WASHINGTON – As the coronavirus began to circulate around the world, the Cuban government ramped up its controversial medical diplomacy program, sending teams of doctors and nurses to Italy, Venezuela and other countries overwhelmed by COVID-19 outbreaks.
Now the island nation is reeling from its own surge in cases – surpassing 6,000 new daily infections last week in a spike that has fueled unrest and anger across the country.
The burst of COVID-19 cases seems to have marked a tipping point that – along with food shortages and spiraling prices – prompted thousands of Cubans to brave arrest and violence in the largest protests seen on the communist island in three decades.
"Prior to the protests, Cubans were sharing pictures of hospitals showing complete collapse," said Javier Corrales, an expert on Latin America and the Caribbean at
Amherst College. "Lockdowns have been harsh and long. Vaccination distribution has been slow. Cubans feel like they cannot trust authorities in terms of data."
Cuba has developed its own three-shot vaccine, which has not been tested outside the country. About 27% of the country's 11 million people have received at least one dose, according to Our World in Data tracking.
It doesn't help that the government has been sending its “White Coat Army" to help care for those sickened with COVID-19 in other countries.
"The coronavirus pandemic has put a spotlight on the failures of many governments around the world," said Daniela Ferrera, a Cuban immigrant who lives in Florida and co-founder of Cubanos Pa'lante, a group that seeks to send aid to Cubans.
"But in Cuba, we have a situation where the Cuban government is sending out their doctors to their allies in Iran, in Russia, in China and other places around the world. And they're not treating the Cuban people," she said.
'Doctor diplomacy' or 'human exploitation'?
Cuba's medical missions program, started after the 1959 communist revolution, has long been controversial, particularly among critics in Washington who equate it to modern-day slavery.
Officials in Havana say it is a demonstration of Cuba's solidarity with needy allies across the globe, and they view the program as a key element of its international diplomacy.
"Cuba is here to help," Inés Fors Fernández, the country's ambassador to Jamaica, said in March 2020, according to the country's official state media, as Cuba announced it would send 100 nurses to its island neighbor. "The world is experiencing one of the worst possible moments in recent years, so it is very important that there is solidarity between Cuba and Jamaica."
Since the program's inception, Cuba has deployed more than 400,000 health workers to 164 countries to help tackle short-term crises, natural disasters and now COVID-19, according to the government.
Human Rights Watch says Cuba has sent about 1,500 medical professionals to other countries since March to help fight the pandemic, on top of the estimated 30,000 Cuban health care workers already stationed abroad.
“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,” José Miguel Vivanco, the group's Americas director, said in a June 2020 report on the program.
That report says the Cuban government engages in a litany of abuses against its doctors and nurses who serve abroad, including placing them under surveillance, confiscating their passports and barring them from being “friends” with people who hold “hostile or contrary views to the Cuban revolution.”
Most notably, the Cuban government takes much of the medical professionals' salaries paid by the host countries.
"The Cuban dictatorship has perfected the art of diplomatic manipulation as they continue to send their so-called ‘medical brigades,’ which is more accurately a human exploitation scam," Sen. Marco Rubio, a Cuban American, said in a statement to USA TODAY.
"The Communist regime exploits these health professionals, even amid the COVID-19 pandemic, in order to fill its coffers," the Florida Republican said.
In a report on human trafficking released on July 1, the U.S. State Department said Cuba "capitalized on the pandemic by increasing the number and size of medical missions."
The government refused to address "labor violations and trafficking crimes despite persistent allegations from observers, former participants, and foreign governments of Cuban officials’ involvement in abuses," the report said.
The Cuban government blasted the State Department findings, saying the report was based on falsehoods.
"This accusation forms part of a campaign by Washington to discredit Cuba’s international cooperation efforts in the sphere of healthcare, for which Cuba has received recognition by dozens of governments and the gratitude of the populations which have benefited from it," Cuba's ministry of foreign affairs said.
Corrales said Cuba likely had to keep sending doctors and nurses abroad during the pandemic, even if that has now come back to haunt them.
"The government makes huge profits from these missions," he said.
That source of revenue has likely become critical during the pandemic, with tourism and other parts of Cuba's economy shut down.
"The pandemic has been devastating in Cuba," said Bob Schwartz, executive director of Global Health Partners, a nonprofit that sends medical assistance to Cuba and other countries.
The U.S. embargo
However, Cuba's medical missions program and its COVID-19 crisis are not as "black and white" as some critics suggest, Schwartz said.
"The reality is Cuba has more than enough doctors in country right now to handle the pandemic," he said. "What they don't have is ... the medicines or the equipment that they need."
The economic fallout of the lockdowns has fueled the food and medicine shortages, Schwartz said, and the situation has been "exacerbated" by the U.S. embargo. Although U.S. trade restrictions include exemptions for medical and humanitarian assistance, many American companies don't want to go through the hassle of getting an export license to ship goods to Cuba, he said.
As Cuba tries to vaccinate its population, Schwartz said, it has run up against a critical shortage of syringes, which is particularly problematic given its vaccine requires three doses.
He and others say the protests are an opportunity for the Biden administration to ease U.S. restrictions on trade, travel and remittances.
"The irony is that, in the last 16 months, the pandemic has created the necessary conditions for protests against the government that a 59-year, wrong-minded and bone-headed American embargo was never able to achieve," said Rep. Bobby Rush, an Illinois Democrat and longtime critic of the hard-line U.S. policy toward Cuba.
Corrales said the U.S. embargo certainly has not helped the situation in Cuba. But he said the Cuban government's own restrictions – on everything from freedom of expression to private-sector activities – created the conditions for the protests.
"Cubans live under one of the harshest dictatorships. People are watched all the time. The state holds a monopoly over the most important jobs. There are horrible restrictions on what self-employed people can do, and who can even become self-employed," he said.
The pandemic just provided a spark for Cubans to demand what they've long wanted, he said: freedom.
This article originally appeared on USA TODAY: Cuba protests: Government sent doctors abroad during pandemic