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By Andrew Jack
Published: May 15 2010 00:21 | Last updated: May 15 2010 00:21
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Asylum: no panacea
Cuban doctors do defect to the US – but often can’t practise
From his modest office in a community centre in the western suburbs of Miami, Julio
Alfonso is helping recreate some of the more positive elements of Cuba’s medical system –
but with a very different ideology. A decade ago, he sought asylum in the US, after more than
a year’s imprisonment in Cuba and a ban from practising medicine due his opposition, as a
Catholic, to conducting abortions; his reluctance to serve abroad in Angola; and his criticism
of the regime.
He calls the Cuban health system “the biggest slave army in history”, citing the low salaries
the doctors earn compared with the foreign currency they bring in for their government. And
he says many of his peers worry over being expected to give speeches supporting the regime
while on assignment.
Alfonso remembers vividly the day in September 2006 when the US eased refugee status for
Cuban medical staff. But while he has since gained the right to work in the US, language
barriers and the burden of retraining mean he cannot qualify here as a doctor. It’s a fate
shared by almost all of the 2,000-plus doctors who have defected to the US since.
After spells as a supermarket worker, a dock worker and a medical technician, Alfonso is
now helping manage a medical clinic for the uninsured and those on low incomes in Miami.
He says it is “criminal” that so many people have such difficulty gaining access to medical
care in the US.
Now, sipping sweet Cuban coffee, he takes a phone call from a contact in Nicaragua seeking
help for Cubans who have sought asylum there. Then he rings Washington to lobby on behalf
of a doctor in his office who defected from Paraguay and is trying to reunite with his wife, a
Cuban who fled while on assignment in Ecuador.
Alfonso would like to see greater US support for Cuban émigré doctors. As is, he spends his
time mirroring Cuba’s medical diplomacy – but on a more modest scale. He co-ordinated the
dispatch of a small contingent of his peers to Haiti last year, and again after the earthquake in
January this year. He has also sent money and medicines to one doctor in Cuba who was
working independently until his recent arrest and imprisonment.