Cuban Doctors: Bolivia's Betrayal And Aftermath

Cuba has long been known for its medical diplomacy, with thousands of its doctors working in healthcare missions around the world. However, in 2019, Bolivia's interim leadership ordered Cuban doctors to leave the country, accusing them of stoking protests alongside Venezuela's socialist government following the resignation of Bolivia's former president, Evo Morales. This incident brought to light the often restrictive and dangerous conditions that Cuban doctors face while working abroad, as well as the complex political dynamics between Cuba and the host countries.

Cuban doctors in Bolivia were accused of stoking protests and ordered to leave the country

Cuba has long been known for its medical diplomacy, with thousands of its doctors working in healthcare missions around the world, bringing in billions of dollars in revenue for the country. In 2007, Cuba had 42,000 workers in international collaborations in 103 countries, with more than 30,000 of those being health personnel. This number fell to 28,000 in 2020.

Cuban doctors are often sent to countries that are ideologically similar or have signalled an openness to such ideologies. In 2016, for example, Cuba sent 100 doctors to Kenya, a country with which it has maintained diplomatic ties for several decades.

However, there has been criticism of Cuba's medical internationalism, with reports that doctors are sometimes sent abroad against their will and without proper compensation. According to a 2019 report by The New York Times, Cuban doctors in Venezuela withheld medicine and treatments from patients who did not support the United Socialist Party of Venezuela (PSUV) during elections.

In 2019, Bolivia's interim leadership ordered Cuban doctors to leave the country and cut ties with Venezuela's socialist government, accusing them of stoking protests following the resignation of President Evo Morales. Cuba denied any involvement in the protests and said that 700 members of its medical mission in Bolivia would be removed. This expulsion came after similar moves from governments in Brazil and Ecuador, with concerns that the medical program was a cover for political meddling.

Cuba's medical internationalism has been criticised for sending doctors against their will

Cuban doctors are often monitored by "minders" and subject to curfews when working abroad. They are also prohibited from discussing their experiences freely and are isolated from the surrounding communities. According to a 2019 New York Times article, Cuban doctors from Mission Barrio Adentro in Venezuela denied medicine and other treatments to secure votes for the United Socialist Party of Venezuela during elections through coercion.

Cuban doctors who participate in overseas programs often do so out of fear of reprisal for refusing. They are also incentivised by higher wages, which are still only a fraction of what is paid by the host countries, as the majority goes to the Cuban government.

The Cuban government keeps a significant portion of the additional salary paid by the host country, and those who break their mission are punished and not allowed to return to Cuba. This has led to thousands of doctors going into hiding or failing to return to Cuba.

The working conditions for Cuban doctors abroad are often difficult and dangerous. For example, a Cuban doctor in Venezuela reported that she was regularly threatened at gunpoint.

Cuban medical internationalism has been praised for its substantial positive local impacts on the populations served, especially in the wake of natural disasters and health crises. However, it is important to recognise that the doctors involved are often sent against their will and face challenging circumstances while providing aid.

Cuban doctors have defected from their medical missions in various countries

Since the 1959 Cuban Revolution, Cuba has sent doctors overseas to provide medical care and training, particularly to Latin America, Africa, and Oceania. While this has been praised as a form of medical diplomacy, it has also been criticised as a form of medical servitude, with doctors working under restrictive agreements, low wages, and difficult conditions. As a result, some Cuban doctors have defected from their medical missions in various countries.

Cuban doctors have defected from their medical missions in Venezuela, Brazil, and Bolivia. In Venezuela, doctors reported being placed in slums with a high level of violence and under constant monitoring by political police. They were also pressured to indoctrinate patients to vote for Hugo Chávez and faced accusations from Venezuelan doctors that they were taking their jobs. In Brazil, some Cuban doctors filed lawsuits to be released from the More Doctors program and work independently. They argued that the program violated the protections of the Brazilian constitution and amounted to a form of slave labour. In Bolivia, a Cuban doctor defected across the border to Chile and sought asylum in Spain.

Cuban doctors who defect face prohibitions on re-entering Cuba and lose any money they earned while overseas. They may also be punished with imprisonment or harassment. Despite the risks, the number of Cuban doctors defecting has grown in recent years. In 2015, a record 1,663 Cuban medical professionals were granted entry into the United States under the Cuban Medical Professional Parole Program. This program, established in 2006, encourages Cuban doctors and nurses on overseas assignments to defect by providing them with assistance at U.S. embassies in the countries where they are posted.

Cuban doctors are often sent to dangerous locations and face harsh working conditions

Cuban doctors have been deployed to areas with high levels of crime and political instability, such as Venezuela, where doctors have reported being threatened at gunpoint by gang members. In Bolivia, Cuban doctors were accused of stoking protests and four doctors were arrested, leading to their expulsion from the country. Similarly, in Mexico, Cuban doctors were withdrawn from the village of El Palmito in Concordia, Sinaloa, due to escalating violence and concerns for their safety.

In addition to facing dangerous working conditions, Cuban doctors often work under restrictive agreements with low wages. They typically receive only a fraction of their salary, with a significant portion retained by the Cuban government. They may also be subject to strict rules and surveillance by Cuban officials to prevent defection.

The working conditions and compensation for Cuban doctors have been criticized as exploitative and akin to forced labor. There have been reports of doctors being sent against their will, facing retaliation for refusing to participate, and experiencing isolation and harsh working hours.

Overall, while Cuban medical missions have been praised for their positive impact on global health, it is important to recognize the challenging and dangerous environments in which these doctors often work.

Cuban doctors are monitored by minders and subject to strict rules and curfews

Cuban doctors are monitored by "minders" and are subject to strict rules and curfews. The Cuban government has been criticised for its treatment of doctors deployed on medical missions globally, with Human Rights Watch stating that the government imposes "draconian rules" that violate the doctors' fundamental rights.

Cuban doctors working abroad are often placed under strict rules and heavy surveillance. Their communications with foreigners and other Cuban citizens are monitored, and they are subject to a curfew, usually set at 6 pm. They are prohibited from fraternising with locals, and if they do so, their mission can be revoked. Cuban doctors are also not allowed to discuss their workplace issues freely and are isolated from the surrounding communities.

Cuban doctors are also subject to strict rules regarding their movement in and out of the country. The Cuban state has control over their travel and emigration, with their preferred skills deemed essential to the country's development. The government has the power to grant or deny authorisation to health workers to leave the country.

In addition to these restrictions, Cuban doctors working abroad face challenging working conditions. They are often sent to areas heavily affected by disasters or to remote and resource-scarce regions. They also face pressure to meet weekly targets and quotas set by Cuban mission leaders, which can lead to unethical practices such as falsifying statistics and providing substandard care.

The strict rules and monitoring of Cuban doctors aim to prevent citizens from defecting once abroad. However, there have been cases of doctors defecting and seeking asylum in other countries due to the challenging conditions and restrictions they face.

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