CubaBrief: On the question of exploiting Cuba’s medical workers one has to distinguish between facts and opinions

The Inter-American Dialogue’s publication the Latin American Advisor on August 4, 2020 asked an important question, “Is the Government of Cuba Exploiting Medical Workers?” to a number of experts and some of the answers were troubling because they went beyond questions of opinion, but fell into questions of facts.

Bernard Baruch, an advisor to Democratic U.S. presidents on economic matters from Woodrow Wilson through Franklin Roosevelt observed in 1946 that “[o]n the question of principles, it is an inalienable right each of us has to express opinions on every policy animating this country, whether national or international. That is the highest function of those who live under a political democracy; of those who cherish the right of free speech. Every man has the right to an opinion but no man has a right to be wrong in his facts. Nor, above all, to persist in errors as to facts.” 

Lenier Gonzalez, founder and deputy secretary general of Cuba Posible and Ambassador Vicki Huddleston, retired U.S. ambassador and former chief of the U.S. Interests Section in Havana both made the claim in the Latin American Advisor piece that Cuba has “successfully faced the Covid-19 pandemic” and Ambassador Huddleston goes further claiming that ” Cuba has eradicated the coronavirus at home.” There a number of problems with this claim.

First, on August 8, 2020 the Cuban government confirmed a rebound of coronavirus cases and placed Havana on a strict lock down. Officials on August 10th claimed that there were 93 new cases reported.

Second, in Cuba, under the Castro regime, there is a history of under- reporting outbreaks of Dengue in 1997, Cholera in 2012, and Zika in 2017 that impacted not just Cubans, but visitors to the island.

Cubans who blew the whistle at the time were jailed by the Castro dictatorship and declared prisoners of conscience by Amnesty International in 1997 and 2012 respectively. 

Havana initially got away with the Zika coverup in 2017, but contact tracing cases of tourists from around the world who had contracted this virus, that causes catastrophic birth defects, led back to Cuba. Researchers reported that thousands of Zika cases had not been reported.

This history led some to reason that this was happening again with COVID-19 when Cuban government officials falsely claimed through February and March 2020 that Cuba was a safe harbor with effective treatments for coronavirus for visiting tourists.

Cuban officials refused to close schools, or take other precautions, Cubans desperately began to take steps on their own against the pandemic, having learned about it on the internet. Teachers, ignoring the regime’s orders, closed schools and sent children home. The Catholic church, aware of the danger presented by public gatherings, suspended religious services.

Cuban demographer Sergio Díaz-Briquets interviewed by Nora Gamez of the Miami Herald explained that “preventive measures were taken late, and many have not been implemented fully, mostly because the government does not have enough resources. There is not even enough soap.” Mr. Díaz-Briquets  added in the same article that “Cuba has other health indicators such as an aged population and higher percentages of people with pre-existing conditions that would suggest they have a more serious problem.”

Cuban-American economist Carmelo Mesa-Lago said in a Harvard webinar on May 1, 2020 that in Cuba, “there is no independent entity that can report its own [coronavirus] figures or criticize the government’s data.”

According to data reviewed by the Miami Herald and reported by Nora Gamez, “in the week ending on March 21 there were 144,095 newly reported ‘acute respiratory illnesses.’ By March 28, the number of new weekly cases of people with acute respiratory diseases rose to 188,816, more than double the weekly average this year. ‘Not only could the increase be explained by a COVID-19 outbreak, it most likely does reflect the COVID-19 outbreak based on when it started and what has been going on in the world,’ said Dr. Aileen Marty, an expert on infectious tropical diseases and director of the Florida International University Health Travel Medicine Program.”

Statistics were published by the regime’s Pedro Kourí Institute of Tropical Medicine in its weekly bulletins. Data had been recorded “since at least the early 2000s to monitor acute respiratory diseases, a category that includes pneumonia, influenza, the common cold and coronaviruses such as new one that causes COVID-19.”

In less than a month (March 15 – April 4th) the Institute “reported 491,494 cases of acute respiratory diseases.”  This was a dramatic increase from measurements taken in Cuba over the past five years, and the months prior to March 2020.

Repeating the errors in fact of the Cuban government could be having serious consequences not only for Cubans but for countries receiving visitors from Cuba, including the United States. Did the failure to limit travel from Cuba or to carefully test, and quarantine those who arrived in special flights after the end of March 2020 contribute to Miami Dade County, Florida being a COVID-19 hotspot?

How can Lenier Gonzalez and Ambassador Vicki Huddleston make such claims that can have such dangerous consequences?

UN experts and Human Rights Watch have raised questions about abuse of Cuban doctors

UN experts and Human Rights Watch have raised questions about abuse of Cuban doctors

On a less life threatening but still important subject of human trafficking the attempt by Wazim  Mowla, of Florida International University,  and Lenier Gonzalez, to view it through a political lens where “right wing” “accusations of ‘slave labor’ have a clear political connotation, and they only make sense as the electoral cycle … becomes relevant.” Ambassador Huddleston underscores the same point but with a quote by “prime minister of St. Vincent and the Grenadines and incoming chairman of Caricom, Ralph Gonsalves” that it “is not human trafficking.” 

They are ignoring international experts that do not depend on the American electoral cycle to address Cuba’s medical missions.

Ms. Urmila Bhoola, the UN Special Rapporteur on contemporary forms of slavery, including its causes and consequences, along with Ms Maria Grazia Giammarinaro, UN Special Rapporteur on trafficking in persons, especially in women and children, sent a letter on November 6, 2019 to the Cuban government regarding the regime’s medical missions in which the special rapporteurs indicated that “according to the conditions of work reported could be elevated to forced labor, according to indicators established by the International Labor Organization. Forced labor constitutes a form of contemporary slavery.”

Also Human Rights Watch, that could not be accused of being “right wing” does argue that “[g]overnments that accept Cuban assistance that includes the abusive conditions imposed by Cuba risk becoming complicit in human rights violations,” said [Jose Miguel] Vivanco of Human Rights Watch, who added that, “Cuba may not be willing to protect its health workers, but other governments should avoid furthering their exploitation.” This would include the prime minister of St. Vincent and the Grenadines and incoming chairman of Caricom, Ralph Gonsalves.

Everyone is entitled to their own opinions but not their own set of facts.

Latin American Advisor, August 4, 2020

Is the Government of Cuba Exploiting Medical Workers?

Aug 4 2020


Q: U.S. Senators Rick Scott (R-Fla.), Marco Rubio (R-Fla.) and Ted Cruz (R-Tex.) in June introduced legislation to require the State Department to publish a list of countries that receive doctors from Cuba through its medical program, and to consider that as a factor in its annual Trafficking in Persons report. What does Cuba’s doctors program consist of, and how important is it for Cuba in terms of both diplomacy and revenue inflows? To what extent and in what ways does the program exploit Cuban medical experts, as its critics allege? Which countries benefit the most from the program, and if the bill is enacted, how much would they stand to lose?

Prime minister of St. Vincent and the Grenadines (center), welcomes Cuban doctors / Photo: Prensa Latina.

Prime minister of St. Vincent and the Grenadines (center), welcomes Cuban doctors / Photo: Prensa Latina.

A: Marco Rubio, U.S. senator (R-Fla.): “The Cuban regime’s so-called ‘foreign medical missions’ have created an international human trafficking scheme through which Raúl Castro and Miguel Díaz-Canel have perfected the art of exploitation and illegal enrichment. As a lifeline for the Communist regime, reports have noted that these ‘medical missions’ withhold a substantial portion of the Cuban doctors’ and medical personnel’s wages. Through deplorable working conditions, confiscation of legal identification and unfair compensation, these ‘missions’ constitute a form of forced labor and modern-day slavery.” 

A: Lenier González, founder and deputy secretary general of Cuba Posible: “This subject has much more nuance and sides than the belligerent narrative that demonizes it. There are currently more than 30,000 Cuban health personnel in many countries assisting vulnerable communities. Over the years, they have provided assistance in three ways. First, they have intervened in world catastrophes without charging anything in return. Second, they have cooperated with third-country agencies to assist in disaster situations, like Norway and the United States have done. And third, Cuba has exported medical services as part of its economic strategy. The country successfully faced the Covid-19 pandemic and also gave its support to 21 nations, a unique experience these days. This has translated into an enormous benefit for developing countries and also a high recognition for the doctors and for the island at an international level. The subject articulates solidarity with a criterion of economic opportunity, since it contributes billions of dollars to GDP. Cuban doctors participate in the missions with their own free will. Before leaving Cuba, the doctor signs a contract for a certain amount of money (set by the government). Physicians’ wages should be higher, their working conditions should be better, and control over doctors should be lessened. Control and centralization are distinctive features of the Cuban sociopolitical and economic systems, not only in the medical missions. It is something that must change to make Cuba’s future sustainable. That said, let’s be frank: the accusations of ‘slave labor’ have a clear political connotation, and they only make sense as the electoral cycle in the United States and Florida becomes relevant.”

A: Otto Reich, president of Otto Reich Associates LLC and former U.S. assistant secretary of state for Western Hemisphere Affairs: “Under the guise of a ‘voluntary, humanitarian, internationalist program,’ Cuba generates between $8 billion and $11 billion every year from the forced labor of doctors and medical workers exported to foreign countries. The ‘forced labor’ description is not mine; it is the U.S. State Department’s language in its most recent Trafficking in Persons Report to the U.S. Congress. The above revenues comprise the single largest source of income for the Cuban military’s coffers. More than 60 countries currently employ about 40,000 Cuban doctors under this system, and 12,000 medical workers have defected over the years. Reports from Brazil and Venezuela, as well as a federal lawsuit filed by Cuban doctors now living in the United States, have exposed these missions as human trafficking, in violation of U.S. and international law. Far from being primarily humanitarian, the missions are an extension of the Marxist government’s propaganda and intelligence apparatus. Cuban doctors assigned to Venezuela, for example, were forced to withhold medical care from patients who didn’t support Maduro. Doctors assigned to Brazil were required to tell patients they had to vote for Rousseff government politicians (favorable to Cuba) to maintain the health care program. All doctors are monitored and surveilled 24 hours a day by Cuban intelligence officials in the foreign countries to make sure they remain loyal to the regime. In addition to these and other illegal practices, the Cuban government keeps 80-90 percent of what the foreign countries pay for their services, and the doctors get only a small fraction of the total. It is easy to see why these programs are so important for Cuba’s military rulers. If the regime cared for the doctors, they would allow them to be paid directly by the foreign employer and to keep their passports while abroad in case they wanted to travel. Why they don’t is self-evident.”

A: Wazim Mowla, researcher for the African & African Diaspora Studies program at Florida International University: “Cuban medical professionals have been an integral component of Caribbean public health systems for more than 30 years, so it was natural that the region’s leaders looked to Cuba during the Covid-19 pandemic. As Caribbean governments recognized that the pandemic would be a shock to their tourism-dependent economies, they quickly requested Cuban medical support to defend themselves against the virus and lessen the future contraction of their economies. Caribbean leaders have been sensitive to right-wing accusations that the medical workers suffer from human trafficking as their experience has assured them otherwise. If this bill is enacted, not only would it undermine the sovereign right of Caribbean countries, but states such as Barbados and Belize could be affected as early as 2021. Both countries were placed on the U.S. State Department’s annual Trafficking in Persons Report’s Tier 2 Watch List for two consecutive years. A country placed on the Tier 2 Watch List for a third year automatically finds itself on the Tier 3 list. The designation would result in U.S. funding restrictions and give the U.S. president the power to direct his representative at multilateral development banks to use their best efforts to deny loans to these countries. With seven Caribbean countries already on the Tier 2 list (one notch below the Tier 2 Watch List), others in the region could face a similar circumstance. Given the economic and public health challenges Caribbean countries will soon face, the region’s leaders are likely to view the bill’s enactment as unfriendly and inhumane.”

A: Vicki Huddleston, retired U.S. ambassador and former chief of the U.S. Interests Section in Havana: “The legislation that Senators Rubio, Cruz and Scott proposed is nothing new. It is a ploy to garner conservative Cuban-American votes and resources and to deny revenues to the Cuban government by using the false rationale that Cuban doctors are being trafficked. The opposite is true; the majority of doctors seek out these positions as their salaries abroad are considerably greater than at home, where there is a glut of physicians. The prime minister of St. Vincent and the Grenadines and incoming chairman of Caricom, Ralph Gonsalves, said that engaging with Cuba’s medical missions ‘is not human trafficking’ and that, by classifying it as such, the United States makes ‘more difficult the fight against genuine human trafficking’ and underestimates ‘the big impact of how much the Cubans are helping.’ Unfortunately, should this legislation pass, we will become even more unpopular with our Caribbean neighbors and important allies such as Mexico and Italy, all of whom are truly grateful for Cuba’s help. It is true that the Cuban government isn’t completely altruistic; it desperately needs the foreign exchange paid by the recipient countries for the physicians’ services. More worrisome, Cuba tarnishes its image by limiting the freedom of the physicians and by confiscating their passports, thereby denying them the right to travel. Yet, the bottom line is this: Cuba has eradicated the coronavirus at home and provided succor to others, while the Trump administration has failed to staunch the pandemic at home and abandoned its leadership abroad.”

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