Doctors for sale

It's no secret Cuba is in the business of exporting doctors and has been for the past decade. About 20,000 of them work in Latin America, mainly in Venezuela, in exchange for close to 100,000 barrels of oil a day from Hugo Chávez. It's business, but you could always find a humanitarian argument if you looked hard enough...

Now, however, there's no more beating around the bush. Cuba and Qatar cut a deal in Doha to staff an entire Qatari hospital with Cuban specialists. The deal is part of multi-million dollar negotiations about a joint venture hotel in Cuba between the Cuban government (which means the Army) and the Qatari Diar Real Estate Investment, a state-run fund. Qatar is not a developing country with millions living in poverty. It has the highest GDP per person in the Arab world and most of the 900,000 inhabitants are migrant workers from South-Asia. It's hard to see this as anything but a cold commercial pact.

Doesn't Cuban have the right to with it's doctors as it likes? Freedom of labour is one thing, but this is something completely different. Exporting professionals as if they were cattle is a dubious business. For starters, in the case of the Cuban doctors, there families are forced to stay behind, as a safe guard against defection. Secondly, what does it mean for health care on the island itself?

In December 2006 I reported for the Dutch newspaper AD from Cuba on the scarcity of doctors and the way in which Venezuelans were flown-in and got preferential treatment. Meanwhile Cubans were lucky to be attended by med-students. I've seen no indication that that has changed. Moreover, deals like this are only more likely to drain the island of one of the few resources for which it receives international acclaim.



Cuban doctors working in a slum in Caracas, Venezuela (photo PIT)

A new era, a new headache

ASUNCION - Paraguay awoke yesterday with the realization that things would never be the same. Elections on Sunday brought an end to 61 years of rule by the Colorado party and turned a former bishop into president-elect. Fernando Lugo beat the government candidate, Blanca Ovelar by a margin of 10 percentage points, bringing about the fall of a party widely accused of corruption and nepotism.

Lugo's supporters flood the streets. Photo InfoLatam.com

Long before the official results were announced supporters of the former priest flooded the streets of Asunción, waving flags and honking the horns of their cars. For many people the day marked the real beginning of a democracy despite the fact that the fall of the dictator Alfredo Stroessner took place 18 years ago. For the first time since 1947 the Colorado party was forced to vacate the presidential palace, making way for a new era in Paraguayan history.

Lugo’s victory and the hope he has awakened in those who voted for him is a credit to his charisma and the perception of many people here that he is mild-mannered and honest. He is not, however, an experienced politician or a hardened deal-maker, qualifications which could prove necessary to manage the quagmire that is Paraguayan politics. Nor does he have the backing of one homogeneous party with a single programme. Rather, his supporters range from communists to liberals including left-wing farmers’ collectives and indigenous groups. Lugo’s problems could just be starting.

“People have enormous expectations now and they will be looking to Lugo for rapid answers to the many problems in Paraguay,” says political analyst Roberto Sosa. He fears Paraguayans will expect miracles of the former-priest and be disappointed when they see that change is slow.
The fact is, Paraguay’s ills are of such a scale that any progress is likely to be slow and difficult. 35 percent of the people are unemployed or work in the informal economy. That same amount live in poverty and almost 20 percent are unable to afford a basket of staple foods on a daily basis. Despite economic growth thanks to soaring world commodities prices, that percentage of extremely poor has only increased in recent years.

The agricultural boom which drives Paraguay’s economy has forced thousands of peasants, unable to adapt, to exchange their rural homes for the slums of Asuncion and Buenos Aires. Others left for Spain or the US. Meanwhile rampant crime and a flawed judicial system have made people anxious about their safety and also spawned emigration.

The former bishop has promised his countrymen he will implement a land reform to redistribute wealth in one of the most unequal societies in the region. He has said he will invest heavely in health and education, as well as create the conditions for the thousands of migrants to return home.

To pay for those reforms he says he will confront Brazil and Argentina about renegotiating the royalties from the immense Itaipú and Yacyretá hydro electrical plants that these nation share.
In Itaipú, Brazil and Paraguay share the energy produced 50/50. However Paraguay only uses 5 percent and according to the treaty, must sell the remaining 45 percent to its partner at cost price. On the other hand Brazil paid for the construction of the damn back in the 1960’s

Now the Paraguayans want a market price for their share of the energy. Sectors of the media in Paraguay have been demanding renegotiation of those treaties for several years and Lugo has taken up that banner. But renegotiation won’t be easy. Brazilian president Lula da Silva repeated yesterday what he has been saying all along, that the treaty is non-negotiable. As for Argentina, given its current energy crisis it also unlikely to be an easy negotiating partner.

Getting the political support he needs to face up to Paraguay’s two larger neighbours will be another challenge for Fernando Lugo. The ragtag alliance that brought him to power won’t have anything like a majority in parliament. To get anything done the former bishop will have to work together with ex-general Lino Oviedo. Oviedo came in third in Sunday’s elections but his party Unace party will expectedly hold sway over a key part of the new congress as soon as it’s make-up is definite. Besides, the Colorados will remain the largest party, although reduced in size.

To make matters more complicated Lugo has said on various occasions that Paraguay needs to draw up a new constitution. He insists, with some grounds, that both the judicial system and the parliamentary process need to be redesigned. But opening the Pandora’s box of constitutional reform, maybe setting Paraguay up for the kind of ongoing civil strife that has all but paralyzed neighbouring Bolivia. In Ecuador and Venezuela the process of rewriting the constitution also polarized those countries, pitting two halves of the population against each other.

The good news is that the Catholic Church seems to have accepted Lugo’s choice to swap the pulpit for the soapbox. At first that decision was met with resistance from Rome, where Cardinal Re decided to suspend Lugo. The cardinal insisted that former bishop was nonetheless still a priest and therefore should stay out of politics.

Yesterday, a spokesman for the church in Asuncion declared that the papal nuntius would plead for the former bishop's case with the Pope in the hope of finding a solution to his status, “in the interest of social peace.”

Ex-Bishop Lugo sweeps Colorados from power

ASUNCIÓN - Well, he made it. Former bishop Fernando Lugo was elected the next president of Paraguay yesterday night, bringing an end to 61 years of one-party rule. Blanca Ovelar, the candidate for the ruling Colorado party accepted defeat close to 9 pm local time, saying the results were “irreversible” and congratulating the Paraguayan people for their behaviour during the voting.

As the official results were still to be announced hundreds of supporters of the one time bishop of San Pedro clamoured in to the streets, honking the horns of their cars and cheering for their candidate.

“This marks a historic date in the history of this country,” Lugo told a press conference while still awaiting the final results. “A few months ago nobody dreamed that this could happen, that a group of political dreamers could unite and put the good of the country first.” He heralded in a new era for Paraguay and an end to “political clientilism."

Lugo’s win brings an end to the hegemony of the Colorado Party, the longest ruling party in the world still to be in power. The party, which continued to rule throughout the dictatorship of General Alfredo Stroessner (1954-1989), is widely blamed for the economic malaise of recent years and often accused of rampant corruption.

The former bishop heads a rainbow coalition ranging from peasant farmer movements to the establishment Liberal Party. He has promised land reform and said he will renegotiate the treaties of the enormous Itaipú and Yacretá damns, hydro-electrical plants that Paraguay shares with Brazil and Argentina respectively.

With 85 percent of the vote counted the leader of the Patriotic Alliance for Change coalition had won at least 40 percent of the vote. That result meant a victory over Ovelar who polls suggested would end with around 31 percent of the vote. Lino Oviedo, a former general convicted of committing a coup, looked to get 22 percent.

Calling in the cavalry

ASUNCIÓN – For the first time since he announced his candidacy in December 2006, the campaign of former bishop Fernando Lugo is starting to show signs of vulnerability.

Fernando Lugo (centre) is accompanied by his vice-presidential candidate Frederico Franco (left) and Hebe de Bonafini of the Argentine human rights group Mothers of the Plaza de Mayo as he walked from his house to the polling booth this morning. (photo PIT)

An opinion poll released by the Ultima Hora newspaper a week before the election on Sunday put the candidate for the Patriotic Alliance for Change at 34.5 percent of the vote, slightly more than 5 points ahead of his nearest rival, ex-general Lino Oviedo. Blanca Ovelar, running for the Colorado party came in a very close third with 28.5 percent.The lead is still significant, but less than it was in February, when Lugo could claim almost 39 percent of the vote. More importantly it shows that while Lugo and Oviedo have more or less stagnated in the polls, the government's candidate is quickly gaining on them.

The difference with a few months ago is that now the mighty Colorado machinery has been put into gear. The party has been in power for over 60 years controls most of the bureaucracy. Now it's closing the ranks and calling for a show of hands on Sunday. Public servants received a personal note from former education minister Ovelar reminding them what the government had done for them. They were also invited to attend rallies and political events in support of the government candidate.

Anyone walking down the street in Asuncion is impressed by the number of SUV's bearing huge red flags and honking their horns. Government buildings are draped in propaganda. Even Paraguay's most famed author, the deceased Augusto Roa Bastos, was used – or perhaps abused - in this campaign. He once famously suggested that his country might be better off being run by a woman. The Colorado party has pounced on those words, using them to promote the would-be first female president of Paraguay.

There's violence too, opposition leaders say. "They've killed at least two leaders of the Tekojoja movement (which supports Lugo) in the last month," claims Belarmino Balbuena, a rural leader and candidate for senator. Although he doesn't know who's responsible, Balbuena believes the escalation of violence is meant to intimidate voters.

Other tactics are also being employed. Last weekend Defence Minister Nelson Mora was linked to the retaining of 200 identity documents belonging to residents in a poor neighbourhood in Asunción. Mora and his aides had gone to the neighbourhood supposedly to hand out food. After he left some of his co-workers told the people that to receive more food they would have to hand in their documents, which 200 did. Opposition parties were notified of the extortion and warned the team of OAS observers, who promptly went to look for themselves. The opposition Liberal Party pressed charges. The intention was obvious – without an identity card, you can't vote. Meanwhile there have been numerous rallies around town and across the country, with massive handouts, to drum up support for Blanca Ovelar.

Last Saturday the party even organized a march of the 'Republican Cavalry,' something dating back to the days of the Colorado dictator General Alfredor Stroessner. Senators and government ministers arrived at the Plaza Caballero on horseback while Ovelar entered the arena in a horse drawn buggy. Spectators attending the rally waved their red handkerchiefs, as president Nicanor Duarte scolded Fernando Lugo for apparently having banned such an equestrian gathering while he was bishop of San Pedro. "As for this hypocritical monseñor who banned a spectacle of the people, we will make him pay in votes," the president said.

In fact the Colorado party may well be served by fewer votes, at least in general. Everything indicates that the ruling party stands to benefit from a low turn out. According to the poll published by Ultima Hora, the lower the turnout the better the chances of Blanca Ovelar. If only 40 percent of the country's three million eligible voters show up, Ovelar will beat Lugo by 34 to 31 percent. For Lugo to win with a clear margin at least a 55 percent must show up. It won't come as a surprise then that the campaign of the former bishop is doing everything it can to get out the vote.

Crucial, in that sense, are the two million Paraguayans who live abroad. By law they can't vote outside of Paraguay, a rule that favours the Colorado party, whose iron grip is felt more closely in Caacupé than in Madrid or New York. Nonetheless Lugo has been wooing their support, hoping that they in turn will influence their family and friends in Paraguay. To do so he has taken to the information highway launching several videos on the YouTube Internet site over the past year, addressing his compatriots abroad.

Meanwhile, a huge chunk of the Paraguayan diaspora lives not in Spain or the US but across the border in Argentina. Somewhere between 800,000 and 1.5 million Paraguayans reside and work at least part of the year in our country. Getting them to make the journey to north to vote on Sunday could put Lugo well on the way to victory. In that light, President Cristina Fernández' decision to give Paraguayans the day off on the Friday before and the Monday after the elections, was seen by many here as a muted sign of support for the bishop.

Bishop on the brink in Paraguay

I´m in Asunción, Paraguay and to say the place is alive with a pre-election buzz would be in pretty bad taste. It was buzzingly lethal mosquitoes bringing dengue and yellow fever to the Latin American back water the past few months, that almost managed to knock the elections of the front pages. Although authorities say they have the outbreak under control, Paraguayans know that what their government says rarely coincides with the perception on the street.

However, the prospect of change is the reason why pilas, as Paraguayans call themselves, are looking to the upcoming ballot on April 20 with a kind of enthusiasm not often witnessed in this land-locked country, despite the ongoing public health scare.

People’s reason for the renewed interest in the democratic process is front running candidate Fernando Lugo. The one-time bishop of the San Pedro diocese is now the favoured candidate of Paraguay’s disenfranchised, of whom there are many. His popularity threatens to end the 61 years of hegemony of the Colorado party.

Paraguay is also the last country to decide it’s future after left-of-centre presidents came into power in the past three years across the region, with the notable exception of Colombia. Were Lugo to win the presidency it would mean a definitive shift from the Colorado Party’s traditional conservative and pro-US stance, and bring Paraguay more in line with it neighbours.

Lugo’s backers include a rainbow of political parties and movements. He unites the militant groups of landless peasants with the much more establishment Liberal-party, Paraguay’s second political force and just about everybody in between. Apart from the Colorado candidate, former education minister Blanca Olevar, Lugo only has one real rival in the elections.

That man is a former general Lino Oviedo, accused and convicted of plotting a coup. A tough-on-crime populist with his own power base, Oviedo was released from prison last year at the behest of the government, in what many saw as a bid by President Nicanor Duarte to divide the field and undermine Lugo’s chances.

Even so, according to journalist Alfredo Cantero, Lugo is still ahead by at least 5 point in the polls. Come election day though, the former bishop’s supporters fear the government will resort to fraud. Speaking at a rally in the aptly named town of Limpio (aptly named 'clean') on Sunday, Lugo said the Colorados had “used fraud to stay in power for the past 60 years.” He added that he saw no reason why 2008 should be any different. His supporters have often voiced on concern over the lack of impartiality of the electoral judges.

“The Colorado party will accept defeat is margin is big enough,” says Cantero, “but they’ll do everything in their power to stop that happening, ranging from fraud to threats and riots.”

Say Lugo does make it to the presidential palace, what does that mean for Paraguay. The question concerning many international observers is whether Lugo looks to business-friendly leftists such as Chile’s Michelle Bachelet and Brazil’s Ignacio Lula da Silva as examples or if he’ll go for a more populist variant of socialism such as Hugo Chávez in Venezuela. When I put the question to him a year ago, during a four-day trip through rural Paraguay, he answered with an evasive smile, “my inspiration is Jesus of Nazareth.”

Since then Lugo has often voiced his admiration for Lula and Bachelet, but always insists that Paraguay is “different,” and therefore needs a different approach. He has promised his rural supports land reform, but without specifying just how that would be brought about. Land distribution is Paraguay is extremely unequal, even by Latin American standards, and so some effort to break up the amassed wealth is certainly necessary. But whether Lugo would go for Chávez confrontational policy of stimulating squatters and mass annexation is far from certain. More likely he will take the route of Ecuador’s Rafael Correa who has reformed the system of inheritance tax to make for a more gradual redistribution.

The other big hurdle for a Lugo administration is energy. Unlike it’s neighbours to the south, Paraguay has plenty of it. The Itaipú dam is the world’s largest hydroelectrical plant, producing 20 percent of Brazilian demand. Paraguay can hardly tuck away a fifth of its 50 percent share in the energy and sells the rest to its partner Brazil. However, the Itaipú treaty, as negotioted by the Colorado dictator Alfredo Stroessner in 1973, forces Paraguay to offer Brazil its share at cost price.

Lugo believes the potential income from energy sales from the dam could bankroll dearly needed health and education reforms. But to do so will mean renegotiating the treaty with Brazil. In past dealings, most notably with Bolivia, Lula has already shown that he can be unbending when it comes to Brazils energy needs.

If you can’t beat them, despair

Alváro Uribe and Evo Morales feel the heat. But can they stay in the kitchen?

Only a year ago Mark Penn was the most influential man in Washington, according to the Washington Post. Now he’s just another lobbyist who thought he thought he could represent the cake and work for the candidate trying to eat it.


Penn resigned as Hillary Clinton’s chief campaign strategist following a conflict of interests. Besides running the Democratic candidate’s nomination, Penn was also lobbying for the Colombian government trying to get a Free Trade Agreement with the US; a deal Clinton is campaigning against.

The antics of an over zealous PR-guru may only dent Hillary’s campaign, but they mean a significant blow to an already beleaguered Alvaro Uribe. The Colombian president was forced to fire Penn’s public relations firm last week, as the news gained momentum.

The timing couldn’t be worse for Uribe’s government. First of all the crisis with neighbouring Ecuador over an incursion into its territory is far from over. Ecuador has dragged Colombia before the International Tribunal in The Hague for fumigating coca-plantations and poisoning land across the border. President Rafael Correa claims that Colombia is purposely discrediting his government by linking it to the FARC guerrilla group.

“I don’t want a fight with Bogotá,” Correa told El País in an interview, “but as long as Colombia keeps up its negative attitude, re-establishing ties will be difficult,” he added, claiming the Uribe government knew that one of the people killed during the now infamous raid on the FARC’s number two Raúl Reyes, was an Ecuadorean. According to the Colombians and the local press the victim was also a supplier to the insurgent group.

Uribe’s second headache is the deteriorating health of Franco-Colombian Ingrid Betancourt, the most prominent of the FARC-hostages. According to her son, Mrs Betancourt is suffering from hepatitis B and leismaniasis and needs a blood transfusion urgently. The government of president Sarkozy, which has turned the plight of Betancourt into its most prominent foreign policy objective, sent a medical team to attend to her, but without an inkling of how to reach the former senator.

So desperate is France is to see Betancourt released, that they have even cooked up an elaborate guerrilla-adoption plan with Spain and Switzerland. According to the French news web site Rue 89, the plan consists of exchanging the hostages for imprisoned FARC terrorists. These would then be shipped off to France, avoiding trial, presumably to spend the rest of their days basking in the Riviera sunshine like many a deposed African dictator. France would also lobby its European neighbours to have the FARC removed from the EU’s list of terrorist organisations.

As for the guerrilla organisation itself, they seem in no hurry to get their high profile hostage back to civilisation, no matter how critical her condition. Yesterday the FARC announced it wouldn’t be freeing any hostages until Washington and Bogotá release some of the imprisoned insurgents. If the worst comes to the worst and Betancourt dies in a remote jungle hideout, it’s hard to see how Uribe won’t be allotted part of the blame.

Meanwhile, in Bolivia, the rift between La Paz and the separatist provinces to the south and east has deepened yet again. President Evo Morales was so desperate that he turned to the Church to help mediate in this conflict, as well as the OEA and a host of foreign ministers from neighbouring countries.

But even the clergy tossed the towel in the ring. Cardinal Julio Terrazas claimed it was “impossible to facilitate the dialogue,” in these circumstances. Nonetheless church officials met with prefects of the rebellious provinces yesterday in the hope of bringing about some kind of truce.

Authorities in the province of Santa Cruz at the head of the separatist movement, have sworn to go ahead with a referendum on autonomy on May 4. La Paz has forbidden the election, calling it an “act of sedition.” Government minister Alfredo Rada threatened to have the seperatist leaders tried for undermining the unity of the country.

But as the Morales government rails against the provinces for demanding a greater say in where their money goes, the real ‘enemy of the people’ is slowly creeping up on Bolivia. Inflation was up to 4,75 percent for the first three months of this year, making the governments aim of 7 percent over 2008 look a little optimistic. Protesters have taken to the streets demanding an end to price rises.

To make matters the worse, the government has taken an unsettlingly familiar approach to combating this economic ill – they’ve tampered with the way inflation is calculated. Claiming the INE – the Bolivian equivalent of the INDEC – needed to incorporate new products into its range, the system has been ‘updated.’ When they do finally appear, the end of year figures for inflation will raise serious doubt. Not only among foreign investors, but also more importantly, among everybody else. From the housewives of El Alto to the coca-farmers of Chapare, all those natural supporters of Evo Morales will kick up a fuss. If that happens, a few rebellious prefects clamouring for attention will seem like Christmas.