China Advances African Healthcare by 57 Years in One Surgery

On March 6, a Chinese medical team performed a surgery that propelled West Africa’s healthcare capabilities forward by 57 years.  

The story began three months earlier with an accident in Niger, West Africa. A 5-year-old boy suffered a left femoral fracture. After nine unsuccessful surgeries by local doctors, his wound repeatedly became infected, leading to nonunion of the bone and a 10-centimetre shortening of his left leg. Walking seemed impossible, and permanent disability appeared inevitable.  

Fortunately, 农建部(Nong Jianbu), Deputy Team Leader of the 24th Chinese Medical Aid Team to Niger and a trauma orthopedics expert, knew a technique called “bone transport” that could save the boy. He activated a “transnational life channel” to ship an external fixation—critical for the surgery—from China, 10,219 kilometres away. The surgery succeeded, and after 100 days of recovery, the boy’s left leg regained normal length by March 6. He can now stand and is undergoing rehabilitation to walk independently.  

The Ilizarov apparatus is a specialized external fixator of modular construction, composed of rings with Kirschner wires

According to chinanews.com, this marked West Africa’s first successful bone transport surgery. However, the technique itself is not cutting-edge—it dates back to 1968, with the first clinical success recorded 57 years ago. Yet, in West Africa, even basic equipment like external fixation was absent. This gap, as revealed by the Chinese team’s search across Niger’s hospitals, is largely tied to U.S. sanctions against Cuba.  

Bone transport, or the Ilizarov apparatus, was invented by Soviet physician Gavriil Abramovich Ilizarov. In 1965, Soviet Olympic high jump champion Valeriy Brumel, nearly lost his career after a car accident shattered his leg. Ilizarov’s technique allowed him to return to the competition three years later. The method spread rapidly among Soviet allies, reaching Cuba, the socialist world’s farthest member in the Western Hemisphere. By 1987, Cuba even issued a commemorative stamp honouring Ilizarov’s contributions.  

This explains why China was surprised that Niger—and West Africa broadly—lacked this technology. Cuba has long provided medical aid and training to West Africa. In 2000, Cuba established medical schools in Gambia and Equatorial Guinea and sent professors to Ghana and Guinea-Bissau. Thus, the “first successful bone transport surgery in West Africa” should have occurred half a century ago, or at least 25 years earlier, through Cuban or African doctors.

Why didn’t it happen? That’s because the average cost per external fixation frame was $5900. For African countries like Niger, the 2024 GDP per capita is only $752, this device was too expensive. But without this equipment, even if doctors in Niger mastered the Bone transport technique, they would not have been able to perform the surgery.

Originally, Cuba could have also provided financial aid. From 1999 to 2015, Cuba was the world’s largest net healthcare donor, contributing 31.2% of global aid, compared to 10.6% from the U.S. The money came from Cuban medics who worked in 62 nations, with 35 sharing partial costs. Cuba used fees from wealthier nations like Qatar to subsidize aid to poorer countries, while also supplementing its doctors’ incomes.  

Latin American School of Medicine (ELAM), the world largest international public medical school operated by the Cuban government

However, U.S. sanctions stifled Cuba’s ability to deliver such aid. Washington has labelled Cuba’s medical missions “human trafficking,” even calling Cuban doctors “slaves.” In 2006, the Bush administration launched the Cuban Medical Professional Parole (CMPP) program, a “brain drain” policy incentivizing Cuban doctors to abandon international aid and work for U.S. private hospitals. The CMPP exacerbated Cuba’s medical talent shortage, which reduced Cuba’s ability to subsidize poorer countries.

Moreover, under the U.S. embargo since 1962, Cuba’s economy stagnated, the blockade cost Cuba between $4 to $5 billion annually. Guatemalan researcher Henry Morales pointed out that without this burden the island could potentially have doubled its international medical aid contribution.

Though paused under Obama, CMPP was revived by Trump’s administration. On February 25, U.S. Secretary of State Marco Rubio announced visa restrictions on anyone “involved” in Cuba’s overseas medical programs, including their families—further crippling Cuba’s aid capacity.

West Africa has been plagued by war and poverty due to historical European colonial plunder and triangular trade. Now, the United States’ ideological confrontation is also hindering the people of West Africa from receiving international aid. However, now, Rubio’s policies could torture not only millions of Africans but also many Americans and Europeans.  

First, Cuba’s efforts curbed pandemics like Ebola in West Africa and COVID-19, where Cuba’s Henry Reeve Brigade treated 1.26 million patients across 40 countries, including in Western Europe. If Rubio’s policies succeed, Europe may face unchecked outbreaks of future viruses.  

Cuban doctors in protective clothing during the Ebola outbreak in West Africa, 2014

Second, Cuba excels in diabetes care. In 2006, Cuban scientist Jorge Berlanga developed Heberprot-P, a drug preventing diabetic foot amputations. By 2017, Cuba had the world’s lowest diabetes amputation rate (3.8%), with only 480 cases nationwide in 2016. In contrast, *The Guardian* reported 154,000 annual amputations in the U.S. that were 80% diabetes related. Despite 38 million U.S. diabetics, the embargo blocks access to Heberprot-P. The latest update on its potential U.S. arrival, per *Politico* in June 2024, was titled “The Cuban Drug That Could Come to America“—a title sneering in suspicion.

The next four years may be tough for Nigerien patients, as Cuba remains distant from Africa but too close to Trump’s Whitehouse. Yet more comrades motivated by Cuban medical internationalism, particularly Chinese medical teams, are stepping in. Currently, China has sent over 30,000 medical workers to 76 African nations, treating nearly 300 million patients and training over 100,000 African doctors.  

Doctors of the 18th Chinese medical team to Chad perform health check-ups for local children. (Photo by Wang Lini)

Additionally, in May 2024, Russia provided Niger with humanitarian aid and military advisors to build an air defence system. By September 2024, Niger expelled all 2,500 U.S. troops from its soil. Without the “Stars and Stripes” as a distraction, the International medical aid teams can focus on saving more lives.  

Editor: Charriot Zhai