Cuban doctors to the rescue — a ‘premature and ill-informed’ move

Dear President Cyril Ramaphosa and Minister Zweli Mkhize,

I am writing to you concerning the arrival of 187 Cuban medical professionals in South Africa.

The global pandemic caused by the novel coronavirus continues to challenge our healthcare systems, in both private and public sectors. We need continuous and agile, expert and innovative, thinking to stay ahead of “the curve”.

At the time of writing (29 April), Covid-19 positive cases in South Africa numbered 4,996; recovered cases 2,073; active cases 2,830. The Covid-19 virus had claimed 93 South African lives. This is from a total pool of 185,497 tests (source: Worldometer).

The logical and proven next step, as per the Level 4 Covid protocol, is to significantly ramp up our volumes of testing. As more industries open for trade and more South Africans ready themselves to return to work, there is a need to harness all our medical, scientific, financial and logistical resources – public and private – into supporting the countrywide mobilisation around Covid-19 mitigation, led, primarily, by Covid-19 testing.

To that end, the government’s sudden decision to bring in epidemiologists and biotechnologists from Cuba seems to be premature and ill-informed. Their projected role in the fight against Covid-19 remains unclear.

Unlike other African countries such as Guinea, Sierra Leone and Liberia, Cuba has not dealt with a major epidemic, like Ebola. Cuba has sent numerous doctors around the world to aid with Covid-19. The financial details of this deployment elsewhere remains non-disclosed at this time. But from the leaked South African documents currently circulating, and already elucidated on by the South African Medical Association, the deployment of such medical specialists at a cost of R500-million is currently not only unnecessary but extortionate – working out at R7,325.47 per person per day for the apparent year-long contracted period.

Patently, these funds could have been better spent elsewhere – and needs to be recovered to allocate elsewhere in our fight against this disease. The doctors need to be re-deployed as soon as possible to another territory to assist where resource deficits patently indicate a need.

While we fully appreciate the ongoing and historic ties between South Africa and Cuba, on the ground, how can one reconcile the cost of the Cuban deployment in minimal numbers to each province, while there are other pressing needs in our healthcare sector.

The majority of our doctors, nurses and allied health professionals continue to be committed to rising to the call of duty, despite sub-optimal work environments and remuneration policies. On the same day that the Cuban document was leaked, the MEC for health in Gauteng was apologising for an unfortunate oversight in health professional salaries for the month.

There is still an ongoing lack of personal protective equipment in both private and public sectors. Doctors and nurses are continually silenced when raising concerns with regards to issuance of PPE. This includes the prolonged use of PPE not in accordance with infection control policies. While the arrival of substantial quantities of protective gear has been announced publicly, there appear to be ongoing logistical hitches in distribution.



There are numerous doctors and healthcare workers in our country that are selflessly committed to supporting both the Health Minister and the President’s vision of an exemplary management of Covid. A concerted effort to draw from these resources is what is required.

South Africans have been managing magnificently thus far – with no need for international resource deployment in our communities – beyond the welcome assistance of global NGO experts in the field, such as Medicines sans Frontiers and other field workers. As we know, the World Health Organisation last week applauded the manner in which SA is managing Covid.

In addition, there are numerous black, female-owned laboratories and micro-enterprises in the private sector with experienced biotechnicians. These are unfortunately sidelined when opportunities to assist with Covid testing arise.

We need to critically revisit this decision. Do current Covid-19 case numbers really justify a 12-month contract at that extortionate rate?  While the government is clear on its plans for quarantine (in a luxury Pretoria Hotel), rapid professional registration with the Health Professions Council of South Africa (HPCSA) and subsequent deployment, there appears to be silence on the costs entailed in accommodating the potential language barriers that may exist as the Cuban medical contingent are deployed to rural communities.

Most disturbing is the rapid registration of the newcomers with the HPCSA. How does the expedition of registration of Cuban healthcare workers differ from expedition of registration of other healthcare workers who have loyally served our country, at suboptimal wages, as they await their progression on the waiting lists for specialist registration and admission to  the Health Professions Council – often to be thwarted in that quest.

In summary:

* The SA-Cuba political history is noted.

* The financial impact of Covid-19 itself is exorbitant.

* The current additional cost burden of Cuban doctors is premature and unnecessary.

* Their projected impact on the Covid-19 curve is opaque.

* We have many dedicated health workers and support staff – many of them idle as routine trauma and elective procedures have reduced to nothing during lockdown.

* We have been globally commended for our exemplary management of the pandemic to date.

* We need to focus resources on ramping up testing and distribution of PPE.

* We can deploy our globally competitive local resources adequately and effectively.

Signed:

Specialist Medical Practitioner (14 years in public and private sectors.) DM/MC

Maverick Citizen is aware of the identity of the author of this letter and has agreed to publish it anonymously to protect her from victimisation.