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Ebola epidemic in Africa: Cuban medical experience in this international health emergency (V)
Epidemia de ébola en África: experiencia médica cubana en esta emergencia sanitaria internacional (V)
Rafael Rufino Corona Pérez
Villa Clara University of Medical Sciences. Cuba.
ABSTRACT
The research paper communicates the obstacles that the "Henry Reeve" Brigade had to receive the financing agreed with the World Health Organization, necessary to fight Ebola in Sierra Leone, due to the economic, commercial and financial blockade imposed on Cuba by the United States, which delayed the construction and assembly of hospitals, even knowing of the explosive increase of the epidemic; and recognizes the patriotic attitude of the collaborators determined to fulfill the mission despite all the setbacks. The political-partisan activity and collective leadership, the appointment of a Cuban business manager, the creation of the Ebola Management Center in the Ministry of Public Health and the designation of a focal point to attend the brigade by the World Health Organization allowed the development and successful completion of the mission.
MeSH: hemorrhagic fever, ebola, disaster sanitation, disaster emergencias, international assistance in disaster, education, medical.
RESUMEN
El artículo comunica los obstáculos que tuvo que asumir la Brigada "Henry Reeve" para recibir el financiamiento acordado con la Organización Mundial de la Salud, necesarios para el enfrentamiento al ébola en Sierra Leona, debido al bloqueo económico, comercial y financiero impuesto a Cuba por Estados Unidos, lo cual retardó la construcción y montaje de los hospitales, aun conociendo del incremento explosivo de la epidemia; y reconoce la actitud patriótica de los colaboradores decididos a cumplir la misión a pesar de todos los contratiempos. La actividad político-partidista y la dirección colectiva, el nombramiento de un encargado de negocios cubano, la creación del Centro de Dirección del ébola en el Ministerio de Salud Pública y la designación de un punto focal para atender la brigada por la Organización Mundial de la Salud permitieron el desarrollo y culminación exitoso de la misión.
DeSC: enfermedad por el virus de ébola, saneamiento en desastres, emergencias en desastres, asistencia internacional en desastres, educación médica.
Editorial Note
The participation of Cuban health professionals in the global campaign against ebola was an unprecedented event in the history of humanity, in the history of Cuba, and in particular in the history of Cuban medicine that demands to be studied, researched and divulged. Their contributions and experiences should be introduced in undergraduate and postgraduate study programs not only because of the historical aspects, but also because of their impact in the medical sciences and because it is a serious health problem that is far from being solved, so outbreaks of the deadly disease are possible, since the conditions that originated it remain intact. From volumen 9, No. 2 on, EDUMECENTRO journal has published a group of articles under the title: Epidemic of Ebola in Africa: Cuban medical experience in this international health emergency, authored by Dr. Rafael Rufino Corona Perez, member of the "Henry Reeve" International Specialized Contingent in Disaster Situations and Severe Epidemics and professor of Villa Clara University of Medical Sciences, who writes his experiences as vivid testimony of what happened in those months, where the intellect, perseverance, courage and struggle for life prevailed facing the health disaster and were proclaimed victorious. In these research paper has been respected the writing in first person by the psychological implication of the facts that are narrated in the personality of the mentioned doctor.
Nota editorial
La participación de los profesionales cubanos de la salud en la campaña mundial contra el ébola representó un hecho sin precedentes en la historia de la humanidad, en la historia de Cuba y, en particular, en la historia de la medicina cubana que demanda ser investigada y divulgada. Sus aportes y experiencias deben ser introducidos en los programas de estudio de pregrado y posgrado no solo por los aspectos históricos, sino por su impacto en las ciencias médicas y por ser un grave problema de salud que dista mucho de estar resuelto. Las condiciones que originaron la enfermedad permanecen intactas. A partir del volumen 9, No. 2 de 2017, la revista EDUMECENTRO publica un grupo de artículos bajo el título: Epidemia de ébola en África: experiencia médica cubana en esta emergencia sanitaria internacional, cuyo autor principal es el Dr. Rafael Rufino Corona Pérez, integrante del Contingente Internacional Especializado en Situaciones de Desastres y Graves Epidemias "Henry Reeve" y profesor de la Universidad de Ciencias Médicas de Villa Clara, quien redacta sus experiencias como testimonios vívidos de lo acontecido en esos meses, donde el intelecto, la perseverancia, la valentía y la lucha por la vida se impusieron ante el desastre sanitario y se proclamaron victoriosos. En estas comunicaciones se ha respetado la redacción en primera persona por la implicación psicológica de los hechos que se narran en la personalidad del mencionado doctor.
The "Henry Reeve" Brigade in Sierra Leone: obstacles, opportunities and decision to win
Since October, we faced a difficult situation with the payment to hotels for the US blockade that did not allow bank transactions in dollars. This aroused hopes in the enemy to affect our unity and create difficulties with the owners of the hotels, so it was decided to pay in Leones (official currency of Sierra Leone) and lose a large sum of money in the change. When debating among the collaborators about our stay in the hotels and the payment of the stipend, the answer was unanimous: _"here we will stay because we did not come to make money"; and again our national anthem was heard. The figure shows the decision to overcome any obstacle that interfered in the fulfillment of the mission.
On December 14, the Cubadebate website in its section "Bloqueo contra Cuba", published an interview with the representative of the Pan-American Health Organization (PAHO) and the World Health Organization (WHO), José Luis Di Fabio, who manifested:
"The fact that they are Cuban has greatly limited the transfer of funds and payment". And he says that Cuba became the first country to send human resources to Africa under the instructions of the WHO, but the US blockade is making it difficult for Cuban doctors to get the money. "Cubans receive about $ 250 a day in travel expenses - the WHO estimates that 60% is for lodging and the rest for food -and for the banking process a license had to be requested from the US Treasury Department".
"We have a situation that is not normal, which does not allow a thorough planning because there is an epidemic situation of high mortality. Cuba's response was immediate. The logical thing is that the facilities where to work had already been ready". Concludes Di Fabio.
The liberation of the Cuban Five and the announcement of the beginning of diplomatic relations with the United States turned out to be the fourth occasion when hotels shuddered with the chords of our national anthem; we all felt that we had collaborated in the change of policy of this government towards Cuba. From that moment on the difficulties with the payment to the hotels ended, an account was created in the Standard Chartered Bank and funds were extracted weekly.
Once the groups were relocated by work areas, the mixed cores of the party in each brigade were organized. The political and party work began when the advance party arrived in cooperation with the political structure of the Permanent Medical Brigade, focusing first on the reception of the collaborators and then on strengthening the unity, discipline and security of the personnel supporting the leadership under the principle of single command.1
In December, Mr. Antonio Pubillones Izaguirre was appointed business manager in Sierra Leone, subordinated to the Cuban embassy in Ghana, which expanded our relations with that country, through its diplomatic corps and international organizations that faced the epidemic.
After more than two months of work, journalist Ricardo González from Vanguardia newspaper in Villa Clara interviewed me several times. Due to its enlightening content and lived experiences, some aspects published on December 6, 2014 are included, on the occasion of the celebration of Latin American Medicine Day, the 3rd of that month.
What are the most important details of the cooperators in their work and control of Ebola?
The most complex issue is to dress in the protective suit for 15 minutes on average; the time depends on the skill acquired. The most important thing is to complete the steps under supervision. Undressing is dangerous, requires an order of disinfection, bathing and change of clothes. The rotations in red zones are every six hours. Every 60 minutes they are relieved and the outgoing staff rests two hours.
Do you continue to receive information and training on Ebola?
We receive training and a lot of information and epidemiologists ensure the safety of employees and respond to control measures according to biosafety regulations. WHO experts train, evaluate and certify each collaborator for work in the red zones and train them systematically.
Professor, a message for the medical relay in the fight against Ebola.
With almost three months in Sierra Leone facing the disease, studying the country and preparing the staff, I can assure that the success is in the organization of work, control and conscious discipline based on a strong ideological preparation to fulfill the mission of our homeland that a great recognition has attained in the world
A message for those who aspire to study Medicine.
As a Consultant Professor of higher education I believe that we must perfect the scientific training of the aspirants, with a solid preparation in physics, chemistry, mathematics and basic sciences and have as a requisite to advance and finish the career and specialty, the proficiency of the English language. Being a doctor requires characteristics and personal gifts on which to form very special political and human convictions, so we have to revolutionize educational methods and achieve the integration of political and mass organizations in professional training.
How the "Henry Reeve" Brigade welcomed the news of the release of the Cuban 5?
The news surprised us; in all the locations and hospitals the collaborators met and we sang the national anthem, the main leaders spoke, poems were recited and cheers were given to the Cuban Five , the Revolution, our leaders and the Communist Party of Cuba. Those were very exciting moments that led to a greater commitment to fulfilling the mission.
Gerardo Hernández described your work as that of true heroes, what is your assessment?
From Gerardo's letter I was impressed by this paragraph: "Now, with that extraordinary lesson of heroism that you are giving to the world, we feel even more proud, and words are not enough to express how much they strengthen us with their example. You are our heroes today". What can I say when the recognition comes from their example of altruism and patriotism! He and his four brothers are a symbol of the immensity of our people, but I do not think we deserve that condition. It is true that courage and other qualities are needed, but it is also an ethical condition for the professional to save lives under any circumstance.
In December, the Cuban Health Ministry Management Center for the fight against Ebola was integrated, which greatly strengthened the brigade with guidelines and regulations, and allowed the request of medicines and resources in accordance with the consumption and particular needs.
The coordinated management of the Central State Administration Agencies involved in the campaign against Ebola through the Cuban Health Ministry Management Center brought new and very positive experiences in the integration of forces to face contingencies that should be applied as a principle, not only in the direction of the defense and in the confrontation to disasters, but in the daily activity to achieve a true intrasectoriality and intersectoriality in the solution of health problems.
In January, a focal point was created between the brigade and the WHO, which facilitated communication with their agencies for their professionalism; the use of the English language was a barrier in communication due to our Latin origin. We remember Richard Díaz, Rodrigo Monroy and Mauricio Calderón with great respect for their friendly relationship and tireless support to the brigade.
The reception and preparation of the personnel required a great effort for the setbacks and the peculiarities of the mission, of a global nature, which demanded working relationships with international institutions and agencies, and imposed a new type of cooperation due to its magnitude and scope; but our willingness and preparedness to face the abrupt changes of the situation, including the possibility of getting sick and even dying was higher; That is why, counting on the recognition and support of our people and its leadership, we never hesitate to achieve the fulfillment of the mission that humanity entrusted to the Cubans.
Declaration of interests
The author declares no conflict of interest.
BIBLIOGRAPHICAL REFERENCES
1. Ubieta Gómez E. Zona Roja. La experiencia cubana del ébola. La Habana: Ediciones Abril; 2016.
Submitted: January 25 2018.
Accepted: February 26 2018.
Rafael Rufino Corona Pérez. Villa Clara University of Medical Sciences. Cuba. E-
mail: rafaelcorona@infomed.sld.cu
Copyright (c) 2018 EDUMECENTRO
