Cuba’s international army of doctors is in retreat

Since 1959, Cuba’s so-called “white coat army” has been one of the Caribbean island nation’s most distinctive exports. “From Latin America to Africa and beyond”, thousands of highly trained medical professionals have worked to fill gaps in overstretched health systems around the world, generating valuable income for Havana in the process, said Al Jazeera.

But the long-standing scheme is now under strain, as the United States seeks to “starve Cuba of much-needed revenue” by putting pressure on its allies to stop importing Cuban medics to prop up their strained health services.

‘Coercive labour’

“For decades” the Cuban government has sent healthcare professionals to work overseas in diplomatic arrangements in which host nations pay Havana directly for the services of its medics, said The New York Times. Doctors are dispatched to “work in remote villages and cities in dozens of countries” where local healthcare systems have difficulty filling posts, but the medics themselves only receive a “small fraction” of what is paid for their services. It is “unclear” exactly how much Cuba has received from such arrangements, but research estimates a revenue of around $4 billion (£2.9 billion) a year from the export of skilled workers, including healthcare workers and teachers.

US officials argue that the programmes amount to a “coercive labour export scheme”, said the Financial Times. The US has expanded visa restrictions on those involved in medical missions, including officials in host countries, whom it accuses of participating in “forced-labour practices”. Last year, it imposed travel restrictions on several officials from Brazil, “once a top destination” for Cuban doctors but where numbers have now rapidly fallen amid increasing pressure from the US.

‘Close to collapse’

“After nearly 50 years”, arrangements will draw to a close in Guyana, said the Associated Press, while “several other Caribbean countries” including St Lucia, Antigua and Dominica are also reviewing their programmes. Medical missions have also ended in staunch Cuban ally Venezuela, as well as Guatemala.

Cuba framed the end of the medical mission in Jamaica as the nation “yielding to US pressure”, said Cuba’s 14ymedio. But Jamaica’s “version is different”, alleging that Cuba “did not even respond” to a proposal to pay doctors directly for their work.

The impact is being felt well beyond the Americas. In Calabria, one of the poorest regions in Italy, the arrival in recent years of 400 Cuban doctors has been “essential to keeping local hospitals running”, said Reuters. But, under duress from Washington, Calabria has now “scrapped plans” to hire 600 further doctors, and is now scrambling in a “global search for medical staff” expected to cost the region €8 million (£6.9 million), said Euractiv.

Giuseppe Ranuccio, vice-president of the Calabrian regional council, told the outlet that the health system was already “close to collapse”. The Cuban doctors “were supposed to buy time for structural reforms”, he said. “But those reforms never arrived.”