Sunday, March 18, 2007

U.S. leaves Cuban physicians in limbo

U.S. leaves Cuban physicians in limbo
Dozens of doctors who acted on an offer of asylum are stranded in Colombia.
By Chris Kraul and Carol J. Williams
Times Staff Writers

March 8, 2007

BARRANQUILLA, COLOMBIA — Family practitioner Alberto Hernandez suffers anxiety attacks. Dentist Norah Garcia is prone to bouts of uncontrollable sobbing. General practitioner Cesar Fernandez, 31, has high blood pressure.

They are among the tens of thousands of doctors, nurses, surgeons and dentists dispatched from their Cuban homeland as medical missionaries to some of the world's poorest countries, in the process earning hard currency for the communist regime. But instead of providing much-needed healthcare, they have been caught up in a wider struggle between leftist Latin American leaders and the Bush administration.

Last summer, the administration announced that any Cuban medical professional sent abroad was eligible for political asylum. Frustrated with their efforts in a program that took them to Venezuela's barrios, or hoping to start a new life in the United States, dozens of Cuban healthcare professionals sneaked across the Colombian border.

Now they're holed up in Colombia, unable to work, while U.S. authorities mull whether to accept them as political refugees.

"We don't know why it's taking so long. We hope the United States government hurries up and makes up its mind," said Ariel Perez, a general practitioner who shares a small apartment with Garcia and another Cuban dentist in southern Bogota.

The approval process would take one to two months, they were told. But several Cubans here say the process has dragged on for half a year.

"All our hopes and dreams are wrapped up in [Bush's] decree," said Garcia, a 46-year-old from Havana whose husband made it to Florida on a raft three years ago. "The uncertainty is the worst, not knowing what will happen while we sit here and do nothing."

Officials at the Department of Homeland Security, which is handling the applications, declined to comment on the process. But government officials who asked for anonymity said it could take a long time if applicants lacked key documentation such as passports and medical licenses.

Colombia has welcomed the Cuban defectors with less than open arms. Most have been denied visas or work permits while the U.S. Department of Homeland Security processes the applications. Colombia, though a close U.S. ally in the region, has no desire to encourage the deserters, analysts say. Bogota is also reluctant to offend Cuba or Venezuelan President Hugo Chavez, for whom the presence of Cuban doctors is an important policy and public relations initiative of his "21st century socialism."

Sleeping at a church

Hernandez, a 43-year-old from the Cuban city of Santa Clara, has been sleeping in a supply room of a local Pentecostal church. He was told in mid-February that his request for a Colombian residence visa had been denied and that he had 30 days to leave the country.

"I am in a limbo from which I don't see an exit," Hernandez said, adding that he is pinning his hopes on getting the U.S. visa before the 30 days are up. He says he has no idea where he will go otherwise.

Medicine is a foreign policy tool of Castro's: He is training about 12,000 students from 83 countries at the Latin American Medical School in Havana. Operation Miracle, a program staffed by Cubans and financed by Chavez, has flown thousands of poor Latin Americans to Havana for free eye surgery.

The programs are also a source of revenue for a country that has struggled since the collapse of its main benefactor, the Soviet Union. In Venezuela, the healthcare professionals' labors are exchanged for $1.5 billion in annual oil shipments that Chavez sends to Cuba.

In places such as the slums of Caracas, the Venezuelan capital, the Cubans often are the first doctors the poor have ever seen. The working conditions are difficult. In the El Museo slum of Maracaibo, where Hernandez worked, there were rampant dysentery, malnutrition and kidney problems — caused, he thought, by open sewage and appalling hygiene. Hours were long and the Cubans often suffered resentment from host country physicians or political opponents of Chavez.

The Venezuelan president, who was sworn in for a third term in January, is fiercely critical of the United States and has made no secret of his ambition to succeed Castro as Latin America's beacon of socialism. With tens of billions of dollars in oil revenue at his disposal, he has teamed up with Castro to bankroll medical assistance at home and in several countries to gain prestige and score diplomatic points.

Escalating defections from the Venezuela program and others come as no surprise. Last year, 30 doctors deserted the program in Bolivia even before the new U.S. hint of asylum, probably to pursue private practice in the region. Their departure from the mission after less than six months was an embarrassment for Havana and the allied government of leftist President Evo Morales. In 2004, 10 physicians working in South Africa refused to go back home.

But the desertion rate among the estimated 26,000 Cubans in Venezuela may be the highest of any mission. In the Maracaibo area alone, Hernandez said, at least 100 of the 500 doctors sent since the mission began in 2003 have fled.

Not always welcome

The Cuban doctors are not always viewed as an unmitigated benefit in the host country.

The nascent media in East Timor have criticized the government for allowing some of the 300 Cuban medical missionaries serving there to promote communism. A Paraguayan Catholic bishop complained to officials in Asuncion last year that some Cuban doctors were imposing "ideological conditions" for provision of free treatment to rural poor.

In Bolivia, 14,000 members of the nation's medical association waged a one-day strike last May in protest of the presence of 600 Cuban doctors, who the Bolivians contended were diverting funds from state hospitals to pay for their upkeep. In Venezuela, doctors complain that Cubans practice illegal medicine because their degrees are not recognized in the country.

Two years ago, the Honduran government asked Cuba to bring its 200 medics home, thanking Havana for the help but saying enough Honduran specialists had been educated in recent years to cover the country's needs with its own nationals.


Homeland Security officials in Washington, where immigration applications are processed, won't release figures on how many petitions it has received from Cuban medical personnel, nor the number it has granted.

Julio Cesar Alfonso, a Cuban refugee and doctor who founded Miami-based Solidarity Without Borders to offer financial and legal help to Cubans trying to emigrate, estimates that about 170 applications for political asylum have been approved among the 200 or so people his group has helped.

The program has proved a complicated one to administer, which is why it may be taking the Department of Homeland Security longer than expected to decide on asylum.

Applications from Cuban medical professionals "require us to look closely to determine whether or not the person is fully eligible for the benefit," said department spokesman Chris Bentley. "The American public expects us to do that thoroughly and take as much time as needed to reach a sound decision."

In addition to the lack of documentation from most of the Cubans who fled Venezuela, there is also the suspicion that some of the refugees may be spies sent by Castro to see who is applying.

Such policy repercussions are far from the minds of Fernandez and Garcia, who fear they will be deported to Cuba if the U.S. turns them down. That could mean jail or social castigation.

"For the moment," Garcia said, "we have no legal rights at all."


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