Johannesburg – South African medical students trained in Cuba may be used to drive the proposed National Healthcare Insurance system. This is if government has its way.
Up to 3 000 trainee doctors are currently on the Caribbean Island where they are receiving extensive training and skills in primary healthcare.
According to Health Minister Aaron Motsoaledi, the group forms part of government's plans to address the dire shortage of medical professionals in the country.
While the jury is still out on the NHI, Motsoaledi said the doctors would play a pivotal role in improving the primary healthcare system.
But does the Cuban programme still work give the controversy that has surrounded some students trained there?
Two years ago a Free State student was stabbed to death by Cuban locals while on a night out. In another incident KwaZulu-Natal Health MEC Dr Sibongiseni Dhlomo was forced to fly to the country to engage medical students who had allegedly neglected their studies to preach the gospel.
Despite these incidents, Motsoaledi said relative progress has been made and that the programme has been effective so far.
"Yes it has an impact. There are hospitals in South Africa who wouldn't have had doctors if it wasn't for Cuba. The reason why we send students to train there is that there is still a huge need for doctors...our system is producing very little of them," Motsoaledi said.
He said since the inception of the Cuban programme five years ago, government has increased the number of medical students trained there from 60 to 1000.
"These students have not completed their training. As we speak we have 3000 of them right now studying medicine in Cuba. This doubles the total number of what the eight medical schools in SA produce per annum," he said.
An optimistic Motsoaledi highlighted that upon the group's return, results would be evident.
He further explained that one of the challenges the country faces is that the Cuban programme trains doctors under the primary healthcare system while South Africa focuses on curative care.
"When they (students) come here we put them in the curative healthcare system and they get disorientated. In areas where we put them in primary healthcare we see huge results."
One of these successes, he said, is in Umzinyathi in KwaZulu-Natal where these doctors were removed in all the hospitals and placed in primary healthcare facilities.
He said within a short space of time there was a decline in maternal mortality rates in that district.
Cuba is regarded as one of the best countries to train doctors and those in the medical field.
Motsoaledi said the Island is often given very little credit for this because of politics.
He said every health minister in developing countries is aware of the high training quality Cuba possesses but some are too embarrassed to admit it.
South Africa, however, has done its best to uphold its diplomatic relations with the Cuban government.
"It is no surprise that Cuba became the first country in the world to eradicate mother to child transmission of HIV because they use primary healthcare. That report was given but very grudgingly. I'm dead sure that if this report was released in a Western country it would have made headline news and a Nobel peace price given somewhere because it is a huge achievement," said Motsoaledi.
He added it was for this reason that the primary healthcare system will be the heartbeat of the NHI.
Motsoaledi further highlighted that at last year's World Economic Forum in Davos, Switzerland, it was acknowledged that healthcare systems across the world were becoming increasingly expensive because primary healthcare was neglected.
"That's what we are going to do (adopt primary healthcare) because Cuba has achieved it with flying colours."
On the issue of medical students 'misbehaving' while abroad, Motsoaledi said these social ills occurred everywhere and were not unique to South Africa.
Meanwhile, the department has given 22 doctors until January 25 to apply for internships.
This comes after the Junior Doctors Association of South Africa revealed that up to 135 intern and community service doctors sat at home without jobs due to the lack of vacancies.
Motsoaledi said contrary to these reports, there are up to 45 posts available in the Free State and Eastern Cape.
He revealed that a majority of medical students reject posts in rural areas and instead opt to work in Cape Town Joburg, Durban and KwaZulu-Natal.
The department emphasised that internships are compulsory and can not be done at any hospital in the country except at those accredited.