Vincent Bevins of the L.A. Times published a story about the Cuban doctors going to Brazil. There are all kinds of stories embedded within it.
First, it is yet another reminder that there are serious economic disparities in Brazil. Glowing reports of development mask a large urban/rural divide, for example. That is definitely true with regard to doctors.
Second, there is incredible indifference to those disparities. This quote really got me.
When asked if any doctor was better than no doctor, CFM President Carlos Vital responded in the negative.
“Pseudo treatment is worse than no treatment,” he said. “If you don’t have a doctor in your city, you can go to the next city and have a quality doctor.”
Sure, just go 100 miles to the next city if you don't have a doctor. Nothing to see here!
Third, more attention needs to be paid to the plight of Cuban doctors, who are paid almost nothing and deployed like soldiers. Thousands of them end up in the United States.
Fourth, even less attention is paid to the impact of aid on local markets. When a country is flooded with food aid, for example, prices plummet. That hurts local producers (though there is plenty of debate about the overall impact). If there are any local doctors, they cannot compete with free ones. If there are no local doctors, then obviously that's not a problem, but then there will never be an incentive for any doctor to start there.
Fifth, why is Brazil importing doctors rather than producing them on its own? That would eliminate problem #4. With financial and idealistic incentives, get Brazilian doctors to work in more remote areas (unfortunately as I write this I cannot get Northern Exposure out of my head).
In the end, though, with this program people are getting healthcare when otherwise they would receive little or none. We need to keep our eyes on that goal while also acknowledging the problems inherent in the way they are receiving it.