For more than 50 years, Cuban medical personnel have been working in hospitals in the Caribbean in far-flung jungle communities and at other health posts under a bilateral program with various countries, but unceasing pressure from the Trump administration to dismantle or drastically amend the scheme is threatening to upend all the efforts of the past decades.
Through Secretary of State Marco Rubio, the administration has been waging a relentless campaign to choke the Cuban government of valuable foreign exchange it earns by sending doctors, nurses, and biomedical engineers to the region on mostly three-year contracts.
Under the system in place for decades, Havana had paid the practitioners less than 20% of their monthly earnings, retaining the greater portion of their remuneration for development purposes and to ease chronic foreign exchange shortages.
Dubbing this system as forced labor and human trafficking, the administration has exerted enormous pressure on governments, demanding either a change to the payment system or an abandonment of the program altogether.
These demands have caused such turmoil in the region that relations between Jamaica and Cuba have tanked to an extent that the Cubans are preparing to withdraw all of the nearly 300-member workforce on the island in the coming weeks as the two governments exchange harsh words.
This is because the Andrew Holness administration has moved to make direct payments to individual practitioners, cutting out the Cuban official system from earning anything, despite the fact that the doctors had obtained free medical training back home.
A weekend Jamaican government statement blamed a lack of response from Havana on key issues for its decision to engage the brigade individually, thereby cutting off access to the money they earn from working in Jamaica.
Angered by the move, Cuban authorities say they are repatriating the entire brigade, although it is not clear how many will sign off on individual contracts.
“These health professionals leave behind an indelible mark and return to Cuba with the satisfaction of a duty fulfilled and the permanent willingness to assist wherever their spirit of solidarity is required,” the ministry said. It pointed to the dedication level of brigade members, noting that “the most recent example of this dedication was seen after … Hurricane Melissa, which severely affected the island. In those difficult circumstances, the Cuban medical brigade remained firmly at their posts, many of its members working for more than 72 consecutive hours and actively joining the tasks of recovering hospitals and communities. Cuba deeply regrets that in this way, a history of fruitful and sustained collaboration is disregarded, one that has brought countless benefits to the Jamaican people, who are now deprived of receiving the basic and specialized health services that Cuban collaborators provided.”
For its part, Jamaica’s foreign ministry issued a detailed weekend statement regretting the end to the program but said the government is duty-bound to work within local labor laws. It said Cuba has accepted a switch to individual contracts in other Caribbean Community (Caricom) countries but chose not to do so in Jamaica.
While negotiating a new umbrella contract, authorities say that they discovered major anomalies, including the embassy seizing the passports of brigade members and that Havana was drawing down most of their salaries.
“Once that was brought to the government’s attention, immediate steps were taken to correct it,” the ministry stated. “The issue was raised with the passport, immigration, and citizenship agency as well as the Cuban authorities locally to ensure that all personnel were allowed to hold their passports. The other issue was that salary payments for Cuban medical personnel, while calculated at the same level as their Jamaican counterparts, were being made by Jamaica to the Cuban authorities in U.S. dollars. That arrangement raised serious concerns under Jamaican labor and tax laws as well as under international labor conventions.”
The ministry expressed disappointment that Cuban authorities had not replied either verbally or in writing to proposals to switch to direct individual payments: “Unfortunately, the continued lack of response had the practical effect of preserving an arrangement that Jamaica could not justify. Given our legal obligations, our duty to ensure fairness to workers in Jamaica, and the need for compliance with our own laws and international conventions, the government ultimately concluded that continuation on the existing terms was untenable.”
Other regional member states from the Bahamas in the north to Guyana in the south, say they have rushed to ensure individual rather than bulk hires to ensure that Cubans continue working at health stations in their territories.