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Vol. 81/No. 45      December 4, 2017


Cuban doctor: Why we went to West Africa to fight Ebola

Below is an interview with Dr. Enmanuel Vigil Fonseca, 34, one of the participants from Cuba at the 19th World Festival of Youth and Students held in Sochi, Russia, Oct. 14-22. It was conducted by Róger Calero, a delegate at the festival from the Young Socialists in the U.S.  

Enmanuel Vigil Fonseca was one of 256 Cuban doctors and nurses who went to Sierra Leone, Liberia and Guinea-Conakry to fight the Ebola epidemic from 2014 to 2015.

All were members of the Henry Reeve International Contingent of Doctors Specializing in Disasters and Serious Epidemics, created in 2005 by Fidel Castro. The Cuban leader that year offered to send 1,586 doctors and 36 tons of medical aid and diagnostic resources to help victims of Hurricane Katrina in the United States. Washington refused the offer. Reeve was a Brooklyn-born volunteer in Cuba’s war for independence from Spain, which began in 1868.

Over the last decade the contingent has provided emergency care in 19 countries, twice in Haiti and Chile. The mission in Sierra Leone was Vigil’s seventh. He had also volunteered in Venezuela, Western Sahara, Ecuador, Nepal, Haiti and Peru.

“When we arrived in Sierra Leone, what we found looked like a warehouse, not a hospital,” Vigil said, with bodies lying everywhere. He praised the work of international teams that set up the treatment center from scratch, and the collaboration with medical personnel from Sierra Leone and other countries.

“We found patients vomiting 20 to 30 times a day. They needed to be hydrated, and we began to give them as many IV lines as necessary,” he said. Other medical personnel in Sierra Leone didn’t do that — their instructions were to avoid direct contact with the patients.

“We made the decision to hydrate the patient, and the survival rate began to change,” Vigil said. When the Cuban volunteers got to Sierra Leone, the mortality rate was 80 percent The Cuban’s treatment helped reduce it to 29 percent.

“The first thing we had to do was to break down the barriers between the patient and the doctor,” he told me. “Sierra Leone is a country that had been at war for years. And here you had a white man, with green eyes, covered completely in a body suit, about to stick you with a needle.

“You don’t ask the patient lying down on the floor to get up so you can examine him. You sit down on the floor with him,” Vigil said, describing the humanity and respect with which Cuban doctors and nurses treated each patient. “We asked them what kind of work they did. We asked them about their families.

“They began to recognize us through the face mask and body suit,” Vigil said, “and then you saw a smile on their faces, you saw hope.”

When it became known that the survival rate was higher at the center with the Cuban personnel, many afflicted with Ebola came, asking to be admitted there.

“We were full and told them there were no more beds,” said Vigil. “It doesn’t matter, we want to be with the Cuban doctors,” patients would say. “‘Then come on in,’ we told them.

“To us, those lying on the floor were not sacks of potatoes,” Vigil said. “They were human beings.”

“‘Why are you still here treating me if you know I am going to die?’” one man asked. “I had to tell him, ‘Yes, you are likely to die, But if so, you are going to at least die with dignity!’”

The way Cuban volunteers treated patients was a frequent source of conflict with center administrators, Vigil noted. They said it wasn’t “cost-effective” to use medication and IVs with patients who had very little chance of survival.

“‘It’s a lost cause,’ they would tell us. But we were going to do everything we could, even if they were dying,” Vigil said. “They are human beings! That’s what we are taught in Cuba.”

Every morning at shift change, we would review the discharges, how many had died, and the number of patients, he said. “We referred to the patients by their names. We found it disrespectful to call them ‘Patient 1’ or ‘Bed 1,’ as some did.

“And then we would all join in a prayer — Cuban, American and Sierra Leone personnel, as well as survivors of the disease who stayed in the center to help because they were immune to the disease, believers and nonbelievers,” said Vigil, who added that he’s a Catholic.

There is an outstanding book about the experiences and accomplishments of the Cuban medical brigade in West Africa, Zona Roja: La experiencia cubana del ébola, by Enrique Ubieta, who traveled with them.

“People have asked me why I write about the Cuban doctors,” Ubieta told a meeting in Havana in 2016. “I don’t write about the doctors. I write about the solidarity and internationalism that is at the heart of the revolution. I write about the seeds we are sowing inside and outside of ourselves. Every time a Cuban doctor takes part in a mission abroad, they renew themselves as revolutionaries.”

“One of the biggest accomplishments of the revolution in Cuba is the family doctor system,” Vigil said, the neighborhood-based clinics that provide primary care free and on demand.

Vigil normally works at the Nguyen Van Troi polyclinic in Havana, one of nearly 500 across the island. Together with the family doctor-and-nurses offices, they are the backbone of Cuba’s medical system. Everyone in the neighborhood knows his or her doctor, said Vigil, “the elderly neighbor who brings you a cup of coffee, the mother of a child you cared for, everyone.”

“Haiti was the hardest,” of his other internationalist missions, Vigil said, describing how he witnessed the devastation imperialism has imposed when he was part of a mission there after Hurricane Matthew in 2016.

“They have tried to replicate our system in other countries, but capitalism won’t allow it,” he said.

As Cuban revolutionary Che Guevara said, the only way to be a revolutionary doctor is to make a revolution.
Related articles:
How Cuba’s revolution transformed workers’ lives
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