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Decades ago Cuba made training and exporting medical personnel their "thing" and they ended up owning that part of the world market despite being a small and ve

by VLM 12y ago

Decades ago Cuba made training and exporting medical personnel their "thing" and they ended up owning that part of the world market despite being a small and very poor country. There is a direct tech analogy with Finland and cell phones. From the small country PoV, if you can't compete in the strategic nuclear bomber world market, or the manufacturing robot world market, you can probably find some market segment, however small, to focus on and take over. Like cellphones, or 3rd world medical care. Other countries could, and probably will, do the same. There is the interesting analogy that Finland isn't doing so well in the post Nokia, iphone and android world. Wonder what could happen to Cuba if the demand for docs dried up (optimistically due to 3rd world advancing into training their own medical workers, and not by the entire 3rd world dying of ebola or in ensuing strife after the epidemic)

will_brown 12y ago
Cuba's healthcare niche is not necessarily limited to 3rd world medical care. Throughout the US/Cuba embargo the US had routinely carved out an exception to trade for Cuba's cancer/anti-cancer medications which have been viewed as cutting edge for over a decade. So perhaps another niche 1st world cancer research and treatments.
- toomuchtodo 12y ago
  I'm both astounded and shamed as a US citizen that we enact broad trade sanctions against Cuba today while happily creating exceptions for anti-cancer drugs.
  - will_brown 12y ago
    Yea, living in Miami, I see how the embargo negatively impacts people on a daily basis. That said the Cuban ex-pats I know are split on the issue - and fiercely - with half die hard supporters of the embargo and half opposed. As long as the embargo is in place, I prefer we bring in Cuban drugs at least for clinical trials, but I don't think US is happy to create exceptions and it is probably embarrassing a tiny island nation which the US has lead a economic crusade against for nearly 50 years produces any cancer drugs superior to those produced in the US.
Retric 12y ago
What I thought was most interesting in the Cuba case was how little technology it takes to train Doctors. Outside of surgery Doctors tend to have other people doing the high tech hands on work like operating an MRI or Doing blood-work. But, as they training people to operate in the 3rd world even surgery tends to be fairly low tech. In reality it's the opportunity costs that makes training doctors so expensive. So, in many ways less developed nations have a huge cost advantage when supplying doctors. The real issue is after exporting them they probably don't send all that much money back home.
- guard-of-terra 12y ago
  The real issue is that developed countries refuse to import doctors. Developed countries have medical doctors associations which keep a close eye on who can become doctor and how, thus limiting the number of doctors in the country and sustaining their high wages. From what I've heard, you have to get an expensive education and then live thru a long and undercompensated and exhausting internship in order to become a full doctor and get all the perks. Any immigrant will also have to face that kind of internship (not easy for someone without a source of income) plus they have to re-learn a lot of things in order to pass the certification. I might be fuzzy on the details, but still: we're lucky in our IT, we have comparative small amount of bullshit and entrenching.
  - maxerickson 12y ago
    It's just the opposite: http://www.ft.com/cms/s/0/9647519c-207a-11e3-b8c6-00144feab7de.html#axzz3FNWxlNtQ http://www.ft.com/cms/s/0/9647519c-207a-11e3-b8c6-00144feab7... Doctors tend to leave undeveloped countries for developed countries.
    - guard-of-terra 12y ago
      It's behind paywall.
      - maxerickson 12y ago
calibraxis 12y ago
Any rich country could replicate Cuba's efforts, but they don't want to. (That is, not sufficiently to actually get it done.) In contrast, some seem to have no problem exporting anti-doctors — uniformed killers and drones. And all that from an island despite US's decades-long embargo and forcing the criminal Guantanamo Bay prison on them.
kaonashi 12y ago
I also find it interesting that this option would not be available to Cuba if it were more integrated economically with the rest of the world. The first thing the IMF would force them to get rid of would be high-end public education programs, or at least put them out of reach economically for a large portion of the population.
- marcosdumay 12y ago
  The IMF can only "force" countries to do things if those countries want to lend money from them. And even then, a country can lie with impunity in a round - unless it wants repeating lending rounds, and lies in important and bad ways. Also, I've never hear about the IMF forcing a country to dismantle its public-education programs. When Brazil was on their hook they did anything but that, and in the later years IMF helped improving it.
  - kaonashi 12y ago
    That seems to have been the general result any time a structural adjustment (or the rebranded, poverty-reduction) program was implemented.
    - randomafrican 12y ago
      Quite often the IMF is an easy scapegoat. You'd be surprised by how often the IMF advice is ignored or by how sound it can be at times. For instance, in Ukraine a few years ago, the IMF's advice was to cut down on some structural expenses (gas subsidies mostly) and not to touch investment expenses as doing that would trigger a recession. For political reasons IMF did the opposite.
      - kaonashi 12y ago
        What it usually is is political cover for local elites to betray their populations; remove barriers to capital flow and trade, gut environmental and labor protections.
masklinn 12y ago
> Decades ago Cuba made training and exporting medical personnel their "thing" and they ended up owning that part of the world market despite being a small and very poor country. Not just medical personnel, in the 60s they were one of the biggest provider of trained personnel in general in the newly independent congo (before being forced out as Zaïrisation ramped up) to both staff the country and provide training (Belgium had avoided/refused to establish a local elite, so when they hightailed the newly independent Congo had no administrators, no teachers, no doctors, …)
atourgates 12y ago
I was just discussing this the other day with one of my friends. We both grew up in the Seventh-Day Adventist church, a church that has made "medical evangelism" a big part of its strategy. The discussion was brought about by seeing an Adventist doctor we'd eaten dinner with a few months ago in California, being interviewed on CNN from a hospital in Liberia where she was caring for Ebola patients. I have grandparents, aunts and uncles who were all trained at Adventist medical institutions, and spent time working at hospitals in 3rd world countries. The Adventist church has its own medical school, as well as a health system (though neither is directly operated by the church). I took a "student missions" year out of college (somewhat like Mormon mission years, only typically more a religiously-driven piece-corps-type year of teaching, medical assistance etc. than direct-evangelism) and spent it in Belize volunteering at a hospital. 3 of the hospital's 5 physicians were Cubans, and I learned first-hand that Cuba and the Adventist church have remarkably similar strategies when it comes to training doctors, and using them as a PR tool. In both cases it seems to be quite effective. In Belize, many people I met thought highly of Cuba, because their most direct interaction was through the doctors they sent. Even here in the states, when the Adventist church is mentioned I'll often hear, "Oh, I think my Doctor is one of those."
deleted 12y ago
[deleted]

by VLM 12y ago

will_brown 12y ago

Cuba's healthcare niche is not necessarily limited to 3rd world medical care. Throughout the US/Cuba embargo the US had routinely carved out an exception to trade for Cuba's cancer/anti-cancer medications which have been viewed as cutting edge for over a decade. So perhaps another niche 1st world cancer research and treatments.

toomuchtodo 12y ago
I'm both astounded and shamed as a US citizen that we enact broad trade sanctions against Cuba today while happily creating exceptions for anti-cancer drugs.
- will_brown 12y ago
  Yea, living in Miami, I see how the embargo negatively impacts people on a daily basis. That said the Cuban ex-pats I know are split on the issue - and fiercely - with half die hard supporters of the embargo and half opposed. As long as the embargo is in place, I prefer we bring in Cuban drugs at least for clinical trials, but I don't think US is happy to create exceptions and it is probably embarrassing a tiny island nation which the US has lead a economic crusade against for nearly 50 years produces any cancer drugs superior to those produced in the US.

Retric 12y ago

What I thought was most interesting in the Cuba case was how little technology it takes to train Doctors. Outside of surgery Doctors tend to have other people doing the high tech hands on work like operating an MRI or Doing blood-work. But, as they training people to operate in the 3rd world even surgery tends to be fairly low tech. In reality it's the opportunity costs that makes training doctors so expensive. So, in many ways less developed nations have a huge cost advantage when supplying doctors. The real issue is after exporting them they probably don't send all that much money back home.

guard-of-terra 12y ago
The real issue is that developed countries refuse to import doctors. Developed countries have medical doctors associations which keep a close eye on who can become doctor and how, thus limiting the number of doctors in the country and sustaining their high wages. From what I've heard, you have to get an expensive education and then live thru a long and undercompensated and exhausting internship in order to become a full doctor and get all the perks. Any immigrant will also have to face that kind of internship (not easy for someone without a source of income) plus they have to re-learn a lot of things in order to pass the certification. I might be fuzzy on the details, but still: we're lucky in our IT, we have comparative small amount of bullshit and entrenching.
- maxerickson 12y ago
  It's just the opposite: http://www.ft.com/cms/s/0/9647519c-207a-11e3-b8c6-00144feab7de.html#axzz3FNWxlNtQ http://www.ft.com/cms/s/0/9647519c-207a-11e3-b8c6-00144feab7... Doctors tend to leave undeveloped countries for developed countries.
  - guard-of-terra 12y ago
    It's behind paywall.
    - maxerickson 12y ago

calibraxis 12y ago

Any rich country could replicate Cuba's efforts, but they don't want to. (That is, not sufficiently to actually get it done.) In contrast, some seem to have no problem exporting anti-doctors — uniformed killers and drones. And all that from an island despite US's decades-long embargo and forcing the criminal Guantanamo Bay prison on them.

kaonashi 12y ago

I also find it interesting that this option would not be available to Cuba if it were more integrated economically with the rest of the world. The first thing the IMF would force them to get rid of would be high-end public education programs, or at least put them out of reach economically for a large portion of the population.

marcosdumay 12y ago
The IMF can only "force" countries to do things if those countries want to lend money from them. And even then, a country can lie with impunity in a round - unless it wants repeating lending rounds, and lies in important and bad ways. Also, I've never hear about the IMF forcing a country to dismantle its public-education programs. When Brazil was on their hook they did anything but that, and in the later years IMF helped improving it.
- kaonashi 12y ago
  That seems to have been the general result any time a structural adjustment (or the rebranded, poverty-reduction) program was implemented.
  - randomafrican 12y ago
    Quite often the IMF is an easy scapegoat. You'd be surprised by how often the IMF advice is ignored or by how sound it can be at times. For instance, in Ukraine a few years ago, the IMF's advice was to cut down on some structural expenses (gas subsidies mostly) and not to touch investment expenses as doing that would trigger a recession. For political reasons IMF did the opposite.
    - kaonashi 12y ago
      What it usually is is political cover for local elites to betray their populations; remove barriers to capital flow and trade, gut environmental and labor protections.

masklinn 12y ago

> Decades ago Cuba made training and exporting medical personnel their "thing" and they ended up owning that part of the world market despite being a small and very poor country. Not just medical personnel, in the 60s they were one of the biggest provider of trained personnel in general in the newly independent congo (before being forced out as Zaïrisation ramped up) to both staff the country and provide training (Belgium had avoided/refused to establish a local elite, so when they hightailed the newly independent Congo had no administrators, no teachers, no doctors, …)

atourgates 12y ago

I was just discussing this the other day with one of my friends. We both grew up in the Seventh-Day Adventist church, a church that has made "medical evangelism" a big part of its strategy. The discussion was brought about by seeing an Adventist doctor we'd eaten dinner with a few months ago in California, being interviewed on CNN from a hospital in Liberia where she was caring for Ebola patients. I have grandparents, aunts and uncles who were all trained at Adventist medical institutions, and spent time working at hospitals in 3rd world countries. The Adventist church has its own medical school, as well as a health system (though neither is directly operated by the church). I took a "student missions" year out of college (somewhat like Mormon mission years, only typically more a religiously-driven piece-corps-type year of teaching, medical assistance etc. than direct-evangelism) and spent it in Belize volunteering at a hospital. 3 of the hospital's 5 physicians were Cubans, and I learned first-hand that Cuba and the Adventist church have remarkably similar strategies when it comes to training doctors, and using them as a PR tool. In both cases it seems to be quite effective. In Belize, many people I met thought highly of Cuba, because their most direct interaction was through the doctors they sent. Even here in the states, when the Adventist church is mentioned I'll often hear, "Oh, I think my Doctor is one of those."

deleted 12y ago

[deleted]