuba, who has left his country for the first time to save lives. When asked what was the worst, he fired off two aspects from his heart: the suffering of little ones and not being able to help them all. That was what Sergio Otero González said, while a woman with bruised face clung to his hand.

It is time to move away from the little boy and attend to people arriving. When he comes back, maybe this nameless innocent will have stopped breathing, and he will have to accept having done everything possible to restore life to a child born marked by tragedy.

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An unbearable stench emerges from the rubble, as people wander the streets.

Today, Haiti is replete with these sad stories. Hospital centres like Delma 33 (ironically called La Paiz) and La Renaissance have many horrors to recount, but the Cuban doctors there are intent on writing large the word LIFE, while Western news agencies are minimising that effort or even refuting it, like the US Fox News TV channel. Are we going to have to put speakers on the moon so that people know that Haiti has known Cuban doctors for many years before the earthquake struck?

Renaissance in Haiti

Paradoxes have taken hold of Haiti; with every glance I discover a contrast, another one... I’d thought that the contradiction between the happy faces looking out from advertisement boards and the crumpled faces of those passing below them was the greatest irony, but I was wrong. Finding the words "Peace" and "Renaissance" on the façades of the most dismal hospitals that I have seen in my life, exceeded any incongruence… So I decided to find the answer in the fluttering of my country’s flag over their doorways.

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Injured people are constantly arriving. It is heartrending to see the large numbers of children.

It would seem that the Haitians are coming to the hospitals where the Cubans are working to find peace. They arrive in an endless stream; everyone wants to be seen immediately, the intolerable pain of their bodies is mixed with a rooted lack of affection, which seems to be instantly cured when one of our doctors gently caresses them. Entire families are moving into the hospital grounds. They have set up their shelters, placed the sick person in the middle, piled up the few possessions left to them and the family, when there still is one, leaves to seek help. Others transport their injured on pieces of hardboard, boards, mattresses… until they virtually corner a doctor.

There, among the many, I found the Dr Madelaine in La Rennaissance hospital centre. Reaching her was a balancing act. One foot first, then the other… stop to recover my balance: beneath me various Haitians writhing in agony, just to have touched them would have been unpardonable. However, the odyssey didn’t end there. Now I had to convince her to recount her experiences. This 32-year-old woman from Granma province is an expert in her work, but shakes when faced with a cassette recorder.

"This cannot be compared to anything that I have ever seen. When I arrived, I was frightened but had no time to allow that fear to grow. I still haven’t forgotten the face of a little two-year-old who they pulled out of the rubble and who arrived in agony. They are bringing lots of people here, but when it’s a child, your heart is wrung even more."

Don’t you despair when you’re being called from all sides and at all times to help people?

"They are desperate, what they have experienced is unthinkable. But we’ve learned to stay calm and treat them with delicacy even though we’re stressed. If you despair you’re not helping anyone and wind up being useless."

Surgeon Abrahana del Pilar Cisneros Depestre emerges from the improvised operating room with a similar equanimity. From inside, covered by sheets, a terrifying sound can be heard. "We’re amputating a leg", she says and invites me in. But my strength doesn’t stretch that far, so I decide to wait for her outside to talk. The only thing that I know about her is that she ended her vacation early to return to Haiti and help.

"Everything is so sad and desolate. The injuries are extremely grave. The most frequent are traumatalogies; many people come in virtually self-amputated, with their limbs almost torn off, with burns incompatible with life, like those of that girl who is looking after a neighbour right now because her mum died and no other family member has been found."

With the passing of days, the possibilities of salvation are minimal for those recently found, says this doctor, who has already lost count of the people who have passed through her hands. "On Friday (January 15) we operated on 15 people; today, Saturday, we’re on our 17th and the day’s not over, there’s one after the other. The severity of injuries is greater, the cases are extremely septic."

And the family members, doctor, what are they saying to you?

"Many people come in alone, but when their families bring them, the pain and sadness is so much that they just look at us, I think that they say it all with that, there’s no need for the word thanks."

Are you tired?

"It’s a fact that we’ve worked really hard, that the days have all merged into one another, but the desire to help is so great that we’re not allowing ourselves to feel tired; on the contrary, maybe we could manage to do more."

One might suspect that so much energy and desire to act are only happening here in La Renaissance. However, at the other extreme of the city, history is repeating itself.

Peace in Delma 33?

In La Paiz University Hospital, known as Delma 33, other doctors confirm the words of Abrahana, Sergio and Madelaine. Another Cuba flag is waving there, and gives entry to an even more shocking scenario. Almost all the injured are to be found outside the hospital. The groans touch one’s heart, the tremendous wounds make you turn your face away, the desolation is pitiful, the looks seeking compassion pierce you to the bone. Everything would seem to ask: will such misfortune ever end?

The aftershock of the night before made them flee in terror, a juncture "utilised" by the doctors to better organise the place and assess the strength of the building.

When we arrived, the Cuban doctors were equipping new spaces, posting signs delimiting areas, disinfecting the floors, classifying the sick and admitting the gravest cases. It was surprising to see so many people helping. Chilean, Cuban, Spanish, Canadian and Mexican specialists were working shoulder to shoulder. They were all speaking one language: that of salvation. They all repeated the same phrase: teamwork.

Cuban Dr. Carlos Guillén, director of the hospital, defined it in this way: "It’s been perfect cooperation; they come to us, seek us out spontaneously for making any decision; we have a meeting in the morning and another in the afternoon with the representatives of each nation, where we define what we are needing, what the priorities are and we are sharing everything."

What most concerned Heriberto Pérez, a Chilean doctor, was the initial disorder, and for that reason, he defends that cohesion among everyone, no matter where they come from, because what really matters is saving lives.

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Rescue work continues although possibilities of survival are diminishing.

Rosalía, a nun, was caressing a little girl whose leg was in danger due to gangrene. She came from Spain to join the tremendous team, which also includes the Haitian resident Asmyrrehe Dollin. For this doctor, who graduated in Cuba, helping his compatriots is the greatest thing that life has bestowed on him. So he is grateful to the island for having given him the possibility to do so. Working together with the doctors who at one point were his professors, is an immense pride for him.

It is only this closeness among the doctors that will alleviate Haiti’s pain. The injured will be back at dusk, but maybe tomorrow the groaning will be less. It will be a blessing when the placards saying, "We need help", placed everywhere like shadows, begin to disappear.

Cuba and Venezuela to reopen health centres in Haiti

Port-au-Prince, Haiti -- January 18, 2010 -- acn The Center for Comprehensive Diagnosis George Gauvin, in Grand Goave town, will be reopened by Cuban doctors to provide first aid to earthquake victims from the surrounding areas of the Western Department of the Haitian capital.

This is one of the five CCDs completed in Haiti with the joint effort of Cuba and Venezuela out of 10 projected as part of a collaboration program. CCD director Dr Eisy Infante said the earthquake took eight Cuban experts by surprise inside the facility. None of them suffered any injuries. The left wing of the building was damaged.

Immediately after the 7.0 earthquake, people with different health conditions, with minor and serious lesions, or broken bones started to reach the hospital looking for help. The patients were assisted on the backyard of the clinic, under a few tents set up for the emergency. Five days later, the Cuban doctors have treated under extraordinary conditions more than 460 patients, including three childbirths.

Those with more serious conditions and requiring amputation have been transferred to hospitals downtown.

The CCD will be reopened soon, while experts at the center are preparing to lead efforts to educate the people to avoid epidemics as they have concentrated in places where they can protect themselves from the constant aftershocks of the earthquake.

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Submitted by Terry Townsend on Mon, 01/25/2010 - 12:42

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A Cuban bank account has now been opened to receive financial contributions to help with the Cuban medical teams working in Haiti.

If you wish to support the Cuban efforts in Haiti directly then you can do so in the following ways:

The preferred method

1. Make a donation via Cuba Solidarity Campaign. We will collate all donations and forward them in lump sums to Cuba to avoid multiple transfer fees (please make cheques payable to ‘CSC’ and write Cuban doctors in Haiti) on the back) and send to address below. You can also donate by Credit Card at 0208 800 0155. All donations will receive acknowledgement.

2. You can make a direct bank transfer to the Cuban bank account (below) set up to receive donations for the Cuban medical effort in Haiti. Please note that making direct bank transfers to Cuba will involve paying significant bank and transfer charges and that you may not receive confirmation or receipts for your donation.

Title: Terremoto Haití (Haiti Earthquake)
Bank: BICSA
Bank Identification Code (BIC) Código SWIFT del Banco: BIDCCUHH
Account number: 01321010770900
Bank Address: Havana, Cuba

Please note: Payments to Cuba should be made in pounds sterling or euros, NOT US dollars.

For details of the Cuban efforts in Haiti including video reports see
http://www.cuba-solidarity.org.uk/news.asp?ItemID=1768
Cuba Solidarity Campaign is also supporting the TUC Aid appeal for Haiti http://www.tuc.org.uk/

Submitted by Terry Townsend on Mon, 02/15/2010 - 17:03

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http://www.trabajadores.cu/news/2010/2/11/elam-doctors-leave-for-haiti-2

2/11/2010

ELAM Doctors Leave for Haiti

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The group is formed by young doctors from 24 countries

A new contingent grouping doctors graduated from the Latin American School of Medicine in Cuba (ELAM) left for Haiti very early Thursday, to support tasks there by Cuban specialists.

When the group was presented with the flag, the young doctors from 24 countries once again thanked leader of the Cuban Revolution Fidel Castro, main promoter of the project, example of integration among nations.

Public Health Minister Jose Ramon Balaguer recalled ELAM foundation in 1999, which have graduated over 7,000 doctors.

He also referred to development of the Henry Reeve Brigade, which is able to immediately activate its over 1,000 specialists to provide aid in any place.

They have made history in such countries as Pakistan, Indonesia, Bolivia, Peru and Salvador, and are examples of professionalism saving lives in very hard conditions, stressed Balaguer.

The minister insisted on the need to prepare a health system in Haiti that responds to people's needs. "All we do will be to consolidate that system," the Cuban Health Minister concluded.

Submitted by Terry Townsend on Tue, 04/06/2010 - 18:24

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Emily J. Kirk and John M. Kirk, Counterpunch, 1 April 2010

Media coverage of Cuban medical cooperation following the disastrous recent earthquake in Haiti was sparse indeed.  International news reports usually described the Dominican Republic as being the first to provide assistance, while Fox News sang the praises of U.S. relief efforts in a report entitled "U.S. Spearheads Global Response to Haiti Earthquake", a common theme of its extensive coverage.  CNN also broadcast hundreds of reports, and in fact one focused on a Cuban doctor wearing a T-shirt with a large image of Che Guevara, and yet described him as a "Spanish doctor".

In general, international news reports ignored Cuba's efforts.  By March 24, CNN for example, had 601 reports on their news website regarding the earthquake in Haiti-of which only 18 (briefly) referenced Cuban assistance. Similarly, between them the New York Times and the Washington Post had 750 posts regarding the earthquake and relief efforts, though not a single one discusses in any detail any Cuban support.  In reality, however, Cuba's medical role had been extremely important, and had been present since 1998.

Cuba and Haiti Pre-Earthquake

In 1998, Haiti was struck by Hurricane Georges. The hurricane caused 230 deaths, destroyed 80% of the crops, and left 167,000 people homeless.[1] Despite the fact that Cuba and Haiti had not had diplomatic relations in over 36 years, Cuba immediately offered a multifaceted agreement to assist them, of which the most important was medical cooperation.

Cuba adopted a two-pronged public health approach to help Haiti. First, it agreed to maintain hundreds of doctors in the country for as long as necessary, working wherever they were posted by the Haitian government. This was particularly significant as Haiti's health care system was easily the worst in the Americas, with life expectancy of only 54 years in 1990 and one out of every 5 adult deaths due to AIDS, while 12.1% of children died from preventable intestinal infectious diseases.[2]

In addition Cuba agreed to train Haitian doctors in Cuba, providing that they would later return and take the places of the Cuban doctors (a process of "brain gain" rather than "brain drain"). Significantly, the students were selected from non-traditional backgrounds, and were mainly poor.  It was thought that, because of their socio-economic background, they fully understood their country's need for medical personnel, and would return to work where they were needed. The first cohort of students began studying in May, 1999 at the Latin American School of Medicine (ELAM).

By 2007, significant change had already been achieved throughout the country. It is worth noting that Cuban medical personnel were estimated to be caring for 75% of the population.[3]  Studies by the Pan American Health Organization (PAHO) indicated clear improvements in the health profile since this extensive Cuban medical cooperation began.

Improvements in Public Health in Haiti, 1999-2007[4]

Health Indicator

1999

2007

Infant Mortality, per 1,000 live births

80

33

Child Mortality Under 5 per 1,000

135

59.4

Maternal Mortality per 100,000 live births

523

285

Life Expectancy (years)

54

61

Cuban medical personnel had clearly made a major difference to the national health profile since 1998, largely because of their proactive role in preventive medicine-as can be seen below.

Selected Statistics on Cuban Medical Cooperation, Dec. 1998-May 2007[5]

Visits to the doctor:

10,682,124

Doctor visits to patients:

4,150,631

Attended births:

86,633

Major and minor surgeries:

160,283

Vaccinations:

899,829

Lives saved (emergency):

210,852

By 2010, at no cost to medical students, Cuba had trained some 550 Haitian doctors, and is at present training a further 567. Moreover, since 1998 some 6,094 Cuban medical personnel have worked in Haiti. They had given over 14.6 million consultations, carried out 207,000 surgical operations, including 45,000 vision restoration operations through their Operation Miracle programme, attended 103,000 births, and taught literacy to 165,000. In fact at the time of the earthquake there were 344 Cuban medical personnel there. All of this medical cooperation, it must be remembered, was provided over an 11-year period before the earthquake of January 12, 2010.[6]

Cuba and Haiti Post-Earthquake

The earthquake killed at least 220,000, injured 300,000 and left 1.5 million homeless.[7] Haitian PrimeMinister Jean-Max Bellerive described it as "the worst catastrophe that has occurred in Haiti in two centuries".[8]

International aid began flooding in. It is important to note the type of medical aid provided by some major international players. Médecins Sans Frontières (MSF), for example, an organization known for its international medical assistance, flew in some 348 international staff, in addition to the 3,060 national staff it already employed. By March 12 they had treated some 54,000 patients, and completed 3,700 surgical operations.[9]

Canada's contribution included the deployment of 2,046 Canadian Forces personnel, including 200 DART personnel. The DART (Disaster Assistance Response Team) received the most media attention, as it conducted 21,000 consultations-though it should be noted they do not treat any serious trauma patients or provide surgical care. Indeed, among the DART personnel, only 45 are medical staff, with others being involved in water purification, security, and reconstruction. In total, the Canadians stayed for only 7 weeks.[10]

The United States government, which received extensive positive media attention, sent the USNS "Comfort", a 1,000-bed hospital ship with a 550-person medical staff and stayed for 7 weeks, in which time they treated 871 patients, performing 843 surgical operations.[11]  Both the Canadian and US contributions were important, while they were there.

Lost in the media shuffle was the fact that, for the first 72 hours following the earthquake, Cuban doctors were in fact the main medical support for the country. Within the first 24 hours, they had completed 1,000 emergency surgeries, turned their living quarters into clinics, and were running the only medical centers in the country, including 5 comprehensive diagnostic centers (small hospitals) which they had previously built.  In addition another 5 in various stages of construction were also used, and they turned their ophthalmology center into a field hospital-which treated 605 patients within the first 12 hours following the earthquake.[12]

Cuba soon became responsible for some 1,500 medical personnel in Haiti. Of those, some 344 doctors were already working in Haiti, while over 350 members of the "Henry Reeve" Emergency Response Medical Brigade were sent by Cuba following the earthquake.  In addition, 546 graduates of ELAM from a variety of countries, and 184 5th and 6th year Haitian ELAM students joined, as did a number of Venezuelan medical personnel. In the final analysis, they were working throughout Haiti in 20 rehabilitation centers and 20 hospitals, running 15 operating theatres, and had vaccinated 400,000. With reason Fidel Castro stated, "we send doctors, not soldiers".[13]

A glance at the medical role of the various key players is instructive.

Comparative Medical Contributions in Haiti by March 23[14]

MSF

Canada

USA

Cuba


Number of Staff:

3,408

45

550

1,504


Number of Patients Treated:

54,000

21,000

871

227,143

Number of Surgeries:

3,700

0

843

6,499

These comparative data, compiled from several sources, are particularly telling as they indicate the significant (and widely ignored) medical contribution of the Cubans. In fact, they have treated 4.2 times the number of patients compared with MSF (which has over twice as many workers, as well as significantly more financial resources), and 10.8 times more than the Canadian DART team. (As noted, Canadian and US medical personnel had left by March 9).  Also notable is the fact that the Cuban medical contingent was roughly three times the size of the American staff, although they treated 260.7 times more patients than U.S. medical personnel. Clearly, there have been significant differences in the nature of medical assistance provided.

It is also important to note that approximately one-half of the Cuban medical staff was working outside the capital, Port-au-Prince, where there was significant damage as well. Many medical missions could not get there, however, due to transportation issues. Significantly, the Cuban medical brigade also worked to minimize epidemics by making up 30 teams to educate communities on how to properly dispose of waste, as well as how to minimize public health risks.  Noted Cuban artist Kcho also headed a cultural brigade made up of clowns, magicians and dancers, supported by psychologists and psychiatrists, to deal with the trauma experienced by Haitian children.

Perhaps most impressively, following the growing concern for the health of the country, due to a poor and now largely destroyed health care system Cuba, working with ALBA (the Alianza Bolivariana para los Pueblos de Nuestra América) countries, presented to the WHO an integral program to reconstruct the health care system of Haiti. Essentially, they are offering to rebuild the entire health care system.   It will be supported by ALBA and Brazil, and run by Cubans and Cuban-trained medical staff. This is to include hospitals, polyclinics, and medical schools. In addition, the Cuban government has offered to increase the number of Haitian students attending medical school in Cuba.   This offer of medical cooperation represents an enormous degree of support for Haiti.[15]  Sadly, this generous offer has not been reported by international media.

While North American media might have ignored Cuba's role, Haiti has not. A pointed remark was made by Haitian President Mr. René Préval, who noted, "you did not wait for an earthquake to help us".[16] Similarly, Haiti's Prime Minister Jean-Max Bellerive has also repeatedly noted that the first three countries to help were Cuba, the Dominican Republic and Venezuela.

Sadly (but not surprisingly), while Cuba's efforts to assist Haiti have increased, international efforts have continued to dwindle. The head of the Cuban medical mission, Dr. Carlos Alberto García, summed up well the situation just two weeks after the tragedy: "many foreign delegations have already begun to leave, and the aid which is arriving now is not the same it used to be. Sadly, as always happens, soon another tragedy will appear in another country, and the people of Haiti will be forgotten, left to their own fate".  Significantly, he added "However we will still be here long after they have all gone."[17] This in fact has been the case.  Canadian forces, for example, returned home and the USNS Comfort sailed several weeks ago. By contrast, Cuban President Raúl Castro noted: "we have accompanied the Haitian people, and we will continue with them whatever time is needed, no matter how many years, with our very modest support".[18]

A representative of the World Council of Churches to the United Nations made the telling comment that "humanitarian aid could not be human if it was only publicized for 15 days".[19] Today Cuba, with the support of ALBA and Brazil, is working not to build a field hospital, but rather a health care system. And, while international efforts have been largely abandoned, the Cuban staff and Cuban-trained medical staff will remain, as they have done for the past 11 years, for as long as necessary.  This is a story that international media have chosen not to tell-now that the television cameras have gone. Yet it is an extraordinary story of true humanitarianism, and of great success in saving lives since 1998.  Moreover, in light of Cuba's success in providing public health care (at no cost to the patients) to millions of Haitians, this approach to preventive, culturally sensitive, low cost and effective medicine needs to be told.  That significant contribution to this impoverished nation, and Cuba's ongoing commitment to its people, clearly deserve to be recognized.  Until then it will sadly remain as one of the world's best- kept secrets.

Notes

[1] "Audit of USAID/HAITI Hurricane Georges Recovery Programme". USAID. 15 May, 2001. Retrieved 10 March, 2010 from <http://www.usaid.gov/oig/public/fy01rpts/1-521-01-005-p.pdf>

[2] See entry for "Haiti" on the Pan American Health Organization website, found at http://www.paho.org/english/dd.ais/cp_332.htm.  Accessed February 2, 2010.

[3] William Steif, "Cuban Doctors Aid Strife-Torn Haiti." The State. April 26, 2004, and found athttp://havanajournal.com/culture/entry/cuban_doctors_aid_strife_torn_haiti/Accessed June 21, 2007.

[4] See entry for "Haiti" on the Pan American Health Organization website, found at http://www.paho.org/english/dd/ais/cp_332.htm. Accessed February 2 2010.

[5] Anna Kovac, "Cuba Trains Hundred of Haitian Doctors to Make a Difference," August 6, 2007. Located on the MEDICC website athttp:www.medicc.org/cubahealthreports/chr-article.php?&a=1035. Accessed February 2, 2010.

[6] Ibid., "Haitian Medical Students in Cuba". Medical Education Cooperation With Cuba. 12 January, 2010. Retrieved 12 January, 2010 from <http://www.mwdicc.org/ns/index.php?p=4&s=33>, "La colabaración cubana permanecerá en Haití los años que sean necesarios", Cubadebate. 24 February, 2010. Retrieved 9 March, 2010 from <http://www.cubadebate.cu/opinion/2010/02/24/cuba-estara-en-haiti-anos-que sean-necesario>, "Fact Sheet: Cuban Medical Cooperation With Haiti". Medicc Review. 15 January, 2009. Retrieved 2 February, 2010 fromhttp://www.medicc.org/ns/index.php?s=104.

[7] "Haiti Earthquake: Special Coverage". CNN. 20 March, 2010. Retrieved 22 March, 2010 from  <http://www.cnn.com/SPECIALS/2010/haiti.quake/>

[8] Tyler Maltbie, "Haiti Earthquake: The Nations That Are Stepping Up To Help", The Christian Science Monitor, Posted January 14, 2010 onhttp://www.csmonitor.com/layout/set/print/content/view/print273879. Accessed January 28, 2010.

[9] "Two Months After the Quake, New Services and New Concerns". MSF. 12 March, 2010. Retrieved 17 March, 2010 from <http://www.doctorswithoutborders.org/news/article_printcfm?id=4320>

[10] "Canada's Response to the Earthquake in Haiti: Progress to Date". Foreign Affairs and International Trade Canada. March 17, 2010. Retrieved 17 March, 2010 from <http://www.internaitonal.gc.ca/humanitarian-humanitaire/earthquake_seisme_h aiti_effort>

[11] "USNS Comfort Completes Haiti Mission, March 9, 2010". American Forces Press Service. 9 March, 2010. Retrieved 11 March, 2010 from <http://www.trackpads.com/forum/defenselink/928304-usns-comfort-completes-ha ti-mission>

[12] John Burnett, "Cuban Doctors Unsung Heroes of Haitian Earthquake", National Public Radio report, January 24, 2010, and found athttp://www.npr.org/templates/story.ph?storyID=122919202. Accessed 28 January, 2010.

[13] José Steinsleger. "Haiti, Cuba y la ley primera," La Jornada, February 3, 2010., Data in this section came from the address given by Ambassador Rodolfo Reyes Rodríguez on January, 27, 2010 in Geneva at the 13th Special Session of the U.N. Human Rights Council on Haiti. It can be accessed at "Cuba en Ginebra: 'Ante tan difícil situación humanitaria en Haití no puede haber titubeos ni indiferencia," on the Cubbadebate website: <http://www.cubadebate.cu/especiales/2010/01/27/cuba-en-ginebra-sobre-recons truccion-haiti>

[14] Connor Gorry. "Two of the 170,000 + Cases". Medicc Review. March 8, 2010. Retrieved 10 March, 2010 from  <http://mediccglobal.wordpress.com/>, "Cooperación con Haití debe ser a largo plazo." Juventud Rebelde. 23 March, 2010. Retrieved March 23, 2010 from <http://juventudrebelde.cu/internacionales/2010-03-23/cooperacion-con-haiti- debe-ser-a-largo-plazo>, "Haiti: Two Months After The Quake, New Services and New Concerns". MSF. 12 March, 2010. Retrieved 17 March, 2010 from http://www.doctorswithoutborders.org/news/article_print.cfm?id=4320>, "Haiti-USNS Comfort Medical And Surgical Support". U.S. Department of Health and Human Services. 11 March, 2010. Retrieved 11 March, 2010 from <http:www.hhs.gov/Haiti/usns_comfort.html>, Brett Popplewell. "This Haitian Town Is Singing Canada's Praise". The Star. 26 January, 2010. Retrieved 17 March from <http://www.thestar.com/printarticle/755843>, "USNS Comfort Leaves Haiti". 13 News. 11 March, 2010. Retrieved 11 March, 2010 from <http://www.wvec.com/internaternalz?st=print&id=87243182&path=/home>

[15] In a March 27, 2010 meeting in Port-au-Prince between President Préval and the Cuban and Brazilian ministers of health (José Ramón Balaguer and José Gomes), details were provided about what Balaguer termed "a plot of solidarity to assist the Haitian people".  Gomes added "We have just signed an agreement-Cuba, Brazil and Haiti-according to which all three countries make a commitment to unite our forces in order to reconstruct the health system in Haiti.  An extraordinary amount of work is currently being carried out in terms of meeting the most basic and most pressing needs, but now it is necessary to think about the future  [.] Haiti needs a permanent, quality healthcare system, supported by well-trained professionals [.]  We will provide this, together with Cuba-a country with an extremely long internationalist experience, a great degree of technical ability, great determination, and an enormous amount of heart.  Brazil and Cuba, two nations that are so close, so similar, now face a new challenge: together we will unite our efforts to rebuild Haiti, and rebuild the public health system of this country".  See "Cuba y Brasil suman esfuerzos con Haití," Juventud Rebelde, March 28, 2010 (Translation to English provided  by authors).

[16] "Presidente Preval agradece a Fidel y Raúl Castro ayuda solidaria a Haití". 8 February, 2010. Retrieved 9 February, 2010 from <http://www.cubadebate.cu/noticias/2010/02/08presidente-preval-agradece-fidel -raul-castro>

[17] María Laura Carpineta, "Habla el jefe de los 344 médicos cubanos instalados en Haití desde hace doce años". Página 12 [Argentina]. February 4, 2010, found at CUBA-L@LISTA.UNM.EDU [18] Ibid. [19] "Press Conference on Haiti Humanitarian Aid," held at the United Nations on March 23, 2004 and found at htto://www.un.org/News/briefings/docs/2004/CanadaPressCfc.doc.htm. Accessed November 21, 2008.

  • Emily J. Kirk will be an M.A. student in Latin American Studies at Cambridge University in September

  • John Kirk is a professor of Latin American Studies at Dalhousie University, Canada. Both are working on a project on Cuban medical internationalism sponsored by Canada's Social Science and Humanities Research Council of Canada (SSHRC).  Professor Kirk co-wrote with Michael Erisman the 2009 book "Cuba's Medical Internationalism: Origins, Evolution and Goals" (Palgrave Macmillan).  He spent most of February and March in El Salvador and Guatemala, accompanying the Henry Reeve Brigade in El Salvador, and working with the Brigada Medica Cubana in Guatemala.