The Business of Exporting Cuban Medical Services / Ivan Garcia

Cuban doctors protesting in Bogota
Cuban doctors protesting in Bogota

Ivan Garcia, 26 February 2016 — In a hospital in East Caracas, a bronze plaque records:”To the medical workers who died in Bolivarian lands while doing their duty”, as if they had fallen in battle.

But they didn’t die in combat. They were victims of the street violence which has converted Venezuela into a slaughterhouse with the highest crime rate in the world. In April 2010, which was the last time the Venezuelan government reported on the matter, 68 Cuban doctors had died for that reason.

For doctors like Jorge (the names of the people interviewed have been changed), Venezuela was a nightmare. “I spent two years in a slum in Cerros de Caracas. Early in the morning you could hear fights and gunfire. It seemed like the wild west. The embassy advised us not to go out in the street at night. I have never felt so afraid. Not even during the war in Angola”.

Venezuela has ended up not just the most dangerous, but also the worst paid by the olive green autocracy, which has made the export of medical services the country’s principal industry.

While he was in Caracas, Jorge was paid $200 a month and the Ministry of Public Health (MINSAP) deposited 150 convertible pesos into a bank account for his wife in Havana. “Cuban doctors go to places nobody wants to go to. And with terrible salaries. The government wins both ways. It gains propaganda and earns money from us”.

“Why do Cuban medical professionals go to difficult locations, risking their lives?”, I ask him. Jorge looks up at the ceiling of the dilapidated clinic in a poor neighbourhood in Havana and thinks for a few seconds, before replying:

“Some go in order to emigrate, others see these journeys as a way of earning some money in order to sort out personal problems. I don’t know, there are lots of reasons, but I can assure you that the last thing on their mind is the altruism that Cuba talks so much about”.

An investigation carried out by various independent journalists for the Institute for War and Peace Reporting (IWPR), published in Cubanet in September 2015, revealed how Cuban personnel in the so-called “international missions” are robbed of their salaries.

According to this investigation, the Asistencia Médica Compensada programme has become a way of getting in foreign currency and a useful diplomatic and public relations tool for the Cuban authorities.

Those who join the medical brigades abroad enjoy higher salaries and have access to major perks. But they have to hand over at least 50% of their income to the government, depending on their assignment. As an example, the report indicates that the doctors located in Trinidad and Tobago deposit half their salaries in an acount in the name of Rody Cervantes Silva, coordinator of the brigade, who then transfers it to the government.

“Supposedly, this is a voluntary ’donation’ says Odalys, who is a dermatologist, and who offered her services in South Africa and Portugal, and explains that the payment system is different in each country.

“The contract you sign with MINSAP doesnt give you much detail. You sign it more because you need the money than for any other reason, and you hardly read the small print. In Pretoria they paid me $400 a month and the bank deposited $1200 for me. Looking into it, I knew that my real salary was $5,000. They kept hold of 70% of it. Even so, with the money you get, you can sort out your house and even buy a second hand car, said Odalys.

The international missions also are a basis for running parallel businesses in the countries in which they operate. Oscar, a gynaecologist, carried out under-the-counter abortions in a private clinic in an African country. “I made $500 for each abortion. I was able to buy a house and a modern car with the money I saved”.

Irene, head of a group of nurses, went frequently to Venezuela, Brazil and Ecuador, for work reasons. “Before I left, I bought three or four thousand dollars.  With this money I could buy flat-screen televisions and cellphones, among other things, and I sold them when I got back. With this investment I make two thousand convertible pesos profit”.

But it is the government which makes the most out of these medical services exports. Ten billion dollars annually. According to Yiliam Jiménez, president of Cuban Medical Sales SA, Cuba has 51 thousand health professionals serving in 67 countries.

This Services Retailer is a network of companies, research institutes and high standard clinics which offer services at competitive prices in the international market.

While many Cuban hospitals and medical centres are crying out for repairs and and patients bring buckets and fans, towels and sheets when they are admitted, clinics like Cira García, the La Pradera Medical Centre and CIMEQ (Surgeons’ Medical Research Centre) offer a la carte menus, have air-conditioned rooms and 24 hour ambulance services.

The overseas medical squads have also converted themselves into a migration option. It’s an unusual week in which Solidaridad sin Frontera, a Miami-based organisation, does not receive six or seven calls from Cubans who want to join the Programme for Cuban Medical Professionals, better known as Visas CMPP, offered by the US government.

Since 2000, about 6,000 medical workers have deserted their international missions. And, up to 2010, 68 Cuban doctors have died in Venezuela, victims of street violece. Six years later, the up to date figure is not known. A plaque in a hospital remembers them.

Iván García

Martí Noticias, February 24, 2016.

Photo: Cuban health workers, who deserted medical missions in Venezuela protest in Bogotá.

Translated by GH