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CUBA STANDARD — The Portuguese minister of health expressed his intent to continue a six year-old for-pay program that has deployed Cuban doctors to 18 smaller towns in the southern rural regions of Algarve and Alentejo that lack primary care services, official media reported.

Portuguese Health Minister Paulo Macedo and the Cuban ambassador in Lisbon, Johana Tablada, described the program “as positive,” according to official news service ACN. The two countries signed the first two-year contract in 2008; the current contract expires this month.

With currently 39 Cuban doctors, the Portuguese program is small. However, it is a bridgehead in the potentially larger European market.

Cuba has also tried to sell Portugal medicine and vaccines, apparently with no results to show so far.

Cuba is successfully expanding for-pay medical service exports, with 5,400 doctors and 1,000 doctors contracted by Brazil and Ecuador, respectively, and smaller programs in Angola, Algeria, South Africa, Qatar and Saudi Arabia. The biggest Cuban medical contingent abroad, an estimated 30,000, is contracted by Venezuela.

Based on a calculation of local salaries for doctors, Portugal pays Cuba at least $1.32 million per year for the services.

Some 10 percent of all doctors working in Portugal’s national health system are foreigners, by far most of them from neighboring Spain. Forty Colombian doctors were contracted in 2009, in addition to dozens of Colombian doctors already working in Portugal.

As is the case in many deployments of Cuban medical personnel abroad, local doctors’ organizations are objecting. In November 2009, a union representing independent doctors sent a letter to Portugal’s prime minister, complaining about the “unacceptable and humiliating” work conditions of the Cuban doctors.

According to the Sindicato Independente dos Médicos, the Cuban government pays its doctors in Portugal euro 500 (US$668) per month. The health minister responded the Portuguese government pays the equivalent of a Portuguese doctor’s monthly salary to the Cuban government, but cannot control how much of that goes to the Cuban doctors.

The host municipalities provide free lodging and transportation to the Cuban doctors. In Cuba, a primary physician earns the equivalent of at most $40 a month.

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