Doctors in departure lounge

As the curtain falls on more than half a century of medical cooperation with Jamaica, highly trained Cuban specialists will begin exiting the island this Thursday, departing on four chartered flights from Kingston to their homeland, which has been reeling from increasingly frequent islandwide blackouts linked to a United States (US)-imposed fuel blockade.

The members of the medical brigade, long celebrated for their decades of service to Jamaica and Jamaicans, said that while they were disappointed that their tours of duty ended abruptly, they are happy to be returning to their families.

Dr Enrique Martinez Gonzales, a rheumatology specialist at the Kingston Public Hospital (KPH), is among those leaving. His two-year tour was cut short by a year following the termination of the programme.

Martinez Gonzales has treated more than 2,000 patients during his time in Jamaica and has expressed concern about the prevalence of rheumatic diseases affecting the joints.

“There is quite a large number of rheumatic cases here in Jamaica, and there are just a few specialists,” he told The Gleaner.

“That’s why the rheumatology clinics, especially in the public sector – for example at KPH – are so large. We conduct two clinic sessions weekly, seeing maybe 30 to 40 patients each day,” he said, noting that their services ended on March 6.

In addition to outpatient clinics, he also attended to inpatients.

“Unfortunately, there is a high number of these diseases, especially lupus and rheumatoid arthritis. It’s a very difficult situation. There are Jamaican rheumatologists as well, but between the two clinics, we see at least 60 to 80 patients,” he explained.

CONCERN FOR PATIENTS

As a consultant, he worked closely with residents and other specialists, but said he is uncertain what will happen to the patients he leaves behind. There will be no replacements.

“I have no idea. There is going to be a gap. It will be more difficult because doctors who remain will be overworked, and patients will face longer waiting times. It is always going to be a problem,” said the consultant, who previously worked in South Africa.

He added that he is looking forward to reuniting with his family in his economically challenged homeland.

Jamaica has said its decision to end the medical cooperation programme followed Cuba’s refusal to agree to the terms of a new memorandum of understanding, after the previous agreement expired in 2023.

Neither country has disclosed the specific sticking points, but The Gleaner understands that Jamaica required Cuban medical professionals to pay all applicable taxes, including contributions to the National Housing Trust. Cuba reportedly objected, arguing that its nationals would not benefit from the NHT and that the requirement was therefore unfair.

UNCLEAR

It remains unclear whether similar tax arrangements exist in other countries hosting Cuban medical personnel. However, in explaining its decision, the Ministry of Foreign Affairs and Foreign Trade noted that Cuba had accepted comparable tax requirements elsewhere.

Dr Humberto Alvarez Luna, a consultant neurologist specialising in disorders of the brain, spinal cord, and peripheral nerves, is also preparing to leave.

“We are the doctors who see patients with conditions involving the brain, peripheral nerves, and spinal cord. We see a lot of patients each week. Our clinic day is Wednesday, and Jamaica does not have many neurologists in the public system, so we assist patients from across all parishes,” he said.

His last day of work was March 6, with patients travelling from as far as Montego Bay in St James.

“They come from hospitals that do not have neurologists. Clinics usually start at 9 a.m. and end between 5 and 6 p.m. Between consultants and senior doctors, all new patients are examined, and follow-ups are done for complex cases,” he explained.

Between 30 and 35 patients are seen each Wednesday. Alvarez Luna’s four-year contract will end without a replacement.

He noted the close collaboration between neurology and neurosurgery.

“Sometimes we share cases. A patient may start with us and then move to neurosurgery if surgery is needed, or vice versa. For example, a patient with head trauma may later develop epilepsy. Surgeons handle the structural issue, and we manage the epilepsy,” he said.

He had replaced another Cuban specialist, who served four years, and was joined by a colleague, who will also be leaving early.

KPH will also lose emergency medicine nurse Yaselis Jacas Serrano, one of four who served at the facility. During her year-long stint, she witnessed numerous cases of gunshot and stab wounds.

Though shy and not fully fluent in English, she became visibly emotional and urged Jamaicans to live more peacefully to reduce the burden on emergency services.

Martinez Gonzales said he was surprised by the outpouring of gratitude from patients, with his phone flooded with messages of thanks.

“If a way could be found for Cuban medical professionals to return, I would come back. I feel comfortable here, and I think they need us. This was not our decision,” he said.

He rejected claims that the programme amounted to human trafficking, and urged the Government to prioritise the needs of the Jamaican people.

Alvarez Luna echoed that sentiment.

“They have to first think about their own people, because most of the patients we treat do not have the resources to go elsewhere. This is their only option,” he said.

erica.virtue@gleanerjm.com