Is There a Doctor in the House?

With Castro's current illness, we can now see the future: Cubans have stability, not a crisis, and a succession plan, not a vacuum.
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In Barlovento, Venezuela, about ninety miles from Caracas, Cuban doctors are providing medical assistance to local Afro-Caribbean families, many of whom never had access to health care before.

Now, the Bush administration has a message to those Cuban doctors: "Drop what you're doing and come to the United States. Don't worry about the immigration line; we'll put you right at the front."

What is going on?

For years, U.S. foreign policy has operated under a myth that Cubans are waiting for the United States to intervene when President Castro's rule comes to its end. We've spent and wasted millions of dollars writing transition plans. Our plans are predicated on Cuba plunging into crisis, and Cubans calling for Uncle Sam to step in and determine a new system of governance and economics for them.

With Castro's current illness, we can now see the future: Cubans have stability, not a crisis, and a succession plan, not a vacuum. America, having walled itself off from the Cuban people with its ban on travel, trade, and diplomacy, can peer over that wall and see China and Venezuela and the nations of Western Europe hard at work enjoying normal relations with Cuba. Even Cuba's dissidents are calling on the United States to back off, and let Cubans decide Cuba's future for themselves.

Having written ourselves out of the script, the U.S. is on the sidelines searching for a role, and this is where the saga of Cuba's doctors picks up.

Cuba has approximately 65,000 trained physicians, roughly ten times the number of doctors the island had under the Batista regime. Cuba's doctors today are what President Kennedy's Peace Corps volunteers were in the 1960s - they are the faces of Cuba's foreign aid program. In addition to providing treatment at home for its population, Cuba sends doctors across the earth - to AIDS hotspots in the developing world, to help tsunami victims in Asia, to bring medical services to desperately poor places, like Barlovento, where many residents have never seen doctors in their lives.

Just about a year ago, when Hurricane Katrina devastated the Gulf States, President Castro offered the services of more than fifteen hundred Cuban doctors and over 25 tons of medical assistance for the victims.

Our reaction could hardly have been less gracious. For weeks, the Cuban government never got an official response to the offer. Scott McClellan, then the White House press secretary, told Castro that instead of offering us doctors, he should have been giving Cubans their freedom. Roger Noriega, then an assistant secretary of state, doubted whether the Cuban doctors - who have somehow managed to produce a lower child mortality rate in Cuba than we have in the United States -- could meet our certification requirements. In the end, their offer was never accepted.

What a difference a year makes. Now, with a Cuban transition under way, and U.S. foreign policy trying to appear relevant, the United States government has an entirely new position on Cuban doctors. We no longer, apparently, question their training, we just want them. On August 11, 2006, the Department of Homeland Security put out a press release issuing the 'ally ally in come free' not only for Cuban doctors working in foreign countries but also for their families who have remained behind in Cuba. All are invited to defect and to be paroled into the United States.

The only applause we've heard for this dubious policy idea comes the Miami exiles and their representatives in Washington, who scorned the offer of Cuban doctors when the people of the Gulf States were suffering, but who now think nothing of enticing them away from their medical missions in the Third World.

This is what our Cuba policy has come to - triggering a Cuban doctors' brain drain and undermining an extremely successful foreign aid program by Cuba that actually helps people living in poverty or desperation meet their medical needs. This was something the United States used to do, when we understood that bringing people together, rather than blowing them to pieces, was the best way to conduct our foreign relations.

Forgive my nostalgia.

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