1.It is very important to learn not to help others too much.
2.The golden rule and Sunday school text that you should do unto others as you would have them do unto you, has to be measured very carefully, lest you do and do and do, and when you are done finished doing, the helped others can neither do anything back unto you nor even unto their own lonesome selves. They got too accustomed.
3.In this context, the crucifixion of the Cuban people puts our health service on the cross for all to see our lack of critical thinking and planning and our overt over-dependency on the Cuban healthcare workers.
4.Someone, some other time, might do the arithmetic comparing the Cuban Health Brigade workers and the American Peace Corps healthcare workers. Suffice it to say that I have worked with both types of healthcare workers. They each live modestly, and maybe the financial arithmetic might show that when primary and secondary and tertiary, medical education are compared, the two systems are not that different. It’s a study worth doing.
5. But let us leave the international politics aside for a while and consider what our healthcare system has gained over the decades that the Cubans have been assisting us. We can count past our fingers and toes the number of nationals trained in healthcare in Cuba. Without the Cuban Health Brigade workers, our healthcare would have been in grave danger. And yet, we still struggle to meet our burgeoning healthcare demands.
6. Who in their right mind would look at all that government land at Holberton, all those acres of singularly owned private land from Comacho’s Avenue to the top of Queen Elizabeth Highway, and build the sole government hospital on a pin-head mount of land, with no room for expansion? Somebody sick, sick, sick; fittingly so for a hospital, I guess.
7. But life is about changes. How do we right the wrong and make life better for as many people as possible? So, what’s the plan? Where do we go from here?
8. One of the dangers of being a member of international organizations like PAHO is that we do not accept that blueprints must be relevant and modified to the peculiarities of each country. One size or one plan does not fit all. PAHO tells us that, but we are hard of hearing.
9. In 1983, when I started working at Holberton, a government vehicle would bring laboratory samples from the peripheral clinics and from St. John’s Health Centre to Holberton and take back laboratory reports. Over the years, more clinics were opened all over the island, and more samples came to the laboratory at Holberton for testing.
10. Then something remarkable happened. Not only did we move to the current hospital built on the uncomfortable point of a needle, almost everyone started driving into the city, including driving to the hospital. Reportedly, some would park at the hospital, with no hospital business to do, and walk into town. How’s that for healthy exercise? They had to come to the city for various reasons, and they and their whole family and neighbours and friends were now mobile, with mobile phones to boot.
11. The peripheral clinics started doing less and less, as more and more of our local doctors, trained in Cuba, came face to face with the myth about medicine and money. It suddenly dawned on many that the money they linked to being a medical doctor was historically parental, or grandparental and even great grandparental, and that the vast majority of us who did medicine came from a working class background. Hence, you either wait for money, or you hustle for money. Good medicine and hustling do not go together.
12. Maybe we need to rethink our healthcare plan. Surely, we need clinics in the various districts and in the suburban areas. There are plans to create what may be called mini or micro hospitals in some strategic areas. All well and good, but these will need specialized healthcare workers and some or many of the services that now can only be had at the needle-point hospital. So, here’s the irony: The hospital is doing a very good, standard hospital job, as well as being asked to do the job of the clinics, and in the while there are acres of unoccupied private land around the hospital, begging to be bought, or acquired, by the government, to build an extensive healthcare plaza to meet the needs of the mobile, ambulant patients, doctors and other members of the health team.
13. We should not have just employed Cuban healthcare workers, we should have studied the healthcare system in Cuba, and most importantly, rationalize how our national, particular circumstances, including the movement of people, operate, so that we develop our healthcare system to suit our needs.
14. Ironically, the loss of our Cuban healthcare workers might force us into decisions we should have made long ago. Healthcare workers from Ghana are not the final solution and total answer. They are only a temporary measure in this new Atlantic Save Trade.
15. Some of us might recall the time when a massive medical ship from the north came here many years ago. Many of our nationals had surgical operations on that ship. To this day, neither the surgical pathology reports nor the surgical specimens are recorded in our hospital or anywhere on inland. I know this because I had an unforgettable telephone conversation with a high-ranking person related to that ship, after they had left, and remined him that our pathology department serves of the repository of such missing medical data and specimens. We must know what help we need and how to use it to suit and improve our lot.
16. When we say goodbye to our Cubans workers and friends and express our sincere gratitude to them, we have to pledge to do better, to plan better, to seek and find local solutions in mathematics and science so that when the North People, or any people for that matter, force us to say if we know this place called Cuba, we do not have to deny the Cuban people three times or more, in their garden of Gethsemane, and, with not even a small lamp of oil to offer, aid in their betrayal and crucifixion.
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So sad, so true, and thank you!
If Tim Hector was alive, Antigua would have been forced to show gratitude to Cuba, by leading a program of HELP CUBA NOW!
And to think that all some of us are saying is that we will never be able to listen and dance to Cuban music the same way ever again.
Funny thing is that we had some Cubans working at APUA, and they were sent home too. The threat was that if they didn’t leave by the 1st of March, no Antiguan could enter the US even with a visa. They were sent packing the next day with the assurance that we would send for them and that they could come back and claim asylum here.
Dr. Simon wonderful article as usual. I agree with you completely that we need to show serious gratitude to Cuba for the assistance they have provided to us, particularly in the Health Sector, and that the discontinuance of their assistance should force us to do serious planning in education to facilitate our developmental needs. However, I disagree with you completely when you characterized the Healthcare assistance from Ghana as a new Atlantic Slave Trade. It certainly is not and whatever linkages we can now forge with the Motherland is always welcomed.
Timely commentary on the debts we owe to Cuba.
I had hoped that from the myriad of persons who got trained there we would have heard a groundswell of like comments but it has been too few.
Thank you, Dr. Lester Simon for some of your highlights in this piece. I do hope that those points you raised about the relative comparisons between the US Peace Corps and the Cuban medical Brigade will be taken up by someone qualified to do so. I would be interested in the analytical information.
Mr. Charles Tabor: What I wrote was Atlantic “SAVE” Trade. NOT “slave”.
I would never say such a thing as a new Atlantic Slave Trade regarding our help from Ghana.
The point is that our Ghanaian
bothers and sisters will not save us in any permanent way from undertaking fundamental healthcare reform.
My sincere apologies for allowing the easily misunderstood term.
Good article. It’s about time we seriously think about developing our own healthcare system. We can’t beg or rely on “slave labour” forever.
Lol Dr. Simon I just reread your article and I am the one who should apologize. You said SAVE and my mind read SLAVE perhaps because Atlantic came before it. I must apologize. Of course a man of your intellect would not countenance that idea.
My dear colleague, we’ve been making these arguments for years. I have written and submitted documents, modified them over time, and submitted them again. This I began in 2001.
I even have witnesses to my conversations with the Minister of Health in recent years, including when he responded to my ideas by exclaiming that they were matters of priority.
Senior technicians must insist on planning the healthcare services; not follow the dictates of anyone who knows not and insists on acting as though they know.
PAHO meetings and the annual expensive trip to Geneva cannot determine what needs to be done in Antigua. That’s just fun and games.
I do hope that a new Health Minister will start by hosting a genuine national healthcare retreat where presentations are made and discussed, and a national rescue plan may be elaborated for country.
I suppose the name Right Winger gives you the right to to repay ignorance.