ARTICLE - CUBAN MEDICS A BIG FORCE

CUBAN MEDICS A BIG FORCE ON HAITI CHOLERA FRONTLINE
(Reuters) - By Pascal Fletcher

PORT-AU-PRINCE - They don't send out press releases, don't have public information officers and their contacts are not widely publicized by the huge international humanitarian operation helping cholera-hit Haiti.

But when the United Nations appeals for more doctors and nurses to combat the deadly disease that is killing dozens by the day, it is to Cuba's medical brigade that U.N. officials are likely to turn to first.

With a tradition of service in the world's poorest and most forgotten states, the Cubans are a major frontline force in the multinational response to the raging epidemic, which has killed at least 2,000 people and probably more, since mid-October in the impoverished country.

While many Western aid workers crowd Haiti's capital, where more than 1.3 million vulnerable homeless survivors of the January 12 earthquake are crammed into tent camps, Cuba's medics are seeking out cholera victims in hard-to-reach rural hamlets.

A Cuban-led team trekked this week to one such settlement -- the dirt-poor mountain village of Plateau in Haiti's cholera-ravaged Artibonite department, where they set up an emergency makeshift cholera treatment center on the benches of a Protestant church.

"We don't look for publicity but we do look for the people," Dr. Lorenzo Somarriba, coordinator of the Cuban Medical Brigade in Haiti, told Reuters at the brigade's headquarters in a Port-au-Prince suburb.

"The Cuban doctors are working in the most difficult places. It's our policy to concentrate on areas outside the national capital," he said, a fact acknowledged by both Haitian and foreign health authorities.

STRENGTH ON THE GROUND
A small Cuban flag sits on the table in front of Somarriba, while pictures of former President Fidel Castro and guerrilla icon Ernesto "Che" Guevara, himself a doctor, adorn the walls.

Plateau represents the 39th cholera treatment location set up and run by the Cubans across much of Haiti's daunting geography, from the coast to the denuded mountains of the interior where poor, illiterate peasants are helpless victims of a deadly diarrheal disease they have never known before.

These locations are carefully marked on a map of Haiti in the Cuban brigade's headquarters and Somarriba, a Cuban vice minister of health, reels off figures and statistics like a general marshaling his forces in a military campaign.

The Cuban-led medical brigade in Haiti is 908 people strong, Somarriba said. It includes Cuban-trained professionals from 19 other countries -- mostly Latin American, Caribbean and African nationals who serve under the Cuban flag.

It is the largest medical contingent in Haiti from any one nation, treating 30 percent to 40 percent of the cholera patients.

The Cuban contingent consists mostly of doctors and nurses but also includes technicians and logistics experts. They have warehouses, a fleet of trucks, and planes that fly in supplies and personnel from the communist-ruled island to the west.

The scale, organization and experience of this presence make Cuba the country that Haiti's government and its relief partners seek out when they need to ramp up the struggling response to the unchecked epidemic.

"They (the Cubans) are available, they are trained up, they have resources in place," said Nyka Alexander, spokeswoman in Haiti for the World Health Organization.

"We know the terrain. We have people who speak Creole and the people know us," says Somarriba, citing the 12-year presence of a Cuban medical brigade in Haiti. Cuban medics first came to help after Hurricane George in 1998.

The United Nations' top humanitarian official, Briton Valerie Amos, said during a visit to Haiti last month that the country needed an urgent surge of foreign medics -- at least 1,000 nurses and 100 more doctors -- if it was to have any hope of curbing the death rate of the raging epidemic.

Britain's government said days later it would fund 115 doctors, 920 nurses and 740 support staff from the region to set up 12 treatment centers and 60 subsidiary units in Haiti.

FIRST TO RESPOND
U.N. officials said Cuba was the first to offer more personnel. "There is a call for everybody but the response came first from the Cubans. They are going to send 300 additional doctors," Edmond Mulet, head of the U.N. peacekeeping mission in Haiti, told Reuters.

Somarriba said the Cuban medical reinforcements were ready in Havana and would be flown in.

He said that besides its own resources, the Cuban brigade was receiving significant contributions for its work from the Panamerican Health Organization/World Health Organization, the U.N. children's agency UNICEF and the World Food Program.

Cuba also had been working since 2007 with socialist ally and oil producer Venezuela to create a health service network across Haiti. Havana already had helped Haiti after the devastating January earthquake, with a medical response reaching a peak of more than 1,700 personnel in March.

Somarriba said Cuban doctors and nurses already in Haiti had treated the first cases of the cholera outbreak on October 15 in Mirebalais in the Center Department, raising the alarm about severe diarrhea later confirmed to be cholera.

In centers run by the Cuban brigade, less people were dying from cholera, Somarriba said. The mortality rate there was under 1 percent, below the national average of 3.5 percent.

He quickly added: "We should avoid competition, comparison. We should all just be helping ... we'll be helping Haiti and all of the Americas because of the risk of this spreading."

They may not have the public relations punch of many international charities but the Cubans have a powerful cheerleader in former President Fidel Castro, who has recounted their exploits in statements on Cuban government websites.

"Haiti needs to be rebuilt from its foundations, with the help and cooperation of everyone," Castro said.