Recently, to the consternation of public health managers in the Caribbean and elsewhere, the United States (US) government has decided to sanction those involved with the Cuban labour export programme, equating it with forms of forced labour, and the leaders of some Caribbean countries have indicated that the Cuban medical practitioners are of vital importance to their health sector and, if needs be, that they are prepared to be sanctioned and have their US visa removed to maintain the presence of Cuban doctors.
The outcome of this controversy will be most interesting, for the days when sovereign states could do what they pleased have long gone. For, example, in 2020 the present US Republican Secretary of State Marco Rubio, was sanctioned twice by the Chinese government and banned from entering China for condemning the country’s human rights abuses.
Prime Minister Ralph Gonsalves of St. Vincent and the Grenadines, after giving an example of the importance of the Cuban medical professionals, told his weekly radio audience that under the agreement with the Cuban government its professionals are paid similar to locals, although he did not know what percent of their salary goes to the Cuban government. But he claimed that it ‘doesn’t mean that they’re exploited. They got a free education.
And if they’re going overseas, making money from that education, it’s not unreasonable for them to put back something in the kitty for more people to be educated. We put our people on bond. The American federal government lends money, and people have to pay back the loans.’ The PM also reported that the issue will be dealt with regionally. Caribbean Community (CARICOM) foreign ministers have met and decided to collate all the relevant information in the hope of having an early meeting with the US government to discuss and solve the problem.
The US Office to Monitor and Combat Trafficking in Persons (Office) states that according to reports published by the Cuban government, by the end of 2023, there were more than 22,000 government-affiliated Cuban workers in over 53 countries. Medical professionals comprised 75% of its exported workforce, but there are also some 7,000 merchant mariners and others such as teachers, artists athletes and coaches. The Cuban government collects $6 to $8 billion annually from its export of services.
The Office states that there are serious concerns with recruitment and retention practices. The Cuban government subjects all government-affiliated workers coercive laws focused upon making profit and labels workers who abscond as ‘deserters’ and bans them from returning to Cuba for eight years. Those who fail to return within 24 months after completing the programme are considered ‘emigrated’, thus losing their citizenship and any property they left behind. By 2021, 40,000 professionals had been sanctioned under these provisions.
Among other things, complaints filed with the International Criminal Court and the UN indicate that most workers did not volunteer for the program, Cuban heads of mission in the host countries subjected workers to surveillance and the Cuban government confiscated between 75% and 90%of each worker’s salary. At the end of 2023, the UN Special Rapporteur for Contemporary Forms of Slavery filed a new communication outlining the persistent concerns with the programme.
The Office also opined that Cuba’s practices can also negatively impact a host country’s healthcare system. Survivors of the programme have reported being forced by the Cuban in-country mission director to falsify medical records and misrepresent critical information to justify their presence and need to local authorities. Some individuals reported ‘discarding medications, fabricating names, and documenting medical procedures that never occurred.’
As noted above PM Gonsalves sought to compare the repayment of students’ debts in the US with that extracted from the Cuban labour export and an interesting article in ‘Counterpunch’ stated that student debt in the US is also a human rights issue. ‘[I]f indentured servitude sounds like a more elegant form of slavery, it’s probably because those in power throughout history have merely tinkered with the legal limits of how to extract labor for the bottom line. … Presently [sic] we are seeing this practice of extracting monies from the most vulnerable being extended and rendered legally opaque as these new “financial products” are being used to exploit the desperate situation of millennials who are facing a grim economic future.
Millennials are being squeezed by the mechanisms of capitalism that begin and end with higher education such that teenagers entering any number of universities today have, in addition to student loans, the “option” to sign a contract for income share agreements (ISA) where they can pay for their education with a fixed percentage of their estimated future income for a set period of time. (Julian Vigo, Counterpunch, 24/01/2020).’
Forbes tells us that student debt in the US almost doubled between 2011 and 2021, moving from $896.8 billion to $1.73 trillion, and that stakeholders are all looking for alternatives, one such alternative being income share agreements (ISA). However, whether ISAs are a viable alternative to student loans, or whether they simply mimic many of the issues already inherent in student lending. ‘While the vocabulary used may differ, the core feature of ISAs and student loans is the same: The student must pay a portion of their income after graduation for a certain amount of time.’ (https://www.forbes.com/advisor/student-loans/what-is-an-income-share-agreement/).
The coercion the Office to Monitor and Combat Trafficking in Persons detected is largely because Cuban professionals can earn much more outside Cuba, and Cuba is an authoritarian state without much soft power to keep even its people. For this latter reason it is maybe not useful to compare what is taking place in the US, that is still – so far – a liberal democratic state, with Cuba.
In the US, the average total cost of a 4-year undergraduate course is about $132,000. The average undergraduate income of undergraduate is about $50,000 per annum and the average annual student loan repayment is about $3,600 over 20 years. This would appear a far cry from Cuba taking between 75% and 90% of each worker’s annual salary. Although, whether or not it is exploitation on the scale being suggested by the US depends upon the basis upon which it is computed.
The US has a competitive electoral democracy system. Florida is currently a Republican state and given the bellicose nature of the US relationship (particularly that of Floridians) with Cuba, to assuage their base, the new Republic administration and Marco Rubio, a Floridan of Cuban extraction with a background of condemning human rights, must at some point at least appear to be hitting Cuba where it hurts.
I hold that autocratic behaviour should be confronted at every juncture but that it must be properly contextualised, and targeting the Cuban labour scheme is unlikely to radically change the Cuban government or its policy. It is more likely to bring an added burden upon Cuban and other peoples and so contribute to greater global acrimony. As suggested by the Caricom leaders, some reform of the manner the scheme works is a better pathway out of the current dilemma.
