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  • Cuban doctor Elisa Barrios Calzadilla inspects a patient during a house call in the city of Itiuba in the state of Bahia, northeastern Brazil November 20, 2013.

    Cuban doctor Elisa Barrios Calzadilla inspects a patient during a house call in the city of Itiuba in the state of Bahia, northeastern Brazil November 20, 2013. | Photo: Reuters

Published 11 June 2019

3,847 public-sector medical positions in almost 3,000 municipalities remain unfilled as of April.

The Brazilian government is struggling to replace more than 8,000 departed Cuban doctors, despite promises made by President Jair Bolsonaro, according to a New York Times report published on Tuesday.

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Based on the most recent figures, 3,847 public-sector medical positions in almost 3,000 municipalities remain unfilled as of April. A deficit caused by the departure of around 8,100 Cuban doctors that were part of the Mais Doctors (More Doctors) program. 

“In several states, health clinics and their patients don’t have doctors,” Ligia Bahia, a professor at the Federal University of Rio de Janeiro told the New York Times, adding that “it’s a step backward. It impedes early diagnoses, the monitoring of children, pregnancies and the continuation of treatments that were already underway.”

On November 2018, Cuba's Ministry of Public Health announced it would withdraw from the cooperation program with Brazil, which functioned since August 2013 and ensured health coverage for over a hundred million Brazilians who had no prior access to healthcare.

The decision was made due to Bolsonaro’s attacks against Cuba’s government and statements questioning the physicians' preparation and conditioning their permanence in the program to the revalidation of their degrees and individual contracts.

Afterwards, the far-right leader confidently said that they would “solve this problem with these doctors.” But six months into his presidential term, which started in January, things are not turning out as expected.

Since about half of the doctors from the program were from Cuba and were deployed to 34 remote Indigenous villages and the poorer areas of more than 4,000 towns and cities, their absence is largely felt in those communities. 

“I told people to think about that before they voted,” health secretary of the municipality of Embu-Guaçu, Dr. Maria Dalva told her patients. 

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According to Folha de Sao Paulo, at least 25 percent of Brazilian doctors, who took over the program between December 2018 and January 2019, have already left the position. 

The Brazilian physicians’ average stay ranges from one week to three months. The main reasons for quitting are their desire to work in better places, receive specialized training and attend their medical residency.

“The willingness of Cuban doctors to work in difficult conditions became a cornerstone of the public health system,” said Bahia. And now with the Cuban physicians gone, those remote and poorer areas are hit the hardest. 

In the first four years of Mais Medicos, the percentage of Brazilians receiving primary care rose to 70 percent from 59.6 percent, according to a report by the Pan-American Health Organization, which coordinated Cuba’s participation.

The departure of Cuban doctors could reverse that trend, with the consequences especially severe for children under five, potentially leading to the deaths of up to 37,000 young children by 2030, warned Dr. Gabriel Vivas, an official with the PAHO.

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