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Why is Canada Refusing Cuban Doctors?

Photograph Source: Jernej Furman – CC BY 2.0

We all have this feeling right now. Fear, sometimes verging on terror, and the main strategy to stay human is to never panic. Still, there is a lot of reason to be greatly afraid. Covid-19 has passed into every country, and most people on earth are on some variant of lockdown. The psychology of it is immense. There is an invisible enemy, somewhere out there, and it is threatening immediately our families and loved ones, and it has removed all outdoor life, socialization, schooling, etc.

We have to take care and hope as individuals that living our lives alone prevents us from harming anyone else. This fear– not of getting sick, but of making others ill– is worse for those of us living with weaker people. The elderly, the frail, those who have blood conditions, have weakened immunity from a million other reasons. Or maybe you just live in an industrialized city and your lungs won’t be able to survive a respiratory infection that leaves massive scarring tissue on those that recover? Young people who have no underlying conditions at all have been dying as well, though in smaller numbers.

Those are the immediate fears, but there is a reason our societies are in near total lockdown beyond their concern for elderly people and the weakened. When the equipment in a hospital runs out, the death rate from these infections jumps many fold. Roughly speaking, if you get Covid-19 and need to go into a hospital, you will need a ventilator to survive. If they are there, such a patient has a roughly 90% survival rate. If there are no ventilators, the number drops below 50%.

If there are not enough ventilators? Then the doctors have to play Mengele, deciding who lives and who dies. My mother is 79 years old with COPD and dementia, so she will be told to go and die alone in the hallway, without an explanation. To choke to death on her own aspirations of lung tissue, blood and other fluids that drown you to death inside your own lungs, while sitting on the floor and being denied to see anyone. I have kept her home living with dementia for years now, precisely because I didn’t want her to die alone feeling uncared for.

And while she’s dying in terror in that hallway? Doctors and nurses around her will try and perhaps fail to prevent themselves from getting sick as well, because we have already collectively failed to protect our health workers from the same massive shortages, forcing them to try and survive using garbage bags and twist ties, or to recycle items that are only manufactured for one use.

These shortages are everywhere. In the US they are the worst infected country in the world, and given it’s a virus, this will inevitably mean a massively larger outbreak in Canada as well. The question is when, not if, and whether it can be kept to a manageable level, rather than prevented. As of April 3?

“Canada has signed an agreement with Amazon Canada to ship medical supplies—surgical masks, face shields, gowns, ventilators, test kits—to provinces and territories, Prime Minister Justin Trudeau said on Friday, to help fight the novel coronavirus (COVID-19).

If the pandemic continues to strain Canada’s healthcare system, medicare workers will suffer from a dearth of medical equipment, so the country has been working to urgently attain supplies, Trudeau said.

On this same theme, Ontario has completely missed carrying out tests, making information on the exact spread of coronavirus unavailable, and thus mitigation efforts are blindfolded swings at a piñata:

“As of Wednesday, Ontario had tested 4,188 per million residents, less than every Canadian province except New Brunswick and Prince Edward Island, which have far fewer cases. Alberta had tested 11,139 per million, and Quebec 8,216 per million.

The provincial public health agency’s labs were heavily dependent on one company’s system to extract RNA, the virus’ genetic material, the agency told Reuters.

Ontario has further data released as well:

According to the province, there are currently 410 available ICU beds in Ontario for COVID-19 patients, in addition to the beds that are currently filled with patients. Anderson said that put the province’s capacity at 70 per cent.

But, he said, the province is also planning to add 900 additional ICU beds for COVID-19 patients in the coming weeks.

With those additional beds in place, a “best case” scenario would keep the numbers in ICUs from maxing out the available beds, according to the province’s projections.

But in a “worst case” scenario, the numbers of people who would need beds would severely exceed what’s available. That could happen if people don’t practice physical distancing, Anderson said.

“It would push beyond the capacity we can bring,” he said.

This is not a provincial problem, but a national one listed by province. For example, in British Columbia, where the nightmare scenario of (elderly) care home infections has been the main story thus far:

“Over 40 nurses from across the Lower Mainland have said they are willing to provide extra help at North Vancouver’s Lynn Valley Care Centre, which has been the centre of a coronavirus outbreak.

But those volunteers come with conditions – that all nurses working in the long-term care facility have access to specialized N95 masks.”

BC has already resorted to getting retired physicians and nurses to come out of retirement for the massive needs projected. Even more important for this disease than equipment is the medical staff themselves:

“VANCOUVER — British Columbia’s call for recently retired doctors to return to work if the COVID-19 pandemic worsens is spurring other provinces to make similar emergency preparations, says the registrar of the College of Physicians and Surgeons of British Columbia.

Dr. Heidi Oetter said the college has emailed hundreds of physicians who left the job within the last two years to reregister for their licences, adding those with experience working in emergency rooms and intensive care units would be most needed.”

And in Alberta, where modeling has only just begun, despite being the province with the largest workforce misleadingly named “essential” still being exempted from social distancing orders (along with massive industrial projects in BC being likewise exempted, as is construction in Ontario):

“As fears of COVID-19 overwhelming health-care resources grow, medical authorities are to begin recruiting retired doctors and nurses.

The Alberta College of Physicians and Surgeons said it expects to email letters to doctors on a list of almost 300 recently retired practitioners this week.

“We’re working with Alberta Health Services to get a better idea of what their needs are,” said spokeswoman Jessica McPhee.

We’re just putting the finishing touches on this letter and it’ll be going out on Wednesday.

In Québec, researchers at McGill University have done studies into the short staffing situation. The title of this recently released study is plain enough:

COVID-19 and labour constraints: Recalling former health care workers not enough.”

But the details of this issue are summed up thus:

“The researchers note that one response has been to encourage former nurses and health care workers to return from retirement and other jobs. However, the reserve pool of potential health care workers is relatively small after accounting for the risks they face. The researchers estimate that if every one-time nurse not currently in nursing was recalled, this would increase the number of nurses by 27%. More broadly in health care, the potential pool could add up to 40% more workers. Nevertheless, two-thirds of these are either in a high-risk group or live in a household with a member from a high-risk group.

In Manitoba, doctors and nurses have been screaming about lack of capacity for almost a full month as of today. The shortage is set, if numbers of infections ultimately get to a similar percentage of the population as the rest of the country. Back in early March, the Manitoba Association of Health Care Professionals was already being about as blunt and clear as possible:

“We’re going to struggle with anything more than a few people coming in that need to be cared for,” said Bob Moroz, MAHCP president, adding the healthcare unions have been crying out about system capacity issues long before the outbreak.

There’s just not enough of us now to manage the normal flu season. Our folks have been stretched to the max already, doing more with less.

Manitoba has 85 ICU beds between the HSC, Grace, St. Boniface and Brandon. Respiratory therapists work and are integral to all of them, according to Moroz, but at HSC, burnout and stress rates are highest.”

This scenario is also seen by the Manitoba Nurses Union.

“We are generally at capacity in our critical care areas on an everyday basis already,” Manitoba Nurses Union President Darlene Jackson said. “If we have to move into over-capacity beds that also means we are going to need more staff.

The very existence of Canada as it currently is perhaps owes a large part of that to prior transmissions of communicable virus pandemics, notably small pox wiping out entire communities of dozens of First Nations across what would later be called Canada. The infectious rate for small pox was roughly R3, or three people get infected for every one person who has the disease. This Coronavirus is still being understood, but it stands to be at this level or higher based on humanity’s first few months dealing with Covid-19. In a setting of mutual aid, overlapping families and constant interaction in a Canadian Reserve setting, having ANY Covid-19 cases is a clear recipe for disaster.

Seeing this in motion, multiple Chiefs working in the Southern Chiefs Organization of Manitoba First Nations had a remarkable and very workable step to try and mitigate such a disaster. They opted to call upon the solidarity work of Cuban doctors, doctors who have worked in pandemics like Ebola, SARS and have worked in disaster relief from hurricanes in the rest of the Caribbean to relief from earthquakes, treating HIV patients, helping children from Chernobyl recover and far, far more.

In recent days, Italy– who have politically been working alongside the US, voting against Cuba at the UN for decades– have been recipients of Cuban internationalist doctors who, despite Cuban-Italian relations for decades, have offered their humanitarian best, knowing that many Cuban doctors will die horrible deaths far from home.

“We are all afraid, but we have a revolutionary duty to fulfill, so we take out fear and put it to one side,” Leonardo Fernandez, 68, an intensive care specialist, told Reuters late on Saturday, shortly before his team’s departure.

He who says he is not afraid is a superhero, but we are not superheroes, we are revolutionary doctors.”

The idea has gone way beyond talk for the sake of hearing words in the air. The Chiefs have specific rationale for asking for such help from the Cuban program.

“First Nations need the imported health care heft to shore up their front-lines in the face of COVID-19, said Daniels. First Nations are already grappling with limited pre-existing health resources that are being strained by the unfolding pandemic, he said.

“We see the writing on the wall. We are going to have a service shortage and we don’t want doctors deciding who is going to live or die,” said Daniels.

“We want to get ahead of it, to have the amount of resources available [so] in the event that occurs, or we get close to something like that, we have done everything we could to try to mitigate that and save the lives of our people.

The province of Manitoba has all of its eggs in the Winnipegian basket. First Nations, even in the south of the province, need several things. To remain isolated. To be able to diagnose and treat possible infections without exposing people. Finding ways to deal with things on reserve is crucial to avoid the historical repeat of small pox infections. Having doctors whose entire mission is to stay with the community to prevent breakouts and treat and track them quickly when someone inevitably gets sick is by far the best response for Chiefs who are trying to make the best decisions to protect their people. This is not off-the-cuff, either. It’s been in the works for awhile, but obviously needs to move faster given the prevailing situation:

“Had we been in charge on this from the get go, the systemic barriers we see in Manitoba would have been addressed long before this sort of scenario ever came into effect… We could have been ready for this and we weren’t.”

Daniels went with a delegation of First Nations leaders and health technicians from Manitoba to Cuba at the end of February to discuss developing a health care partnership with the Caribbean island country. Under the partnership, Cuban doctors would go north to provide care and potential Indigenous health care workers would go south for training.”

Outside of the United States, country after country is putting aside politics in this current moment, to deal with the needs of the people over and above historical party allegiances or nationalist prides. Saving individual human lives and protecting as much of humanity from an unprecedented wave of suffering has become more important than anything else. Many European countries have been openly declaring their intent to defy sanctions on Iran to act in humanitarian fashion. China was a recipient of Canadian supply help two months ago, Canada is receiving Chinese state help as we speak.

Unlike the United States, Canada has never officially joined their obsession with destroying Cuba’s government. Canada is supposed to be on good terms with Cuba. So what does former Foreign Minister and current Deputy PM Chrystia Freeland have to say about the already arranged deal between Manitoba Southern First Nations and the Cuban People?

“Freeland said Canada has enough medical resources to deal with the COVID-19 pandemic without international help.

Canada’s health care system, which is staffed by outstanding health care professionals, has the capacity to deal with this extraordinary challenge,” said Freeland, during the daily federal government news conference on the country’s pandemic response.

“Our job as a government is to work very hard to provide our health care system with all the resources it needs to help all Canadians — Indigenous and non-Indigenous.”

There is not a single iota of doubt– not a little tiny bit– that this is a straight up lie, and a lie that has the likely consequence of mass death among the elders of Southern Manitoba First Nations. There is not one single report anywhere– not one, and Freeland is educated enough to know this– that suggests that this is true. Freeland is playing the same game we see with White House Press Briefings, pretending there are ventilators that are not there, that the resources are fine, that there are enough doctors, that enough is done to take the burden off the health system.

These lies will kill people.

This is not just a reprehensible attack on indigenous peoples. What this horrible lie is all about is also making certain that indigenous people have to move into cities if they get sick. They will be a long way from treatment centres. The outbreaks that inevitably happen will happen at a much, much higher rate because Cuban doctors are trained to contain and track transmissions. That is their specialty.

But let’s say you are unconcerned with the plight of first nations in southern Manitoba. Where do you think they will go when they get infected? The big cities. Winnipeg first, but not only. Such reductions of spread provided by the free, solidarity work of Cuban doctors—who have treated me once years ago, and my mother once several years later, so my bias comes from personal experience– inevitably reduce the strain on the rest of the province, the country and more. If Canada can “flatten the curve,” won’t many medical professionals want to volunteer in other countries as well?

This is a global problem and we must pool global resources. And Canada is, like everyone in the world, woefully unprepared. Being less chaotic than the US is not sufficient, this is a human pandemic. The Cuban government has already saved countless lives the entire world over. They are in Iran, Italy, Spain, Jamaica, Surinam, Venezuela, and multiple locations throughout Africa.

Canada must immediately stop lying about capacity that all health professionals state very clearly without caveat is not there. We do not have enough doctors, equipment, nurses or ventilators. We have none of the interferon alpha 2B drug, called a wonder drug by Harvard researchers, but blocked in the US by sanctions:

“The drug, called Interferon Alpha-2B Recombinant (IFNrec), is jointly developed by scientists from Cuba and China, where the coronavirus COVID-19 disease outbreak first emerged late last year. [….]

Cuba first used advanced interferon techniques to treat dengue fever in the 1980s and later found success in using it to combat HIV, human papillomavirus, Hepatitis B, Hepatitis C and other diseases. The use of Interferon Alpha-2B Recombinant “prevents aggravation and complications in patients reaching that stage that ultimately can result in death,” Cuban biotech expert Luis Herrera Martinez said, according to a recent Yale University Press Blog feature written by the University of Glasgow’s Helen Yaffe. She called the treatment a potential “wonder drug” against the new coronavirus.

Canada is concerned that allowing Cuba is would provide Cuba with “free propaganda” due to their work. But here’s the thing: When you win a medal, you should get pictures on the podium. When you discover a cure for disease, tyou should get recognized by other scientists around the world, and when your doctors have both drugs and treatment, and an “army of white coats” willing to work in the most dangerous places in the world, you should be called heroes.

Playing politics with Cuba now, because of Miami based threats, is tantamount to betraying humanity, but more importantly it’s a calculated attack on the indigenous populations of Canada. Their lives & ours, all Canadians, and ultimately all humans, are worth more than Freelands fear that Cuba will look good.

Cuba already looks good. There are more than 3 major politicians in the world who are obsessed with destroying Latin American socialism. But for this, let’s speak of three. Donald Trump has openly allowed his country to be ravaged to a level that is still beyond comprehension, even though we all know its happening. Trump is beyond the capacity of human emotion, or empathy. Despite many, many years of following politics closely and being disappointed most of those days in what I see, the last two weeks has caused a level of rage, fear and anger from listening to the statements coming from DC I have not known before.

That fear is real. The biggest nursing home outbreaks have been mere miles from here, on the other side of the 49th parallel. 600 care homes have been infected in Canada. 600 of them. Viruses don’t carry tiny passports. The president of Brazil has been blocked off twitter for making statements that would increase the destruction of public health. His determination to “put Brazil back to work” is leading to a massive human catastrophe. The level of damage being done to the poor and the sick by misleaders like Trump and Bolso is years from being quantifiable, but it will be enough dead to start an entirely new country or two.

The wholesale failure to prevent about 80-90% of the coming deaths should all fall on the head of the US administration, and the same goes in Canada where jurisdictions are deliberately avoiding doing what must be done. There is no excuse for operating major sites like Site C, CGL pipeline construction, major building across Ontario, any and all industrial work in Alberta (to mine tar sands that are now less valuable than their subsidy, every barrel of mock-oil dug up currently is spreading viruses, as well as losing public money during the worst financial crises since 1929). But the even greater crimes are using this major outbreak to play politics, and force suffering on people.

Canada has allowed the death of enough elders already. Canada has historically wiped out enough First Nations due to pandemics already. Canada has followed along with US berating of the Cuban people enough already. Chrystia Freeland has done enough to promote unneeded deaths already.

Treating Covid-19 is not something to do as a means of blackmailing an entire population. No, Canada, First Nations don’t need to die so you can play international liars on behalf of the Empire that has brought us all on every corner of the globe to the brink of catastrophe. Now is the time to put that away, and work with all who come in the spirit of cooperation and the commonality of humanity.

Those leaders– Trump, Bolsonaro, Freeland, Trudeau and others– sadly, too many to count– who stop mitigation efforts are criminals. When they block nations from giving solidarity to the poorest, and act in manners that allow massive transmissions of Covid-19, including leading to death? I quote Doug Ford, far right wing premier of Ontario:

“The hard truth is right now, today, there’s very little separating what we will face here in Ontario from the devastation we’ve seen in Italy and Spain.

Canada must stop playing games and political manoeuvres as if they somehow are more important than preventing the wholesale destruction of First Nations communities. Issue an immediate visa to any and all Cuban doctors who pledge to work inside various reserves and communities, preventing and tracking Covid-19 infections from being modern day small pox.

If Freeland, or Trudeau, or anyone else continues to lie and tell us the materials are right there, and that we already have enough doctors, nurses, ventilators and masks, we should be prepared to send them where they belong: The Hague in Brussels. Cuba is not the enemy, Covid-19 is. First Nations seeking health care are not the enemy, government officials blocking that same health care are.

If you are in distress and I stand in front of the ambulance long enough for you to die waiting for it, I should be charged with causing your death. If I use police forces or any bodies of armed men to do this exact same thing to entire peoples, I should stand trial as an international criminal. Because lies to the people about their medical care right now, combined with denying it to them, is the highest form of criminal act there is.

Bring Southern First Nations in Manitoba (and elsewhere) the “Army of white coats”–now.

Macdonald Stainsby is an anti-tar sands and social justice activist, freelance writer and professional hitchhiker looking for a ride to the better world, currently based in Vancouver, Canada. He can be reached at mstainsby@resist.ca

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