The Uganda Medical Association (UMA) and the nation’s National Organisation of Trade Unions (NOTU) both issued statements this week protesting a government plan to import 200 doctors from Cuba, taking jobs that would go to domestic Ugandan doctors and enriching the communist Castro regime.
The outcry against importing Cuban doctors in Uganda closely follows a similar incident in Kenya, where doctors’ unions demanded the government help local medics find work before replacing them with outsiders.
The Cuban government makes much of its money through trading doctors, sent around the world to practice in countries suffering severe medical shortages. The governments requesting the doctors pay the Cuban government directly, which, according to doctors who have defected, keep most of the money. Recent estimates suggest that Cuba makes up to $8 million a year on the doctor trade, while the doctors themselves live on meager working “stipends” that often make it difficult for them to feed themselves.
In Brazil, 150 Cuban doctors have sued the Cuban government to be allowed out of their onerous contracts with the regime and receive a reasonable salary for their work. Cuban doctors who have escaped the system have regularly referred to it as “slavery.”
Uganda has yet to accept the doctors. Local newspaper the Monitor first broke news the government had begun considering a plan to import 200 doctors from Cuba in December, but Ugandan Health Minister Sarah Opendi only confirmed the plan last week. On Tuesday, the UMA issued a statement demanding Kampala abandon the plan.
UMA president Ekwaro Obuku turned to China’s state-run Xinhua news agency to protest the plan.
“We appeal to government to immediately advertise 500 posts for specialist doctors with the terms offered to Cuban doctors in the regional, district and rural hospitals across the country and we pledge to mobilize Ugandan doctors to fill these up,” Obuku demanded, noting that the costs of travel, lodging, and services like translation will mean that the government will ultimately pay more for the Cuban doctors even if their salaries are lower.
“The language barrier creates the need for nurses and midwives as interpreters, which removes them from lifesaving duties merely to facilitate communication between Cuban doctor and Ugandan patient,” he noted.
According to Obuku, over 1,500 domestic specialist doctors are ready to accept jobs throughout Uganda, if the government would offer them. The 200 Cuban doctors would only hurt local Ugandans who went through the effort of going to medical school only to find that their government prefers foreigners, Obuku argued.
The trade union group, NOTU, argued that importing Cuban doctors would be tantamount to the government accepting defeat in effectively running the country.
“We have the specialists here with us, but the government has failed to motivate them,” NOTU Secretary General Christopher Werikhe told the Monitor. “Instead they are bringing foreigners who will be marching away with fat salaries on top of fat allowances which they [government] have constantly denied countrymen, it is absurd.”
“If it is becoming a trend, we can tell workers like teachers to lay down their tools so that government brings Cubans too!” he added. “Instead of recruiting Cuban doctors government should enhance salaries of civil servants across the board to motivate them and enable them deliver the required service.”
The Monitor notes that the Ugandan health ministry has said it would pay Cuban doctors $1,500 a month. That money goes directly to the government in Havana, however, not the doctors—meaning Cuba can pay the doctors however much out of that salary as they wish.
The government pays a “senior consultant” Ugandan doctor an average of $1,215 a month, which means the Cuban doctors will be more expensive even without taking into consideration travel, lodging, and translation services.
The situation arising in Kenya last month unraveled similarly. The Kenyan government announced that it would import one hundred Cuban doctors to Kenya and send two to each of the country’s states to practice in poor communities. Kenyan officials argued that the Cubans were sorely needed to fill in medical jobs that Kenyans could not. The Kenya Medical Practitioners, Pharmacists and Dentists’ Union (KMPDU) said there were at least 1,000 Kenyan doctors ready and willing to take those 200 jobs.
“Kenya has 1,000 doctors who are not employed. They have waited for deployment since May 2017. There are additional specialists who have been waiting for deployment to counties. Is there room for these Drs in Kenya?” the head of the KMPDU, Ouma Oluga, wrote on Twitter.
Kenya’s reliance on foreign doctors, Oluga continued, had created a situation where no students in the country wanted to go into the medical field knowing they would not get jobs in their own country. At the end of the most recent school year, the union accepted zero newly-graduated doctors.
The Kenyan government claims to have a shortage of 34,445 doctors, relying on World Health Organization (WHO) estimates of how many doctors per capita a country needs. Yet Nairobi consistently refuses to hire Kenyan doctors, instead importing thousands from places like Egypt and Pakistan.
Cuba sends its doctors all around the developing world in exchange for cash. The communist government keeps an estimated 75 percent of each doctor’s salary and pays them a living “stipend.” Yet many doctors in Cuba sign up for the programs abroad, hearing they will make the salaries that the foreign governments pay them ($1,500 a month in Uganda, for example). Compare that to the domestic salary of $804 a year, and many doctors choose the more apparently lucrative position.
Cuba also makes money training foreign doctors within its borders, yet this program has suffered as the foreign students tarnish its reputation when they get home, unable to perform basic medical tasks. Nations such as the Pacific island of Tuvalu have canceled their training programs with Cuba after their students returned home with no skills to perform their duties properly.
This month, South Africa is facing a similar dilemma. The nation is expected to take in 700 domestic students this year who will be returning from training in Cuba, a program that the nation’s health minister said “was a headache for both countries.” Officials are facing extreme concerns that the returning students would have to go through a second round of rigorous training to make them able to perform medical tasks, bringing into question why South Africa was paying for Cuba to provide them training that would not make them immediately able to work as doctors.
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