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The Cuban government retains the majority of the money paid by the Bahamian state for each healthcare professional sent under the framework of bilateral medical cooperation.
According to a report from the Cuba Archive project, based on contracts obtained through unofficial channels, the Havana regime retains between 83.9% and 91.6% of the payments, while the collaborators receive only a small monthly stipend.
The contract between the Bahamas and the Cuban Medical Services Marketing Company (CSMC), an entity wholly owned by the regime, stipulates monthly payments of up to $12,000 for a "medical specialist advisor," of which only $1,200 goes directly to the Cuban professional, while the rest goes to the government's coffers.
Out of the agreed monthly salary of 5,000 dollars for categories such as health technicians or computer engineers, only 990 is allocated directly to the worker as a stipend.
In addition, the Bahamas covers housing, transportation, health insurance, English courses, and administrative expenses, which raises the cost per worker well above the local average salary.
According to the report, more than 100 Cubans are currently working in the Bahamian healthcare system, spread across hospitals such as Princess Margaret and Rand Memorial, as well as in other institutions.
The so-called medical mission includes technicians, nurses, physiotherapists, and even biomedical engineers, many of whom perform low-skilled tasks, according to the document.
This is complemented by clauses that prohibit workers from accepting independent contracts, require them to maintain confidentiality, and even allow the CSMC to impose disciplinary sanctions from Cuba.
The report classifies these conditions as veiled forced labor under the guise of a "humanitarian mission."
Testimonies from former collaborators indicate that many live in precarious conditions, with low incomes and unable to gather enough money.
Some workers are even in the Bahamas without a valid work permit, which contradicts local immigration laws.
The report also denounces that collaborators are coerced into participating in demonstrations against the U.S. embargo, organized by the Cuban embassy, as part of the political utilization of the brigades.
While the Cuban regime collects over 11 million dollars annually from this program, workers not only receive a minimal portion of the payment, but according to the report, they also fall victim to a structure that violates human rights, international labor standards, and Bahamian local laws.
Despite all these irregularities, in December 2024, the Minister of Health and Wellness of the Bahamas, Dr. Michael Darville, and the director of the Public Hospitals Authority, Dr. Aubynette Rolle, reaffirmed the "positive" nature of the agreement with the Cuban regime and expressed their interest in expanding bilateral health cooperation.
For years, the so-called Cuban medical cooperation has been under scrutiny by the international community due to the coercive conditions imposed on health professionals sent abroad.
In this regard, recently the Minister of Public Health of Cuba, José Ángel Portal Miranda, publicly acknowledged that the passports of medical collaborators were held by brigade leaders for years, as a "preventive measure" to avoid desertions.
Although he claimed that this practice has decreased, his statements confirmed one of the most persistent complaints about the lack of freedom of movement for these workers.
A few days earlier, a report from the U.S. State Department highlighted that the Cuban regime obtains over $4.9 billion annually from exporting medical services, withholding a significant portion of the salaries that should go to the professionals.
This report described the practice as a form of forced labor and human trafficking, emphasizing that the government imposes abusive working conditions, including the inability to accept independent contracts and the obligation to participate in political activities.
In March of last year, Senator Marco Rubio spoke out against Cuban medical missions, which he described as an "atrocious practice" for operating under exploitative conditions.
Rubio warned about the necessity of evaluating the existing medical agreements in the Caribbean on a case-by-case basis, to determine the legitimacy and respect for human rights in each one.
Frequently asked questions about Cuban medical missions and their impact
How much money does the Cuban government retain from payments for medical missions?
The Cuban government retains between 83.9% and 91.6% of the money that countries like the Bahamas pay for each Cuban medical collaborator. The professionals receive only a small monthly stipend, while the remainder of the payment goes to the Cuban government's coffers.
What are the working conditions of Cuban doctors abroad?
The working conditions of Cuban doctors abroad are described as labor exploitation. Doctors are subject to movement restrictions, passport retention, and work under strict surveillance from the Cuban regime. Additionally, they face reprisals if they decide to leave the mission.
What are the international criticisms of Cuban medical missions?
Cuban medical missions have been internationally criticized as a form of "modern slavery" and "forced labor." International organizations and governments, such as that of the United States, claim that these missions violate human rights and international labor standards, as the professionals work under exploitative conditions and do not receive their salaries directly.
How are the salary deductions for Cuban doctors justified?
Some Caribbean leaders, such as the Prime Minister of Saint Vincent and the Grenadines, have justified salary deductions by arguing that doctors should contribute to the Cuban state due to the "free education" they received. However, this justification ignores the reports of labor exploitation and the conditions of semi-slavery that doctors face abroad.
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