With the COVID-19 pandemic stretching well being methods worldwide, Pacific international locations have capitalised on their relative isolation to keep away from the worst. Border closures and different measures have slowed and stopped the unfold of the virus to the purpose some nations have recorded no instances in any respect.
Even the place the virus has not unfold, nevertheless, establishing screening, quarantine and mass vaccination programmes has stretched already restricted well being methods. The place neighborhood transmission has occurred, as in Fiji and Papua New Guinea, it has severely examined nationwide well being methods.
The excellent news is that these small nations have been extra resilient than they may in any other case have been as a result of a dramatic enhance within the variety of docs employed within the Pacific previously decade.
In some international locations this has seen a doubling or extra of physician numbers. For instance, from 2012 to 2019, the variety of docs in Kiribati elevated from 18 to 51. Outstanding will increase have additionally been recorded within the Solomon Islands (79 to 170), Tonga (44 to 80), Vanuatu (27 to 67) and Tuvalu (7 to 27).
The place these docs come from could shock you. Most are new graduates of the Latin American Faculty of Medication (ELAM) in Cuba. Over the previous decade, greater than 250 Pacific college students have travelled to Cuba, realized Spanish, and accomplished six years of medical coaching on full scholarships from the Cuban authorities.
Solidarity and compassion
Cuba has an extended historical past of worldwide medical cooperation and Cuban docs have served in over 150 international locations. Within the Pacific, roughly 50 Cuban docs have served in Nauru, Kiribati and Vanuatu since 2006.
However Cuba has additionally recognised that having international docs workers well being methods indefinitely is unsustainable, and that “the perfect supplier is a effectively educated, homegrown well being skilled”.
The aim of ELAM is due to this fact to coach college students from decrease revenue and medically under-resourced communities who will go on to serve their international locations. Coaching docs is an act of solidarity and compassion constructed on Cuba’s dedication to well being as a human proper.
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Whereas the programme started lengthy earlier than the COVID-19 pandemic, its influence on well being system resilience and disaster response has been essential. With out expert professionals as a primary line of defence, there could be no efficient well being safety or pandemic response.
Cuban drugs and medical coaching additionally emphasises prevention, public well being and neighborhood care. It’s a mannequin designed for low-resource environments, effectively matched to the wants of the Pacific. As one Cuban-trained graduate in Tuvalu stated:
Cuban-trained docs have a way for preventive drugs […] I believe our greatest contribution within the well being providers could be to use what we realized in Cuba and to adapt it to our well being system in Tuvalu.
On account of this pandemic our sources have develop into much more restricted than earlier than. So, prevention and good well being promotion could be the primary objectives to attain to restrict the usage of already scarce sources.
On the identical time, the return of those graduates and their integration into native apply hasn’t all the time been easy. Their preliminary integration has been threatened by an absence of locations in medical internship programmes within the area. These needed to be quickly created or upscaled within the Solomon Islands, Vanuatu and Kiribati.
Whereas they demonstrated good primary medical data and robust foundations in preventative well being, many Cuban graduates did poorly on their entry exams for internship coaching.
Particularly, they struggled with primary procedures and in addition with medical English, having studied in Spanish.
Cuban compassion: Coaching docs for a Pacific island nation operating out of time
Partly, although, issues have been the results of variations between Cuban and Pacific well being methods and wishes. Many ailments prevalent within the Pacific have been eradicated in Cuba, which additionally has a a lot greater physician to inhabitants ratio and due to this fact extra outlined skilled roles throughout the well being sector. As a medical coach famous:
The Cuban-trained interns stated that in Cuba you’d by no means take your individual blood samples […] You wouldn’t interpret the X-rays. You’d have a number of different individuals to try this for you. In order that they’d by no means be taught any of these abilities. However they have been eager to. They have been so eager to be taught.
Sustaining entrance line staff
Bridging programs and profitable intern coaching have addressed these variations. Issues have eased as graduates have moved into jobs, with some additionally endeavor post-graduate coaching in Fiji, New Zealand and elsewhere.
Cuba’s direct Pacific contribution has slowed because of the pandemic and modifications in regional governments, with just one Cuban physician nonetheless within the area (in Kiribati).
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However a digital assembly final 12 months between Cuban specialists and representatives from seven Pacific international locations did tackle regional responses to the pandemic. Cuba has additionally supplied post-pandemic help to Nauru and Palau, and stays open to cooperation with different Pacific international locations.
It’s protected to say, nevertheless, that many Pacific nations have been capable of reply effectively to the challenges of COVID-19 due to Cuba’s previous help. Particularly, the sturdy sense of service, neighborhood and solidarity constructed into Cuban medical coaching has sustained and motivated Pacific well being staff on the entrance strains.
Due to Dr Helen Leslie and Assoc. Prof Robert Huish for his or her recommendation and help early on this analysis, and to Cristine Werle for her grasp’s thesis work in Kiribati.
Sharon McLennan acquired funding for this analysis from the Royal Society of New Zealand's Marsden Fund.