Internationalist Doctors: A Conversation with Vanessa Almeida and John Chikuike Ogbu

In the late 1990s, two powerful hurricanes swept through the Caribbean, leaving scores dead and injured. The human catastrophe that emerged in their wake showed the need for more doctors in the region. In response, Fidel Castro founded the Latin American School of Medicine [ELAM, for its Spanish initials] in Havana.

Inspired by Cuba’s internationalism, Venezuela founded its own ELAM in 2007. The school has graduated thousands of doctors from around the world. If you visit its busy headquarters in the center of Caracas, you can hear anything from Arabic to Haitian Creole, from Portuguese to English spoken in its hallways. 

We talked with two young ELAM students about their experiences at ELAM. Vanessa Almeida is a 5th-year student hailing from Itamaraju, a small rural town in Brazil. John Chikuike Ogbu is a second-year student born to a working-class family in the city of Enugu, Nigeria. 

Vanessa, as the main student spokesperson, could you explain the ELAM’s purpose and project?

Vanessa Almeida: The ELAM was the apple of Chávez’s eye and a child of the Cuban Revolution. The Latin American School of Medicine is a community of future doctors from around the world, particularly from the Global South, who are committed to returning to their home countries and working with underserved populations. 

Cuba’s ELAM dates back to 1999. In fact, it was founded when the situation on the island was really difficult. What did Fidel do in the face of adversity? Did he give up on the revolution’s internationalism? No, he turned around and said: While others send weapons and armies to occupy countries, we will send an army of doctors to save lives. It was part of his “Battle of Ideas.” Then, in 2007, Chávez brought Cuba’s ELAM project to Venezuela.

Today, ELAM doctors can be found in barrios and favelas, and in the most remote rural areas around the world. 

Hugo Chávez, the founder of Venezuela’s ELAM, believed that healthcare was a universal right, and international solidarity was at the center of his politics. That’s why Cuba’s ELAM was such a perfect match for the Bolivarian Revolution. 

The ELAM is perhaps the project that best expresses Cuba’s and Venezuela’s dedication to promoting social justice and equality around the world… even during very hard times! 

Venezuela has faced severe difficulties in recent years due to US sanctions. While the ELAM never closed its doors, surely there have been challenges. 

Vanessa: Things haven’t been easy: the blockade, the pandemic, the political attacks on the revolution. Yet Venezuela kept its doors open to us and became our home away from home. 

When things got really difficult, Nicolás Maduro could have said: Let’s just focus on our people. Instead, he decided to follow Chávez’s example and maintain the ELAM project alive. This is a wonderful story. In return, we students commit more and more to the Revolution and to becoming that army of doctors that Fidel and Chávez dreamed of. 

One thing that I should add to this is that even when things were very difficult in Venezuela, the school provided food and housing for us. It also covered the costs related to studying. I’m grateful for this: most of us could never have studied medicine back home, or if we had the option, it would have cost us an arm and a leg.

How is the practice of medicine conceived at the ELAM? 

John Chikuike Ogbu: The ELAM’s conception of medicine is radically different from the conventional one. Our curriculum focuses on “integral community medicine,” which involves a humanist perspective that brings together science and a commitment to society. 

Love and humility are key to becoming community doctors. We learn all this while studying anatomy, biochemistry, and medical ethics.

ELAM physicians go into the world, dedicated to the well-being of communities; they don’t sit in a fancy doctor’s office waiting for the sick to come to them to be “healed” by a God-like doctor. Additionally, the kind of healthcare promoted by the ELAM is, first and foremost, preventive. 

Capitalism commodifies everything, even healthcare. The ELAM, on the other hand, de-commodifies it. Vanessa, could you talk about that?

Vanessa: That’s true, capitalism commodifies everything, even health! Conventional doctors are trained to “fix” people so they can charge you a pretty penny and send you back into the capitalist workforce. They are not trained to understand patients’ psychological pain or their socioeconomic concerns. 

On the other hand, an ELAM doctor will understand the community where she practices because she lives there; because she walks through its streets on her way to the office; because she talks to those in the community and visits those who are sick at home if necessary. 

An ELAM doctor is not trained to get rich but to serve the people. In my case, when I graduate, you can be sure that I won’t be involved in commodifying health. Instead, I will work hard for the sake of a thriving, healthy community.

I should add that the kind of medicine promoted by the ELAM is “integral,” transcending the conception that patients are mere sums of their organs. We see patients holistically, with diagnoses accounting also for their cultural context, socioeconomic factors, and family context. 

This holistic approach allows us to get to the root causes of a recurring headache or a terrible bellyache, potentially offering solutions that don’t solely rely on medication. Of course, this doesn’t mean that scientific knowledge is not important to us, but it is just one part of the solution.

What is the role played by internationalism in the ELAM?

John: The ELAM is a truly internationalist initiative. It hosts students from over 20 countries at the moment, predominantly from the Global South. The institution has a solid South-South perspective, and its heart beats for the oppressed. 

Chávez dreamed that the ELAM would become an international community, and that is precisely what has been achieved. Our classmates and comrades hail from Latin America, the Caribbean, and Africa, and there’s also a significant contingent of Palestinian brothers and sisters studying here. 

John, before coming to Venezuela, were you familiar with the Bolivarian Process?

John: I was unfamiliar with Chávez and the Bolivarian Process before coming to Venezuela. I had the dream of becoming a doctor and got into the ELAM via an institutional agreement. That is, it was only here that I got to learn about the Bolivarian Process and fell in love with the Venezuelan pueblo. I’m immensely grateful to be realizing my dream of studying medicine at the ELAM!

Vanessa, you are a militant of the MST [Landless Workers Movement], an organization with longstanding connections to the Bolivarian Process. What significance does Chávez’s legacy have for you?

Vanessa: In the MST, we love Chávez very dearly, because he reshaped the course of Latin American history, because he was a true internationalist, and because he cared about the working people of the world. He also connected with campesinos in a special way.

However, my commitment to Chávez, and also to Fidel, deepened at the ELAM. In our school, Chávez is alive!

There’s a story about Chávez that I found very moving. When he was being treated for cancer in Cuba, he constantly inquired about his people: How is my pueblo? He would ask it in the morning, he would ask it when waking up from surgery, and he would ask the same question to every person who visited him. He was always thinking about the people!

As ELAM physicians, we must emulate this: the people, the pueblo, are our first, second, and third priority. 

But to do this well, we have to study a lot. That’s why I wake up at 5 am every day and go to bed late. I have to make the most of this extraordinary opportunity. Then, when I graduate, I’ll go back home and offer to the community what the Bolivarian Revolution gave to me.

John, as a Nigerian, you’re pretty far from home and have had to learn a new language. Could you share that part of your story with us?

John: Indeed, not everything has been easy. First, when I arrived, I had to go through a long quarantine period, practically in isolation. Then, there’s the challenge of the language. I didn’t speak Spanish when I arrived, and I still struggle with it.

I remember that as a pre-med here, I had to study biochemistry, which is challenging in itself. Trying to navigate the content while learning the language was stressful, but I was determined to succeed. I would turn to YouTube, borrow books and, if need be, my classmates would come to the rescue. Little by little my language skills improved, and although the academic regime remains intense, most of the time I don’t struggle with the language.

There have been other hurdles too: we are all far away from home and have very long days, so sometimes I can’t call my family and that’s hard. Thankfully, my classmates and teachers are becoming a second family to me, so while I miss my family back home, I don’t feel so lonely anymore. 

Vanessa, can you tell us about the academic work at the ELAM and its curriculum?

Vanessa: Here at the ELAM, we have a very demanding schedule of study and practice. As a 5th-year student, I have long hours of hospital rotations alongside some 24 hours per week of formal classes.

Our professors, hailing from Cuba and Venezuela, are very qualified and they are also committed to the revolution. However, they don’t impose any politics on us: our hearts are with the Bolivarian Process not because it’s a requirement, but because we receive so much love from Venezuela. 

Finally, I would highlight that our professors teach us how to be humanist scientists, committed medical professionals, and better people overall. 

Both of you are actively involved in medical practice. Let’s delve into that aspect of your education.

John: I intern at the Amelia Blanco Integral Diagnostics Center [CDI], where we learn about preventative and curative medicine. We also do house-to-house visits to map the community and understand the socioeconomic profile of the barrio. This is key to becoming an “integral” doctor. 

Learning to work and care for people early on is very important at the ELAM. If we don’t have a good rapport with the people, we won’t be able to help them heal. 

Vanessa: Currently, I’m in rotation at the Victorino Santaella Hospital in Altos Mirandinos, and the experience has been extraordinary. I have learned a great deal from the residents, doctors, and specialists, and also from the hospital director, who is truly committed. You can often see her in the hallways of the hospital solving problems, making sure that there are medical supplies, and so on. That’s how any medical administrator should be: hands-on.

In my medical rotations, I learn how to treat and care for both an old woman and an infant and how to perform certain surgeries. Meanwhile, I was developing the skills to accompany people through very challenging moments. 

Returning to the impact of the blockade that Venezuela faces, have you observed its effects on the medical system?

Vanessa: I have. The blockade has has a clear impact on hospitals and medical facilities. Despite these challenges, there are dedicated doctors and medical personnel who have risen to the occasion, performing miracles to save lives.

The government also works to ensure that hospitals are adequately stocked. I have personally witnessed how some of the South-South alliances are yielding results. Medical facilities are better stocked now. While some packaging and instructions may be in Chinese or Arabic – presenting its own set of challenges – we now have the skills to identify supplies. We make the most of what we have.

In short, the US blockade is criminal, and its impact on the health of the Venezuelan people is very real, but we are able to care for our patients.