Mirebalais, Haiti - Since October 2010, when a Cuban medical mission first detected cholera in Haiti, the disease has killed 6,600 people and sickened more than 476,000 – nearly 5% of the nation’s population – in what United Nations officials call the world’s highest rate of the disease.

The Cuban medical mission has won accolades for staying on the front lines in the cholera fight and undertaking a broader effort to remake this country’s shattered health care system.

Paul Farmer, the United Nations deputy special envoy to Haiti and a founder of Partners in Health, a non-government organization that has worked extensively on health care in Haiti, said the Cubans helped to mobilize health officials and lessen the cholera death toll. Even more, while the death rate peaked last December and the world’s attention has largely moved on, “Half of the NGOs are already gone, and the Cubans are still there,” he said.

Cuban doctors have worked in Haiti since 12998, when 100 arrived after a hurricane as part of Cuba’s five-decade program of establishing international medical missions. Since then, Cuba has worked with Haiti and Venezuela and lately Brazil, Norway and other countries to build and provide staff and equipment for several dozen small community hospitals and clinics.

The Cubans have sent doctors abroad since the 1960s as a form of ‘medical diplomacy’ that brings doctors to remote areas of poor countries, mainly in Africa, as well as to allied countries like Venezuela, said Katrin Hansing, a professor at Baruch College in New York who is writing a book on Cuban overseas aid.

“It gives them a lot of political capital in the developing world, to keep up that heroic image of Cuba against the United States, that despite the embargo they still champion help to less-developed countries,” she said.

It has also been an important source of foreign currency for Cuba, with earnings from the export of medical services, including 37,000 health workers overseas, estimated at more than $2 billion. Doctors’ pay is roughly $500 per month.

The Cuban medical mission was among the largest international aid contingents to respond after the January 2010 earthquake struck Haiti. And since the cholera outbreak, the mission has treated more than 76,000 cases of the disease, with just 272 fatalities – a much lower ratio, at 0.36%, than the average across Haiti, in which 1.4% of cases ended in death.

“We work a lot on the education of the population,” said Dr Lorenzo Somarriba, the chief of the Cuban medical mission. “We send people to the homes of the victims and educate them on the disease and provide them with tabs to clean the water.”

Several of the doctors, many recent medical school graduates, said they relished the chance to practice what they had only heard about from textbooks.

“We knew cholera from school, but it was hard to believe and see it here because Haiti didn’t have it before,” said Dr Robert Pardo Guibert, who directs a clinic in Hinche. “But it is amazing because we treat everything here, every day there are different kinds of cases.”

The Haitians do not care what nationality the physicians are. “They provide good service,” said Mercidieu Desire who was being treated for diarrhea. “I came in, they treated me and I feel better.”