The Cuban government is defending its medical support brigades, often called "medical missions," which it dispatches to neighboring Caribbean nations and across the globe. However, these programs face increasing criticism for allegedly being based on the forced labor exploitation of Cuban medical professionals and for depriving Cuban citizens of desperately needed access to healthcare services.
Some countries are already treating Cuban medical personnel fairly and ethically, standing against the Cuban government's unjust practices. This demonstrates that it is not an impossible task.
It has been revealed that over 22,000 Cuban government-affiliated workers, the majority of whom are medical personnel, are working in harsh and inhumane conditions in 50 countries. Through this exploitation of labor, the Cuban government reportedly generated a staggering $4.9 billion (approximately 6.7 trillion KRW) in revenue in 2022 alone.
Testimonies from Cuban doctors indicate that the Cuban government confiscates between 75% and up to 95% of their salaries. Doctors who have left the program have exposed various instances of abuse, including unpaid wages, confiscation of passports and medical licenses, restrictions on their rights abroad, and penalties for leaving the program.
In 2018, affected doctors filed a class-action lawsuit. In this ongoing case, the plaintiffs claim they were subjected to forced labor under the threat of severe economic, personal, and legal repercussions.
In February 2025, the U.S. government took measures to end Cuba's forced labor exports. Consequently, Cuban government officials and government officials from countries involved in Cuba's forced labor practices may be barred from entering the United States. Additionally, immediate family members of those responsible for facilitating the Cuban regime's forced labor schemes may face similar sanctions.
Announcing the expanded policy, U.S. Secretary of State Marco Rubio stated, "Cuba continues to profit from the forced labor of its workers, and the regime's abusive and coercive labor practices are clearly documented." He emphasized, "The United States is committed to combating forced labor practices worldwide."
The Reality of Cuba's Labor Exploitation
Each year, tens of thousands of workers are dispatched overseas through the Cuban government's labor export programs. These individuals work in various professions, including teachers, artists, athletes, coaches, engineers, forestry technicians, and merchant mariners. As of the end of 2022, medical professionals accounted for an overwhelming 75% of the Cuban government's labor export program.
These medical personnel remain under the influence of the Cuban government's coercive laws and practices. The Cuban government labels workers who abandon their overseas missions as "deserters," prohibiting them from returning to Cuba and visiting family for eight years. Workers who do not return to Cuba within two years of the end of their mission are considered "emigrants" and may lose their citizenship protection, legal rights, and property in Cuba under Cuban law.
In 2023, the United Nations Special Rapporteur on contemporary forms of slavery issued a letter expressing concerns about the situation of Cuban workers sent to Italy, Qatar, and Spain. The letter was based on complaints from workers who claimed they were forced to participate in the program, were prevented from freely interacting with locals, were subjected to strict curfews and surveillance, and had 75% to 95% of their salaries confiscated by the Cuban government.
The Harm Caused by Forced Labor
The coercive nature of Cuban medical labor does not necessarily guarantee quality medical services in the receiving countries. Often, even medical personnel labeled as "experts" lack adequate medical training. Cuban government officials have reportedly pressured medical staff to falsify medical records to legitimize the medical missions.
The Cuban government pays its doctors a minimal portion of the salary they receive in the host countries. This can lead to an increase in unemployment rates among local doctors and nurses in those countries.
The U.S. Department of State advises countries that accept Cuban medical personnel to consider the following questions: Do Cuban doctors possess the same qualifications as local medical school graduates? Are doctors paid directly? Is their salary confiscated? Do medical personnel have guaranteed personal passports? Is freedom of travel guaranteed? Are family members allowed to accompany them?
To ensure the protection of medical personnel's rights, labor contracts should be transparently disclosed. Basic preventative measures to avoid facilitating forced labor include regular, unannounced labor inspections in accordance with local laws to identify signs of trafficking and ensuring that Cuban workers receive the same legal protections as other foreign workers.
Barbados, Guyana, Jamaica, and Trinidad and Tobago have demonstrated that it is possible for host governments to ensure the proper treatment of workers.
Medical professionals should be treated with dignity and respect. The U.S. Department of State believes that Cuban medical personnel should voluntarily participate in medical missions, enjoy freedom of movement, freedom of expression, and freedom of association during their assignments, and receive fair wages for their labor.
Current Status of the Cuban Healthcare System: Cuba boasts a high level of healthcare, a result of the government's proactive investment and efforts to improve access to medical services since the revolution. However, severe shortages of medicines and medical equipment due to economic difficulties and U.S. economic sanctions are a significant issue. This can lead to situations where patients in Cuba do not receive adequate treatment and serves as a basis for criticism of the government's overseas medical mission policy. (Source: Various reports from human rights organizations and news outlets)
International Labour Organization (ILO) Convention on Forced Labour: The International Labour Organization defines forced labor as "all work or service which is exacted from any person under the menace of any penalty and for which the person has not offered himself voluntarily," and advocates for the abolition of all forms of forced labor. Cuba's overseas medical mission program has consistently faced allegations of violating the ILO Convention on Forced Labour. (Source: International Labour Organization)
Shifting U.S. Policy Towards Cuba: While the United States previously pursued the normalization of relations with Cuba, it has recently shown a move back towards a more hardline policy, expressing concerns about the Cuban government's human rights issues and forced labor exploitation. The entry restrictions announced in February 2025 can be interpreted as part of this policy shift. (Source: U.S. Department of State)
Cuba's overseas medical mission program presents both a positive aspect of humanitarian aid and serious problems of forced labor exploitation of medical personnel and the weakening of the healthcare system within Cuba. The international community must continue to monitor and pressure the Cuban government to respect the human rights of its medical professionals and ensure that its citizens receive the necessary healthcare services.
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