U.S. Unjustified Campaign To Discredit Cuba’s Foreign Medical Mission Program 

Over the last several years, the U.S. has been waging a campaign seeking to discredit Cuba’s foreign medical mission program. This campaign includes the State Department’s annual reports on human trafficking that have alleged Cuba has been engaged in illegal forced labor of some of its medical professionals in these programs. Another part was the recent decision to deny U.S. visas to Cuban officials directing the medical mission program.[1] The most recent measure has been the U.S. Agency for International Development (USAID’s) soliciting bids to conduct research and analysis of evidence regarding the forced labor allegation. Some Congressmen also have suggested reactivation of a U.S. program providing U.S. parole visas for such medical professionals to be admitted to the U.S.[2] Unsurprisingly Cuba denies these allegations and condemns these U.S. programs. (Emphases added.)

Here we will look at key parts of this trafficking in persons report, the recent USAID solicitation of bids for research and analysis, Cuba’s response to that solicitation and a demonstration why the U.S. allegations are specious.

U.S. 2019 Trafficking in Persons Report [3]

The most recent such report, which was issued on June 20, 2019, said the following, in part:

  • In November 2018, Cuban healthcare workers filed a class action in the U.S. District Court Southern District of Florida under the Trafficking Victims Protection and the Racketeering Influenced and Corrupt Organization Acts alleging the Cuban government profited from the export of healthcare professionals; the case remains pending.[4] In Brazil, the Cuban government collected revenue for each professional’s services and paid the worker a fraction of the revenue depositing a large percentage of the worker’s wages in an account in Cuba only accessible upon completion of the mission and return to Cuba. . . . Some participants in foreign medical missions as well as other sources allege Cuban officials force or coerce participation in the program; the government has stated the postings are voluntary, and some participants also have stated the postings are voluntary and well-paid compared to jobs within Cuba. Observers report the government does not inform participants of the terms of their contracts, making them more vulnerable to forced labor. The Cuban government acknowledges that it withholds passports of overseas medical personnel in Venezuela; the government provided identification cards to such personnel. Some Cuban medical personnel claim they work long hours without rest and face substandard working and living conditions in some countries, including a lack of hygienic conditions and privacy. Observers note Cuban authorities coerced some participants to remain in the program, including by withholding their passports, restricting their movement, using “minders” to conduct surveillance of participants outside of work, threatening to revoke their medical licenses, retaliate against their family members in Cuba if participants leave the program, or impose criminal penalties, exile, and family separation if participants do not return to Cuba as directed by government supervisors.” (Emphases added.)

USAID’s Solicitation of Research Bids [5]

On August 12, 2019, the U.S. Agency for International Development (USAID) announced that it was offering up to $3 million to organizations that would “investigate, collect, and analyze information related to human rights violations – including forced labor – of Cuban medical personnel exported overseas.”

USAID purported to justify this effort by alleging, “The Cuban regime exploits its medical professionals, teachers and other workers, using them to buy international financial and political support and keep its struggling economy afloat, while pocketing the majority of these workers’ salaries and subjecting them to poor living conditions, constant surveillance, and threatening those who wish to leave their mission. At the same time, Cubans on the island struggle to find adequate healthcare and other basic services while the regime touts the false narrative that it has the best medical care in the world.” (Emphasis added.)

In addition, USAID said, “the information collected should also document the effects of these practices on Cubans on the island. The data collected would be used for advocacy within Cuba, in Latin America and with regional and international bodies, such as the Inter-American Commission on Human Rights (IACHR) and the United Nations Human Rights Council (UNHRC) in an effort to pressure the Cuban regime to improve the living conditions of doctors and other workers, and promote greater respect for labor and other basic human rights for all Cuban citizens.”

Cuba’s Response[6]

In an August 30 Declaration, the Cuba Foreign Ministry “energetically denounces and condemns the recent aggression of the government of the United States against Cuba via a USAID program designed to fund actions and information searches to discredit and sabotage the international cooperation being provided by Cuba in the health area in dozens of countries for the benefit of millions of persons.  This is an endeavor added to the crude pressures exercised against a number of governments in order to obstruct Cuban cooperation and to the earlier efforts for the same purpose such as the special ‘parole’ program designed to steal human resources trained in Cuba.”

“The heart of this immoral calumny consists of alleging, with no factual foundations whatsoever, that Cuba is involved in the traffic of persons or in the practice of slavery, and wishing to degrade the meritorious work that hundreds of thousands of Cuban health professionals and technicians are voluntarily undertaking, and have been undertaking, throughout history, in a number of countries, especially in the Third World.”

This is “an affront to the bilateral and intergovernmental cooperation programs, all lawfully set up between the Cuban Government and the governments of dozens of countries, which have been consistent with the [U.N.] guidelines referring to South–South cooperation and which have responded to the health requirements that those same governments have defined in a sovereign manner.”

“This is an attack against the efforts in solidarity which have received the acknowledgement of the international community and the specific praise from the most senior officials of the United Nations, the World Health Organization and the Pan-American Health Organization.”

“These lies reveal the low morality of the [U.S.] government and its politicians who devoted themselves to the business of aggression against Cuba.  The campaign has millions of dollars of funds and the complicity of a number of the mass media giants and, particularly, of unscrupulous reporters who have sacrificed their so-called impartiality and objectivity in the service of the political interests of the [U.S.] government.”

“For decades . . . in those nations having more unfavorable economic conditions, that cooperation has been provided, and is being provided, as a gesture of solidarity; its expenses are covered by Cuba practically in their entirety. Likewise, and following the [U.N.] conceptions on cooperation between developing countries, this is being offered in various nations on the basis of complementarity and partial compensation for services rendered.”

Cuba has provided “self-sacrificing and humanist professionals ready and willing to work of their own free will in the most difficult of conditions, and of the ideas of health coverage that years of successful experience has permitted us to build up.”

“The Cuban technicians and professionals participating in those programs do so in an absolutely free and voluntary manner.  While serving their missions, they continue to be paid their entire Cuban salaries and they also receive stipends from the destination countries, along with other forms of compensation.”

“In cases where Cuba receives compensation for the cooperation being provided, those . . . [countries] distinguish themselves by contributing a highly valued, fair and totally lawful amount for the funding, sustainability and development of the massive and free health system that is accessible to each and every Cuban, as well as for the cooperation programs that are carried into many parts of the world.”

“Access to health is a human right.  The United States is committing a crime when it wishes to deny that or to obstruct it for political reasons or as aggression.”

This Cuban criticism was echoed in an August 31 tweet by President Miguel Diaz-Canel, who said, “The carelessness, the lie, the perversity of the empire crumble before the moral height accumulated by the dignified history of the Cuban missions in health.”

The Specious U.S. Allegation of Illegal Forced Labor [7]

The contention that Cuban medical personnel in Cuba’s foreign medical mission program are engaged in illegal forced labor is meritless for at least the following reasons:

  • Medical education in Cuba is free and requiring medical graduates to pay the country back by such participation seems entirely appropriate and may indeed be a contractual or quasi-contractual obligation.
  • International medical aid has been a significant part of the Cuban people’s tradition of international solidarity, and some Cuban medical personnel have said that such service had a major positive impact on their lives and medical careers.
  • The relevant standard for evaluating the allegationthat Cuba’s international medical mission program violates international law is the International Labor Organization’s Forced Labour Convention, 1930.
  • That multilateral Convention or treaty provides that “for the purposes of this Convention, the term forced or compulsory labour shall not include . . . any work or service which forms part of the normal civic obligations of the citizens of a fully self-governing country.” (Art. 2(2)(b).) (Emphasis added.)
  • Although it is true that the Cuban government receives direct payment from other countries for the foreign medical mission program and that the Cuban government retains some of those payments before paying the Cuban medical professionals, it also is true that such payments to those professionals exceed what they would have earned for similar services in Cuba. In addition, some of the payments to the Cuban professionals are deposited in Cuban accounts only accessible upon their completion of service and return to Cuba. But such practices do not constitute proof of forced labor.
  • While it also is true that some Cuban medical professionals who have participated or are now participating in the foreign medical mission program allege that they were coerced into doing so, the report indicates that the Cuban government and other participants deny that allegation and that there has been no independent adjudication of that allegation. (Emphases added.)
  • Also relevant to this allegation is Cuban medical professionals’ undoubted awareness of the significantly higher compensation they potentially could obtain if they were able to relocate in the U.S. or certain other countries.
  • A detailed study by Indiana State University’s Emeritus Professor of International Politics and Latin America, Dr. H. Michael Erisman, has rejected this accusation of forced labor.

The latest report on Cuba also fails to mention that the U.S. and Cuba apparently had friendly bilateral discussions about other human trafficking issues during the Obama Administration (2015 through January 17, 2017) and the Trump Administration (2017-2018).

The hypocrisy of the State Department’s repeated assertion of this claim of forced labor without recognizing the ILO’s Forced Labour Convention is shown by Secretary of State Pompeo’s congratulating the ILO on its centennial anniversary only one day after the release of the 2019 Trafficking in Persons Report. The Secretary said:

  • “The dignitaries that convened in Paris in 1919 to end the Great War knew that any lasting peace needed to be rooted in the protection of individual rights, including the rights of workers and employers to associate freely and bargain collectively. “
  • The United States proudly hosted the first International Labor Conference in 1919 and the “war-time conference that enshrined the ILO’s enduring founding principles and aims in the Declaration of Philadelphia. As strong supporters of the ILO and its mission, we reflect on the important role played by Americans to create and sustain this organization, including David Morse, who served as ILO Director-General for 22 years, and under whose leadership the ILO won the Nobel Peace Prize.”
  • “As the ILO enters its second century pursuing objectives critical to economic prosperity and security around the world, the United States recommits itself to advancing the rights of workers globally.

Another rebuttal of the U.S. allegations about the medical mission program recently was provided by a U.S. citizen, Dr. Graham Sowa, who has a Cuban medical degree and who now is a resident in internal medicine in a Florida hospital. He did not participate in the Cuban medical mission program, but his Cuban friends who are now physicians have done so and who totally reject this allegation. Sowa said, ““Cuba says they want to provide humanity with medical care. It is their commitment toward international solidarity.”

Conclusion

No matter how many times the U.S. alleges that Cuba’s foreign medical mission program engages in illegal forced labor does not make it so. The U.S. has not even publicly submitted an attempted legal justification for these allegations.  The U.S. is wasting money on this specious claim.

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[1]  New U.S. Government Hostility Towards Cuba’s Medical Mission Program, dwkcommentaries.com (Aug. 14, 2019)

[2] Senators Rubio and Menendez Call for Restoring U.S. Parole Program for Cuban Doctors, dwkcommentaries.com (Jan. 11, 2019). See also posts listed n the “Cuban Medical Personnel & U.S.” section of List of Posts to dwkcommentaries—Topical: CUBA.

[3] State Department Unjustly Downgrades Cuba in Annual Report on Human Trafficking, dwkcommentaries.com (June 22, 2019).

[4]  Pais, Health Organization Accused of Trafficking Doctors to Brazil, Courthouse News Service (Dec. 3, 2018)  The class action complaint, which was filed November 30, 2018, alleges that the Pan American Health Organization collected over $75 million since 2013 by enabling and managing the illegal trafficking of Cuban medical professionals in violation of the Trafficking Victims Protection Act and the Racketeering Influenced and Corrupt Organizations Act. Nothing of substance has happened so far in this case. The last docket entry was on July 2, 2019, for an order setting a hearing on July 18, 2019, for Pan American Health’s objections to and appeal from a magistrate judge’s order denying its motion to transfer the case to the U.S. District Court for the District of Columbia. (Civil Docket, Rodriguez v. Pan American Health Org., Case #: 1:18-cv-24995-DPG (Aug. 30, 2019).

[5] Eaton, USAID plans to spend up to $3 million to investigate Cuban doctors, Cuba Solidarity Campaign (Aug. 12, 2019).

[6] Cuba Foreign Ministry, Statement: The Government of the United States Is Earmarking Millions of Dollars To Obstruct Cuban Medical Cooperation (Aug. 30, 2019); The regime blames the US for complaints about the exploitation of Cuban doctors, Diario de Cuba (Aug. 29, 2019); Diaz-Canel described the ‘attacks’ and the ‘attacks by the US on the slae of medical services, Diario de Cuba (Sept. 1, 2019).

[7] State Department Unjustly Downgrades Cuba in Annual Report on Human Trafficking, dwkcommentaries.com (June 22, 2019); Guzzo, Are Cuban physicians human trafficking victims? No way, says Brandon doctor with Havana degree, Tampa Bay Times (Aug. 29, 2019).

 

 

Declining U.S. Rankings in Important International Socio-Political Indices

There are many international rankings of socio-political characteristics of the countries of the world. Here are at least six in which the U.S. ranking is declining.[1]

Freedom of the Press Index. The U.S. ranking has declined from 41 in 2016 to 48 in 2019in this index by Reporters Without Borders. Despite the importance of freedom of press in the First Amendment to the U.S. Constitution, the U.S. this year is behind all of Europe, Australia, Canada and New Zealand as well as far below Papua New Guinea and right below Romania.

This Index is “determined by pooling the responses of experts to a questionnaire devised by RSF [Reporters Sans Borders]. This qualitative analysis is combined with quantitative data on abuses and acts of violence against journalists during the period evaluated. The criteria evaluated in the questionnaire are pluralism, media independence, media environment and self-censorship, legislative framework, transparency, and the quality of the infrastructure that supports the production of news and information.”

Human Development Index. This index from the U.N. measures life expectancy, education and per capita income. For the most recent year (2018), the U.S. is 13th behind most of our European friends, Australia and Canada.

Level of Corruption Index. Compiled by Transparency International, this Index for 2018 (the most recent year) has the U.S. as 22nd in 2018 with a score of 71/100 versus 18th in 2016. The U.S. is far below Denmark, Sweden, Australia and Canada as well as below Estonia and just a little less corrupt than the United Arab Emirates and Uruguay.

The U.S. along with Brazil and the Czech Republic was listed as a “country to watch” in 2019. According to Transparency International, “With a score of 71, the United States lost four points since last year, dropping out of the top 20 countries on the CPI for the first time since 2011. The low score comes at a time when the US is experiencing threats to its system of checks and balances as well as an erosion of ethical norms at the highest levels of power.”

Income Inequality Index.  The Gini Coefficient measures perfect equality as 0 and perfect inequality as 1. In the mid-1970s the U.S. had a coefficient of 0.406 and in the mid-2000s as 0.486. Other reports of this Index by the CIA had the U.S. at 39th with a score of 0.450 (2017) while the World Bank said 59th with 0.410 (2013).

Global Peace Index. This Index is produced by the Institute for Economics and Peace (IEP) as the world’s leading measure of global peacefulness. This report presents the most comprehensive data-driven analysis to date on peace, its economic value, trends, and how to develop peaceful societies.” From a ranking of 124th in 2018, the U.S. has declined to 128th out of 163 in 2019.

Social Progress Index. This ranks countries by their average score for scores for three broad dimensions: Basic Human Needs, Foundations of Wellbeing, and Opportunity. For 2019 the U.S. had a score of 84.78 for a ranking of 25 out of 146 countries after declining since 2014. All of the G7 countries are ahead of the U.S. in health and education.

Conclusion

These indices are examples of contemporary efforts to reduce complex socio-political phenomena to digital numbers and thereby enable the construction of tables and rankings. Theoretically one could make a detailed analysis of the assumptions and sources of the data used to make these tables and rankings in order to make an informed conclusion about the validity of the indices. But the overall conclusion of these indices that the U.S. is not Number One would be shocking to many Americans.

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[1] Kennedy, The U.S. Is Falling, World View (Summer 2019) ;Reporters without Borders, World Press Freedom 2019; UN Development Programme, Human Development Indices and Indicators (2018) Transparency International, Corruption Perceptions Index 2018 ;World Bank, GINI Index (World Bank Estimate)–Country Rankings; CIA, Distribution of Family Income—GINI Index ;Institute for Economic and Peace, Peace Index 2019; Social Progress Imperative, Social Progress Index (2018); Kristof, Keynote Address, American Oxonian (Winter/Spring 2018).

 

Cuba Reveals Purported U.S. TOP SECRET Document for Overthrow of Venezuela’s Government

On April 30, 2019, Granma, the official newspaper of the Communist Party of Cuba, published a summary with selected quotations of a purported TOP SECRET U.S. plan to overthrow the Venezuelan government issued by the U.S. Southern Command.[1] According to Granma, this plan outlines “[s]teps to speed up the definite overthrow of Chavismo and the expulsion of its representatives.” According to Granma, this “plan” has the following sections: Parts I, II and III and Media Plan, which are set forth below.

This “plan” may have been overtaken by this week’s apparent failure of the attempt by Venezuelan leader Juan Guaidó to oust Maduro from power, which will be discussed in a future post.

“Part I of the Plan”

Part I of this plan, according to Granma, was “implemented before the Venezuelan elections last year, but did not succeed in overthrowing Maduro. It contains the following:

– “Increase internal instability to a critical level, by ‘intensifying the undercapitalization of the country, the leaking out of foreign currency and the deterioration of its monetary base, bringing about the application of new inflationary measures.’”

– “The document suggests exacerbating divisions between members of the government, emphasizing the difference between the population’s living conditions and those of their leaders, and making sure that these are exaggerated.”

– “Fully obstruct imports, and at the same time discouraging potential foreign investors in order to make the situation more critical for the population.”

– “Appeal ‘to domestic allies as well as other people inserted from abroad in the national scenario in order to generate protests, riots and insecurity, plunders, thefts, assaults and highjacking of vessels as well as other means of transportation with the intention of deserting the country in crisis through all borderlands and other possible ways, jeopardizing in such a way the National Security of neighboring frontier nations.’”

– “The plan emphasizes the importance of ‘causing victims’ and ‘holding the Venezuelan government responsible.’”

– “Promote internationally the idea that the country is facing a humanitarian crisis.”

-“ Spread lies about extensive government corruption.”

– “Link the government to drug trafficking to discredit the Maduro administration before the world and among Venezuelan supporters.”

-“ Promote ‘fatigue inside the members of the PSUV (United Socialist Party of Venezuela), inciting annoyance and . . . [disunity?]among themselves, for them to break noisily from the government.’”

-:Design a plan to incite ‘the profuse desertion of the most qualified professionals from the country, to leave it with no professionals at all, which will aggravate even more the internal situation, and along these lines, putting the blame on the government.’”

“Part II of the Plan”

 

-“’Encourage dissatisfaction with the Maduro regime.’”

– “Highlight ‘the incompetence of mechanisms of integration created by the regimes of Cuba and Venezuela, especially the ALBA and PETROCARIBE, in order to tackle the situation of the country and its inability to find solutions to the problems that citizens are facing.’”

– “One section of the document is entitled: ‘Using the army officers as an alternative of definite solution.’”

– Continue preparing “conditions inside the Armed Forces to carry out a coup d’état before the end of 2018, if the crisis does not make the dictatorship collapse, or the dictator does not decide to move aside.’”

– “Continue ‘setting fire to the common frontier with Colombia, multiplying the traffic of fuel and other goods. The movement of paramilitaries, armed raids, and drug trafficking. Provoking armed incidents with the Venezuelan frontier security forces.’”

– “Recruit ‘paramilitaries, mainly in the campsites of refugees in . . . [three areas of Colombia], areas largely populated by Colombian citizens who emigrated to Venezuela and have returned.’”

“Part III of the Plan”

– “Prepare ‘involvement of allied forces in support of Venezuelan Army officers, or to control the internal crisis.’”

– “Establish ‘a speedy timeline that prevents the Dictator [Maduro] … winning control of the internal scenario.’”

– “Obtain support and cooperation from ‘friendly countries (Brazil, Argentina, Colombia, Panama, Guyana).’”

– “Organize ‘provisioning, relief of troops, medical and logistical support from Panama.’”

– “Make ‘good use’ of electronic surveillance and intelligence signals; of hospitals and equipment deployed in Darién (Panamanian jungle), Plan Colombia’s drone equipment, as well as the ‘landing fields’  at the former Howard and Albroock military bases in Panama; as well as those of Río Hato; and the United Nations Humanitarian Regional Center, designed for catastrophe situations and humanitarian emergencies, which has ‘an aerial landing field and its own warehouses.’”

– “Propose ‘moving on the basification of combat airplanes and choppers, armored conveyances, intelligence positions, and special military and logistics units, police, military district attorneys, and prisons.’”

– “Develop ‘the military operation under international flag, patronized by the Conference of American Armies, under the protection of the OAS, and the supervision, in the legal and media context of [OAS] General Secretary Luis Almagro.’”

– “Declare the ‘necessity of the continental command be strengthened to act, using the instrument of the Inter-American Democratic Charter, in order to avoid the democratic rupture.’”

– “’Binding Brazil, Argentina, Colombia and Panama to contribute greater numbers of troops, to make use of their geographic proximity and experience in forest regions.’”

– “Strengthen the ‘international’ nature of the operation ‘with presence of combat units from the United States and the other named countries, under the command of a Joint General Staff led by the USA.’”

– “Promote ‘international participation in this effort, as part of a multilateral operation with contributions from States, Non-profit Organizations, and international bodies. Supplying the adequate logistic, intelligence, surveillance, and control support,’ anticipating as key geographical points . . .[six towns] in Colombia, and . . . [three] in Brazil.”

“Media Plan”

 “’Create within the country, via local and international media, the dissemination of messages designed and based on testimony and publications originating in the country, making use of all possible capacity, including social media.’”

– “’Justifying and assuring through violent means the international backup to the deposing of the dictatorship, displaying an extensive dissemination, inside the country and to the entire world, through all open means and the capacities of the psychological war of the U.S. Army.’”

– “Back up and ‘strengthen’ the image of the OAS, as a multilateral institution to resolve regional problems.”

– “Promote ’the request of a dispatch of a UNO military force for the imposition of peace, once Nicolas Maduro’s corrupt dictatorship is defeated.’”

Conclusion

The Granma article says this purported plan was revealed [discovered? pilfered?] by Argentine intellectual Stella Calloni. A simple Google search of her name revealed that she is an 84-year-old Argentine journalist who specializes in Latin American international politics.[2]

That same Google search discovered that on May 17, 2018, Calloni did publish an article about this purported TOP SECRET U.S. document on Voltaire.net.org.[3]

That article by Calloni in turn cited to a publication on that same website of what appears to be an actual copy of a TOP SECRET U.S. document of that title and that date and authored by Admiral Kurt W. Tidd, Commander, U.S. Southern Command.[4]

The U.S. Southern Command, which is located in Doral, Florida,,  is one of ten Unified Combatant Commands (CCMDs) in the United States Department of Defense. It is responsible for providing contingency planning, operations, and security cooperation for Central and South America, the Caribbean (except U.S. commonwealths, territories, and possessions), their territorial waters, and for the force protection of U.S. military resources at these locations. USSOUTHCOM is also responsible for ensuring the defense of the Panama Canal and the canal area. According to Its stated mission, it  “deters aggression, defeats threats, rapidly responds to crises, and builds regional capacity, working with our allies, partner nations, and U.S. government (USG) team members to enhance security and defend the U.S. homeland and our national interests.”[5]

Admiral Kurt W. Tidd was the Commander of the Southern Command in May 2018 until he retired on November 26, 2018; the current Commander is Admiral Craig L. Faller. [6]

Although the Granma article purports to summarize an actual “TOP SECRET” document, there is no indication in this article or those by Calloni that this “plan” was actually adopted or approved by higher U.S. officials. And, as noted at the start of this post, this apparent “plan” may have been superseded by this week’s apparent failure of an attempt by Venezuelan leader Juan Guaidó to oust  Maduro from power, which will be discussed in a future post.

This blog has not compared, line-by-line, Granma’s English translation of the Plan with the apparent English-language original, but Granma’s version does track the apparent original. Nor has this blog attempted to determine whether there was any action on this apparent plan by higher officials in the Department of Defense or other agencies of the U.S. government.

Thus, this purported or apparent U.S. document raises, but does not resolve, disturbing issues.

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[1] U.S. master plan to destroy Bolivarian Venezuela, Granma (April 30, 2019).

[2]  Sierra, Calloni, chronicler of our time, Granma; Stella Calloni, Wikipedia; Stella Calloni, EcuRed: Cuban Encyclopedia.

[3]  Calloni, The United States “Master Stroke” against Venezuela, Voltaire.net.org (May 17, 2018). The Hong Kong-based Voltaire website says it was founded by French intellectual Thierry Meyssan as a “web of non-aligned press groups dedicated to the analysis of international relations . . . from diversified political, social and cultural backgrounds . . . and does not aim to promote a particular ideology or a world vision, but to hone the critical thinking of its readers . . . [and place] reflection before belief and arguments before convictions.”

[4]  Tidd, TOP SECRET: Plan to overthrow the Venezuelan Dictatorship—“Masterstroke,” Voltaire.net.org (Feb, 23, 2018).

[5] U.S. Defense Dep’t, U.S. Southern Command; United States Southern Command, Wikipedia.

[6] U.S. Defense Dep’t, Admiral Kurt W. Tidd; Kurt W. Tidd, Wikipedia; Inter-American Defense Board, Retirement Ceremony for Admiral Kurt W.Tidd and USSOUTHCOM Change of Command Ceremony (Nov. 29, 2018).

 

Cuba’s Current Dire Economic Situation 

In the midst of the flurry of recent commentary about the new U.S. policies regarding  Cuba, including this blog’s current exploration of the many facets of those policies, it is easy to ignore or forget Cuba’s very difficult current economic situation, which only will be made worse by these U.S. policies. Here is some information about that economy.[1]

According to the Associated Press, “After two decades of relative stability fueled by cheap Venezuelan oil, shortages of food and medicine have once again become a serious daily problem for millions of Cubans. A plunge in aid from Venezuela, the end of a medical services deal with Brazil and poor performances in sectors including nickel mining, sugar and tourism have left the communist state $1.5 billion in debt to the vendors that supply products ranging from frozen chicken to equipment for grinding grain into flour, according to former Economy Minister José Luis Rodríguez.”

“That economy is afflicted by deep inefficiency and corruption. Many state employees demand bribes to provide services to the public. Others spend only a few hours a day at their jobs, spending the rest of their time doing informal private work or selling supplies stolen from their office, warehouse or factory. Despite a highly educated and generally well-qualified workforce, Cuba’s industrial sector is dilapidated after decades of under-investment. The country produces little of value on the global market besides rum, tobacco and the professionals who earn billions for the government working as doctors, teachers or engineers in friendly third countries.”

“The agricultural sector is in shambles, requiring the country to import most of its food. Economy Minister Alejandro Gil said Saturday that Cuba would spend $5 billion on food and petroleum products this year.”

“Over the last 20 years, many of those billions came from Venezuela’s socialist government, which has deep ties to Cuba’s and sent nearly 100,000 barrels of oil daily for years. With Venezuela’s economic collapse, that has roughly halved, along with deep cutbacks in the economic relationship across the board. And the news has been bad in virtually every other sector of the Cuban economy. Nickel production has dropped from 72,530 metric tons in 2011 to 50,000 last year, according to Rodríguez, the former economics minister. The sugar harvest dropped nearly 44%, to a million tons. The number of tourists grew only 1%, with many coming on cruise ships, a relatively unprofitable type of visitor. Overall GDP growth has been stuck at 1% for the last three years.”

“Meanwhile, under agreements Castro struck to rehabilitate Cuba’s creditworthiness, the country is paying $2 billion in debt service to creditors such as Russia, Japan and the Paris Club.”

“Stores no longer routinely stock eggs, flour, chicken, cooking oil, rice, powdered milk and ground turkey, among other products. These basics disappear for days or weeks. Hours-long lines appear within minutes of trucks showing up with new supplies. Shelves are empty again within hours.”

“No one is starving in Cuba, but the shortages are so severe that ordinary Cubans and the country’s leaders are openly referring to the ‘special period,”’the years of economic devastation and deep suffering that followed the collapse of the Soviet Union, Cuba’s Cold War patron.”

“‘It’s not about returning to the harshest phase of the special period of the ’90s,’ Communist Party head Raul Castro said last week. ‘But we always have to be ready for the worst.’”

“Two days later, President Miguel Díaz-Canel said cutbacks were necessary because: ‘This harsh moment demands we set clearly defined priorities in order to not return to the worst moments of the special period.’’”

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[1] Assoc. Press, Shortages Hit Cuba, Raising Fears of New Economic Crisis, N.Y. Times (April 18, 2019).

 

 

Senators Menendez and Rubio Call for Restoring U.S. Parole Program for Cuban Doctors

On January 9,  Cuba-American U.S. Senators Bob Menendez (Dem., NJ) and Marco Rubio (Rep., FL) offered S.Res. 14—Affirming that the Government of Cuba’s foreign medical missions constitute human trafficking.[1]

This proposed resolution, however, is based upon a false premise as will be shown in the final section of this post. First, we will examine this new resolution itself and the two Senators statements in support of the resolution and then the basics of the Cuban medical mission program and the former U.S. immigration parole program for Cuban medical professionals engaged in that program.

The Cuban Medical Mission Program[2]

According to a 2011 article in the Wall Street Journal, since Cuba since 1973 has been sending medical ‘brigades’ to foreign countries, “helping it to win friends abroad, to back ‘revolutionary’ regimes in places like Ethiopia, Angola and Nicaragua, and perhaps most importantly, to earn hard currency. [The] Communist Party newspaper Granma reported in June [2010] that Cuba had 37,041 doctors and other health workers in 77 countries. Estimates of what Cuba earns from its medical teams—revenue that Cuba’s central bank counts as ‘exports of services’—vary widely, running to as much as $8 billion a year.”

Again, according to the same Wall Street Journal article, Cuban doctors often desire such overseas assignments because they provide opportunities to earn significantly more money than at home. “When serving overseas, they get their Cuban salaries [of $25 per month], plus a $50-per-month stipend—both paid to their dependents while they’re abroad. . . . In addition, they themselves receive overseas salaries—from $150 to $1,000 a month, depending on the mission.” Many on-the-side also engage in private fee-for-service medical practice, including abortions. As a result, many of the Cubans are able to save substantial portions of their overseas income, which they often use to purchase items they could not have bought in Cuba like television sets and computers. Other desirable purchases are less expensive U.S. products that they can sell at a profit when they return to Cuba.

In more recent years, many of the Cuban medical missionaries have gone to Venezuela and Brazil, the latter of which late last year terminated the program and most of the Cubans returned to the island, while some remained in Brazil.

The U.S. State Department in its annual reports on human trafficking has alleged that Cuba’s use of Cuban medical personnel in its foreign medical mission program constitutes illegal forced labor.[3] This allegation will be rebutted in the last section of this post.

The Former U.S. Immigration Parole Program fo Cuban Medical Professionals[4]

On August 11, 2006, the U.S. Department of Homeland Security in conjunction with the Department of State, announced a program] that . . . would allow “Cuban medical personnel conscripted to study or work in a third country under the direction of the Cuban government to enter the United States.”

Under the program “Cuban Medical Professionals” (i.e., health-care providers such as doctors, nurses, paramedics, physical therapists, lab technicians and sports trainers) are eligible if they meet the following criteria: (1) Cuban nationality or citizenship, (2) medical professional currently conscripted to study or work in a third country under the direction of the Government of Cuba, and (3) not otherwise ineligible for entry into the U.S. Spouses and/or minor children are also eligible for such parole.

The program “was the brainchild of Cuban-born Emilio González,” a former U.S. Army colonel, the director of the U.S. Citizen & Immigration Services from 2006 to 2008 and a “staunchly anti-Castro exile.” “He has characterized Cuba’s policy of sending doctors and other health workers abroad as ‘state-sponsored human trafficking.’” The Cuban doctors, he says, work directly for health authorities in other countries and have no say in their assignments.

On January 12, 2017, in the final days of his president, President Obama terminated this program. The announcement said that the U.S. “and Cuba are working together to combat diseases that endanger the health and lives of our people. By providing preferential treatment to Cuban medical personnel, the medical parole program contradicts those efforts, and risks harming the Cuban people.  Cuban medical personnel will now be eligible to apply for asylum at U.S. embassies and consulates around the world, consistent with the procedures for all foreign nationals.”

The Cuban government applauding the end of this program, said it “was part of the arsenal to deprive the country of doctors, nurses and other professionals of the sector, . . . and an attack against Cuba’s humanitarian and solidarity medical missions in Third World countries that need it so much. This policy prompted Cuban health personnel working in third countries to abandon their missions and emigrate to the [U.S.], becoming a reprehensible practice that damaged Cuba’s international medical cooperation programs.”

The termination of this program was welcomed by Senators Patrick Leahy (Dem., VT) and representative Kathy Castor (Dem., FL), but criticized by Senators Rubio and Menendez with Rubio expressly calling for the then new Trump Administration to restore the program.

The Proposed New Resolution[5]

After multiple Whereas clauses, the proposed Resolution would declare that it is the sense of the Senate that:

  • “The Government of Cuba subjected Cuban  doctors and medical professional participating in the Mais Medicos program to state-sponsored human trafficking;
  • Cuban doctors participating in the MaisMedicos program should have been permitted to work under the same conditions as all other foreign 9 doctors participating in the program;
  • the Government of Cuba should compensate  Cuban doctors that participated in the Mais Medicos programs for the full amount of wages that were garnished by the Government of Cuba;
  • Foreign governments that sign agreements with the Government of Cuba or the for-profit Cuban Medical Services Trading Corporation (CMS) or other companies affiliated with the Government of Cuba to procure the services of Cuban professionals  directly assume risks related to participation in forced labor arrangements;
  • The Pan American Health Organization must immediately provide greater transparency about its participation in the Mais Medicos program and its agreement with the Government of Cuba and the for-profit Cuban Medical Services Trading Corporation (CMS);
  • The United States Department of State must downgrade Cuba to Tier 3 in its annual Trafficking in Persons (TIP) report, given new evidence on Cuba’s foreign medical missions and the Government of Cuba’s longstanding failure to criminalize most forms of forced labor; and
  • the Department of State must re-establish the Cuban Medical Professionals Parole (CMPP) program.”

The Senators’ ‘Press Releases for the New Resolution[6]

The two Senators issued essentially identical press releases. Here is what Senator Menendez’s stated.

Senator Menendez condemned “ the Cuban regime for a program that sends tens of thousands of Cuban medical professionals to foreign countries to work under conditions that qualify as human trafficking.” In addition, he stated.“For 60 years, the Cuban regime has been finding new ways to exploit its people. Recent information from Brazil shows how the Cuban government profits from its state-sponsored foreign medical missions, which they sell as medical diplomacy but look a lot more like indentured servitude. This bipartisan resolution sheds additional light on the Cuban regime’s role in human trafficking, and is another call for greater accountability from Cuban officials, their overseas partners, and the international community.”

The press release also quoted Senator Rubio. ““It is outrageous, though not surprising, that the Cuban dictatorship continues to manipulate and traffic physicians in order to enrich itself. This form of forced labor should not go unnoticed by the international community. We must stand against the regime’s modern-day slavery scheme and support the doctors seeking justice after serving in these so-called international medical missions.”

Finally the press release stated that the “introduction comes after an investigative report by the Diario de Cuba recently revealed the indentured servitude of Cuban medical professionals described in Brazilian diplomatic cables detailing the terms of the Government of Cuba’s medical missions to Brazil. In 2016 alone, it is estimated that the Castro regime earned more than $8,000,000,000 from exporting the services of Cuban professionals, of which foreign medical missions represent the majority of the income.”

Analysis of the Merits of the Resolution[7]

The resolution is without merit and should be rejected. Why? Because the Cuban medical mission program is not illegal forced labor.

The U.S. parole program for Cuban medical personnel was and is also unjustified. Cuban students receive their medical education without any tuition. As a result, it is only reasonable to require such students, after receiving their medical degrees, to “give back” by serving on a Cuban foreign medical mission for which they are paid more than they would have earned in Cuba. Yes, the Cuban government is paid more for their services on such missions by foreign governments than the medical personnel are paid by the Cuban government, but that also is reasonable and appropriate. The contention that such service is illegal forced labor or semi-slavery is absurd.

  • First, the State Department reports admit that there is conflicting information and allegations on the foreign medical mission work. Coercion is alleged by “some participants” and unnamed “other sources.” On the other hand, the reports admit that the Cuban government denies these allegations, and instead the Government and “some participants” assert the postings are “voluntary and well paid compared to jobs within Cuba.” The reports also concede there is conflicting information on whether other means, including withholding Cuban passports, are used to coerce or force participants to remain in the program.
  • Second, there apparently has not been any fair adjudicative process to determine which of these conflicting sets of information is valid.
  • Third, the accusation of forced labor for such participants has been rejected in a study by Indiana State University’s Emeritus Professor of International Politics and Latin America, Dr. H. Michael Erisman. He says, although there may be “some cases where . . . [Cuban medical professionals] are pressured into accepting overseas assignments, . . . most evidence indicates that the overwhelming majority are motivated by philosophical and/or pragmatic considerations. In the first instance, one needs to understand that the Cuban medical profession . . . is permeated by norms which stress self-sacrifice and service to the community, both at home and abroad. At the core of this ethos is the principle, which is firmly entrenched in the curriculum of the island’s medical schools and reinforced throughout one’s career, that health care should not be seen as a business driven by a profit motive, but rather as a human right that medical personnel have an unconditional duty to protect. Such convictions often underlie participation in the medical aid brigades. There are, however, also some pragmatic factors that can come into play. Overseas service could . . . help to further one’s professional aspirations and for some assignments the total remuneration involved is more generous than what is available back in Cuba. . . . [T]hese are the considerations which apply to the vast majority of people” in such programs, not involuntary servitude.
  • Fourth, According to Granma, Cuba’s Communist Party’s newspaper, “Internationalist medical aid has been a longstanding part of the Cuban people’s tradition of solidarity, since the beginning of the Revolution. As early as 1960 a brigade was sent to Chile following an earthquake there, and to Algeria in 1963, to support the new country recently liberated from colonialism.” The Granma article included the reflection of four Cuban doctors who have participated in such missions and who treasure the positive impact of those experiences on their professional and personal lives.
  • Fifth, this reports do not cite to the relevant legal definition of “forced labor” to assess this claim. Most pertinent is Article 2(2) of the Forced Labour Convention, 1930, which states, in part, ”the term forced or compulsory labour shall not include . . .  any work or service which forms part of the normal civic obligations of the citizens of a fully self-governing country.” (Emphasis added.)

Moreover, as a previous post noted, a respected international journalist, Alma Guillermoprieto, recently reported that Cuban medical doctors serving on the island now earn $67 per month, but $500 per month when serving on a foreign medical mission.

The $67 monthly salary for Cuban physicians in Cuba compared with the $24 or $27 monthly income of other Cubans is a result of Cuba’s adoption of a “pyramid” compensation system whereby highly trained workers like physicians earn more than lower-skilled workers like busboys. This system, however, is being undermined by lower-skilled workers like gas-station attendants and waiters earning additional income from stealing and illegally selling gasoline and from earning tips in hard currency at restaurants and hotels serving foreign tourists. Indeed, Raúl Castro in his speech at the April 2016 Congress of the Communist Party of Cuba called this the “inverted pyramid” problem that had to be solved.

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[1] Resolution by Bob Menéndez and Marco Rubio asks to restore the US refugee program for Cuban doctors, DiariodeCuba Cuba (Jan. 10, 2019); Menéndez: the Cuban regime and its foreign partners ‘must be held accountable’ for the exploitation of doctors, DiariodeCuba (Jan. 10, 2019). 

[2]  See New York Times Calls for End of Special Immigration Relief for Cuban Medical Personnel, dwkcommentaries.com (Nov. 22, 2014). 

[3] See these posts to dwkcommentaries: U.S. Upgrades Cuba in State Department’s Annual Report on Human Trafficking (Aug. 7, 2015); U.S. Reasserts Upgrade of Cuba in Annual Report on Human Trafficking (July 2, 2016); Cuba’s Unchanged Status in U.S. State Department’s Annual Report on Human Trafficking (Aug. 15, 2017).

[4] Ibid;  U.S. Ends Special Immigration Benefits for Cubans, dwkcommentaries.com (Jan. 13, 2017). 

[5] S. Res. 14- a resolution  affirming that the Government of Cuba’s foreign medical missions constitute human trafficking. (Jan. 9, 2019); Sen. Menendez, Press Release: Senators Menendez, Rubio Introduce Senate Resolution Condemning Castro Regime’s Forced Labor of Cuban Doctors (Jan. 10, 2019);CubanSen. Rubio, Press Release: Rubio, Menendez Introduces [sic] Resolution Condemning Castro Regime’s forced Labor of Cuban Doctors (Jan. 10, 2019).

[6] Ibid.

[7] See posts listed in the “Cuban Medical Personnel & U.S.” section of List of Posts to dwkcommentaries.com—Topical (CUBA).

Raúl Castro’s Celebration of the 60th Anniversary of the Cuban Revolution’s Triumph

On January 1, 2019, the 60st anniversary of the triumph of the Cuban Revolution, Raúl Castro delivered a lengthy address in Santiago de Cuba celebrating that anniversary as well as the 150th anniversary of the beginning of Cuba’s wars of independence from Spain. [1]

Castro said Cuba “will continue to prioritize defense training tasks, at all levels, in the interests of safeguarding independence, territorial integrity, sovereignty and peace, based on the strategic concept of the War of the Entire People, as is reflected in the recently approved Constitution of the Republic.”[2]

Also mentioned were the challenges facing the Cuan economy in 2019. It was necessary to “reduce all non-essential expenses and save more; increase and diversify exports; raise the efficiency of the investment process and enhance the participation of foreign investment, which, as stated in the guiding Party documents, is not a complement, but a fundamental element for development.”

In addition, the speech was peppered with the  following negative comments about the U.S. involvement in that history:

  • “Cuba’s victory against Spain “was usurped by the U.S. intervention and the military occupation of the country, which gave way to a long period of oppression and corrupt governments, subservient to its hegemonic designs.”
  • “The Revolutionaries attack on the Moncada barracks on July 26, 1953 also was an assault on ‘the crimes and abuses of a bloody tyranny, completely subordinated to the interests of the United States.”
  • “Already on January 8, 1959, upon his arrival in Havana, the Commander of the Revolution [Fidel] expressed: ‘The tyranny has been overthrown, the joy is immense and yet there is still much to be done. We do not fool ourselves into believing that from now on everything will be easy, perhaps from now on everything will be more difficult.'”
  • “On May 14, 1959, Cuba adopted the first Agrarian Reform Law “that upset the powerful economic interests of U.S. monopolies and the Creole bourgeoisie, which redoubled the conspiracies against the revolutionary process.”
  • “The nascent Revolution was subjected to all types of aggressions and threats, such as the actions of armed gangs financed by the U.S. government; assassination plans against Fidel and other leaders; the murder of young literacy teachers, many of them still adolescents; sabotage and terrorism throughout the country with the terrible toll of 3,478 dead and 2,099 disabled; the economic, commercial and financial blockade, and other political and diplomatic measures in order to isolate us; the campaigns of lies to defame the Revolution and its leaders; the mercenary invasion at Playa Girón [Bay of Pigs] in April 1961; the October [Missile] Crisis in 1962, when the military invasion of Cuba was being prepared in the United States; and an endless list of hostile acts against our homeland.”
  • “Over 60 years Cuba has has “seen twelve U.S. administrations that have not ceased in the effort to force a regime change in Cuba, one way or another, with varying degrees of aggressiveness.”
  • “Now once again, the U.S. government seems to be taking the course of confrontation with Cuba, and presenting our peaceful and solidary country as a threat to the region. It resorts to the sinister Monroe Doctrine to try to roll back history to the shameful era in which subjugated governments and military dictatorships joined it in isolating Cuba.”
  • “Increasingly, senior officials of the [U.S.] current administration, with the complicity of certain lackeys, disseminate new falsehoods and again try to blame Cuba for all the ills of the region, as if these were not the result of ruthless neoliberal policies that cause poverty, hunger, inequality, organized crime, drug trafficking, political corruption, abuse and deprivation of workers’ rights, displaced people, the eviction of campesinos, the repression of students, and precarious health, education and housing conditions for the vast majority.”
  • “They are the same who declare the intention to continue forcing the deterioration of bilateral relations, and promote new measures of economic, commercial and financial blockade to restrict the performance of the national economy, cause additional constraints on the consumption and welfare of the people, hinder even further foreign trade, and curb the flow of foreign investment. They say they are willing to challenge International Law, to contravene the rules of international trade and economic relations, and aggressively apply extraterritorial measures and laws against the sovereignty of other states.”
  • “The extreme right in Florida . . . has hijacked [U.S.] policy toward Cuba, to the pleasure of the most reactionary forces of the current U.S. government.”
  • “On July 26, [2018] here in Santiago, I explained that an adverse scenario had formed, and again the euphoria of our enemies had resurfaced, and the haste to materialize their dreams of destroying the example of Cuba. I also pointed out the conviction that the imperialist blockade of Venezuela, Nicaragua and our country was tightening. Events have confirmed that assessment.”
  • “After almost a decade of practicing unconventional warfare to prevent the continuity, or impede the return of progressive governments, Washington power circles sponsored coups – first a military coup to overthrow President Zelaya in Honduras, and later they resorted to parliamentary-judicial coups against Lugo in Paraguay, and Dilma Rousseff in Brazil.”
  • The U.S. “promoted rigged and politically motivated judicial proceedings, as well as campaigns of manipulation and discredit against leftist leaders and organizations, making use of monopoly control over mass media.”
  • “The aggressive actions [of the U.S.] against [Venezuela] . . . must cease. As we warned some time ago, the repeated declaration of Venezuela as a threat to the national security of the United States, the open calls for a military coup against its constitutional government, the military training exercises undertaken in the vicinity of Venezuelan borders, as well as tensions and incidents in the area, can only lead to serious instability and unpredictable consequences.”
  • “It is equally dangerous and unacceptable that the United States government unilaterally sanctions and also proclaims the Republic of Nicaragua a threat to its national security. We reject the attempts of the discredited OAS, Organization of American States, to interfere in the affairs of this sister nation.”
  • “Faced with the [U.S. recent reassertion of the] Monroe Doctrine, the principles of the Proclamation of Latin America and the Caribbean as a Zone of Peace, signed in Havana by Heads of State and Government, which some allies of the United States now seek to disregard, must be applied and defended, for the good of all.”[3]
  • “As expressed by our Minister of Economy and Planning at the last session of the National Assembly, the cost to Cuba of [the U.S. blockade of Cuba is]calculated according to internationally approved methodology, [at] 4.321 billion dollars last year, equivalent to almost 12 million in damages every day, a fact that is overlooked by analysts who tend to question national economic performance.”

Nevertheless, Raúl reiterated Cuba’s “willingness to coexist in a civilized manner, despite the differences, in a relationship of peace, respect and mutual benefit with the United States. We have also clearly indicated that Cubans are prepared to resist a confrontational scenario, which we do not want, and we hope that the levelest heads in the U.S. government can avoid.”

American Journalist’s Assessment of Cuba’s Current Situation[4]

Jon Lee Anderson, an American journalist who has written extensively about Cuba, first stated what he saw as Cuba’s achievements over the last 60 years. It is “stable, having overcome such existential threats as the Bay of Pigs invasion in 1961, the Cuban missile crisis in 1962 and a half-century of diplomatic isolation and withering economic sanctions imposed by the United States.”

Cuba also has “weathered the collapse of the Soviet Union, its main Cold War benefactor, and a slew of traumatic internal ructions including the Mariel boatlift in 1980 and the Cuban raft exodus in 1994. Last but not least, Cuba has managed its first major political transitions, following the death in 2016 of its defining leader, Fidel Castro; the presidential retirement, last year, of his younger brother, Raúl Castro; and Raúl’s succession in office by Miguel Díaz-Canel Bermúdez, a 58-year-old Communist Party loyalist.”

Most importantly, he says, “the Cuban Communist system shows no sign of collapse.” But it is going through significant changes with greater opportunity to disagree with the government as evidenced by recent changes to regulations affecting the private sector and the arts.

Conclusion

Although I hope that there will be increasing opportunities for Cubans to express disagreement with their government’s policies, I am not as sanguine as Anderson about whether and when there will significant changes on such questions. Like any well-established and large system or organization, such changes are difficult and usually take longer than anticipated by some.

It also is interesting to compare this lengthy speech by Raúl with the shorter and less revealing recent statement by President Diaz-Canel that was mentioned in a prior post. Is this difference significant?

According to a U.S. journalist, the latest version of the proposed new Constitution, if as anticipated it is approved in the February referendum, provides that “the National Assembly must approve a new electoral law within six months after the new Constitution is enacted. Then, within another three months, the National Assembly must choose a new president, vice president and Council of State from among its deputies currently in office.” In addition, the new Constitution would create the new office of Prime Minister, requiring the president to share power. Therefore, it is possible that Diaz-Canel will be President for only a short time.[5]

==========================

[1] Castro, After 60 years of struggle, sacrifices, efforts and victories, we see a free, independent country, the master of its own destiny (Jan. 2, 2019).

[2] The final draft of the proposed Constitution that will be submitted to a referendum in February 2019 is now available online.

[3] In February 2018, the Monroe Doctrine was favorably mentioned, in response to a question by an academic observer, by then Secretary of State Rex Tillerson, as discussed in an earlier post.

[4]  Anderson,  Cuba’s Next Transformation, N.Y. Times (Jan. 5, 2019).

[5] Gámez Torres, Cuba could have a new government soon if draft Constitution takes effect, Miami Herald (Jan. 5, 2019).

Disruption in Cuban Medical Mission to Brazil

On November 14,  Cuba’s Ministry of Public Health stated that the island was ‘discontinuing’ its participation in the Program Mais Médicos, or More Doctors, in Brazil. [1]

In response to this Cuban move, a well-known Brazilian lawyer presented an appeal to Brazil’s Supreme Court requesting a “habeas corpus” so that the 8,332 Cuban doctors currently working in  Brazil and were summoned back to their country can remain in their positions as asylees or as permanent residents. The attorney also asserted that even though the Brazil-Cuba agreement for this program barred Brazil from granting the Cuban doctors political asylum or permanent visas, Cuba’s unilateral termination of the program also terminated the ban on granting such relief to the Cuban doctors.

Cuba has received more than $249.5 million a year for its doctors in Brazil, according to a researcher interviewed by the Miami Herald. The elimination of this revenue for Cuba will have a huge negative impact on Cuba’s economy and finances. Just one such problem is Brazil’s demand for Cuba to pay the arrears it owes Brazil for the $680 million loan it provided for the development of the port of Mariel near Havana. Cuba already is $71.2 million in arrears, according to Brazil’s National Bank for Economic and Social Development.

This current set of disputes was predicted by Brazil’s recent presidential campaign when then-candidate Jair Bolsonaro raised questions about the quality of the Cuban doctors’ training and said the doctors would have to prove their medical credentials by getting their diplomas validated in Brazil, a process that has previously been waived for Cuban doctors. He also criticized the Cuban government’s keeping around 75 percent of their salaries paid by Brazil even though the doctors earn more in Brazil than they did on the island. [2]

Another criticism by Bolsonaro was the employment contract between Cuba’s Ministry of Public Health and the Cuban doctors, in which the doctors are banned from having family accompanying them during their mission. In addition, Bolsonaro said his government would offer asylum to Cuban doctors who wished to stay in Brazil.

The Program was launched by former Brazilian President Dilma Rousseff to send Cuban physicians to underserved regions in the South American country and was arranged by the Pan American Health Organization (PAHO). the New York Times reports. Around 20,000 Cuban doctors have worked in Brazil in the span of five years. By the end of 2017 there were Cuban health workers in 64 countries, with Brazil and Venezuela as the main destinations.

The current horrible living conditions in Venezuela has caused many of the Cuban doctors serving there to try to escape to other countries.[3]

Impact on Cuban Health Care[4]

Meanwhile back in Cuba there are reports that its “export” of medical doctors to other countries, including Brazil and Venezuela, has caused a significant reduction in the number of health professionals providing primary care on the island. For example, In 2010 the number of doctors assigned to Family Clinics was 36,478, while in 2017 there were only 13,131; that is, a 64% drop in less than a decade. The result of this imbalance is a sharp decrease in health personnel in Cuba, the closure of infrastructures, a reduction in the number of hospital beds, shortages at pharmacies, and an increase in diseases related to deficient health conditions.

Conclusion

Those of us in the U.S. who want to see both Cuba and Brazil succeed will need to keep watch on this situation and try to assess the merits of the two countries’ arguments and claims.

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[1] Center for Democracy in Americas, Cuba Central News Brief: 11/16/18A lawyer asks the Supreme [Court of Brazil] for guarantees of permanence for Cuban doctors, Diario de Cuba (Nov. 18, 2018).

[2] The U.S. has alleged that the Cuban medical professionals on foreign missions are engaged in illegal forced labor due to their not receiving the total payments by foreign governments for their services. This blog, however, has rejected that U.S. claim for various reasons. (See U.S. State Department Unjustly Continues To Allege That Cuba’s Foreign Medical Missions Engage in Forced Labor, dwkcommentaries.com (Aug. 17, 2017).

[3] See  Cuban Medical Professionals Continue To Escape from Foreign Medical Missions, dwkcommentaries.com (Mar. 15, 2018).

[4] Fernández & Diaz Ezpí,  23,000 Fewer Doctors: A Raw Deal for Cubans, Diario de Cuba (Nov. 12, 2018); More doctors for Maduro: bleeding into the Cuban primary health system continues, Diario de Cuba (Nov. 12, 2018).