MEDICINE MANIFESTO; CUBAN DOCTORS BRIGADE FACING

1. (C) (SUMMARY) The Cuban Medical Brigade (CMB) was welcomed
into Honduras with open arms in 1998, after the devastation
of Hurricane Mitch. However, over the past seven years that
welcome has been worn out, according to some government
offices and the Honduran medical community (HMC). With the
current leftist trends in the region, there is concern by the
Government of Honduras (GOH) that the Cuban presence in the
country, especially in rural poverty stricken areas may not
be what the doctor ordered. The HMC, specifically the
Honduran College of Medicine, feels the assistance of the CMB
is no longer warranted or wanted. Recently, the GOH agreed
that the Cuban doctors should leave. However, this decision
is not set in stone. The Honduran Ministry of Health (HMH),
the ultimate decision maker, still has not made a declaration
as to whether the doctors will remain. (END SUMMARY)



2. (C) Following Hurricane Mitch the CMB entered the country
as part of the international relief effort. They have
maintained and increased their presence within the country
via a bilateral agreement with Cuba. The agreement allows
Hondurans to study at the Latin American Medical School in
Cuba and allows Cuban doctors to serve rural areas of
Honduras, where Honduran doctors refuse to go. It is
estimated that Cuban doctors have conducted over seven
million consultations since entering the country, while over
700 Hondurans have studied in Cuba, a majority in the medical
field. However, this program is neither free nor cheap. It is
estimated that annually the HMH spends 14 million lempiras to
maintain the program.



3. (C) The significant number of Cuban doctors in the country
has caused concern for two major and very different reasons.
First, there is a concern that, in addition to treating the
sick, the doctors are spreading their ideology in the rural
and poverty stricken areas of the country. It has been
reported that part of CMB's mission is to promote the
Cuban/communist ideology, especially to the poor masses. Wall
Street Journal senior editorial writer , Mary Anastasia
O'Grady called the doctors, "Fidel's foot soldiers, with the
potential for soft indoctrination." This is the cause of
serious concern in the GOH, specifically with the Honduran
Army, who feel that the Cuban presence could undermine
government efforts in these areas.



4. (C) The second concern is that the Cuban doctors are
taking positions that would otherwise be filled by Honduras'
estimated six thousands doctors, 40% of which are currently
unemployed. In addition, EmbOffs have been told by the
Honduran Public Health sources that the Cuban doctors are not
well trained, have little or no equipment/supplies and there
have been numerous complaints about the quality of care
received. On the other hand, a Honduran surgeon working off
his debt in an internship/community service project in
Mosquitia told a ConOff that he was thankful for the Cuban
doctors and because of them he is able to take a vacation.
The ConOff noted that overall he was positive about the
efforts of the Cuban doctors and commented that they are
doing lots of good work, mostly in poor areas, where Honduran
doctors refuse to work. These positive sentiments seem to be
shared by a majority of the Honduran people.



5. (C) The appreciation and respect for the Cuban doctors has
made it difficult to remove them from the country. This is
not the first attempt to have the CMB removed from the
country. In 1999, a similar but unsuccessful attempt was
made. According to local newspaper sources, President Maduro
has distanced himself from the issue by saying the decision
whether the CMB remain in Honduras is solely up to the HMH.
Palmer