Slaves in White Coats / Miriam Celaya
Posted on February 13, 2014
In the nineteenth century, slave crews were rented out after the harvest
to other landlords, providing the slaves a few trifles.
HAVANA, Cuba, Feb 12 — The recent “defection” of Cuban doctor Ramona
Matos Rodríguez, who provided services in Brazil under an agreement
signed between that country and Cuba, part of the program “More Doctors
for Brazil” once again brings to the forefront the controversial topic
of the exploitation of health professionals by the Cuban regime in its
desperate race to obtain hard currency.
Matos’s claims are based on the deception which she stated she was
victim of, since she was not aware of the two countries’ agreement
providing for a monthly royalty payment equivalent to about $4000 per
physician, of which Cuban doctors would only be paid $1000 each month,
that is, approximately 25% of the total of the original contract.
In addition, the Cuban government would have violated the contract
signed by doctors in Cuba prior to their departure to Brazil, since, in
practice, they get just over $300 per month, while the Cuban bank holds
back $600 to be accessed by the doctors with the use of a debit card on
their return to Cuba three years after completing their “mission”.
A Longstanding Trick
The subcontracting system of Cuban doctors to other countries has become
one of the most important sources of hard foreign currency for the Cuban
government, plus an instrument of political manipulation for electoral
purposes by some populist governments. In this sense, the olive-green
caste behaves like the old slave-holding landowners in the nineteenth
century Cuban sugar industry aristocracy, whose crews were rented out
after the harvest to other landlords for dissimilar tasks, providing the
slaves with a few coins of some other trifles.
However, manipulation of these services by the regime is neither really
new nor limited to physicians. Other Cuban slaves are equally contracted
out with unconscionable benefits for the regime, although the movement
of physicians has been the most conspicuous and substantial. It began in
the early and distant decade of the 1960?s by sending the first doctors
to Algeria, and it was kept up more or less regularly in other places of
the Third World, especially in African countries as part of commitments
by the regime with Moscow.
They were mainly programs that responded to the political interests of
the Kremlin, which Cuba was a satellite of, though back then doctors
were deployed in small numbers without detriment to the health care of
the Cuban people.
Since the 1990’s, rental of doctors increased with the pressing need to
find alternative sources of income that would allow the alleviation of
the crisis sparked by the disappearance of the “socialist camp”. Since
then, the practice has been maintained at an increasing pace, with
health care in Cuba rapidly deteriorating. The revenue from these
contracts is not used for technological equipment, improving the
infrastructure or other essential items to offer Cubans efficient and
high quality service.
After ”solidarity”, the facts
According to an undisclosed unofficial source, it is true that few Cuban
doctors know how much they will earn in the countries where they provide
services. ”One thing is the ‘contract’ we signed in Cuba, usually at a
mass meeting where they read us the ideological-political act and they
presented us with paperwork which we had to sign in a hurry, without
having read it and without receiving a copy, and another thing is what
we will find at our destination, because sometimes reality is harder
than what we imagined, and we find ourselves in a position of having to
use our own funds in order to survive, or at least to improve conditions”.
Extreme violence is another danger faced by doctors in many destination
countries, and their contracts, in which indemnification payments are
not addressed, do not protect them against that.
An undetermined number of doctors have been murdered, while still others
have been victims of assaults, aggression and rape. The lack of
knowledge on the part of physicians, both about the exact amount of
payments received by the Cuban government and what they will get is
another trick of the regime to exploit, on a large scale, the qualified
workforce that enrolls in these missions only to improve their living
Thus, the motivation of physicians is not just humanitarian but
practical: to get material and financial benefits or to cover essential
needs – such as purchasing what is needed to repair their homes, for
example — that their income in Cuba cannot meet. ”Otherwise, there would
not be thousands of us willing to sacrifice, being away from the family
and running many risks” said the source. There are also those who view
the missions as a way to emigrate.
Our source philosophizes: “No teacher in medical school in the 1980’s
explained to us that the Hippocratic Oath included abandoning the
priorities of Cuban patients, but it is still difficult to talk about
ethics in the current conditions.
As for the money, not all missions pay the same. For example, in Haiti,
it’s the equivalent to $200 per month, of which it is necessary to
disburse $50 per month for a low-quality meal, plus $30 a year for
connection to the internet. At the end of one full year of work, we
would have accumulated $2000 in a Cuban bank, paid out in CUC. Living
conditions depend on where the doctor is providing these services: in
Port au Prince it’s usually in a group home, while elsewhere it is in a
tent. There is a great risk of contracting contagious diseases, such as
dengue fever and respiratory ailments, etc. At the same time, extreme
personal hygienic and sanitary measures must be strictly adhered to in
order to avoid cholera.
Payment varies in Angola, but it averages about $600 a month, while in
South Africa it’s $900 to $1000. Venezuela has been the most permanent
destination, and though years ago it was attractive to Cubans because it
allowed importing home appliances for some time; restrictions on imports
have increased because the regime in Havana finds it more profitable to
optimize extraction of hard currency of these “slaves-missionaries”
through its own sales networks, at exorbitant prices.
Not all slaves qualify to be rented out. When asked about the
requirements a doctor must complete to be selected for a mission, the
source consulted ensures us that there is a selection process, but
nobody knows the exact criteria and procedures to be followed. “There is
a preceding decanting”.
For example, one does not necessarily have to be a member of the party
and stand out as ‘fire-eater’, but any suspicion that they might be a
possible emigrant because they have close relatives living abroad can
result in cancellation of the mission. I know of many cases like this,
but you are never told the reasons for the cancellation clearly. These
are things that leak out. They aren’t always thorough in their research,
and every once in a while, one slips by them. I don’t know who is
responsible for conducting the “investigations” exactly, because they
are not carried out by medical authorities, but they are done, and the
methodology appears to be that of (State) Security. ”
Indignation without the indignant
Another specialist, in this case an instructor, details other aspects
that the press has barely addressed and that constitute a serious
problem: the impact the missions have had on shortages of doctors in
clinics for the care of the Cuban population. Thus, at this time a very
complicated process is underway consisting in taking out the
“non-essential” physicians to occupy permanent positions in hospitals
and offering them one of two options: go on a foreign mission or work in
an office as a family doctor.
This has sparked the widespread discontent on the part of many doctors
who, while they trained as required in general practice, at present they
practice in diverse specialties, including surgery, from training in
courses for preparation of the fulfillment of massive collaboration
programs, such as Operation Miracle and others, which allowed them to
rise in rank through their qualifications.
To leave the specialties they have achieved in order to handle consults
in primary care means a significant setback as professionals. Some
doctors comment informally they would prefer to stay at home and devote
their time to private care rather than to accept such conditions. On the
other hand, a significant group of physicians who finished their
services abroad don’t feel ready now to repeat the experience, arguing
that the risks and the sacrifices are greater than the obtained benefits.
“It’s a process of outrage, but with no outraged” a female doctor friend
of mine tells me, referring to all the doctors who complain among each
other about the treatment they receive from the Cuban authorities, which
treats them as slaves or as basic resources, but who are not motivated
enough to get organized and demand their rights.
Meanwhile, many “democratic ” governments complicity lend themselves to
violations of the most basic labor rights of these and other Cuban
specialists, and some institutions and international officials are
pleased with the cooperation programs of the Castros and with the health
rates coldly reflected in the official statistics of the dictatorship.
Certainly, if there is something as vast and deep as the foundling of
the people of Cuba, it’s the impunity of her government.
Translated by Norma Whiting
Cubanet, 12 February 2014 | Miriam Celaya
Source: Slaves in White Coats / Miriam Celaya | Translating Cuba –