As evening falls in Caracas, Venezuela, Dr. Eloy hurries to close his office and return to the collective housing where he has been living for nearly five years. After graduating as a doctor in Cuba in 2013, he went to Venezuela in the hopes of increasing his salary, which barely exceeded $60 a month.
“The Cuban government exports around 40,000 doctors who provide their services abroad,” Dr. Elaine Acosta, a scholar at Florida International University, said in her August 2021 report General Panorama of Cuba’s Medical Brigades in Latin America. “According to data from the Venezuelan government, 25,000 collaborators remain active [in the country].”
Cuba’s international missions allow doctors to earn more than their salary at home, but it is the regime that makes the most of it. “In the last decade, [Cuban] professionals hired abroad brought in an annual average of more than $11 billion,” the German news agency DW reported in 2020.
“The export of services is the main source of income [for the Cuban regime]. Health services, which Cuba calls ‘medical collaboration,’ historically account for 50 to 75 percent of the total,” María Werlau, researcher and director of the nongovernmental organization (NGO) Archivo Cuba, said.
“For decades and with the help of allies and partners, Cuba made [people] believe that these ‘missions’ were altruistic and solidary ‘collaborations.’ [Until] 2010 the government acknowledged receiving income from them. The scheme has always generated income for the Cuban State and is anchored to the exploitation of workers,” Werlau added.
Eloy, the doctor who prefers not to reveal his full name for fear of reprisal from the Cuban regime, told Diálogo in a phone interview that he works in extremely poor conditions, with hardly any food, while sharing a room with five other doctors.
“Cuba gives us a red, official passport, which is not valid for us to travel anywhere else. If we flee, they punish us by preventing us from returning to visit our relatives for eight years,” Eloy said of a de facto entry ban to Cuba for those who abandon the mission. “The Cuban regime keeps between 75 and 90 percent of the salary that recipient countries pay for their health personnel.”
Eloy also said that Cuba keeps one of his account frozen, which he will only be able to use when the mission ends. “If you [defect] you lose all the money you saved. Cuba offers you, in each country, a stipend that is barely enough to eat,” he says.
The foreign income that Cuban doctors bring in is essential for Cuba, whose economy is suffocating from the collapse of tourism, among other reasons. “In addition, the international medical brigades are, feasibly, the main source of political influence, propaganda, and international legitimacy for the Cuban dictatorship,” Werlau said.
Prisoners Defenders, a Madrid-based NGO that advocates for human rights and legal action, denounced the Cuban regime for its overseas medical missions that amount to human trafficking, documenting 64-hour workweeks, a lack of contracts, restriction of movements, and constant surveillance.
Javier Larrondo, president of Prisoners Defenders, has been collecting testimonies of Cuban doctors abroad. “Of the 622 testimonies presented, 60 percent said they were forced to alter statistics. They pulled fake patient names out of the phone book.”
“The doctors are the victims of this story — their families are being held in Cuba, their passports and degrees as well; they are like people who don’t exist unless they abide by the Cuban government’s rules. There are many state security agents who pose as doctors to do espionage; they make up about 15 percent of the contingent deployed worldwide,” Larrondo concluded.