The Trump administration wants to reassert hegemony over Latin America. Cuba is one of its main targets. Through right wing allies and by its own means it targets Cuba's most successful export program – the provision of Cuban doctors to countries in need of them.
In 2002 the Bush administration created a program to train Latin American legal personal to wage a "war on corruption" in their home countries. Back in their countries the U.S. trained people would be fed U.S. intelligence on left wing politicians. It would allow them to launch which hunts on those the U.S. wanted out of the way.
Sérgio Moro, a Brazilian judge, took part in U.S. program. Fed with (dis-)information from the U.S. he launched lawfare against then President Lula of Brasil and his Worker Party. The campaign was successful. In 2018 Lula was put into jail solely based on dubious claims made by one criminal witness.
Protocols of leaked chats between Judge Moro, the prosecutor, and other people involved provide that his intent was not to serve justice but to incarcerate Lula to prevent his party from winning the presidency. The plot succeeded and the extreme right wing politician Jair Bolsonaro won the election. After his inauguration he immediately installed Moro as Minister of Justice.
Bolsonaro immediately started to take care of U.S. priorities. Especially the poor in Brazilians now have to suffer under these policies. Their access to healthcare has severely diminished:
During his campaign for the presidency, Mr. Bolsonaro, a right-wing populist, committed to making major changes to the Mais Médicos program, an initiative begun in 2013 when a leftist government was in power. The program sent doctors into Brazil’s small towns, indigenous villages and violent, low-income urban neighborhoods.
About half of the Mais Médicos doctors were from Cuba, and they were deployed to 34 remote indigenous villages and the poorer quarters of more than 4,000 towns and cities, places that established Brazilian physicians largely shun.
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Cuban doctors have long complained about getting only a small cut of the money for their work, and Mr. Bolsonaro said they would have to be allowed to keep their entire salaries and to bring their families with them to Brazil. They would also have to pass equivalency exams to prove their qualifications.“Our Cuban brothers will be freed,” Mr. Bolsonaro said in an official campaign proposal presented to electoral authorities. “Their families will be allowed to migrate to Brazil. And, if they pass the revalidation, they will begin to receive the entire amount that was being robbed by the Cuban dictators!”
Two weeks after Mr. Bolsonaro won the presidency in October, Cuba ordered all its doctors out.
There were a total of 11,500 Cuban doctors in Brazil. The Economist explained the deal:
The Cuban doctors participate in Brazil's Mais Médicos (More Doctors) programme, which aims to bring medical services to remote or underserved parts of the country by employing overseas doctors, mainly from Cuba. It was created in response to the mass protests that rocked Brazil in June 2013 over the poor quality of public services, including healthcare. The programme pays each participant a salary of around US$4,500 a month. However, the participation of Cuban doctors is organised through the Pan American Health Organization (PAHO). The Brazilian government disburses the payments to the PAHO, which then transfers the monies to the Cuban government after taking a 5% administrative commission. The Cuban government pays the medical professionals working in Brazil a monthly salary of US$1,245, and pockets the rest.
Under the program housing and food for the doctors is paid by local authorities. Most of the Cuban doctors who volunteered for the program like it:
Yanet Rosales Rojas, 30, spent three years working in the Brazilian town of Poços de Caldas, where on average she earned more than 10 times her monthly salary in Cuba. She returned to the island last year, and was able to buy an apartment in Havana.
“You earn much more than what you get in Cuba. I always wanted to travel and treat people in other countries. This was my chance,” she said.
Leasing medical professionals is Cuba’s main export, bringing in more hard currency than tourism: last year professional services by doctors and nurse brought in $11bn, compared to $3bn in tourism.
The chance to earn abroad is major incentive to study medicine, …
The doctors receive their education in Cuba for free. The income the Cuban Ministry of Public Health makes through the program is used to equip Cuban clinics and to import medicine. Cuba provides free healthcare to its citizens.
Not all Cuban doctors in Brazil wanted to return to their home country. They had hoped to continue to work in Brazil, but their bet on Bolsonaro's words went bad:
More than 2,000 Cuban doctors have chosen to remain in Brazil, defying the call to return home. But with the special arrangement with Cuba terminated, they are now ineligible to practice medicine until they pass an exam — which the Brazilian government has not offered since 2017 and for which the Health Ministry has set no date.
The doctors not only lost their professional job and income but now also need to take up low income work.
Bolsonaro had promised to replace the Cuban doctors with Brazilian ones. But there are too few of them. They also do not want to work in remote towns or slums:
In February, it looked as if Mr. Bolsonaro would fulfill his promise: the national Health Ministry announced that all of the positions left vacant by Cuba’s withdrawal had been filled with Brazilian doctors. But by April, thousands of the new recruits had either quit or failed to show up for work in the first place.
In total some 28 million people across Brazil have lost access to a doctor:
“In several states, health clinics and their patients don’t have doctors,” said Ligia Bahia, a professor at the Federal University of Rio de Janeiro. “It’s a step backward. It impedes early diagnoses, the monitoring of children, pregnancies and the continuation of treatments that were already underway.”
The Trump administration likes the steps Bolsonaro took. It wants to starve Cuba of access to hard currencies that the body leasing of doctors provides. It is also one of the reasons why it targets Venezuela:
Around 50,000 Cuban health professionals work in 66 countries worldwide, although around half of those work in Venezuela, with an additional 11,456 in Brazil.
The Cuban doctors in Brazil are gone and the U.S. is pressing for those in Venezuela to leave. Trump's National Security Advisor John Bolton falsely claims that the Cuban doctors in Venezuela are military personal that should leave the country. The Cuban Revolutionary Armed Forces have in total only 39,000 regular troops. To suggest that more than half of them are in Venezuela, even though none are ever seen there, borders on lunacy.
The Trump administration is looking for additional ways to destroy Cuba's doctor leasing program:
The George W. Bush administration initiated the Cuban Medical Professional Parole Program (CMPP) in 2006. The idea was to persuade overseas Cuban doctors to abandon their posts and relocate to the United States. Cuba’s medical solidarity programs, in place for half a century, would suffer. President Obama ended the CMPP in January, 2017. Now the U.S. government wants to reinstate it.
Some have compared the Cuban leasing of doctors to other countries to 'human trafficking'. But it is no different from what IBM or other companies do when they train their staff and send them as consultants to other countries and companies. The consultants get a higher income than at home, and their company makes a large cut on whatever the customer pays.
The Cuban doctor program is good for the people of Cuba. Tens of millions of people in other Latin American and African countries depend on it for their basic healthcare.
The Trump administration just sent the hospital ship USNS Comfort to "help refugees from Venezuela". It is fake humanitarianism. The crisis the U.S. sanctions on Venezuela cause creates more damage than 1,000 such ships could compensate for. That the U.S., and right wing government it supports, are out to destroy it the Cuban doctor program shows that it has no intention to really care for people in need.