Algeria currently pays Cuba $70 million annually for the services of 890 Cuban doctors, but these doctors claim they receive only a fraction of their promised wages, have their passports confiscated, and live in squalid conditions.
A US senator introduced a new bill on June 17 targeting countries that hire Cuban doctors through the island country’s “medical missions,” less than one month after Algeria publicized its involvement in the practice.
The bill, titled “Cut Profits to the Cuban Regime Act,” requires the US State Department to publicize the list of countries that benefit from Cuba’s medical missions. An estimated 50,000 Cuban healthcare workers are contracted in 67 countries around the world.
Deeming the medical missions a form of “modern-day human trafficking,” the bill calls upon the State Department to consider a country’s use of Cuban doctors as a factor in their annual “Trafficking in Persons Report” ranking.
The Republican senators leading the effort — Rick Scott (Florida), Marco Rubio (Florida), and Ted Cruz (Texas) — argue that the Cuban government participates “in the human trafficking of doctors” and “any country that requests medical assistance from Cuba is aiding their human trafficking efforts.”
“The international community must stand against the use of forced labor and the Cuban regime’s exploitation of this crisis,” said Senator Scott.
The senators also believe the Cuban government has been trying to profit from the COVID-19 pandemic. Despite the island itself needing medicine, equipment, and doctors, Cuba has sent more than 1,400 doctors and nurses to over 20 countries to treat coronavirus patients.
The island nation has categorically denied such accusations, insisting the missions are displays of cooperation and solidarity.
While the country has earned praise for its medical missions, Cuban doctors have reported infringements of their civil and human rights.
“This program is one of the Cuban regime’s largest source of revenue, yet they rarely, if ever, pay a living wage to the medical professionals they force to work in other countries, confiscating their passports and subjecting them to poor living conditions and surveillance,” the senators stated.
Only countries that pay the Cuban health care workers directly, ensure the safety of their travel documents and wages, and make all agreements public and transparent will be exempt from a harsher human trafficking evaluation from the State Department. The host countries must also allow Cuban healthcare workers to bring their families with them and ensure Cuba is not receiving any additional compensation from the professionals’ work.
Senator Cruz, who is of Cuban descent, said the bill “will send a strong warning that the United States will not turn a blind eye to the trafficking of Cuban doctors.”
The “Cut Profits to the Cuban Regime Act” adds to Senator Scott’s efforts to urge the Trump Administration “to continue to take concrete steps to hold the Cuban regime accountable.”
Cuban doctors in Algeria
Algeria has received Cuban doctors since the 1960s and may be one of the countries affected by the bill.
The Algerian government pays Cuba $70 million annually for the services of 890 Cuban doctors, or approximately $79,000 per doctor, Algeria’s official gazette reported on May 21.
Quoting three Cuban doctors in Algeria, the Miami Herald reported that the Cuban government keeps most of their salaries.
“We never knew how much Algeria paid for our work,” one doctor said. “It was secret.”
The doctors reported they get paid $900 a month. Of this wage, $350 is deposited into a Cuban bank account, and they receive the rest in Algerian dinars.
“Algeria pays with hard currency and for a specific time. Cuba uses all that money and then has no way to pay us,” a doctor told the Herald.
“The explanation is that the country needs that money to invest in health and education, but every time I return [to the island], things are getting worse,” he said.
“We live in crowded conditions, many of us sharing the same place. Conditions are bad, security worse,” he added.
Another Cuban doctor involved in a medical mission said Cuban officials withheld his passport when he arrived in Algeria. “When you arrived in Algiers, they take it away from you, and they don’t return it to you until you go [back to Cuba] on vacation.”
Independent Cuban outlet 14ymedio reported on May 26 that the Algerian government pays Cuba for medical services in ophthalmology ($34.74 million), maternal and child health ($30.25 million), oncology ($4.836 million), and urology ($1.976 million). The agreement dates back to January 30, 2018.
The decree stipulates that the North African country is responsible for the doctors’ accommodations and repatriations in the event of illness or death. Cuba, meanwhile, covers the cost of flights for the workers who go back to the island on vacation and ensures that it has a list of specialists available in case of vacancies.
While countries like Bolivia and Ecuador have rescinded their medical service contracts with the Cuban government and a lawsuit continues over Cuban doctors’ underpaid wages in Brazil, Algeria has made public its agreement with the island nation.
Human trafficking in Algeria
The 2019 “Trafficking in Persons Report” ranked Algeria on the Tier 2 Watch List, which includes countries that are working to meet minimum anti-trafficking standards but witness an increase in the number of trafficking victims and fail to provide evidence of tangible efforts to combat severe forms of trafficking. Countries such as Afghanistan, Bangladesh, the Central African Republic, Congo, Iraq, and Nicaragua are also on the Tier 2 Watch List.
While the Algerian government dedicated resources for its anti-trafficking committee and approved a 2019-2021 anti-trafficking action plan, Algeria did not systematically identify trafficking victims or report investigating, prosecuting, or convicting offenders.
Undocumented sub-Saharan migrants, primarily from Mali, Niger, Burkina Faso, Cameroon, Guinea, Liberia, and Nigeria, are most vulnerable to labor and sex trafficking in Algeria.
“While facing limited opportunities in Algeria, many migrants illegally work in construction and some engage in prostitution to earn money to pay for their onward journey to Europe, which puts them at high risk of exploitation,” the report stated.
“Some migrants become indebted to smugglers, who subsequently exploit them in forced labor and sex trafficking upon arrival in Algeria.
“In 2019, civil society organizations reported anecdotal reports that criminal networks exploit young adult women from sub-Saharan Africa, aged 18-19, in sex trafficking in Algeria.
“Criminal begging rings are common and reportedly increasing in Algeria. Media sources suggest leaders of begging networks coerce or force sub-Saharan African migrant children to beg through the use of punishment.
“Local leaders suggest migrant children may also be coerced into work by their parents as a result of extreme economic pressures,” it added.
If Algeria actively pursues anti-trafficking reforms, the 2020 report may move the country’s ranking from the Tier 2 Watch List to Tier 2, which acknowledges its efforts to meet the minimum standards for the elimination of trafficking. Morocco is ranked as a Tier 2 country, along with Germany, Denmark, Hong Kong, Iceland, Ireland, Jordan, Oman, and Qatar.
The “Cut Profits to the Cuban Regime Act” would unravel these efforts if Algeria continues to benefit from Cuban medical missions and permit the alleged exploitation of foreign doctors within its borders. However, Algeria’s recent publication of its agreement with Cuba may indicate it is working towards improving its compensation, safety, and transparency conditions.