Thursday, November 05, 2015

Stories for those who don't want Hispanic immigrants


I was one of three World Health Organization staffers assigned to a research project in Colombia. Several Colombians were also assigned to the project, all with strong professional qualifications. Our closest Colombian colleague was a physician who spoke fluent English as well as Spanish, and had a post doctoral degree from the Johns Hopkins University school of public health; he was assigned to our project by an internationally respected Colombian university.

He and his wife, a nurse. were suffering a real tragedy in the illness of their son. The child was in the hospital every month it seemed, and required a lot of attention, If his parents were not both trained medical practitioners I don't know how they could have managed. But our colleague never complained, never failed to show up on time and work a full day, and was a always a professional participant in every activity. (The boy died at age 5, about a year after the events described in the following paragraphs.

The project offices were provided by a Colombian university on campus. At the time I am writing about, the students were on strike, holding open air meetings on campus. The campus was surrounded not by police, but by tough mountain troops brought in by the federal government. They were heavily armed.

On the morning in question, three of us were in the project offices: another WHO project member and I and the Colombian colleague described above. I as the senior of the three decided that we were not safe, and should lock up and leave. As we did so we had to walk past a mob of hundreds of demonstrating students to reach the end of the campus and a line of troops (who were apparently there to keep the student demonstration contained with the campus).

A large number of the students rushed our small party. Our Colombian physician, without hesitation, put himself between the mob of students and we WHO staffers, protecting us with his body and with his voice, explaining we were an international research team affiliated with WHO and should not be harmed. We got out safely!

Were we in danger. A couple of things suggest we might have been. The International Edition of the Herald Tribune the next day published a story that we had been beaten up by the mob. That next day, the situation exploded. 14 people were killed on campus, one a few yards from our (then empty) offices. An estimated 25,000 people were arrested that day, a number far exceeding the jail capacity in our city; prisoners were placed under guard in the sports stadium.

Were we saved by our Colombian colleague? I don't know, but I think the important thing is that this man with all his responsibility did not think twice before getting in the way of what he believed to be serious danger in order to protect two foreign colleagues that he had know for less than a year.

Dominican Republic

I had the great good fortune to work for some time with a Public Health physician in the DR; he had spent time in jail under sentence of death. As he explained to me, in medical school he and some fellow student were talking in their dormitory rooms about Rafael Trujilo. Trujillo was dictator of the Dominican Republic for more than three decades. The students agreed among themselves that the only way his rule was likely to end was assassination. Trujillo had a very effective secret police, and discovered "the plot", had the students arrested and condemned to death.

There was a worldwide outcry at the injustice and letters poured in from around the world written by health workers, scientists and human rights advocates. Eventually the sentences were reduced. After Trujillo's death, the students were released, and my colleague returned to medical school, became a physician, went on to specialize in public health, and was teaching health administration and health planning in the medical school in Santo Domingo, the capitol. He too spoke fluent English as well as Spanish (and for all I know, other languages).

I worked with him for a year to do an assessment of the health conditions, health services and health resources in his country. He led a Dominican team, and I brought in experts to provide assistance in areas where such assistance appeared to be needed. On the basis of this assessment, the USAID mission in the Dominican Republic developed, in conjunction with Dominican authorities, a health sector loan; it focused on developing an rural health system aimed at reducing infant and child mortality. The assessment had recognized that the rural families faced very high child mortality, that there were few resources to pay for medical services in the rural area, but that by focusing on appropriate public health interventions, a lot could be done at low cost. Importantly, the assessment recognized that in the 19th century had successfully provided services in the rural areas with army medics rather than doctors -- thus there was a proven domestic model for such a service.  My colleague also held a number of meetings with groups in the DR who had opposed such delegated medical services for the poor in the past, explaining that the new system would not only meet their objections, while saving lives, but would in some cases serve their economic interests better than the existing do nothing process. They achieved adequate Dominican support to make the new rural health system feasible.

Amazingly, just before the loan came through, my colleague was appointed Minister of Health of the Dominican Republic. He not only had an idea of what he wanted to do, but had a plan for how to do it, and new money to implement the plan. He even had a small team who understood what had to be done and how to do is, for he took key members of his assessment teams to the Ministry with him,

Something over five years later he showed up in my office in Washington unannounced. He had made the trip to the USA specifically to tell me what he had been able to do as Minister to implement the plans. In those five years, infant and child mortality in the rural areas of the Dominican Republic had been cut in half. Thousands of lives had been saved, This had been accomplished by an efficient service based on delegated functions to health promoters and auxiliary health service providers. I can only imagine the obstacles he must have overcome to make that rural health service a reality.

How many of us can ever claim such a success, yet this man did so after being condemned to death and held in jail in the country he eventually served so well.


Hugo Spadafora was a Panamanian doctor and public health official. My office carried out a health sector assessment in Panama, and he was the man chosen to lead the Panamanian team; a long time friend and close colleague led the U.S. funded team of consultants. I was kept abreast of the work of the joint team, and got to visit Panama and meet Dr. Spadafora.

Thus was the Panama ruled by Omar Torrijos, the dictator from 1968 to 1981 (to be replaced by Manuel Noriega, dictator from 1983 to 1989). According to Wikipedia:
Originally a critic of the military regime headed by Omar Torrijos, he (Spadaforo) served as its Vice-Minister of Health. 
Spadafaro was completely dedicated to the welfare of the people and this was risky in Panama. Indeed,:
Concerned about the increased Soviet and Cuban influence in the Sandinista regime of Nicaragua and the delay of free elections, Spadafora joined the Sandino Revolutionary Front (FRS) alongside Edén Pastora ("Comandante Zero"), hero of the August 1978 seizure of Somoza's palace. 
Wikipedia states:
Torrijos died in a plane accident on July 31, 1981. Colonel Roberto Díaz Herrera, a former associate of Noriega, claimed that the actual cause for the accident was a bomb and that Noriega was behind the incident.
Wikipedia goes on to report:
About this time (1984), Hugo Spadafora, a vocal critic of Noriega who had been living abroad, accused Noriega of having connections to drug trafficking and announced his intent to return to Panama to oppose him. He was seized from a bus by a death squad at the Costa Rican border. Later, his decapitated body was found, showing signs of extreme torture, wrapped in a United States Postal Service mailing bag. His family and other groups called for an investigation into his murder, but Noriega stonewalled any attempts at an investigation. Noriega was in Paris at the time of the murder, which was alleged by some to have been at the direction of his Chiriquí Province commander, Luis Córdoba. A conversation captured on wiretap between Noriega (in Paris) and Córdoba included the exchange: 
Córdoba: "We have the rabid dog."
Noriega: "And what does one do with a dog that has rabies?"
President Barletta was visiting New York City at the time. A reporter asked him about the Spadafora matter, and he promised an investigation. Upon his return to Panama, he was summoned to FDP headquarters and told to resign. He was replaced by First Vice President Eric Arturo Delvalle. As a friend and former student of George Shultz, Barletta had been considered "sacrosanct" by the United States, and his dismissal signaled a marked downturn in the relations between the U.S. and Noriega. Herrera, a former member of Noriega's inner circle, told Panama's main opposition newspaper, La Prensa, that Noriega was behind Spadafora's murder, and many other killings and disappearances as well. This resulted in an immediate outcry from the public.
How Proud We Should Have Been Had These Men Chosen to Immigrate to the USA!

These three men were highly cultured, highly educated, who had achieved positions of trust and responsibility in their own countries. One put his safety on the line to assure mine, one served in prison under a death sentence imposed by its dictator, and one was actually tortured and beheaded. All were devoted public health physicians, who took risks of contracting serious diseases every day for years. All faced unsympathetic governments to help their people, All had taken the trouble to learn English as a second language. I would have been proud to sponsor any of these three for citizenship if asked. Each would raise the quality of our people by joining us.

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