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The first of thousands of Cuban doctors left Brazil after the president of his far-right party, Jair Bolsonaro, urged the Cuban government to break a cooperation agreement, leaving millions of Brazilians without medical care.
Bolsonaro said Cuban doctors were used as "slavery", with the Cuban government taking 75 percent of their salaries.
He said the program launched in 2013 could only continue if they received full pay and were allowed to bring their families from Cuba.
Bolsonaro, an admirer of US President Donald Trump, was elected last month by Brazilians tired of the rise of crime and widespread corruption that have reached new heights for nearly fifteen years leftist governments with close ties with Cuba.
Cubans practiced mainly in poor and remote areas of Brazil, where Brazilian doctors do not want to work. The government is now trying to replace them with 8332 positions left vacant by the sudden departure of Cubans.
Cuba has a respected health service and generates significant export earnings by sending more than 50,000 health workers to more than 60 countries.
Even receiving a fraction of their salary, the money was good for doctors according to Cuban standards.
While they were lining up to check in at the Brasília airport, many of them had 49-inch, mainly 49-inch, smart TVs intended to be taken to Cuba, where imported devices are very expensive.
"I will be happy to see my children but sad to leave people without medical care," said Lume Rodriguez, a general practitioner who spent two years in the interior of the state of Bahia.
"Our patients came to kiss us goodbye," said 32-year-old Rafael Sosa from Granma province in eastern Cuba. "I have visited many patients here who had never had a doctor at home."
In many Brazilian cities and the suburbs of cities that relied on Cuban doctors, waiting rooms at public health posts, generally crowded, were empty this week and announcements indicated that appointments had been canceled until at new order.
Adrielly Rodrigues, a 22-year-old pregnant woman, was denied Wednesday as she was appearing for a prenatal exam in Santa Maria, a town near the capital Brasilia.
"We are so worried that we do not have money to pay for a private doctor, she is five months pregnant and still needs to be monitored and tested," said her mother, Adriana Rodrigues.
A national pressure group of mayors, the NPF and the council of municipal health authorities, Conasems, said in a statement that 29 million Brazilians could be deprived of basic health care. They urged the government to allow Cubans to stay.
Bolsonaro, who will take office on Jan. 1, announced last week that he would grant asylum to any Cuban who would ask for it, which would aggravate tensions with Havana. He added that Cuban doctors are not qualified and should pass exams to practice in Brazil.
The Ministry of Health expects next week to lift the obligation on Cubans to validate their medical degree in Brazil so that they can continue to work directly under contract with the Brazilian government and not through the the Pan American Health Organization.
It is unclear how many Cubans will want to break with the program of doctors against export set up by the communist government, which is present in some sixty countries, especially if they have children in Cuba, because that would be tantamount to doing a wrong maneuver.
Brazil plans to fill the medical vacuum with local recruitment. In just two days from the opening of the registration, 3648 Brazilians have been selected to fill the vacancies, said a spokesman for the ministry, but these replacements are found mainly in large urban areas .
A Cuban who will stay in Brazil is Richel Collazo, who was so loved in the small town of Chapada, in southern Brazil, that the mayor asked him to become municipal secretary for health.
"My city needs doctors and plays a key role in our medical care," Mayor Carlos Catto said by phone.
