Cuban Health Care Workers’ Motives: Idealism or Necessity?
Posted on November 27, 2014
By Jeovany Jimenez Vega
During an interview last Thursday on his afternoon radio program the
host, Ninoska Perez, told me about the mood he perceived in the Cuban
medical brigade workers dispatched a few days ago by Raul Castro. He was
struck by the “unfriendly” demeanor some of these professionals showed
upon leaving for West Africa to confront the Ebola epidemic. I could not
comment because I had not seen the television program in question, but
his observation did cause me to think about the motives of Cuban health
care workers who have joined medical missions in recent decades.
Although regularly presented by the Cuban government as examples of
lofty philanthropic aspirations, in reality these missions have become
in the span of a few short years the main source of income for this
Caribbean nation. We have all witnessed how the government in Havana —
rather than simply acknowledging that this is a fee-based service from
which it has, on the whole, profited handsomely — continues to portray
my self-sacrificing colleagues as selfless messiahs.
At the same time it downplays the notion that a health care worker —
someone who is paid poverty-level wages — might embark on such a mission
in order to somewhat mitigate his desperate economic situation. The
pretense is that this is more than simply a contract labor issue,
something for which a fee is paid. In itself this is certainly not
immoral, but the assumption is that the “new man” is motivated only by
the purest form of altruism.
Far be it for me to question those who put themselves in harm’s way. As
I am not God, I have no right to do so. In light of what they are doing,
a modicum of humility on my part is in order since I am not the one
facing possible exposure. Nevertheless, a number of facts come to mind
that cannot be denied.
First of all, the Cuban professionals who have been sent on these
missions for more than a decade now do not do so under the same
conditions as their counterparts from other countries. Elsewhere, these
things follow a natural course. In other words, the workers themselves
make the decision to enter into employment contracts based on their own
interests and prospects.
Under a totalitarian government like Cuba’s, however, the parameters are
quite different since our professional workers are not operating from a
position of personal freedom.
It is no secret that a health care worker on a medical mission almost
never has any say over where he is assigned. And once in the host
country, he is monitored as though he were a child. This applies to his
personal relationships — from the people with whom he talks and
associates to when and where he goes out with them — as well as to even
very small payments for outside work, which are expressly forbidden.
Furthermore, while working overseas, his “salary” is no more than 15% to
20% of the contract price agreed upon by the two governments. In many
cases this amounts less than the legal minimum wage in the host country.
The remainder is retained by the Cuban treasury.
Upon his return, our colleague is not allowed to bring into the country
anything more than stipulated by the mission director, which amounts to
a few very limited boxes of merchandise, and then only after his period
of service has officially ended. Back in Cuba, he can access only half
of the salary he was paid, with the balance remaining frozen in some
In the event he should decide to end his term of service earlier than
expected for personal reasons, he would be considered a deserter and
would forfeit all the money he had earned. Even his family would not be
able to access his bank account. He would also be strictly prevented
from returning to Cuba for eight years, even for a short period to visit
his children or in the event of a serious illness or the death of one of
Given all this, it is understandable why Ninoska would describe the
current contingent as “an army of slaves.” Setting aside the harsh
description, it is evident that the relationship the government
maintains towards individual workers is not one of respect but rather
continues to be punitive and despotic in nature.
But there are parts of the world that still do not understand that the
government that treats its citizens in such an arbitrary way is the same
one that is sending our colleagues to Africa. It is the same one that is
killing us at airports with astronomical prices and draconian customs
regulations, the same one which pays us salaries that are laughable when
compared to a cost of living that reaches soaring heights, the same one
that does nothing to mitigate the state of affairs it itself has created
and encouraged, all of which are incompatible with its humble
proclamations of universal generosity.
Under such circumstances — knowing they face threats from an oppressive
force that is both employer and executioner — it is impossible to assess
the sincerity of some our health care workers when they appear in public
singing the praises of the revolution, the party and proletarian
internationalism. It is quite disturbing to see a familiar face among
this group after having heard him complain bitterly about living and
working conditions that are sometimes simply bad but often are appalling.
This “benevolent” government — the only one that is sends its physicians
off to glory or to death — demonstrates its contempt for us in the most
brutal way. And the reason it can do this with impunity is because it
keeps trotting us around like victory pennants, or like the collateral
behind the emotional blackmail it uses to garner votes and commitments
from foreign governments in international forums.
That is why in domestic policy they can afford to grossly neglect the
welfare of their own people. Who would guess that a government that
takes the “laudable” action of sending a contingent to Africa larger
than those of the rest of the world combined would be capable of
subjugating its own people? How would a world dazzled by such an
admirable initiative suspect that our civil rights are not respected or
that on a daily basis we are subjected to physical attacks, arbitrary
detentions and fully orchestrated acts of repudiation?
When Dr. Margaret Chan, Director-General of the World Health
Organization, or John Kerry, US Secretary of State, praises the Cuban
government — even when it is clear their remarks are limited only to its
role in the current health crisis — they voluntarily or involuntarily
concede ground and thus give Cuban authorities another slap on the back,
allowing them to perpetuate their domestic policy of indentured servitude.
But those of us dealing with this grim reality are not deceived by those
who have a monopoly on everything, even when they are disguised as
sequined divas on the world stage. We don’t forget that this is the same
government which continues to speculate with our most basic needs. We
know that they intend to perpetuate our misery because they know that a
bankrupt people, materially and spiritually impoverished, will always be
more susceptible to their whims than a serene and prosperous people.
From Citizen Zero I wish my colleagues from Cuba and around the world
much luck and success in this critical mission, which is essential if
humanity is to eradicate this dangerous scourge. At the same time, I
cannot help but abhor the way the Cuban government politically
manipulates the personal risks these workers are assuming. Ultimately,
it will be the infallible, inexorable and certain judgment of history
that will separate the gold from the dross and the diamond from the coal.
27 October 2014
Source: Cuban Health Care Workers’ Motives: Idealism or Necessity? /
Jeovany Jimenez Vega | Translating Cuba –