Florida Senators’ Bill to Block Cuba’s COVID Aid: Yankee Arrogance & Insensitivity

The United States leads the world in exporting weapons. Cuba leads the world in exporting medical services. Yet in the funhouse mirror that is Florida politics, it’s Cuba’s export that is the problem.

According to the State Department, the US comprises nearly 80% of the world’s weapons trade, exporting four times more weapons internationally than the next nine countries combined.

By contrast, Cuba sends 50,000 Cuban doctors and medical personnel to work across 67 countries, providing critical aid to some of the world’s poorest and most neglected populations.

Yet under the pretense of fighting “human trafficking,” Florida Republican senators Rick Scott and Marco Rubio, along with Texas Republican Senator Ted Cruz, seek to impede Cuba’s medical assistance programs. Their new bill, the “Cut Profits to the Cuban Regime Act,” would target both Cuba and the countries accepting Cuban medical aid.

This is the latest in a long line of attempts to strangle the Cuban economy. The centerpiece of these efforts is what’s often considered to be the longest trade embargo in history. Over the past quarter century the United Nations has annually passed a resolution condemning the American embargo by an almost unanimous vote. In recent years, the only nation to consistently side with the US against the resolution has been Israel, a country which, ironically, does extensive trade and even joint economic ventures with Cuba.

For decades the US targeted Cuba with the accusation that Cuba was “exporting revolution.” This was always deeply hypocritical. The US has a ghastly record of supporting and arming murderous dictatorships in Latin America—regimes far worse than the Cuban dictatorship. In fact, during the 1970s and 1980s there were few Latin American countries that did not have a pro-American military dictatorship. The fact that Cuba gave a little—usually very little—assistance to Latin Americans seeking to free themselves was long a pretext for US economic warfare against the island. In the wake of the Cold War Cuba has developed the most humane and helpful export imaginable—doctors—yet the US uses even this against the Cuban government.

Scott, the bill’s sponsor, has found an ally in President Trump, who describes the Cuban doctors participating in Cuba’s medical internationalism as “slaves.” Countries receiving Cuba medical assistance deny this and condemn Scott’s bill. Gaston Browne, prime minister of Antigua and Barbuda, criticizes Scott’s “new definition of human trafficking,” explaining:

“…for over 30 years we have been utilizing Cuban specialists…to suggest…employing the services of Cuban professionals is a form of forced labor and therefore human trafficking, that is not true, we do not accept it.”

In a recent column condemning Scott’s bill, longtime Caribbean diplomat Ronald Sanders asserts:

“Caribbean countries have no basis for believing that the medical personnel are ‘forced labor’…Cuban medical personnel have conducted themselves with professionalism, integrating well with local medical teams, and passing on their knowledge and experience.”

The Organisation of Eastern Caribbean States has also criticized American claims, and the Miami Herald notes that American opposition to the Cuba medical program “is not making headway in the Caribbean.”

Dr. Gracilliano Díaz, who served in the Cuban medical mission to fight Ebola in Sierra Leone in 2014, explains:

“We do this voluntarily…what matters to us is that we contribute to the world.”

Dr. Leonardo Fernández, who has volunteered in Cuban medical missions on three continents, asks:

“How can I be a slave when my family receives my full salary while I’m abroad?”

Certainly, life is not easy for these Cuban doctors. Like many professionals in Latin America, the pay they receive for their work is modest. They are often asked to work in areas wracked by terrible poverty or even violence. While living standards in Cuba are certainly unenviable, Cuba does not have the mass slum poverty nor violence that exists in many parts of Latin America. Understandably, Cuban doctors arriving in other countries can find this change in circumstances disheartening.

Nor is this to say that there isn’t any mismanagement in these programs, another of Scott’s pretexts. And while Cuba’s domestic medical system is exceptional by Latin American standards, Cuba’s export of doctors does have effects in Cuba. A joke one sometimes hears in Cuba is this:

A Cuban man goes to Jose Marti International Airport in Havana to look at the list of flights to various countries. An airline representative asks him, “Sir, are you looking for a tourist destination?” The man replies, “Oh no, I’m just trying to see my doctor.”

Ed Augustin, a journalist for The Guardian who is based in Havana, says Cuban doctors go abroad out of a combination of altruism, materialism, and the opportunity to prove themselves in different, more difficult medical environments. He explains:

“In seven years of conversing with medics in Cuba, I’ve never met a doctor or a nurse who said they were forced to work abroad. Waiting lists are oversubscribed.”

Cuban geneticist Greicy Rodríguez told Augustin she is proud that in Venezuela in 2008 she helped people who had never even seen a doctor before. After she revived a baby near death from dehydration, she explains, “Her family ended up naming her after me. It was a beautiful experience.”

Cubans on medical missions also benefit because they gain access to hard currency. This allows their families to purchase consumer items generally unavailable in Cuba, and the doctors come back well off compared to the average Cuban. Cuba specialist Mark Keller of the Economist Intelligence Unit explains:

“If you have a family member abroad who’s earning dollars, you’ll live a totally different life.”

George W. Bush created the Cuban Medical Professional Parole program in 2006 with the specific goal of encouraging Cuban medical personnel to defect to the United States.

While that program did not have much impact, it is certainly true that these Cuban doctors do have a large economic incentive to come to the US. American doctors earn good salaries but they also graduate medical school with an average debt of $250,000. Cuban doctors, educated free of charge by the Cuban government, would arrive in the US debt free. It’s no surprise that the Cuban government works to discourage such defections--imagine how we would feel if a group of American doctors sought to skip out on massive federal student loan debts to move to another country. 

Moreover, it is not uncommon for governments to expect service from students in whose education they have invested. Americans who want to become military officers often go to one of the three major military academies--West Point (Army), Annapolis (Navy), or Colorado Springs (Air Force). The 13,000 cadets currently attending these schools—and the hundreds of thousands who have done so over the past two centuries—did so with the agreement that upon graduating, they owed the US government a certain amount of service. This service—generally five years—is in exchange for the government’s investment in their education and training. Are Senators Scott, Rubio and Cruz suggesting that the graduates of these academies who currently serve are “slaves”? When the US government deploys them overseas, is this “human trafficking”?

Despite the shortages which afflict the Cuban medical system, Cuban doctors are proud of their work, both in Cuba and abroad. Wayne Smith, former head of the US Interests Section in Havana who saw this first hand, praises their “incredible dedication.”

In fact, according to the World Health Organization, Cuba—a small island with scant natural resources—has a life expectancy rate equal to that of the US, and higher than that of almost any other Latin American nation. Cuba’s infant mortality rate of 8/1,000 is the lowest in Latin America, and near that of the US.

Patricia Danzon, a professor of Health Care Management at the University of Pennsylvania’s Wharton School, asserts “[Cuba] does remarkably well in terms of infant mortality and life expectancy, and on those metrics it is comparable to the U.S.” In fact, according to the WHO, Cuba recently became the first country in the world to eliminate mother-to-child transmission of HIV and syphilis.

Cuba is also renowned for its capacity to rapidly deploy medical teams to disaster areas around the world. Examples include:

• West Africa in 2014 to help fight the Ebola virus epidemic
• Honduras, Guatemala and Haiti after Hurricanes Mitch and Georges in 1998.
• Earthquake missions to Nicaragua, Iran, Pakistan and Haiti in 1972, 1990, 2005, and 2010 respectively
• Sri Lanka following the 2004 Asian tsunami
• Venezuela after 1999 mudslides in Vargas state, which killed 20,000 people.
• Numerous countries, including Italy, currently to help fight Covid-19

Others actions, like “Operation Milagro”, operate on a long-term basis. Milagro provides free eye medical treatment to citizens of the OECS to prevent blindness or to restore vision from cataract, diabetic retinopathy and other reversible types of visual impairment.

It’s little wonder that recipients of Cuba’s medical aid criticize American actions against Cuba’s “doctor diplomacy”, including Scott’s bill. Sanders contrasts Cuba’s medical assistance with the “remarkable indifference to the critical public health emergency confronted by all Caribbean countries” shown by Scott, Rubio and Cruz. He asserts:

“…the presence of Cuban medical personnel has made a huge and beneficial difference…to manage COVID-19 and its spread. It is no exaggeration to say that without the Cuban medical personnel the medical system of several Caribbean countries would have collapsed.”

Browne explains:

“Cuban nurses and doctors are a significant part of the health infrastructure of many Caribbean countries and if they were to force us to get rid of these Cuban professionals, then they will dismantle our health system.”

Robert Maguire, retired director of the Latin American and Hemispheric Studies Program at George Washington University, says:

“The U.S. aid presence in the Caribbean has been pretty skimpy…[it’s] not a surprise that the governments of the Caribbean would turn to Cuba for assistance; Cuba has a history.”

Scott’s bill is an effort to hurt the Cuban economy by cutting off the $7 billion Cuba earns annually from exporting medical services. It is also an election year stunt pandering to Florida’s Cuban émigré population.

Yet whatever the strategic or electoral rationale, this attempt to interfere with desperately needed medical assistance at a time of crisis is rightly seen in Latin America as Yankee arrogance and insensitivity. The US has largely turned its back on helping the world’s poorer nations fight COVID-19—how can it pass judgment on Cuba’s efforts to provide this critical aid?

Glenn Sacks has a Master’s Degree in Latin American Studies from UCLA and has traveled in Cuba.

This is an updated, clarified and expanded version of the column. To read the column as it originally appeared in the Florida Daily, please click here.