Monday, May 31, 2010

Israel attacks Gaza aid fleet

Israel attacks Gaza aid fleet


Al Jazeera's report on board the Mavi Marmara before communications were cut

Israeli forces have attacked a flotilla of aid-carrying ships aiming to break the country's siege on Gaza.

At least 19 people were killed and dozens injured when troops intercepted the convoy of ships dubbed the Freedom Flotilla early on Monday, Israeli radio reported.

The flotilla was attacked in international waters, 65km off the Gaza coast.

Avital Leibovich, an Israeli military spokeswoman, confirmed that the attack took place in international waters, saying: "This happened in waters outside of Israeli territory, but we have the right to defend ourselves."

Footage from the flotilla's lead vessel, the Mavi Marmara, showed armed Israeli soldiers boarding the ship and helicopters flying overhead.

Al Jazeera's Jamal Elshayyal, on board the Mavi Marmara, said Israeli troops had used live ammunition during the operation.

LIVE BLOGGING

 Aftermath of Israel's attack on Gaza flotilla

The Israeli military said four soldiers had been wounded and claimed troops opened fire after "demonstrators onboard attacked the IDF Naval personnel with live fire and light weaponry including knives and clubs".

Free Gaza Movement, the organisers of the flotilla, however, said the troops opened fire as soon as they stormed the convoy.

Our correspondent said that a white surrender flag was raised from the ship and there was no live fire coming from the passengers.

Before losing communication with our correspondent, a voice in Hebrew was clearly heard saying: "Everyone shut up".

Israeli intervention

Earlier, the Israeli navy had contacted the captain of the Mavi Marmara, asking him to identify himself and say where the ship was headed.

Shortly after, two Israeli naval vessels had flanked the flotilla on either side, but at a distance.

IN DEPTH

 

 Focus: On board the Freedom Flotilla
 Focus: 'The future of Palestine'
 Focus: Gaza's real humanitarian crisis
 Outrage over Israel attack
 Tensions rise over Gaza aid fleet
 'Fighting to break Gaza siege'
 Aid convoy sets off for Gaza
 Programmes: Born in Gaza
 Video: Israel's Gaza PR offensive
 Video: Gazan's rare family reunion abroad
 Video: Making the most of Gaza's woes

Organisers of the flotilla carrying 10,000 tonnes of humanitarian aid then diverted their ships and slowed down to avoid a confrontation during the night.

They also issued all passengers life jackets and asked them to remain below deck.

Al Jazeera’s Ayman Mohyeldin, reporting from Jerusalem, said the Israeli action was surprising.

"All the images being shown from the activists on board those ships show clearly that they were civilians and peaceful in nature, with medical supplies on board. So it will surprise many in the international community to learn what could have possibly led to this type of confrontation," he said.

Meanwhile, Israeli police have been put on a heightened state of alert across the country to prevent any civil disturbances.

Sheikh Raed Salah,a leading member of the Islamic Movement who was on board the ship, was reported to have been seriously injured. He was being treated in Israel's Tal Hasharon hospital.

In Um Al Faham, the stronghold of the Islamic movement in Israel and the birth place of Salah, preparations for mass demonstrations were under way.

Protests

Condemnation has been quick to pour in after the Israeli action.

Mahmoud Abbas, the Palestinian president, officially declared a three-day state of mourning over Monday's deaths.

Turkey, Spain, Greece, Denmark and Sweden have all summoned the Israeli ambassador's in their respective countries to protest against the deadly assault.

Worldwide outrage has followed the deadly Israeli attack of Gaza aid convoy [AFP] 

Thousands of Turkish protesters tried to storm the Israeli consulate in Istanbul soon after the news of the operation broke. The protesters shouted "Damn Israel" as police blocked them.

"(The interception on the convoy) is unacceptable ... Israel will have to endure the consequences of this behaviour," the Turkish foreign ministry said in a statement.   

Ismail Haniya, the Hamas leader in Gaza, has also dubbed the Israeli action as "barbaric".

Hundreds of pro-Palestinian activists, including a Nobel laureate and several European legislators, were with the flotilla, aiming to reach Gaza in defiance of an Israeli embargo.

The convoy came from the UK, Ireland, Algeria, Kuwait, Greece and Turkey, and was comprised of about 700 people from 50 nationalities.

But Israel had said it would not allow the flotilla to reach the Gaza Strip and vowed to stop the six ships from reaching the coastal Palestinian territory.

The flotilla had set sail from a port in Cyprus on Sunday and aimed to reach Gaza by Monday morning.

Israel said the boats were embarking on "an act of provocation" against the Israeli military, rather than providing aid, and that it had issued warrants to prohibit their entrance to Gaza.

It asserted that the flotilla would be breaking international law by landing in Gaza, a claim the organisers rejected.

 Source:Al Jazeera and agencies
 

Tuesday, May 25, 2010

CUBAN-TRAINED DOCTORS IN HAITI FOR THE LONG HAUL

CUBAN-TRAINED DOCTORS IN HAITI FOR THE LONG HAUL 

Story and Photos by Conner Gorry

When the earthquake hit Haiti on the sunny afternoon of Jan.12, Cuban doctors serving throughout the country’s health system were among the first responders. Within 24 hours, these health professionals were joined by Cuban specialists trained in disaster response and epidemic prevention. Members of Cuba’s Henry Reeve Emergency Medical Contingent, many of these volunteers had served in post-disaster situations in Pakistan, Indonesia, China and elsewhere. 

A confluence of factors – the scope and location of the earthquake, the number of victims, the tenor of the destruction, and its disproportionate impact on vulnerable populations including pregnant women and children – make the Haitian scenario more complex than those in which the Henry Reeve Contingent has previously served. Innovation, combined with a targeted scaling up, was clearly needed. Enter doctors trained at Havana’s Latin American Medical School (ELAM).

“When I saw the images, I knew I had to help. Even before they asked for volunteers, I was ready to go to Haiti,” Dr. Carlson George, an ELAM alum, told me on the eve of his departure for Port-au-Prince on Feb. 11. Today, there are more than 700 ELAM-trained doctors and students from 27 countries providing free primary care, vaccinations, rehabilitation and other specialized services alongside Cuban colleagues as members of the Henry Reeve Contingent – now numbering 1,452.

THINKING GLOBALLY, ACTING LOCALLY

Cuban-Haitian health cooperation, initiated in 1998, has been marked by its collaborative approach, involving Haitian stakeholders in program design, implementation and evaluation. The earthquake response upholds this tradition: more than half of the ELAM-trained professionals in the Contingent are Haitian. This includes residents, family doctors, and 5th-year medical students.

The presence of Haitian doctors and medical students is critical to the Contingent’s efficacy. Not only do they serve as translators – essential to any relief effort in this French and Creole speaking country – but they bring indispensable cultural competencies to health services provision. The importance of understanding the culture of health here cannot be understated: in Haiti, a country where 71 percent of the population lived in poverty before the quake, the public health system is financed by patient fees – everything from gloves to anesthesia must be paid for before treatment. Not surprisingly, this means most people have limited experience with formal health care services since they can’t afford to see a doctor (or go broke trying). Haitian members of the Contingent not only understand these realities, they’ve lived them, so they’re careful to explain to patients – in Creole – that Cuban services are free, plus basic health promotion and prevention concepts like how vaccines work and the importance of breast feeding. Sometimes, however, the health education gap looms large: many surgeons, like Costa Rican orthopedic surgeon resident Dr. Douglas Valverde, explained how difficult it is to convince patients of the necessity of amputation, with some ultimately refusing the procedure.

As the emergency phase formally draws to a close (and the rains arrive), most international medical relief teams are scaling back their Haitian efforts. Unfortunately, the health picture remains dire, taking onnew urgency with increased risk for malaria, typhoid, leptospirosis, and meningococcal meningitis projected through June. After nearly 12 years of health cooperation with Haiti – through hurricanes, flooding, social unrest, and now a catastrophic earthquake – Cuba has favored engagement over withdrawal. The strategy continues: Cuban members of the Henry Reeve Contingent were given the opportunity to transition into the Comprehensive Health Program, making its standard two-year commitment, while ELAM doctors were given the option of remaining between three months and two years. “I’ve committed to stay here a year. The Haitian people need us,” Dr. Sindy Gómez from El Salvador told me. Those committing to stay beyond the emergency phase have been posted to 20 community hospitals and 39 health clinics throughout the country.

When I asked Dr. Patrick Dely, a Haitian doctor currently serving in Port-au-Prince how he sees Haiti’s future, he took several moments to respond. “This earthquake makes me want to work harder, fight harder for change,” he told me. “People talk about the reconstruction of Haiti, but for me Haiti was never constructed. We have to talk about construction.” In hospitals and health posts throughout Haiti, Cuban-trained doctors are dedicating themselves to that construction, helping rebuild the health system one patient, family and community at a time.


 

 Conner Gorry is senior editor of the MEDICC Review. This report is the result of Conner Gorry’s month-long assignment covering the Henry Reeve Contingent in Haiti. For more, see MEDICC Field Notes.

Cuban Medical Interationalism (an overview)

By Andrew Jack

Published: May 15 2010 00:21 | Last updated: May 15 2010 00:21

Cuban medical personnel assembled to assist Lousiana after Hurricane Katrina
Cuban medical personnel assembled and waiting to assist Louisiana after Hurricane Katrina; the US did not take up its neighbour’s offer of help

When word reached Juan Carrizo that Hurricane Katrina had struck New Orleans on August 29 2005, he reacted with military precision. From his office in a former Cuban naval base just west of Havana, while Washington um-ed and ah-ed over its own response, he began mobilising specialists to assist the thousands of Americans affected by the disaster.

Cuba itself had been scarred by Katrina, but Carrizo’s focus at the former Granma Naval Academy – a concrete campus on a balmy, palm- lined beach – was the other side of the Gulf of Mexico, as he helped to co- ordinate an unprecedented humanitarian mission to his country’s giant neighbour and arch political rival. Within three days, Carrizo, dean of the Latin American Medical School (Elam), had assembled 1,100 doctors, nurses and technicians, and 24 tonnes of medicine, all ready to fly to Louisiana. They were dubbed the Henry Reeve Contingent, in honour of a New York-born Cuban hero who fought against the Spanish in the 19th century.

Cuban students at work at an Elam laboratory
Cuba: Anatomy students at Elam, the medical school set up after hurricanes Georges and Mitch devastated the Caribbean in 1998
Fidel Castro, still president of Cuba at the time, said in a speech he made later that month: “Our country was closest to the area hit by the hurricane and was in the position to send over human and material aid in a matter of hours. It was as if a big American cruise ship with thousands of passengers aboard were sinking in waters close to our coast. We could not remain indifferent.”

But the US didn’t respond to the offer of assistance. It didn’t even acknowledge it. “We prepared more than 1,500 doctors with all the necessary knowledge, equipment and supplies, who were ready to start work as soon as we entered the country,” recalls Carrizo, shaking his head. “The US government didn’t accept them, and many people died who could have been saved. That was a sad day for medicine, and for American society.”

Since 1998, when Hurricanes Georges and Mitch devastated the Caribbean and Castro resolved to train one doctor for every person killed by the storms, Carrizo had been set to work establishing Elam, the Latin American Medical School. It has since trained more than 33,000 students from 76 countries, who then return home to practise, largely among poor patients. This year, for the first time, some of its foreign graduates formally joined Cuban medical specialists on Henry Reeve Brigade missions to Haiti and Chile, following the most recent earthquakes.

Such “medical diplomacy” has been part of Cuba’s foreign policy almost since the revolution – and has grown in intensity over the past few years, fuelled above all by strong demand from Venezuela. In some of the most remote and neglected parts of the world, where western countries have “brain drained” away most of the medical expertise, Cuban personnel are winning friends while helping to fill a desperate need. In the past half century, some 130,000 have worked abroad, and today, 37,000 – half of them doctors, the rest nurses and other specialists – are spread across more than 70 countries. Now Elam is training many more from these nations too.

A Cuban doctor seeing patients at a mobile clinic in the village of Chansolme, Haiti
Haiti: A Cuban doctor treats patients at a mobile clinic in Chansolme; while abroad, Cuban medics earn up to 10 times their local salary

Havana’s approach irritates many, including doctors in other countries who feel undermined by rivals parachuted in to provide free services, and western nations whose health systems are very differently structured. At home, Cuban doctors face modest pay and limited choices, tempting them to volunteer overseas despite regrets about abandoning their own communities and concerns over intimidation while abroad. Some have even defected, although Cuba’s tough emigration controls seriously weaken the impact of the brain drain that prompts so many of their low-paid peers in other countries to pack their bags. Medical diplomacy is a potent form of “soft power” – but one with a hard edge.

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Tuesday, May 4, 2010

Cuba answers the call for doctors

Havana’s Latin American Medical School takes passionate young people from developing countries and sends them home as doctors. It’s all about driving health equity, writes Gail Reed. Now the challenge is to get medical societies to accept them.

Dr Midalys Castilla is animated as she talks about the graduates of Havana’s Latin American Medical School (ELAM) who are serving with Cuban medical teams in post-’quake Haiti. By the end of February, 557 of these ELAM graduates from 27 countries had made their way to Port-au-Prince, swelling the ranks of teams that will staff public health facilities past the emergency phase. “Doctors willing to go where they are most needed for as long as they are needed: this is the reason our school was established,” says Castilla, academic vice-rector and a founder of the institution that was created after another disaster hit the region over a decade ago.

In 1998, hundreds of Cuban doctors were dispatched to the Dominican Republic, Guatemala, Haiti, Honduras and Nicaragua after two devastating hurricanes. Their services in remote, underserved communities begged the question of what would happen when they returned home.

Dr Midalys Castilla, one of the founders of the Latin American Medical School in Cuba.
Eduardo Añé
Dr Midalys Castilla, one of the founders of the Latin American Medical School in Cuba.

This dilemma of sustainability prompted the decision to establish ELAM, its central campus located on Havana’s western shoreline. The first students from Central America arrived in February 1999 and graduated from the six-year curriculum in 2005. Since then, 7248 physicians from 45 countries have obtained ELAM degrees, with current enrolment being 9362 students from 100 countries mainly in the Americas, the Middle East, Africa, Asia and the Pacific Islands.

In addition to its size, ELAM has other distinguishing features that align it with a handful of similar institutions worldwide founded expressly to address inequities in access to medical care. Medical schools in countries such as Australia, the Bolivarian Republic of Venezuela, Canada, the Philippines and South Africa share “social accountability” as their premise. The World Health Organization defines social accountability of medical schools as “the obligation to direct their education, research and service of activities towards addressing the priority health concerns of the community, region and/or nation that they have a mandate to serve”.

ELAM’s aim is to educate physicians primarily for public service in disadvantaged urban and rural communities, developing competencies in comprehensive primary care, from health promotion to treatment and rehabilitation. In exchange for a non-binding pledge to practise in underserved areas, students receive a full scholarship with a small monthly stipend, graduating debt-free.

Student recruitment processes for ELAM vary from country to country, where school administrators may involve representatives from Cuban embassies, local civil society, grassroots organizations or government in the selection process. Candidates must have at least a high-school diploma, a good academic record, aptitude and pass the admissions exam. Numbers of applicants can be daunting: third-year student Javier Montero from southern Chile recalls that more than 600 people applied for 60 places the year he was admitted to ELAM.

Preference is given to low-income applicants, who otherwise could not afford medical studies. “The result is that 75% of our student body comes from the kinds of communities that need doctors, including a broad representation of ethnic minorities and indigenous peoples,” explains Castilla. For example, student Alfredo Cayul’s family is indigenous Mapuche and makes its living by subsistence farming in Chile; Jamaican Shereka Lewis’s mother is a secretary, her stepfather a carpenter; Keitumetse Joyce Let’sela’s widowed mother in Lesotho is a schoolteacher; and Vanessa Avila, from California, United States of America (USA), comes from a first-generation family of Mexican immigrants, her father being a gardener and her mother a housewife.

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