Letter from Bolivia:Cuba and Venezuela have joined in an ambitious scheme to bring health and literacy to those who want them in Latin America: to judge from the results achieved over the past year here in Bolivia it is a notable success.
It is eclipsing whatever aid effort is made by the EU or the US while greatly boosting the popularity of Bolivia's leader Evo Morales, Fidel Castro and president Hugo Chavez of Venezuela.
Here in one of the world's poorest countries and elsewhere in this region, it has created a political situation which neither the friends nor the opponents of Morales and the other two leaders can afford to ignore.
Take Alexander, a Cuban doctor, who, helped by his blond wife Susi, run the Cuban hospital at El Alto, the satellite town of one million inhabitants, close to Bolivia's commercial capital La Paz. It caters for up to 1,000 patients a day with a staff of 46, of which more than half are doctors, and is one of 20 Cuban hospitals which are already in operation in one of the poorest countries in the western hemisphere. Another 23 are to be added this year.
Alexander and Susi were old hands in Cuban foreign aid: they had worked in Zambia and then in the Gambia. "That was good for my English," Alexander said, recalling the English friends they met in Africa now living in Barking, London and constant visitors to their home in Havana.
A few hundred metres away was another establishment, the specialised ophthalmic hospital, a joint Cuban-Venezuelan operation financed by Venezuela and open from nine to five where Cuban surgeons carry out non-stop eye operations. It is one of a number of such centres where Cuban specialists carried out 56,144 operations last year. They include two on Bolivia's borders with Peru at Copacabana and Argentina at Villazon where more Peruvians and Argentines respectively are treated than Bolivians. All are treated on the same terms: treatment is completely free.
Indeed the Cuban and Venezuelan governments have announced that they are offering eye surgery to anyone living in the western hemisphere, including the US, with an inclusive package including return journeys to Cuba for the patient and a companion, and medicines for the inclusive price of nothing.
The effect of the initiative in the small islands of the Caribbean on Cuba's doorstep is reported to be immense. Bizarrely one of the reasons why there are Cuban-Venezuelan hospitals sited in Bolivia is that many patients could not scrape enough money together for a passport which would enable them to go to Cuba.
In January, in his state of the nation speech, Morales reported that in the previous 12 months Cuban doctors had attended 3,217,897 patients - more than one in three of the population - saving 4,179 lives in 4,664 non-eye operations. The Cubans sent 564 tonnes of medical supplies.
There are 1,766 Cuban health workers in Bolivia at the moment and another 300 doctors due to arrive later in the year. In another part of town, the Cuban and Venezuelan governments are hard at work supporting the president's literacy campaign with teacher training, television sets, cassettes and books. Some Bolivian doctors are reported to be resentful of the Cuban staff, distrustful of their competence and suspicious of their political motives, but Jaime Ribera, a prosperous Brazilian-trained urologist from Santa Cruz, who is about to build himself a new clinic in his home town, had no worries.
"At first I thought the Cubans were bringing their politics and would try to make our people into communists - though that would be a difficult process as no one wants communism here. But I've seen no evidence that this is happening. I'm glad they're here," he said. It was a much needed boost to the Bolivian health service where a small proportion of the working population had union-organised health insurance, some were rich enough to buy private health cover, while the rest had to rely on the pitifully inadequate state system.
Cuba, backed by the oil funds of president Chavez of Venezuela, is harvesting diplomatic rather than ideological benefits. At Alexander's hospital there was no sign of political propaganda except for a poster for the 40th anniversary of the death of Che Guevara here in Bolivia which the Bolivians themselves are officially recalling. Alexander himself, though friendly, abstained from making much comment. "We're guests in this country, you know," he told me.
There does, nevertheless, remain some resistance to Cuban aid. In his report on 2005, the president recalled that the remote northern jungle province of Pando wanted no truck with the Cubans. But when the prefect or governor of the province had an accident it was the doctors from the Caribbean who looked after him and saved his life. It is clear that the Cubans and Venezuelans are making a special aid effort for the recently installed Bolivian government but Cuba's aid effort is worldwide. Evidence of that is Alexander's own international experience and the news, for instance, that Havana signed a health deal with the Solomon Islands, the former British colony in the western Pacific, shortly before it was hit by a tsunami earlier this month.
Welcoming the first Cuban ambassador in Honiara, the islands' capital, the governor general Nathaniel Waena said technical co-operation agreements would pave the way for Solomon Islanders to train in the Cuban health sector and for Cuban medical brigades to serve in the islands.
The EU can count on the impending Spanish gift of 700 ambulances to Bolivia to raise its profile here. But Venezuelan and Cuban aid is much bigger. No one is happier than the Bolivians at the international competition to help them and are not worried that the Cubans and Venezuelans are winning that race.