As a newly minted U.S. citizen, Ramona Matos, as soon as a physician in Cuba, didn’t hesitate when deciding whom to vote for final yr.
She selected Donald J. Trump, the candidate who promised to be robust on Cuba’s communist authorities.
She hoped he would assist free the Cuban individuals and, particularly, put an finish to a instrument the federal government in Havana has used to melt its picture world wide — one which Ms. Matos discovered notably repugnant for private causes.
For many years, the Cuban authorities has despatched hundreds of well being professionals to work in distant villages and cities in dozens of nations, the place they get only a fraction of what the international locations pay Cuba for his or her companies.
“These docs are slaves to the Cuban dictatorship,” stated Ms. Matos, 63, who, after posts at Cuban medical missions in Bolivia and Brazil, is a manufacturing facility employee in South Florida.
Starting on his first day in workplace, Mr. Trump has began tightening the screws on Cuba, together with on its international medical program.
With a Cuban American secretary of state and an envoy to Latin America referred to as a longtime hawk on Cuba coverage, the Trump administration rapidly imposed harder measures. It was the newest twist within the back-and-forth strategy towards Cuba, which shifts from aggression to softening, relying on who occupies the White Home.
The Trump administration reversed strikes made by the Biden administration, returning Cuba to the listing of state sponsors of terrorism, which limits its capability to do enterprise world wide, and restoring the suitable of Individuals to sue over property confiscated on the island a long time in the past.
Cuban officers have had their visas yanked and the administration has prohibited enterprise transactions with corporations controlled by Cuba’s military, intelligence and security services, which handle very important pursuits reminiscent of tourism and imports.
Republican administrations have tried to focus on Cuba’s medical missions earlier than, however Mr. Trump is taking a tougher line: In February, for the primary time, the U.S. authorities stated it will withdraw the journey visas of officers in international locations that host the medical brigades.
The measure threatens certainly one of Cuba’s principal sources of foreign money, simply because the nation grapples with an enormous wave of migration, widespread energy outages and meals shortages.
It’s troublesome to determine precisely how a lot the medical program generates for Cuba — specialists observe that the federal government’s figures are sometimes unclear, as a result of it regularly modifications the descriptions of the funds and lumps collectively totally different sorts of companies.
Total, Cuba earns greater than $4 billion a yr by exporting well being care staff, building employees, educators and different sorts of expert employees, in accordance with a study by Cuba Archive, a Miami-based human rights group, which produced the findings for the State Division’s annual Trafficking in Persons report.
4 authorities officers, two from Venezuela and two from Cuba, have misplaced their journey visas to america over the brand new medical brigade coverage, the U.S. State Division stated.
“I don’t agree with every little thing Trump does, however with reference to Cuba, I discover it great,” Ms. Matos stated.
Cuba’s medical brigades work in dozens of nations from Africa to South America and the Caribbean.
Although they’re typically depicted as humanitarian missions for nations in want of well being care, the international locations pay Cuba for docs, nurses, technicians and different service suppliers, serving to the Cuban authorities fund its personal well being care system.
Cuban officers say the nation at the moment has 24,000 individuals posted in 56 international locations. This system peaked in 2014 however has declined over the previous decade due to disputes with Brazil and cutbacks in Venezuela.
The well being employees, who examine medication at no cost in Cuba, typically take part in this system willingly as a result of they earn way over they’d at residence.
However they solely obtain a portion — human rights activists say 2 to fifteen p.c — of what governments pay Cuba for his or her companies. Half of the employees’ pay is held in a devalued native foreign money account in Cuba, from which they’ll withdraw solely after returning residence from their assignments.
Docs who served abroad say their passports have been taken from them, they weren’t allowed to socialize with locals and, in some communities, needed to preserve a 6 p.m. curfew. Additionally they couldn’t carry their households. Below the administration of President George W. Bush, docs who fled this system have been supplied fast-track entry into america, and plenty of abandoned.
One physician who fled in 2019 stated the month-to-month wage she obtained in Venezuela’s native foreign money throughout a interval of hyperinflation was sufficient to purchase only a loaf of bread and a can of soda. She labored 48-hour shifts, typically with out electrical energy, and bunked with three different Cuban docs.
“It’s a Cuban authorities enterprise, actually,” stated the physician, who requested that she solely be recognized by her first title, Leydy, as a result of the federal government typically harasses her household at residence. “The reality is, it’s exploitation.”
Leydy is now finding out to be a nurse practitioner in Florida. As a result of she by no means returned to Havana, the Cuban authorities saved the $10,000 she earned in Venezuela over 15 months, she stated.
Maria Werlau, the manager director of Cuba Archive, the Miami-based human rights group, described this system as “a scheme for compelled labor.”
The quantity governments have paid Cuba per physician varies, starting from $900 in Guatemala to $5,000 in Kenya. In Equatorial Guinea, docs obtained $1,000 of the $10,000 the federal government paid for them, Cuba Archive’s report stated.
Ms. Werlau famous that U.S. federal regulation requires sanctions towards international locations that take part in trafficking. Whereas the State Division has accused Cuba of labor trafficking for years, Ms. Werlau believes america must also penalize governments that take part in this system.
The Cuban authorities insists that the medical program doesn’t meet the worldwide authorized definition of labor trafficking as a result of staff should not tricked and know the place they’re going.
The workers obtain a wage, pension and a “first rate” stipend within the vacation spot nation, the place their lodging, transportation and sometimes meals bills are lined, Cuba’s deputy international minister, Carlos F. de Cossío, stated in an emailed response to questions.
“The Cuban professionals who take part achieve this voluntarily,” he stated.
Mr. de Cossío stated they’ve “full freedom of motion,” an assertion human rights activists say lots of of docs who’ve left this system have disputed.
No international locations have withdrawn from this system due to the brand new coverage, Mr. de Cossío stated.
Mr. Trump’s coverage to cancel visas from officers of nations that take part in this system “is geared toward strangling the Cuban financial system by way of threats and coercion on governments and entities of third international locations, thus reinforcing the siege they’ve imposed for many years,” he stated.
“Predictably,’’ Mr. de Cossío added, “it has affected our individuals’s lifestyle, proscribing revenue, damaging important companies reminiscent of electrical energy, water, transportation and well being care.”
Leaders of a number of Caribbean international locations have balked on the new visa rule and stated they’d fortunately forfeit journeys to america.
Jamaica has as much as 400 Cubans, largely nurses, who’ve stuffed essential gaps within the nation’s medical care, stated Christopher Tufton, Jamaica’s minister of well being and wellness.
“We don’t have any proof that there’s trafficking going down,” Mr. Tufton stated in an interview.
In Trinidad and Tobago, the place 87 nurses and 9 docs from Cuba work, the authorities have ensured that this system meets labor requirements, Prime Minister Stuart Younger stated.
“We stay grateful to Cuban well being care suppliers who present service in key areas to individuals of Trinidad and Tobago in circumstances that they and we might be pleased with,” stated Amery Brown, a medical physician who serves as minister of international affairs. “The circumstances are literally glorious.’’
However a Cuban physician who had been posted in Port of Spain, the capital of Trinidad and Tobago, and who spoke on the situation her title not be printed as a result of she fears reprisals, stated a lot of her $3,500 month-to-month fee was saved in a Cuban account that it was troublesome to outlive.
Mauricio Claver Carone, Mr. Trump’s envoy for Latin America and a longtime advocate for robust sanctions on Cuba, stated extra international locations wanted to make use of a mannequin just like the one in Barbados, the place the federal government hires docs straight.
“We need to mainly have a united voice towards indentured servitude, towards human trafficking,” he stated.
In 2018, Ms. Matos sued the PanAmerican Well being Group, a U.N. company that had a task in managing this system in Brazil. She considers it “fashionable slavery.”
“Isn’t {that a} slave, that you simply limit an individual from going wherever they need, speaking to whoever they need?” she stated. “To not point out the salaries.”
Prior Beharry contributed reporting from Port of Spain, Trinidad and Tobago.
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