Cuban Doctors and Schisms in Brazil

Brazil has top notch health care for those who can afford it.  Even treatment through public health programs such as SUS and INSS hospitals is, if you know how to work the system and have friends, not really that terrible.  Although I have to admit that I have not used the system for a long time.

So the debate on the hiring of 4000 Cuban doctors is interesting and perplexing at the same time.  Those in favor state the need for better health care especially in rural and poor regions where the Cuban doctors are supposedly heading.  I think everyone can agree on that point but it is not quite so simple.  The Brazilian medical association and most of its members are up in arms, stating that the Cuban doctors are a threat to the medical class and the health of Brazilians.  They say Cuban doctors don’t speak Portuguese and have not been adequately trained or lack the qualifications of a “real” Brazilian MD.  There was even a very ugly incident today where protesting medical students and interns were reportedly shouting at and directing derogatory and racist remarks at black Cuban doctors arriving to work.

The schism, in my opinion, reflects the increasing polarization that is preceding the 2014 presidential election.  The street protests of June seemed to place Dilma’s easy reelection in doubt. The left, led by the PT (Lula’s worker’s party), has gone on the offensive to make up for lost ground.  At the same time, the center left Tucanos (PSDB and allies) are trying to portray Dilma as imcompetent and her administration as just a continuation of the same corrupt practices that were revealed in the mensalao, the Congressional vote buying scandal.

The polarization in some arenas has gotten so bad that some on the more radical left have stated that there is a coup in the works planned for September 7, Brazilian Independence Day.  The radicals on the other side are alleging that Dilma and the PT have totally lost their legitimacy and that the Cuban doctors are, in reality, guerilla fighters, seeking to impose socialism or communism.  It is hard to believe but this is the kind of stuff that is going around and being brought up and, unfortunately, not only on the fringes.

I have been reading Jose Murilo de Carvalho’s book Os Bestalizados about the Republic and how political participation was controlled and co-opted in the First Republic (1889-1930).  The book makes one think that Brazil is still in that long process of acquiring a civic society, building citizenship and political participation.   The recent protests show that Brazilians want change but want it within the confines of a working political system.  The danger is that a minority might be able to convince and cajole the majority into accepting a “revolutionary” change.  That is what the military and the technocrats called the 1964 coup against the supposedly leftist “revolutionary” forces of Jango and Brizola.

A friend of mine posted a quote from Buckminster Fuller the other day.  In Portuguese, it read: “Voce nao muda as coisas lutando contra a realidade atual.  Para mudar algo e preciso constuir um novo modelo que tornara o atual modelo obsoleto.”  In English, (forgive me any mistake here Bucky) “You cannot change things by fighting reality.  To change, you must create a new model that will make the old model obsolete.”  Both left and right affirm they have new models but they are not very convincing.  Probably, the best we can do is to participate in the slow construction of education, institutions, and participation taking into account new technologies and systems without throwing out the advances toward freedom and political democracy that have been made.

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