Cuban doctors and their large-scale medical training program came to Timor Leste in 2004, then to Kiribati, Nauru, Vanuatu, Tuvalu and the Solomon Islands over 2006-2008. By its size and focus, this ‘South-south’ program, more than any other, is transforming the health systems of those island nations. Cuba’s ‘solidarity aid’ in health and education is famous in Africa and Latin America, but only more recently spread to the Southwest Pacific. By 2008 there were around 350 Cuban health workers in the region, with 870 East Timorese and more than 100 young Melanesians and Micronesians engaged in medical training.
We may identify several particular benefits in this program. First, the health training is at a well recognised international standard of technical excellence. Second, the program is oriented to the needs of developing countries, focusing on rural, primary and preventive elements, and making more use of human resources than expensive technology. Third, the program is systematic, aiming to build public health systems, and not simply provide project aid or individual training. Fourth, the ethos of training prepares students as public spirited community health workers rather than medical entrepreneurs; this in turn helps reduce the impact of the chronic ‘brain drain’ or the loss of trained professionals through migration.
Challenges are also posed by this program, for both the developing recipient-country and aid agencies. In the first instance, there must be a flexible incorporation of and investment in the newly trained doctors, investment in infrastructure, a commitment to ongoing training and to coordination of other health projects and programs. In the second case, aid agencies should note the Cuban commitment to language training and systemic programs, and look for opportunities to articulate with the island nations’ newly developed human capacity.
The Reality of Aid: Special Report on South-South Cooperation