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 international locations to rethink their agreements with Cuba.
Orlando Sierra/AFP/through Getty Photos
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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 talk swirling round a Cuban program that sends tens of 1000’s of docs and different medical professionals overseas to look after individuals.
Cuba proudly says these “medical brigades” present solidarity with their fellow international locations within the World South. However this system shouldn’t be solely altruistic. It is also one of many largest sources of overseas cash for the island because the international locations receiving the small military of well being staff pay Cuba for them.
The U.S. State Division has lengthy been important of this technique, alleging that the members are coerced and underpaid by the federal government. In a press release to NPR, the State Division calls it “pressured labor” and “human trafficking.”
Now, the Trump administration is ratcheting up the strain 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 strain are Guatemala, Guyana, Jamaica, St. Vincent and the Grenadines, Paraguay and Honduras. They’re phasing out the packages, reevaluating the cost mannequin and typically canceling altogether.
Here 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 offers medical help 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 in the course of 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 accordance with Granma, the official paper of the communist social gathering 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 docs themselves see solely a small proportion of that cash.
When Dr. Leyani Perez Gonzalez was a health care provider in Cuba within the early 2000s, she says it was laborious to make ends meet. “The cost for a health care provider 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 grow 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 individuals with totally different persistent ailments, kids, 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 a variety 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 concept the place to go and no concept what her future held.
Fortunately for her, she quickly realized 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 referred to 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 america promotes accountability for individuals who allow the Cuban regime’s pressured 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 docs.
“The international locations 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 overseas coverage, which is predicated primarily on coercive diplomacy: ‘Do it our means, 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.Ok., says this program “is, actually, way more complicated” 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 earnings of overseas funds for Cuba. The Cuban docs are type 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 sensible,” serving to Cuba “with their financial context, whereas doing good on this planet.” She additionally factors out that, whereas the docs 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, and so they handle to renovate their flats, or purchase this or have this, and so they have a lifestyle that the frequent Cuban individuals do not have,” she says.
She says the opposite long-standing challenge is Cuba’s confiscation of the members’ passports. She says, from Cuba’s perspective, it has invested in coaching the docs totally free and would not wish to lose them. Given how laborious it’s for Cubans to go away the island and the way unhealthy 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.
“I’m very happy because they are offering to the doctors the power to be paid and to have freedom,” she says.
