The mayor of one of Italy’s biggest cities was effusive in her praise for the Cuban medics who spent three months in the country helping fight coronavirus.
"It is not the victory over the virus we are celebrating," Chiara Appendino told the assembled dignitaries. "It is the victory of the values represented by those who came from the other side of the ocean, of solidarity and generosity."
Appendino, a member of Italy's populist Five Star Movement, was speaking at a ceremony in Turin this month to thank one of the Cuban teams. They were among 3,600 health professionals from the Caribbean nation battling the pandemic in 35 countries around the world.
Their high-profile work in wealthy western as well as poorer nations has sharpened a bitter international controversy over Cuba’s long-standing policy of sending thousands of medics to work abroad, mostly in developing countries and usually in return for hard cash.
The Cuban government has said about 30,000 of its doctors and nurses are deployed overseas. The "Henry Reeve Brigades" – named after an American who died fighting for the island's independence in the 19th century – are hailed as a beacon of solidarity by international socialists but denounced as a trafficking scheme by the US state department, which has cited "persistent allegations" that some participants were coerced to remain in the programme. Human rights groups have also criticised the conditions Havana imposes on the missions.
Cuba’s own success in combating Covid-19 – the island has one of the lowest infection and mortality levels in the Americas – has given the scheme fresh impetus, frustrating Washington’s attempts to cut off what has become the communist government’s main source of foreign exchange, worth $6.2 billion in 2018.
"The example that you have given with your altruism, with your dedication and solidarity ... is one of the best ways in which we are crushing the perverse intentions of the [US]empire to discredit the solidarity and exemplary work of the Cuban medical brigades," said Cuban president Miguel Díaz-Canel earlier this month as he welcomed a mission home from Andorra.
Contact tracing
Cuba’s free community-based health system, a door-to-door search for coronavirus carriers, the isolation of those infected and rigorous contact tracing have helped it keep infections below 2,500 and deaths below 100 in a population of 11 million as of July 22nd.
Echoing the sentiments of many Cubans, Verónica Martinez, a Havana secretary, said the government had done an excellent job because it had prioritised healthcare and education for decades. “Cubans are disciplined when it comes to health, and we respect what our government and healthcare officials tell us to do,” she said.
Initially Cuba offered its medical services overseas for free, but after the collapse of the Soviet Union eliminated Havana's main source of aid the government started charging. In 2015, when the "pink tide" of leftist Latin American leaders was at a high water mark, as many as 50,000 Cuban medics were sent out.
But under pressure from Washington, the conservative governments that subsequently came to power in Brazil, Ecuador, El Salvador and Bolivia expelled the Cuban teams.
Aníbal Cruz, who resigned as Bolivia's health minister in April, sent 705 doctors back to Cuba in November 2019, soon after the fall of left-wing former president Evo Morales.
Cruz estimates that one of South America’s poorest countries paid Havana almost $150 million over 13 years for medical personnel. This included a salary for each doctor of approximately $1,000 a month, but Cruz said Cuba’s government retained $800 and gave the doctors $200. He alleged that many of the personnel deployed were not medics but political operators and state agents.
“This was a work of political indoctrination camouflaged as a medical solidarity mission,” said Cruz.
Make money
Cuban officials in Havana slammed the comments as "false accusations". José Carlos Rodríguez, Cuba's ambassador to Rome, separately said earlier this week that services to Italy had been given free of charge, and rejected allegations of political motivation.
A registered nurse in Havana, who asked that her name not be used and who said she had worked in Ecuador, said health workers saw the missions as a chance to make more money than the $70-$100 a month they usually earned at home.
“The missions are presented as both a gesture of solidarity, a reward and a way to fund healthcare, and I think that is at least partially true,” she said. “Are there problems? Of course, but we are not slaves. The only scandals I know of at the health ministry are when people are paid off by the people they are supposedly trafficking to jump the line to go abroad.”
However, Human Rights Watch this week criticised “draconian rules”, including curbs on freedom of expression, privacy and movement, imposed on the missions.
“Cuban doctors deployed to respond to the Covid-19 pandemic provide valuable services to many communities, but at the expense of their most basic freedoms,” said José Miguel Vivanco, Americas director at Human Rights Watch.
The controversy shows no sign of abating. Supporters of Cuba in the US, Latin America and Europe are campaigning for next year's Nobel Peace Prize to be awarded to the medical brigades.
Meanwhile in the US Congress three Republican senators last month tabled the Cut Profits to the Cuban Regime Act, which would require the state department to publish a list of countries that contract with Havana for medical personnel and to consider that a factor in their ranking in the department’s annual Trafficking in Persons report.
Challenging issue
One senior western diplomat familiar with the Cuban medical programme described it as “a really challenging issue”.
“For some countries it’s worth paying for them ... if you need good clinicians at a reasonable price for remote areas. But the scheme does have some elements of forced labour even if some of the participants wouldn’t describe it that way.
“There’s a genuine ethical question out there for countries which avail themselves of this service. But for the Cubans it’s a straight economic question – it’s a cash cow.” – Copyright The Financial Times Limited 2020
