CubaBrief: How international health agencies kowtowing to Cuba endangers lives, a Cuban COVID-19 timeline, and a call to audit PAHO in The Wall Street Journal

The world is in the midst of a deadly pandemic, in part because international organizations, such as the World Health Organization (WHO), are failing us because they have been co-opted by dictatorships that have priorities in conflict with the mission statements of those entities.  Its American subsidiary, the Pan American Health Organization (PAHO) has a record as terrible as WHO. Both organizations have praised the Castro regime, while the WHO has also kowtowed to the Chinese communist dictatorship for years.


PAHO has been caught up in scandals involving the failure to report a viral outbreak of Zika in Cuba in 2017, and human trafficking. The WHO subsidiary was sued, because PAHO was profiting off the trafficking of Cuban doctors in an arrangement with the Castro regime that Mary O’ Grady described in her April 12, 2020 OpEd in The Wall Street Journal where she called for an audit of the PAHO. The Yucatan Times also has an important article titled “The Cuban medical brigades -A history of enslavement“, raising concerns from a Mexican perspective.

Along with these scandals is the reality that the quality of the doctors trained in Cuba falls short of the standards in other Latin American countries, raising concerns about the care they provide. But The New York Times reported on something more sinister, how Cuban doctors in Venezuela were ordered to deny or ration care to advance Nicolas Maduro’s election prospects in the March 17, 2019 article, “It Is Unspeakable’: How Maduro Used Cuban Doctors to Coerce Venezuela Voters,” including the denial of needed oxygen to deathly ill patients.

This relationship between PAHO, the World Health Organization, and the Castro dictatorship also resulted in dangerous lies. For example, the 2016 claim of the World Health Organization Bulletin that “last year Cuba became the first country in the world to eliminate mother-to-child transmission of HIV and syphilis as public health problems.” When I asked visiting Cubans that worked in the healthcare sector about these claims, they just rolled their eyes. Meanwhile, according to Avert, an NGO that provides information on HIV worldwide, “nearly 90 percent of new infections in the Caribbean in 2017 occurred in four countries — Cuba, Dominican Republic, Haiti and Jamaica.”

Health officials in Cuba are most likely underreporting the full impact of the Wuhan Virus in the island now. They have a long track record of not reporting disease outbreaks on the island. Footage has emerged of a dead body in the street in Pinar del Río, and police afraid of being infected trying to figure out what to do.

Victor Batista Falla, uncle of the Grand Duchess Maria Teresa, died of coronavirus in Havana on April 12, 2020. He had been hospitalized at the Pedro Kourí Tropical Medicine Institute for a week.  Batista Falla was a prominent publisher and “one of the greatest sponsors of Cuban literature in exile.”

CiberCuba reported on April 1, 2020 that the mother of a young girl with coronavirus was detained after criticizing Raul Castro and Miguel Diaz Canel for the spread of the illness. Cynically, Diaz Canel on April 9, 2020 stated that “hiding information can be woefully lethal” but the official communist daily Granma warned that reporting “false or malicious news about the coronavirus” was punishable by up to four years in prison.

Let us examine what the regime considers “false or malicious news” based on how it has applied the policy in the past.

In 1997 when dengue broke out in Cuba, the regime tried to cover it up. When a doctor spoke out, he was locked up, sentenced to 8 years in prison. Amnesty International recognized Dr. Desi Mendoza as a prisoner of conscience, and he was released from prison in 1998 under condition he leave Cuba. The dictatorship eventually recognized that there had been a dengue epidemic.

A 2012 cholera outbreak once again demonstrated how the Cuban public health system operates. News of the outbreak in Manzanillo, in the east of the island, broke in El Nuevo Herald on June 29, 2012 thanks to reporting by the outlawed independent press in the island. Official media did not confirm the outbreak until days later on July 3, 2012. BBC News reported on July 7, 2012 that a patient had been diagnosed with Cholera in Havana. The dictatorship stated that it had it under control. Independent journalist Calixto Martínez was arrested on September 16, 2012 for reporting on the Cholera outbreak, and declared an Amnesty International prisoner of conscience. Cholera outbreaks would continue on the island.

The Castro regime succeeded in covering up the 2017 zika outbreak, but eventually in 2019, due to sick foreign tourists diagnosed with the disease, it was traced back to Cuba. PAHO tried to excuse the failure in reporting as a “technical glitch.” History of past outbreaks would indicate otherwise.

Worse yet, international media outlets in order to maintain a presence in Cuba have compromised their reporting and too often peddle government propaganda, camouflaged as news and echoing the statements of WHO and PAHO without question, while omitting the history of covering up past epidemics where doctors and journalists were jailed for speaking out.

The Inter American Press Association Report on Cuba in 2011 described the process whereby press agencies can cross the line into biased reporting through something akin to Stockholm syndrome:

The Cuban government wages a policy of the carrot and the stick against foreign correspondents accredited in Havana. If the correspondent becomes too raucous in his criticism, all sorts of problems are created for him until his presence in Havana turns into a torment, or else they denounce him in the official press to the point that he leaves the country. If, on the other hand, if he behaves nicely, they let him work and even facilitate contacts and interviews for him. This brings about permanent self-censorship and even reports with a touch of sympathy for the regime.

Meanwhile independent journalists in Cuba and China, who are trying to do real reporting, are threatened, jailed or go missing. Morning Star News is reporting how a Christian independent journalist has been targeted. “Intelligence officials in Cuba have increased harassment of an independent journalist, summoning [ Yoe Suárez ] and his mother twice in the past two weeks to threaten harsh consequences if he continues reporting on human rights issues, sources said,” informed Morning Star News.

The Victims of Communism Memorial Foundation has provided a timeline of the explosion of the Wuhan virus around the world and the coverup by Communist China and obsequious statements of the WHO that further legitimized their lies. This kind of timeline should be maintained for the Cuban response to the coronavirus.

Reuters reported the claim made by the official press in Cuba on March 11, 2020 that “four Italian tourists who were staying at a hostel in the southern town of Trinidad after arriving at Havana airport on Monday had presented respiratory symptoms and were taken to a hospital on Tuesday. On Wednesday, the hospital confirmed that three of the tourists had tested positive for the coronavirus, the broadcaster said.”

Panama’s Ministry of Health, a day earlier, on March 10th reported that two Panamanians, ages 55 and 29 who visited Cuba had tested positive for the coronavirus when they returned home.

On March 11, 2020, Nicolas Maduro was promoting Cuba’s “interferon” as a cure that saved “around 3,500 lives in China” declaring Cuba in the vanguard, Caribbean National Weekly called it the antidote for COVID-19, and Newsweek was calling it a “wonder drug.” The reality is far more humble. Interferon Alpha-2B Recombinant (IFNrec) was jointly developed with China, but they did not pioneer the discovery of interferon. Interferon research, not surprisingly, was pioneered in Switzerland in the 1950s.

Despite this, the Cuban dictatorship’s military run tourism industry continued to pitch Cuba as a travel destination last month and posted a tweet on March 13, 2020 claiming that Coronavirus does not replicate at high temperatures and that the island is now 29-32 degrees Celsius. Havanatour is owned and run by the Cuban military.


On March 16, 2020 Barbara Díaz, director of marketing for the Castro regime’s Ministry of Tourism in a press conference said, “Clients who decide of their own free will to come to Cuba are welcomed.” The dictatorship’s director of marketing declared that “our social function is to receive tourists, give them assistance … and demonstrate that Cuba is a safe country in all aspects.”  The government had not canceled flights from Italy or other hotspot countries, reported Nora Gamez in The Miami Herald.

The fiction presented by the Cuban government was that the Wuhan virus was not present in Cuba until March 9, 2020 when these four Italian tourists arrived to Cuba, but how does one explain that the Florida Department of Health announced on March 15, 2020 that a 17-year-old male from Cuba tested positive [for the Wuhan virus] in Hillsborough County.

On March 6, 2020 Granma, the official communist newspaper of Cuba, made the claim that “to date, no cases of Coronavirus ( Covid-19 ) have been confirmed in Cuba.” At the time, there were cases in Brazil, Dominican Republic, Mexico, Panama, Peru, Argentina, Paraguay, Spain, the United States, Canada, Italy, Germany, France, and many other places. Regime officials claim to be ready if and when an outbreak takes place.

This type of claim was made during the zika outbreak in 2016-2017 and it was learned in 2019, through studies of zika infected tourists from around the world, that Cuba had over 5,000 zika cases active on the island in 2017 that the dictatorship did not report.

At the same time officials of the Castro regime  reported that there is a shortage of soap and detergent in Cuba that will not be alleviated until May – June 2020.

The Castro regime blames the embargo for its shortages, although those items are not restricted by US sanctions, but Cubans blame the internal blockade raised by the Castro regime and are circulating a petition calling for its end so that civil society can create a humanitarian bridge and get supplies to Cubans in need.

South Florida has become a hot spot for the pandemic in Florida. Furthermore, the emerging hotspot in Florida is Hialeah, the city with the largest number of Cubans per capita in Florida.  Not shutting down travel to and from Cuba earlier, because the regime failed to alert the severity of the outbreak on the island, may be a contributing factor to this emerging disaster.

Hundreds of thousands of people are dying, and the numbers could rise to the millions, but too many are still giving the benefit of the doubt to dictatorships such as Cuba’s and China’s and the consequences will continue to be dire.

The Cuban dictatorship reported on April 13, 2020 that it had a total of 726 coronavirus cases, 121 recovered and 21 deaths. Meanwhile North Korea, a Cuban allycontinues to report no cases. Willing to bet your life on the accuracy of these numbers?

The Wall Street Journal, April 12, 2020

Audit the WHO’s Pan American Arm

PAHO shouldn’t get a dime of U.S. funding until it stops carrying water for Cuba.

 By Mary Anastasia O’Grady

Pan American Health Organization (PAHO) building in Washington DC.

Pan American Health Organization (PAHO) building in Washington DC.

President Trump is unhappy with the response of the World Health Organization to Covid-19 and has promised to take a “good look” at its U.S. funding. Hallelujah. If the coronavirus prompts a Washington audit of the practices of the WHO, a devastating storm will have blown some good.

A review of the WHO’s Western Hemisphere subsidiary, the Pan American Health Organization, or PAHO, is also in order. Its record of supporting antidemocratic regimes seeking to destabilize legitimate governments weakens public health rather than strengthening it.

The U.S. once played a lead role at PAHO, and the organization achieved substantial gains against infectious diseases. In the 1950s and 1960s, dengue fever was eradicated in most of the region.

Yet while American taxpayer dollars still fund roughly half PAHO’s budget, serious medical influence at the organization has waned. In its place are ideologues who carry water for the Cuban military dictatorship and its medical export business.

Havana boasts about sending medical personnel abroad as if it runs a charity. But governments pay Havana for Cuban health-care workers, who then receive a miserly stipend from the regime, which leaves them in poverty. The dictatorship profits by keeping the lion’s share of the income.

This is human trafficking and it violates international law and the laws by which the WHO is governed. As I reported in January, Cuban medics who escaped the program are suing PAHO in U.S. federal court. They allege that when Brazilian law and congressional opposition got in the way of launching the scheme, PAHO stepped in as a financial intermediary to launder the illegal payments of a secret Cuba-Brazil agreement. On April 3 the venue for that suit was moved to Washington.

The deal was exposed when Brazilian journalists won the release of Brazilian documents connected with the Cuban medical missions. These include the minutes of a February 2017 meeting in Havana of Cuban, Brazilian and PAHO officials, which I have seen. PAHO told me in January that “it is false to state” that Brazil was engaged in human trafficking with Cuba and that PAHO “would never participate in any activity or program related to human trafficking.”

But the minutes outline how the three parties strategized a response to legal challenges filed in Brazil by Cuban workers demanding to receive their full pay as per Brazilian law. The Cuban vice minister of health expressed concern about the potential legal pitfalls for Havana’s moneymaking arrangement with Brazil and demanded that Brazil find a solution that would fulfill the commitment it had made to Cuba under the agreement.

According to the minutes, PAHO legal counsel Heidi Jiménez, acting “on behalf of PAHO,” committed to enforcing the commitments Brazil had made under the agreement. Ms. Jiménez further committed to preparing for the attorney general of Brazil “an official response . . . to the legal actions put forth by the [Cuban] doctors.” PAHO didn’t reply to requests for comment.

PAHO’s complicity in making chattel out of Cuban workers is appalling. But the more outrageous aspect of its partnership with Havana may turn out to be the health outcomes for the region.

Cuban doctors, who escaped from various assignments around Latin America, testified at a State Department event in 2019 in New York. One doctor said that when no patients visited the clinic in Bolivia where she worked, her boss in Havana instructed her to invent names and illnesses to provide “statistics.” Logically, this created an illusion that Cuban medicine was serving a great need abroad and curing the sick.

According to her testimony, doctors were also told to requisition medical supplies and pharmaceuticals for patients who didn’t exist. This would have allowed Farmacuba, a state-owned pharmaceutical company, to sell its products to host countries. Farmacuba also collects a fee as an intermediary between medical suppliers in China, India and Russia and its “clients” in Latin America. When products arrived, the doctor said, the Cuban medics were instructed to destroy them. Another doctor said spreading regime propaganda was part of his job.

A further public-health problem generated by Cuba is its “Latin American School of Medicine,” which educates Cubans and students from around the region. Yet when Cuba-trained doctors return to their home countries they often don’t pass muster. As far back as 2012, the University of Costa Rica found that most graduates of Cuban medicine were unqualified to practice in that country. In 2015 Chile’s El Mercurio reported that out of 787 Cuban-educated doctors in Chile more than half couldn’t pass local medical-board exams even on the fourth try.

Cuba’s medical scams aimed at earning hard currency and spreading communist propaganda have created a false sense of progress in the battle against infectious diseases in the region. Before PAHO gets another dime of U.S. funding, it ought to explain why it aids Havana’s phony health-care schemes.

Write to O’



Morning Star News, April 13, 2020

Intelligence Officers in Cuba Ratchet Up Harassment of Christian Journalist

Morning Star News Cuba Correspondent | Morning Star News | Monday, April 13, 2020

MIAMI, April 10, 2020 (Morning Star News) – Intelligence officials in Cuba have increased harassment of an independent journalist, summoning the Christian and his mother twice in the past two weeks to threaten harsh consequences if he continues reporting on human rights issues, sources said.

As part of his Christian calling, Yoe Suárez has reported for non-state media outlets in Cuba since 2014 about human rights and freedom of religion issues, including the imprisonment of husband-and-wife pastoral team Ramón Rigal and Adya Expósito. They were imprisoned in April 2019 for homeschooling their children.

Following a series of interrogations and threats by Cuba’s Department of State Security (DSE, the inland intelligence branch) over the past year, an intelligence official identifying himself as a second-in-command-for-the-press summoned Suárez and his mother on April 3 to the Siboney Police Station, Playa municipality in Havana, according to Suárez.

The official, who identified himself as “Captain Jorge,” issued a series of implied threats to Suárez’s mother about consequences her 29-year-old son would suffer if he continued working as a reporter outside of Cuban intelligence controls, Suárez said.

“He told us, ‘You don´t know what a dungeon is, or what it is to have a patrol in front of your house,’” Suárez told Morning Star News.

Suárez added that the official said, “The Office of the Prosecutor and Minors can intervene,” suggesting they could take him into custody and also take custody of Suárez’s less than 2-year-old son. Cuban civil law’s Family Code states that “both parents, or one of them, will lose custody over their children when they are convicted as a sanction for a final sentence issued in criminal proceedings.”

“This time they were much less kind than the last,” Suárez told Morning Star News. “He mentioned to me an article of the penal code under which I qualified for the crime of mercenarism.”

Cuba’s mercenarism law (Law 62, Section Eight, Article 191, Subsection 1 of the Cuban Penal Code) calls for prison of 10 to 20 years, or death, for a Cuban citizen who, “in order to obtain payment of a salary or other type of material retribution, is incorporated into military formations fully or partially integrated by individuals who are not citizens of the State in whose territory they intend to act.”

Subsection 2, Article 191 provides similar penalties for anyone “who collaborates or executes any other act aimed directly or indirectly at achieving the objective indicated in the previous section.” Cuban intelligence has a historical precedent of accusing Christians of being CIA agents on pretexts ranging from receiving a Christmas card from abroad to receiving offerings from Christians in foreign currency.

The official told him that he shouldn’t underestimate the DSE, Suárez said. Adding another level of pressure, “he told me that he had many contacts, and that through them he could spread the word that I was a State Security agent, to discredit me,” Suárez said.

“After that, and in front of my mother, he had no qualms about asking me if I wanted to join DSE as an informant, apparently within [Cuban newspaper] Diario de Cuba,” Suárez said. “I told him that my work is strictly journalistic, that I do not do police or intelligence work. Then he says to me, ‘Well, I’m not a police officer, and this is not a recruitment because that takes longer; State Security does not jump into a pool from a fifth floor without first measuring the depth, width and temperature of the water.’”

Suárez said the official told him he does not care if a journalist works for a non-state media outlet “as long as he does so under the control of the State Intelligence.’”

When Suárez declined to promise that he would work under intelligence controls, the officer said he had power to make him look like a government agent, causing him to lose credibility as a journalist and in his personal life, Suárez said. He warned the journalist that this would be the first and last time he would talk with him, and that the next time they saw each other would be in an “operation” against Suárez.

The April 3 encounter took place a day after two DSE agents summoned Suárez’s mother to a travel agency office near her home to interrogate her.

“All they seek is to put pressure on me through my family,” Suárez told Morning Star News. “My mother is very disturbed – fearful for me and for the consequences I may suffer. Right now, she is not able to even speak.”

The previous week, on March 27, two government agents summoned Suárez to Siboney Police Station and, while interrogating him, said they could “save” him from intelligence punishment – that he still had time to correct his ideological course. They asserted that the “dialogues” of recent interrogations represented a first phase, but that other, harsher phases would come if he continued to report for Diario de Cuba and other “enemy” media outlets.

Reporting on Rights Issues

Suárez, a member of the Cuban Evangelical League, said authorities are targeting him not for anything specific but due to “a cluster of anger about my work.”

The anger stems from the visibility his reporting has given to cases sensitive for the communist regime, he said. Along with the pastoral couple’s imprisonment for homeschooling, such cases include evangelical church protests against a new constitution approved in February 2019, and the government’s rejection of attempts by several denominational leaders to register the Alliance of Cuban Evangelical Churches.

Suárez has also covered another taboo topic: The Military Units of Aid to the Production (UMAP), euphemistic name for concentration camps to which the government, from 1965 to 1968, sent those considered a “social scourge.” Among them were artists, homosexuals, Jehovah’s Witnesses, priests, pastors and lay evangelicals.

Suárez wrote about UMAP in an award-winning report that records pastor Alberto González describing how he was subject to more than 12 hours of work, torture and humiliation for being a student of a Baptist theological seminary.

Recently the independent Diario de Cuba published Suárez’s extensive article on violations of religious freedom in Cuba, particularly harassment and detention of leaders of the Apostolic Movement, one of the most punished Christian organizations on the island.

In the most recent of his books, “The Breath of the Devil: Violence and Gangsterism in Cuba,” Suárez shares the account of gang members who have converted to Christianity.

“Cuban officials say that this doesn’t exist, that there are no gangs,” Suárez said.

Suárez has also reported for Newsweek and Univisión, along with Christian news sites Evangélico Digital and Evangelical Focus. Regularly targeted by authorities as a result of his work, in 2016 Suárez was expelled from the Latin American Press Agency, Cuba’s official state news agency.

Prior Summons

On Feb. 5, DSE officials summoned Suárez and his mother to a police station in Havana.

A captain identified only as Enrique interrogated him for three hours, threatening that his family would suffer “consequences” if he continued reporting outside state controls, Suárez said. The official also informed him of an indefinite restriction on travel outside the country.

Cuba’s list of people put under such travel bans has grown to more than 200 Cubans, including 15 religious leaders, according to a list updated by Patmos Institute. The government typically imposes the ban on freedom of movement to citizens who communicate through unofficial channels. Suárez published his findings on this topic.

State security agents “are very upset when data is offered,” he told Morning Star News, “because it is not an opinion, and thus increases the credibility of journalistic work.”

The last three summons Suárez has received from state security officers have come as authorities demand social distancing to prevent further spread of the novel coronavirus. Critics on social media have lamented that authorities don’t care if those summoned for questioning become infected or die from the pandemic.

Previously, on Aug. 9, 2019, joint forces of State Security and the National Revolutionary Police arrested Suárez in Guantánamo while he was on his way to conduct an interview, according to Evangelical Focus. At the provincial headquarters of the Ministry of the Interior, he was interrogated and threatened with prison if he ever returned to the city.

Officials filed a report of alleged counterrevolutionary activity, and he was handcuffed and deported from the city of Guantánamo.

Suárez had intended to interview members of the Rigal-Expósito family and journalist, lawyer and Catholic Roberto Jesús Quiñones, who also ended up in jail for trying to defend the pastoral couple’s efforts. In late March Pastor Expósito received a commute to serve the rest of her sentence at home. Her husband remains in prison.

Shortly after the trip to Guantánamo, Suárez and six other Christians, along with artists and intellectuals, addressed an open letter to the Cuban government demanding freedom for pastors Rigal and Expósito, freedom of expression, press and movement and opening of the Cuban educational model that is under strict state control.

On Sept. 14, 2019, upon arrival at José Martí Airport from Spain, Suárez’s passport was taken by immigration officers, according to the Havana-based Association for Freedom of the Press. They led him to an office within the terminal, where a Political Police (DSE) officer who identified himself as Danilo questioned him about the event he attended. Suárez later received back his passport.

Since then authorities have been increasingly antagonistic toward him, culminating in the April 3 summoning of him and his mother. In that interrogation, he said, the official told him he was “putting on a shirt that was too big for him,” and that his attitude “typifies the crime of mercenarism.”

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Yucatan Times, April 10, 2020

The Cuban medical brigades -A history of enslavement

For decades, the propaganda machine of Fidel Castro’s dictatorial communist regime created an illusion woven from Havana. It made the world believe that the professionalism of Castro’s Cuba’s doctors was almost irreplaceable. That their knowledge was superior to the health care offered in the rest of the world. That medical propaganda was woven over the years, and many countries -accomplices- embraced such fantasy.

An article by Octavio Gómez Dantés for Nexos Magazine

In search of explanations for the growing problems in the health sector, President López Obrador spoke a few months ago about the alleged lack of doctors in the country: “There are 270,000 doctors, and we must have, according to international standards, 393,000. We are short 123 000”. “Besides, the doctors there are,” he added, “do not want to go and work in remote communities”.

These statements seemed to pave the way for a measure that will hardly help solve the critical situation our country’s health services are going through: the hiring of Cuban doctors who, until recently, worked in the Mais Medicos program in Brazil. The government has not ruled out the possible arrival of a group of Cuban doctors specialized in intensive care that would help meet the demand associated with Covid-19.

The international medical brigades, which made Cuba so famous, have long since ceased to exist. In their place, commercial missions were set up and are operated by doctors who work under conditions of open slavery: guarded by personnel from the security apparatus of their country, prevented from traveling accompanied by their families, and deprived of most of their salary.

These are three questions that the Mexican authorities will have to answer before requesting the Cuban government’s help in confronting the pandemic: 

I) Is the support of this group of Cuban doctors necessary – can’t Mexican doctors go it alone? II) If the help is accepted, will the violation of human and labor rights of the doctors who serve in the so-called foreign missions, as it already happened in the eyes of the whole world in Brazil, be overlapped?III) Will members of the Cuban security apparatus who usually form part of these missions be allowed to enter Mexican territory?

The first international medical brigades were organized shortly after the triumph of the Cuban Revolution, in 1963, in support of Algeria, which suffered a massive exodus of doctors after its independence, followed by brigades to support the national liberation movements of Guinea-Bissau and Angola, and later by the Sandinista Revolution in Nicaragua.

These brigades have also been mobilized in cases of natural disasters. They were sent to Chile, Nicaragua, and Iran to support the victims of the earthquakes that hit those countries in 1960, 1972 and 1990, respectively; to Honduras, Guatemala and Haiti in 1998, after Hurricanes Mitch and George; to the states of Vargas, Miranda and Falcon in Venezuela after the storms of 1999 that killed more than 20,000 people, and to Indonesia after the 2004 tsunami.

Since the 1980s, however, these missions began to pursue commercial rather than humanitarian and geopolitical objectives. Their numbers grew after the fall of the Berlin Wall, as a result of the dramatic decline in economic subsidies Cuba received from the Soviet Union and the disappearance of the preferential trade treaties the island’s government had established with the socialist countries of Eastern Europe. In 1998, after the so-called “white flight” following the demise of apartheid, no fewer than 400 Cuban doctors arrived in South Africa. Within a few years, medical missions were sent to Cape Verde, Ivory Coast, Gambia, Equatorial Guinea, Mozambique, and Zambia.

The turning point in this process, however, came with the cooperation program that Cuba established with Venezuela as part of the trade agreements they signed in 2000 and 2005. This program, known as Doctors for Oil, involved the export of more than 30,000 Cuban doctors and dentists to Venezuela in exchange for 105,000 barrels of oil a day.

The next waves of exports were to Bolivia, Ecuador, Guatemala, Haiti, Honduras, and Nicaragua. In 2013, Brazilian President Dilma Rousseff announced the hiring of four thousand Cuban doctors to provide medical care in vulnerable rural areas of Brazil through the Mais Médicos program. The number of Cuban doctors in this country increased year by year until it reached 15,000 in 2018.

It is estimated that half of the Cuban doctors, no less than 40 000, work in more than 60 countries in Asia, Africa, and Latin America. According to Cuba’s Trade Minister, the export of medical services is the country’s primary source of foreign exchange, ahead of sugar, tobacco, nickel, tourism, and remittances. It is estimated that these services generate around 11.5 billion dollars annually.

The cross-border movement of health workers has become a global phenomenon that brings enormous economic benefits to exporting countries. In principle, there is nothing questionable about Cuba renting its surplus doctors to foreign countries. The problem is the conditions under which it is doing so. This export of medical services, which the Cuban government insists on calling “proletarian internationalism” or “solidarity support,” is being implemented in a context of enormous control and in violation of the labor rights of Cuban doctors and the International Labor Organization agreements on wage protection. The Cuban government, which operates through the company Comercializadora de Servicios Médicos Cubanos (CMSC), has been accused of human trafficking and sued in Brazilian courts.

The Brazilian government paid the doctors working at “Mais Médicos” a monthly salary of USD 4,150 in addition to providing them with food, transportation, and health insurance. However, the Cuban doctors received only US$1,000 per month, of which US$600 was deposited in accounts in Cuba to which they had no access until they returned home at the end of their mission. The rest, $3,150 per month, was appropriated by the Cuban government in an act that can legally be considered “withholding of salary,” which is a criminal offense.

To this should be added prohibitions and continuous surveillance. Health workers operating medical missions are not allowed to establish personal relations with the local population or speak to journalists or diplomats and must request authorization to travel outside their jurisdiction. 

Cuban security personnel are responsible for ensuring compliance with these measures. Janoi Gonzales, a Cuban doctor, exiled in the United States since 2013, said: “In each mission, there is a person who is called a ‘juridical.’ Everyone knows that … he is a state security agent, who controls everything, who accuses, who has the right to review your private documents, your phone, everything. Offenses are punishable by penalties ranging from warnings and confiscation of a percentage of your salary to expulsion from the mission and immediate return to the island”.

Julie Feinsilver, author of the book Healing the Masses: Cuban Health Politics at Home and Abroad, says Cuban doctors trained under the Revolution know no other system and see missions abroad as an honor and an opportunity to learn and serve. But the reality seems to be more complicated. Cuban doctors, who earn less than $50 a month at home, leave the island in search of freedom and prosperity, which they often find in exile.

The number of health care workers assigned to international missions who have defected has increased dramatically, in part as a result of the implementation of the Conditional Intake Program for Cuban Medical Professionals, established by President George W. Bush in 2006, which granted Cuban doctors working on international missions residency visas. The Obama administration discontinued this program in January 2017 because it was affecting the health of the Cuban people.

According to El País, no fewer than 5,000 Cuban doctors, nurses, and therapists have deserted their missions in the last decade. In 2013, 3,000 Cuban doctors arrived in the United States from Venezuela. The same phenomenon was observed with Cuban health workers employed in the Mais Médicos program. Ramona Matos Rodriguez, the first Cuban doctor to leave this program and apply for asylum in Brazil, said: “I am sure that if I return to Cuba, I will be arrested. The Cuban government deceived me”. She sued not only the Brazilian government and the municipal government of Pacajá, where she worked but also the CMSC and the Pan American Health Organization (PAHO), which acted as an intermediary for her mission in Brazil.

To this, we should now add the lawsuits that several Cuban exiled doctors recently filed against PAHO, in general, and several of its officials, in particular. According to the plaintiffs, this organization not only supervised the “Mais Médicos Programme” – and therefore implicitly approved the conditions under which it was being carried out – but also obtained direct monetary benefits. They cite a Brazilian government document stating that Brazil paid PAHO $1.5 billion, and PAHO transferred $1.425 billion to Cuba. The Cuban government paid Cuban doctors 125 million dollars and kept 1.3 billion dollars. PAHO withheld the remaining US$ 75 million, which it could not have used for program management costs because these were the responsibility of the Brazilian government.

Journalist Andrés Oppenheimer, who has been writing about the irregularities of the Mais Médicos program for several years, said: “When I first wrote about the situation of Cuban doctors in Brazil in September 2013, I described this agreement -and the supervision of PAHO- as “scandalous.” Now, if it turns out that PAHO also made US$75 million from this program, we would be looking at a UN agency that would have profited from a modern-day slave trade. That would no longer be just immoral but could be criminal.

The next chapter in this saga could be the hiring by the Mexican government of several thousand Cuban doctors who are leaving Brazil. The spearhead of this hiring could be the intensivist doctors who would support the response to the coronavirus pandemic.

The problems that the government of President López Obrador will have to face if it decides to incorporate Cuban doctors into its response strategy to the Covid-19 pandemic – and to INSABI later on – are diverse and complex. 

Three stand out among them: I) The existence of a high level of underemployment and unemployment among Mexican doctors, who will rightly feel discriminated against.II) The necessary revalidation of the studies of these health professionals, which is usually very strict in Mexico and takes several years,III) The acceptance by the Mexican authorities of the working conditions prevailing in international medical missions, which have been described as violating the human and labor rights of Cuban doctors

An additional, but not minor, issue is the presence of members of the Cuban government’s security apparatus on national territory. In Guatemala, a few years ago, a high-ranking official from the Mexican embassy commented that two people were better aware than the president himself of what was happening daily in Guatemalan territory. In essence, one was President Bush, through the CIA, and the other, President Castro, through the “juridical” missions operating throughout the country. 

It was with the Cuban medical missions that these obscure characters also arrived in Hugo Chávez’s Venezuela. Today they hold positions in the entire Venezuelan government, including the armed forces. Are we going to allow them to enter Mexico? If so, will their presence eventually extend to the whole of government apparatus?


Octavio Gómez Dantés for Revista Nexos
April 07 2020

Octavio Gómez Dantés is a researcher at the National Institute of Public Health of Mexico.