Cubans in the Desert

Could a remote Cuban hospital in Qatar hold the future of Cuba’s medical internationalism?


Qatar’s Zikreet peninsula is so remote that fences along the highway protect motorists from camels and the odd introduced African ostrich. Yet this remote location is also home to Qatar’s newest hospital. Apart from its place in the desert, what makes this hospital different from other facilities in the country is that nearly the entire medical staff is from a single country: Cuba.

Qatar’s new hospital boasts some 200 doctors, nurses, and medical specialists from Cuba. According to the facilities management this is the first fully “Cuban Hospital” outside of Latin America. Indeed, this quiet experiment on the edge of a largely obscure peninsula could have a profound impact on the medical policies of both Qatar and Cuba.

Some 40,000 Cuban medical personnel and specialists are currently working in 68 countries around the globe (the US is not one of them). The largest contingent of Cuban medical staff aboard is stationed in Venezuela as part of a “doctors for oil” program. Now, the Cuban Hospital in Dukhan drops all pretense of medical internationalism. Cuba’s skilled staff is provided in exchange for payments to Havana.

Qatar’s medical facilities will undergo a privatization process ahead of the 2022 FIFA World Cup in Qatar, under which hospitals will receive payments based on treatments provided to patients. The Cuban hospital’s chief operating officer Phil Lowen believes that the facility could be competitive under a more free-market system: “The patient is at the center of the system under the Cuban model and the emphasis is on patient experiences and the quality of care.“ The future of Cuban medical care will not be decided by efficacy but, rather its ability to maintain its highly trained medical staff.

20th century communist states prided themselves on the quality of their medical care and staffs. Today, aging populations around the globe mean that many countries will face a shortage of medical staff in the coming decades. Yet trained medical personnel from Cuba or Eastern Europe could also easily find jobs abroad. Milan Kundera’s novel The Unbearable Lightness of Being describes the brief flight of a Czech medical professional from Prague who easily finds work in Switzerland. Following the collapse of communism, the Czech Republic sought to keep medical education free and hoped to maintain there. Today, many recently graduated Czech medical personnel are actively recruited for vastly higher paying jobs in Germany. Germany isn’t the only country with a sharp demand for medical personnel; the United States will need to fill some 800,000 nursing vacancies by 2020.

Many Cubans I spoke with in Qatar felt their underpaid work in the desert was a way of paying back the Cuban state for the free medical education they received. In the coming years Cuba will likely see important political and economic changes. However, the Cuban hospital in Dukhan suggests new modes for maintaining aspects of Cuba’s socialist medical system in coming years. Cuban medical staff could be sent overseas to staff Cuban hospitals that maintain the island nation medical practices and culture. Such posts could earn cash for the Cuban state and serve as a stepping stone for Cuban doctors ultimately seeking lucrative work elsewhere. Many will likely return home with both new skills and the hard currency they earned abroad.

Conversely, Cuba already has an established medical tourism industry. In the future, countries like Qatar could invest heavily in modernizing this sector allowing Cuba to compete more effectively with other medical tourism destinations.

Such changes could lead to direct and indirect improvements in opportunity for scores of Cubans. Qatar’s Cuban Hospital was born out of a private meeting between the Emir of Qatar Hamad bin Khalifa Al-Thani and then Cuban President Fidel Castro in 2005. Ironically, the father of Cuba’s Marxist-Leninist system may also have laid the foundation for what could become Cuba’s greatest market success in an era of globalization.

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