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Extensive care

Cuba has long been a medical destination for Latin America’s leftist leaders and trainee doctors. Venezuela’s Hugo Chávez, for example, travelled to the Caribbean island on several occasions for surgery following diagnosis of the cancer that would eventually kill him, while thousands of medical students have received subsidised training in Cuba since its revolution in 1959. 

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But it’s the country’s white-coat diplomacy overseas that has been most effective. Cuba’s doctors have been on call at nearly every major international disaster of the past 60 years, from the Algerian War of Independence to the Chernobyl disaster. Alongside others in Latin America, it has a strong presence in Africa: in 2020 Cuban doctors were dispatched to South Africa to help deal with a coronavirus outbreak there. What has raised a few eyebrows is their sage presence in more developed nations. 

Calabria’s right-leaning governor recently signed an accord to bring almost 500 Cuban doctors to the southern Italian region. A medical system that has suffered from chronic financial mismanagement and mafia infiltration arguably needs all the help it can get. But thorny issues, such as the fact that the Cuban doctors only receive a small amount of their salaries (with the rest going to the state) and that Italian doctors say they want to work as long as the conditions are right, have called into question the host nation’s motives.

Despite – or perhaps even because of – this, however, the image of the selfless Cuban doctor going out into the world to treat, care for and heal remains.


politics  brazil
Back to the future

The four-year tenure of Jair Bolsonaro has left Brazil isolated on the world stage as the former president took increasingly provocative positions on climate change, coronavirus and Ukraine. It also left the nation divided at home. The election of Luiz Inácio Lula da Silva – his third such triumph – is a chance to reset. Here’s what’s in Lula’s in-tray for when he takes office again on 1 January 2023.

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Restoring Brazil’s international standing
Western leaders such as Joe Biden and Emmanuel Macron wasted no time in congratulating Lula on his victory, a sign of both the goodwill he has generated and their desire to work with his administration. But his first test comes close to home: Bolsonaro alienated many of his fellow Latin American leaders; Lula needs to get them back onside if Brazil, the continent’s largest and most populous country, is to take the lead in the region. 

Protecting the Amazon
Brazil is home to 60 per cent of the world’s largest rainforest, which itself is home to about 10 per cent of the world’s known species. Thankfully the country now has a president who is committed to protecting it. His first task is to reverse the logging licences granted by his predecessor. As well as the felling of trees, deforestation also causes the uprooting of communities. Lula has signalled the creation of a new ministry dedicated to the protection of Brazil’s indigenous people, many of whom live in the Amazon basin. 

Unifying the country
It will be important for Lula to remember by how slim a margin he won the 2022 presidential election: 50.9 per cent to Bolsonaro’s 49.1. Brazil is a deeply divided country, as was evident in Bolsonaro supporters’ protests after the result. Lula must immediately set about bringing it back together. One way for him to signal such intent would be by naming a politically diverse cabinet. It is unlikely that he will appoint any senators from the far-right but including talented centrists such as Simone Tebet would show a desire to bridge the political divide. 


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environment ––– sierra leone

Up, up and away

Situated between the Atlantic Ocean and a rapidly heating continent, Freetown, the capital of Sierra Leone, is particularly vulnerable to the effects of climate change. “We are seeing a huge increase in rural-to-urban migration,” Yvonne Aki-Sawyerr, the city’s mayor, tells monocle at the UN Climate Conference (Cop27) in Sharm El-Sheikh. Over the past 20 years, the population of the city has almost doubled to 1.2 million residents, in large part due to the desertification of agricultural land. 

Aki-Sawyerr (pictured) has become a figurehead for Africa’s fight against climate change. “We haven’t been waiting for the national government,” she says, explaining the importance of large cities leading change. “When we launched Transform Freetown [an urban-regeneration plan], our first significant source of funding was the World Bank. We approached them directly but they only deal with nation states, so we asked Sierra Leone’s ministry of finance to get involved.” 

For the mayor, green policy should be bottom-up rather than top-down. Take Freetown’s public transport fleet, which is old and heavily polluting. In partnership with Sierra Leone’s Ministry of Transport and Aviation, the city will launch a solar- powered cable-car system that can transport up to 6,000 people an hour. Aki-Sawyerr believes that it will be a “game-changer” for Freetown – and for Africa.


Images: Reuters, Getty Images

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