Cuban medical doctors maintain their nationwide flag upon arriving in Honduras for a medical mission in February 2024. Now the medical doctors are leaving Honduras because the U.S. urges international locations to rethink their agreements with Cuba.
Orlando Sierra/AFP/by way of Getty Pictures
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Orlando Sierra/AFP/by way of Getty Pictures
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 medical doctors and different medical professionals overseas to take care of folks.
Cuba proudly says these “medical brigades” present solidarity with their fellow international locations within the World South. However this system just isn’t solely altruistic. It is also one of many largest sources of international cash for the island because the international locations receiving the small military of well being employees pay Cuba for them.
The U.S. State Division has lengthy been vital of this technique, alleging that the members are coerced and underpaid by the federal government. In an announcement to NPR, the State Division calls it “compelled labor” and “human trafficking.”
Now, the Trump administration is ratcheting up the stress on international locations to drag 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 packages, reevaluating the cost 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 usually offers medical support to impoverished communities and rural, underserved areas — usually in lower-resource international locations like Angola, Guatemala and Venezuela however in some high-income international locations as nicely. For instance, a Cuban group 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 international locations, in keeping with Granmathe official paper of the communist celebration in Cuba.
Beneath the agreements made with particular person international locations, the Cuban authorities usually will get paid a hefty sum for every medical practitioner however the medical doctors themselves see solely a small proportion 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 cost 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 sneakers.”
The monetary challenges drove Gonzalez to use to turn out to be 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 totally different power illnesses, kids, pregnant girls,” she remembers.
The U.S. perspective
Gonzalez appreciated working with the sufferers however she says the remainder of the expertise was depressing — and scary. She was positioned in an impoverished neighborhood with lots of violence. Plus, she says, the Cuban authorities was watching her continuously and took steps to verify 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, though she had no passport, no concept the place to go and no concept what her future held.
Fortunately for her, she quickly discovered that the U.S. shared her issues 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 below President Barack Obama, when he reinstated diplomatic relations with Cuba.
However now — below 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 some African international locations as a result of they labored with Cuba on these packages. “Our motion sends an unmistakable message that the US promotes accountability for many who allow the Cuban regime’s compelled labor export scheme,” Rubio stated on the time in a press assertion.
The U.S. additionally just lately handed a legislation permitting it to impose sanctions on international locations that work with Cuban medical doctors.
“The international locations which have damaged off these contracts are afraid. They’re afraid of retaliation by the US,” 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 primarily on coercive diplomacy: ‘Do it our approach, or else.’ So: ‘Do away with the Cuban medical doctors, 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-Batallaa professor of world sustainable improvement on the College of Warwick within the U.Okay., says this program “is, in actual fact, way more complicated” than the U.S. makes it out to be.
She acknowledges that Cuba has a powerful monetary incentive for this system: “It’s the highest earnings of international funds for Cuba. The Cuban medical doctors are sort of a commodity that’s being utilized by the nation to outlive economically.”
Nevertheless, she is fast so as to add that some see this technique as “extraordinarily good,” serving to Cuba “with their financial context, whereas doing good on the planet.” She additionally factors out that, whereas the medical doctors aren’t paid nicely, they earn considerably greater than they’d make in Cuba. They usually volunteer for these missions. “They then return to Cuba, they usually handle to renovate their flats, or purchase this or have this, they usually have a lifestyle that the frequent Cuban folks haven’t got,” she says.
She says the opposite long-standing problem is Cuba’s confiscation of the members’ passports. She says, from Cuba’s perspective, it has invested in coaching the medical doctors without spending a dime and does not wish to lose them. Given how arduous it’s for Cubans to depart the island and the way unhealthy the financial disaster is, “there aren’t any precise figures they’ve ever shared, however (the variety of medical doctors who desert would explode, for those who give them passports. So they’d by no means conform to that. That is no shock,” she says.
When a particular rapporteur appeared into the system for the Workplace of the United Nations Excessive Commissioner for Human Rightsthey flagged a number of points, together with working and dwelling situations for the members and punishment for members of the family in Cuba if their relative abandons their submit overseas.
What occurs to well being care?
As international locations pull out of their agreements with Cuba and medical doctors pack their baggage, a giant query looms.
“If we begin canceling all these packages, what’s going to occur with these susceptible communities that may lose entry to well being care?” Panichelli-Batalla asks. NPR requested the State Division about any plans for the U.S. to fill this function however didn’t obtain a response to that query.
Some international locations — the Bahamas, for instance — hope to pay the Cuban medical doctors immediately. That chance thrills Dr. Gonzalez, who now lives in Florida and has retrained to work as a nurse practitioner within the U.S.
“I am very completely happy as a result of they’re providing to the medical doctors the ability to be paid and to have freedom,” she says.
