Cuban Health Care. Don Fitz
which they happily gave him, and made arrangements with the mayor to vaccinate students. Realizing the seriousness of the situation and knowing that Cuba had recently conducted its own polio vaccination campaign, Puente called MINSAP in Havana for permission to take on a similar endeavor. MINSAP director Machado approved and assigned Dr. Helenio Ferrer, Cuba’s Director of Epidemiology, to fly to Moscow for the vaccines. The Soviets agreed to provide 200,000 doses to the Congo for about four thousand pesos. Following appeals by the Cubans, they agreed to donate the vaccines, which arrived in June 1966.66
There were not enough doctors and nurses to administer the vaccines, but since they were placed in caramel candies, it was possible to train others to distribute them. In cooperation with the Congolese government, its militia, the Federation of Women, and Cuban troops, Ferrer coordinated the vaccination of over 61,000 children in the first such campaign in Africa.67
Unfortunately, the attempted coup of June 27, 1966, blocked administration of the second dose. Accounts tend to be vague about whether blocking the second dose prevented the first dose from being effective. However, when asked, Piñeiro, who was in the Congo from September 1966 to November 1967, explained, “As a result of not getting the second dose, there would be the same rate of polio.” He returned to the Congo in May 1969 and witnessed the Congolese Ministry of Public Health administering both doses, which were provided by the Soviets. He strongly believed that the earlier joint experience with the Cubans was critical in making the 1969 effort successful.68
In Guinea-Bissau, Díaz’s group found themselves with no Cuban nurses, so they trained several local youth. They were so impressed with the work of the Guineans that they sought and obtained permission from Cabral to bring four back to attend Cuban nursing school, from which they later graduated.69
This was not the only time that Cuba extended its educational resources to Africans. A few years earlier in the Congo, Cuban doctors noticed dedicated young people studying at night under streetlights. They asked the Congolese government about sending some of them to Cuba to study. The Congolese government agreed and, on January 24, 1966, 254 youths boarded a ship for Havana. This was the first time a significant number of foreign scholarship students went to Cuba. Nevertheless, there were problems. Rather than choosing students strictly on the basis of academic performance, many were selected according to personal connections or bribes. By late 1967, more than one hundred had returned home, per their own or the Cuban government’s request. Despite this, by 1978, twenty-five had Cuban medical degrees and others graduated as lab technicians or engineers.70
Cuban authorities soon decided that its military forces would leave Africa. Yet medical personnel would continue with replacement teams of “pediatricians, orthopedics, surgeons, and ear-nose-throat specialists who would be civilian rather than military doctors.”71
PHYSICIANS, HEAL EACH OTHER
Cuban doctors provided preventive care and treatment not only to troops and civilians, but also to themselves. The most famous example was Che. With him in Zaire, Zerquera remembered the day Che’s malaria was complicated by an asthma attack. Zerquera worried about the possibility of having to tell Fidel that he let Che die there. Che was not an exception. Delgado, for example, treated himself three times for malaria.72
Camacho spoke about how, soon after his arrival, acute jaundice caused another doctor, Jesús Pérez, to return to Cuba, leaving him with only one other doctor at their medical post. A year later, he was transferred to head the military hospital in Guinea-Bissau’s southern front because a doctor there was ill.73
The long walks and physical exhaustion of battlefield medicine took their toll. When Díaz arrived in Guinea-Bissau, he weighed 180 pounds. He left twenty months later, weighing only a hundred pounds. He had also experienced the unusual danger of disappearing shoes:
I returned to the base after it was completely destroyed, and I could not find any of my belongings, not even my tennis shoes. This type of footwear was the best for the circumstances, since we had to cross many rivers, and they dried much more quickly than boots and were a lot lighter…. During the first long walks, I lost all of my toenails … my feet were constantly wet and the hiking was constant … and in Cuba I had the habit of walking five kilometers every day.74
Some of the most unpleasant surprises awaited doctors upon completing their African assignments. Delgado recounted:
The year that we returned, almost all of us tested positive for filaria in our blood. In the subtype loiasis, it goes from the vital organs to the eyes, leaving the person blind. This was precisely the type we had. Reading about it scared me because, at the time, it was said that there was no guaranteed cure. We were treated in a hospital for two months.75
Camacho was also more than a little nervous:
I had filaria, which doesn’t exist in Cuba, and I had no idea until I passed through the checkpoint. It required a double treatment, both for the adult parasite and the larva. They didn’t have the medicine in Conakry and had to look elsewhere. Finally, I received the intravenous injections and took pills…. We arrived in Cuba in January 1968.76
IMPACT, REFLECTION, UNANSWERED QUESTIONS
By the end of the 1960s, when the Cuban revolutionary government had been in power for only ten years, doctors had been through four different situations in Africa: (1) in Algeria, they had treated only civilians; (2)in Zaire, the rebels had shown little enthusiasm for victory; (3)in the Congo, the government’s commitment had proven to be empty rhetoric; but (4)in Guinea-Bissau, there had been a successful military uprising with a strong commander and dedicated troops.
Cuba knew that the United States could invade at any time. As a result of African expeditions and experience gained by military doctors, a new generation of physicians would be trained by those who had been through war and could teach others how to treat combat victims. Perhaps the most lamentable irony of Cuba’s forays into Africa was that the country’s most capable leader, Che, led guerrillas into Zaire, the least promising front. Since no Cuban leader had been to sub-Saharan Africa for more than one day, the strategy of going to Zaire was based on misinformation, solidarity with Cuba’s own black population, and the defense of its revolution. When Che embarked on his last mission in Bolivia the following year, it was because he and Fidel agreed that Latin America must again occupy the foreground of Cuba’s participation in armed struggles.77
The connection between the approach to medicine practiced on the island and the methods learned by its doctors overseas was limited.78 Lessons from the experiences of the polio campaign in Cuba were adopted in the campaign in the Congo. Conversely, the exposure to medical issues in Africa was invaluable for developing Cuban understanding of tropical and infectious diseases. Nevertheless, nothing like Cuban polyclinics appeared in the battle conditions of Africa, where the necessity to provide emergency care was all-encompassing.
Still, Cuban engagement in Africa left a profound impact, both on the host countries and on the Cubans who went. Cuba learned that if students were to travel to the island for education, they must be screened for academic potential. The Congo became prepared to complete its own vaccination campaign. Guinea-Bissau recognized its debt to Cubans for its successful struggle for independence. “Many of our comrades are alive today only because of the Cuban medical assistance,” noted PAIGC official Francisco Pereira. “The Cuban doctors really performed a miracle. I am eternally grateful to them: not only did they save lives, but they put their own lives at risk. They were truly selfless.”79
White doctors who experienced the stressful conditions and parasitic diseases of Africa witnessed even greater sacrifices by black troops. One of the reasons that so many volunteered to serve in Africa was a feeling of urgency to spread the revolution. Later, Olvaldo Cárdenas spoke to Piero Gleijeses about this sense of urgency:
We believed that at any moment [the United States was] going to strike us … and for us it was better to wage war abroad than in our own country. This was the strategy of “Two or Three Vietnams”; that is, distracting and dividing the enemy’s forces. I never imagined then that I would be sitting [in