Brazilians living in poor and under-served regions of the country are wondering what the exit of thousands of Cuban doctors will mean for their future access to healthcare.

Since mid-November Cuba has recalled thousands of doctors from Brazil following demands by president-elect Jair Bolsonaro that the terms of the doctors' contracts be revised. He wants Cuba to pay the doctors in full; at present, Havana takes about 70 percent of the wages earned by doctors serving in Brazil under a WHO-brokered programme called More Doctors, which was started in 2013 under the watch of then-president Dilma Rousseff.

As well as asking Havana to pay doctors fully, Bolsonaro says the terms of the More Doctors deal should be changed to allow the families of Cuban doctors to join them in Brazil. He also urged Cuban doctors to renew their medical licences in Brazil in order to practice. Cuba has flatly refused the demands to renegotiate the More Doctors programme and has asked the doctors to return home.

Thousands of Cuban doctors were working in underserved, poor areas of Brazil before Bolsonaro made his demands. They are among a wider pool of Cuban doctors working in around 77 countries. Estimates suggest Cuba earns $8bn each year from sending doctors abroad and taking a cut of their wage. But while some Cuban doctors say they still make more than working in Cuba; others say the Cuban government should not take their wages at all.

Meanwhile, health experts in Brazil are now concerned that a shortage of Cuban doctors will badly affect the communities they have long served. Brazilian doctors tend to work in wealthier parts of the country and the More Doctors programme helped bring healthcare provision to more than 700 municipalities where healthcare provision had been scant.

What will be the likely impact of the standoff for millions of people in poor areas of Brazil, how can Brazil bridge the gap in healthcare provision, and what does the impasse mean for Cuba? Join the conversation to find out.

On this episode of The Stream, we speak with:

Luiz Facchini @ABRASCO
Coordinator, Associação brasileira de saûde coletiva

Dr. Paulo Abati

Arturo Lopez-Levy @turylevy
Assistant professor, Gustavus Adolphus College

Nora Gámez Torres @ngameztorres
Journalist, Miami Herald 

Without its flying doctors, Cuba’s economy will be in intensive care - Bloomberg
Cuba's most valuable export - its healthcare expertise - Forbes