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SÃO PAULO – Cuba announced Wednesday the recall of thousands of doctors deployed in poor and isolated areas of Brazil after the elected president of the Brazilian far right criticized the treatment of the communist country to health professionals.
Cuba began deploying health professionals in Brazil in 2013 as part of the Mais Medicos program, launched by leftist Dilma Rousseff, when she was president. It provided medical services to communities underserved by Brazil's public health system.
For the residents of many small towns and low-income, violent urban neighborhoods, this was the first time a doctor had been living there for years, making the program extremely popular.
If most of the money that Brazil pays for the service goes to the Cuban government, the meager salary that the visiting doctors earn is still far greater than what they earn at home.
Jair Bolsonaro had warned that the terms of the agreement would change when he assumed the post of President of Brazil on 1 January, saying that the Cuban government could not keep any part of his salary and that doctors should be allowed to bring their families, which they are currently not allowed to do.
Mr. Bolsonaro also raised questions about the quality of the training of doctors in Cuba and said that they should prove their medical credentials by having their degrees validated in Brazil.
"Cubans receive about 25% of the salary. The rest feeds the Cuban dictatorship, "said Bolsonaro the newspaper Correio Braziliense earlier this month, adding that he had met a Cuban doctor to whom he had not been allowed to take his children. "Can you maintain diplomatic relations with a country that treats its people like this?"
In response, the Cuban authorities told the Pan American Health Organization – which helped manage the program – that its doctors had to leave Brazil.
"These unacceptable conditions make it impossible to maintain the presence of Cuban professionals in the program," said the Cuban Ministry of Health Wednesday, accusing Bolsonaro of making comments "derogatory and threatening."
He also posted a tweet in English accusing the Cuban government of rejecting the impact that the decision to remove doctors would have on Brazilian patients, he wrote that Havana refused to "repair the deplorable situation of these doctors in flagrant violation of human rights".
More than 8,000 of the 18,000 doctors currently employed by the Mais Medicos program are Cuban, and their sudden departure would have a significant impact on the most needy communities in Brazil. The end of the program would also have a negative impact on Cuba's net results. The government's medical services export program is one of its main sources of revenue.
According to the Cuban Ministry of Health, in the last five years, nearly 20,000 Cuban doctors have worked in Brazil under this program, treating more than 113 million patients. Brazilian authorities claim that more than 60 million Brazilians without access to a doctor now have access to Mais Medicos.
Cuba sends doctors to dozens of countries, sometimes to deal with humanitarian crises and often under medical service contracts. Countries pay millions of dollars each month to the government to provide doctors, making them the country's most valuable exports.
But in Brazil, a growing number of Cuban doctors have rebelled in recent years. Dozens of people have filed lawsuits in Brazilian courts challenging the arrangement of being treated not as agents of the Cuban state, but as independent contractors who should be paid a full salary.
Noel Fonseca Gomez and his partner were the only doctors to travel for miles when they arrived in Arari, northern Brazil, in 2014.
"The work is rewarding, but I had to leave my children behind," said the Cuban doctor. "And then you discover what the Brazilian doctors are earning. When I started to fight for my rights, the Cuban government excluded me from the program. "
Mr. Fonseca was finally able to move his family to Brazil and made it their permanent home.
Cuba punished those who defected by prohibiting them from returning to the island for eight years.
"I think most of Medicos's doctors are going back to Cuba," said Fonseca. "Their families are there and they are not likely to be banned from visiting them."
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