Todos para la "renta":
"I think medical services will have replaced tourism as our most
important source of revenue in 2005," said Garcia, who directs the Cuban
Economy Study Center at Havana University.
Source :"Cuba's medical services becoming major moneymaker", South
Florida Sun Sentinel, Dec.18 2005.
These medical services are rendered both within Cuba and outside as
doctors are rented out to countries like Venezuela, South Africa,
Zimbabwe and lots of others.
"A distinction is usually made between the short-term temporary flows
which occur when countries such as China and Cuba send health personnel
abroad to earn foreign exchange"
As lots of university graduates medical doctors have to perform a number
of years of free service for the state. Doctors had to perform 3 years
as service in "payment" for their education.
Cuba - Act No. 1254 respecting social service and its regulations issued
by Decree No. 3771 of 1974 provided that Cuban citizens who graduate in
higher education or as middle-level technicians or through regular
courses for primary school teachers, are obliged to perform social
service (for the duration of three years), in accordance with the
planning and priorities for development work laid down by the
Government. Unjustified refusal to perform social service entails
temporary or permanent disqualifications from exercising his or her
profession, which is recorded in the workbook of the person concerned.
The Government has indicated that the provisions relative to temporary
or permanent disqualification and everybody knows.
This system has worked for years. Being a doctor (or other university
graduate) was no real impediment to leave the country once one had
completed the 3 years service.
From 1999 onwards the attitude changed as the Cuban regime had started
to "rent out doctors" to other countries (1) and NGO's. The Cuban
government realized that its doctors had a "commercial value" and that
allowing them to emigrate (even after completing their obligations to
the government) would reduce Cuba's "earning power". Doctors were sent
(against payment) to countries like Venezuela (doctors for oil),
Zimbabwe, South Africa, Namibia, ... The Cuban regime tried to deny
these deals (especially in the case of Venezuela), but was soon
disproved. The whole industry of renting out doctors brings in more than
U$ 750 million annually for Cuba. "I think medical services will have
replaced tourism as our most important source of revenue in 2005," said
Garcia, who directs the Cuban Economy Study Center at Havana University. (2)
1999: MINSAP regulation 54.14 (3)
"Moreover, since 1999, Cuban physicians have not been able to leave Cuba
with proper documentation and permits according to the MINSAP regulation
Number 54.14 According to this regulation, medical doctors and dentists
must serve 3 to 5 years in designated areas in the island of Cuba before
they are considered for a permission to leave the island. In this
manner, Cuban physicians are blatantly discriminated and made to suffer
higher penalties than the rest of the professionals. "
Note that it says "considered" for permission. that permission is in no
way guaranteed and this process itself can again take years.
"Resolution 54 denies exit permits to medical professionals until they
have performed 3 to 5 years of service in their profession after
requesting permission to travel abroad."
" In February a group of 31 medical professionals sent a letter to the
authorities protesting the Government's decision not to allow them to
proceed with their legal emigration. These medical professionals were
granted immigrant status by other countries, but the Ministry of Health
had refused to grant them permission to secure exit permits. The doctors
made the document public. The Government responded by terminating their
employment, relocating them to remote and undesirable health care
facilities, or ostracizing them." (4)
In 2002 health minister Damodar Peña Penton said that doctors who want
to emigrate should face stiffer requirements.
"The health department requires that doctors who request permission to
emigrate spend three to five years at posts specified by authorities in
the region where the medial practioners live.
We have to increase the strength of the evaluations of the re-settled
doctors and our control over them," warned Peña during a meeting with
regional medical directors, according to a source who sought anonymity.
A poor evaluation of a doctor who seeks to emigrate means that he or she
has to spend more work time before leaving." (5)
The current situation is one of total dependence of doctors on the
"goodwill" of the Cuban government. The despair this creates is clear.
Marriages brake up and people take to leaving Cuba in an illegal manner
as this doctor did on the "taxi boat".(6)
Refusing to go abroad as a doctor can also lead to sanctions under Cuban
Cuba - section 220 of the Labour Code: a sentence of imprisonment of
from six months to two years may be imposed on a person who, by breach
of the duties placed on him by his office, employment, occupation or
profession in a state economic unit (particularly of his duties relating
to the observance of the standards or standard-setting instructions and
other rules and instructions concerning technological discipline) causes
harm or substantial prejudice to the production output or to the
rendering of services by the
unit or to its equipment, machines, machinery, tools or other technical
devices. The Committee has noted the information provided by the
Government in its report (including the documents annexed to the
report), to the effect that any sentences of correctional labour imposed
for violations of this provision are subject to the person sentenced
being willing to perform such labour.
In the recent rumored reforms again Cuban doctors are excluded from the
reforms. they will still need exit visas.
Source: El pais: Cuba rebaja las restricciones para viajar, April 18,2008.
(1) "Castro's "Doctor Diplomacy", Originally published in the Medical
Sentinel 2000;5(5):163-166. Association of American Physicians and Surgeons.
A distinction is usually made between the short-term temporary flows which
occur when countries such as China and Cuba send health personnel abroad to
earn foreign exchange
"Cuba denies medics-for-oil trade", Sapa-AFP, 10/10/2000.
"CUBAN BARTER SYSTEM DOES NOT FAVOR VENEZUELA", UNIVERSAL PRESS
SYNDICATE, Nov. 2000.
"Cuba, Venezuela Sign Oil Deal", The Associated Press, October 30, 2000.
"Venezuela and Cuba trade oil for doctors", Andy Webb-Vidal and Marc
Frank, Financial Times, October 11 2004.
http://groups.yahoo.com/group/CubaVerdad/message/13248 (In Spanish)
"Cuba and Venezuela Deepen Ties with Medical-Oil Swap", NewsMax.com
Wires, July 13, 2005.
" Venezuela medics march over jobs", BBC NEWS, 2005/07/15.
"Using oil to spread revolution", The Economist Newspaper, Jul 28th 2005.
"HOW VENEZUELA SUBSIDIZES THE CASTRO REGIME", Cuba Transition Project,
Issue 10, April 2005.
http://ctp.iccas.miami.edu/FACTS_Web/Cuba Facts Issue 10 April 2005.htm
"Cuba's medical services becoming major moneymaker", South Florida Sun
Sentinel, Dec.18 2005.
"Medical know-how boosts Cuba's wealth ", BBC, Jan. 17 2006.
"The income to Castro's purse from this "doctor diplomacy" in Zimbabwe
alone is estimated at $1.2 million (U.S.) per month."
Gaither C. Diserción en Zimbabwe empaña la "diplomacia médica" de
Castro. El Nuevo Herald, June, 12, 2000.
"According to a Cuban economist, overall earnings from the export of
medical, teaching and other professional services could reach $750m
(€586m, £404m) this year, most of it from Venezuela."
"Castro's doctors give Chávez shot in arm", Financial Times, 2/9/05.
The ministry's Director of International Corporation Joseph Chite told
the Public Accounts Committee recently that the agreement to have
students from Malawi trained in various fields in Cuba has turned out to
be expensive for Malawi and the students suffer in Cuba because they are
He said the Cuba demands that the Malawi pays fees for its students,
many of whom were sent to study medicine, information technology and
athletics but the Cuban government demands that the expatriates Cuba
sends to Malawi be fully paid by the Malawi government.
Chite was answering a question from PAC members who wanted to know how
the bilateral agreement with the government of Cuba was working.
"Malawi is not utilizing the agreement because the situation on the
ground is different. We are even thinking of withdrawing the remaining
student in Cuba because the conditions he is living is are very pathetic
," Chite said.
(3) "Castro's "Doctor Diplomacy", Originally published in the Medical
Sentinel 2000;5(5):163-166. Association of American Physicians and Surgeons.
Also: "GRADUACIÓN CIENCIAS MÉDICAS CURSO 2002-2003"
(4) "Country Reports on Human Rights Practices - 2001", Released by the
Bureau of Democracy, Human Rights, and Labor, March 4, 2002
(5) "Health minister asks tighter restrictions on doctors who want to
emigrate", Omar Ruiz, Grupo Decoro, Cubanet, December 9, 2002.
"Ministro de Salud pide más rigor para médicos que quieren emigrar",
Omar Ruiz, Grupo Decoro, Cubanet, 6 de diciembre, 2002.