Cuba sends docs on medical missions. The U.S. is not a fan : NPR

[ad_1] <img src="https://npr.brightspotcdn.com/dims3/default/strip/false/crop/5541x3687+0+0/resize/1100/quality/50/format/jpeg/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F31%2F02%2Ff6a8959743a6a1091fe71ffcbdc0%2Fcuba-doctors-2036327921.jpg" data-template="https://npr.brightspotcdn.com/dims3/default/strip/false/crop/5541x3687+0+0/resize/{width}/quality/{quality}/format/{format}/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F31%2F02%2Ff6a8959743a6a1091fe71ffcbdc0%2Fcuba-doctors-2036327921.jpg" class="img" alt="Cuban doctors hold a national flag upon arrival at Palmerola International Airport, 50 kms north of Tegucigalpa, on February 27, 2024. The 100 medical specialists-brigade will stay in Honduras for two years and includes anaesthesiologists, oncologists, neurosurgeons, cardiologists, and endocrinologists. " fetchpriority="high"/> Cuban docs maintain their nationwide flag upon arriving in Honduras for a medical mission in February 2024. Now the docs are leaving Honduras because the U.S. urges nations to rethink their agreements with Cuba. Orlando Sierra/AFP/through Getty Photos cover caption

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Orlando Sierra/AFP/through Getty Photos Is it a praiseworthy humanitarian effort or an affront to human rights?

That is the controversy swirling round a Cuban program that sends tens of 1000's of docs and different medical professionals overseas to look after folks.

Cuba proudly says these "medical brigades" present solidarity with their fellow nations within the World South. However this system will not be solely altruistic. It is also one of many largest sources of international cash for the island because the nations receiving the small military of well being staff pay Cuba for them.

The U.S. State Division has lengthy been essential of this method, alleging that the members are coerced and underpaid by the federal government. In a press release to NPR, the State Division calls it "compelled labor" and "human trafficking."

Now, the Trump administration is ratcheting up the stress on nations to tug out of those preparations with Cuba. A quantity in Latin America and the Caribbean are falling into line. Among the many nations yielding to this stress are Guatemala, Guyana, Jamaica, St. Vincent and the Grenadines, Paraguay and Honduras. They're phasing out the applications, reevaluating the fee mannequin and generally canceling altogether.

This is the way it works — and why it is so controversial.

The backstory This system started greater than 60 years in the past and sometimes gives medical help to impoverished communities and rural, underserved areas — typically in lower-resource nations like Angola, Guatemala and Venezuela however in some high-income nations as properly. For instance, a Cuban crew went to Italy to assist out throughout the early years of the COVID disaster.

The numbers are spectacular: In 2024, greater than 20,000 Cuban medical personnel had been serving in additional than 50 nations, in line with Granma, the official paper of the communist social gathering in Cuba.

Beneath the agreements made with particular person nations, the Cuban authorities typically will get paid a hefty sum for every medical practitioner however the docs themselves see solely a small share of that cash.

When Dr. Leyani Perez Gonzalez was a physician in Cuba within the early 2000s, she says it was arduous to make ends meet. "The fee for a physician in Cuba, at the moment, was about $20 month-to-month," she says. "With $20 in Cuba at the moment, I can solely purchase — like one pair of footwear."

The monetary challenges drove Gonzalez to use to change into a part of a Cuban medical mission overseas. She says she might receives a commission roughly 4 instances extra working aboard. In 2008, Cuba despatched Gonzalez to Venezuela. "I used to be in a major care setting, seeing folks with completely different persistent ailments, youngsters, pregnant ladies," she remembers.

The U.S. perspective Gonzalez preferred working with the sufferers however she says the remainder of the expertise was depressing — and scary. She was positioned in an impoverished neighborhood with quite a lot of violence. Plus, she says, the Cuban authorities was watching her continuously and took steps to ensure she could not escape. She needed to return to Cuba. "They eliminated our passports," she says.

She describes the medical missions as a type of slavery.

She ended up deciding to flee, although she had no passport, no thought the place to go and no thought what her future held.

Fortunately for her, she quickly discovered that the U.S. shared her considerations about Cuba's medical missions. Throughout George W. Bush's presidency, the State Division created a system that allowed Cuban medical professionals serving overseas to hunt refuge within the U.S. and get residency. It was known as the Cuban Medical Skilled Parole Program and ended underneath President Barack Obama, when he reinstated diplomatic relations with Cuba.

However now — underneath President Trump and Secretary of State Marco Rubio, a long-time critic of the Cuban regime — the U.S. is returning to its adversarial method to this system. That comes on prime of a punishing oil blockade the U.S. is imposing.

In August 2025, the Trump Administration moved to revoke visas and impose visa restrictions on authorities officers in Brazil, Grenada and a few African nations as a result of they labored with Cuba on these applications. "Our motion sends an unmistakable message that america promotes accountability for many who allow the Cuban regime's compelled labor export scheme," Rubio mentioned on the time in a press assertion.

The U.S. additionally just lately handed a legislation permitting it to impose sanctions on nations that work with Cuban docs.

"The nations which have damaged off these contracts are afraid. They're afraid of retaliation by america," says William LeoGrande, a professor of presidency within the Faculty of Public Affairs at American College. "That is typical of Donald Trump's international coverage, which is predicated basically on coercive diplomacy: 'Do it our approach, or else.' So: 'Eliminate the Cuban docs, or else.' "

It is difficult Not everybody agrees with the U.S. place on Cuban medical missions. It is "actually excessive," says LeoGrande.

Stephanie Panichelli-Batalla, a professor of worldwide sustainable improvement on the College of Warwick within the U.Okay., says this program "is, actually, rather more advanced" than the U.S. makes it out to be.

She acknowledges that Cuba has a robust monetary incentive for this system: "It's the highest revenue of international funds for Cuba. The Cuban docs are sort of a commodity that's being utilized by the nation to outlive economically."

Nonetheless, she is fast so as to add that some see this method as "extraordinarily sensible," serving to Cuba "with their financial context, whereas doing good on the earth." She additionally factors out that, whereas the docs aren't paid properly, they earn considerably greater than they'd make in Cuba. They usually volunteer for these missions. "They then return to Cuba, and so they handle to renovate their residences, or purchase this or have this, and so they have a way of life that the widespread Cuban folks haven't got," she says.

She says the opposite long-standing concern is Cuba's confiscation of the members' passports. She says, from Cuba's perspective, it has invested in coaching the docs totally free and does not wish to lose them. Given how arduous it's for Cubans to depart the island and the way dangerous the financial disaster is, "there aren't any actual figures they've ever shared, however [the number of doctors who desert would explode, if you give them passports. So they would never agree to that. That's no surprise," she says.

When a special rapporteur looked into the system for the Office of the United Nations High Commissioner for Human Rights, they flagged several issues, including working and living conditions for the participants and punishment for family members in Cuba if their relative abandons their post abroad.

What happens to health care? As countries pull out of their agreements with Cuba and doctors pack their bags, a big question looms.

"If we start canceling all those programs, what is going to happen with those vulnerable communities that will lose access to health care?" Panichelli-Batalla asks. NPR asked the State Department about any plans for the U.S. to fill this role but did not receive a response to that question.

Some countries — the Bahamas, for example — hope to pay the Cuban doctors directly. That possibility thrills Dr. Gonzalez, who now lives in Florida and has retrained to work as a nurse practitioner in the U.S.