Venezuela’s Cuban health programme fraying at the edges

New York, NY – As Venezuela’s presidential election looms, the international stakes could not be higher for Hugo Chavez and his movement. If the firebrand Venezuelan leader should falter, the South American nation’s carefully crafted system of regional alliances could fall by the wayside.

Take, for example, the Caribbean theatre, where Chavez has pursued unprecedented ties with the Castro brothers in Cuba. Under the Mision Barrio Adentro programme, which was initiated in 2003, Cuban doctors have been deployed to poor Venezuelan neighbourhoods. In exchange, Chavez provides much needed discounted oil to the Communist island nation. Recently, Chavez declared that some 30,000 Cubans labour within the Venezuelan medical sector.

Barrio Adentro and joint Cuban-Venezuelan initiatives demonstrate Chavez’s willingness to break free from the traditional US orbit. With a big question mark now hanging over Chavez’s health, however, it’s unclear what might befall the flagship health program. Chavez officials have sometimes sought to tarnish the opposition by claiming that any new conservative government would curtail Chavez’s social policies, including Mision Barrio Adentro.

“It’s a lie that the bourgeoisie will continue the missions if they win,” Chavez has said, adding, “they will destroy them. They will get rid of the Cubans and they will privatise health again.”  

In light of the record, it’s hard to imagine that a new administration in Caracas would be quite as zealous in pursuing joint Cuban-Venezuelan programs. Chavez’s conservative challenger in the upcoming presidential election, Henrique Capriles Radonski, played a controversial role at the Cuban embassy during a short-lived coup against Chavez in 2002. At the time, Capriles was mayor of the Caracas municipality of Baruta, and allegedly allowed anti-Chavez protesters to run amok while they menaced the embassy. Today, Capriles is careful to chart a modest course, remarking that he did not oppose Barrio Adentro. The conservative says that he would be “mad” to overturn the best of Chavez’s social policies.

“The missions belong to the people. I don’t agree with this form of politics: inventing stories to pressure, blackmail and psychologically terrorise people,” he declared.

Poor working conditions

Whatever the case, there’s some evidence to suggest that beneath the surface, all is not well within the Cuban health programme in Venezuela. According to secret cables recently disclosed by whistle-blowing outfit WikiLeaks, Cuban doctors have faced daunting challenges. In 2009, the US embassy in Caracas noted that, while some Cubans had volunteered to go to Venezuela, “many others have complained of being forced (or directed) by Cuban authorities to work in Venezuela under President Chavez’s social mission programs for a period of one to three years”.

Upon arrival in Venezuela, many Cubans reportedly had their passports confiscated by Barrio Adentro officials, so as to “prevent their fleeing the mission”. Furthermore, Cuban medical officials complained “of constantly being watched and monitored by co-workers”. Others reported that they had been required to conduct “mandatory political work” in Venezuela, “especially around elections”, when they were expected to “read propaganda in clinics and gather potential voters”.

In addition, the doctors were “often required to staff politically charged health drives on Sundays”. As early as 2006, US diplomats reported that “the care Cuban doctors provide is often lacking and that many ‘physicians’ are actually medical students”. What’s more, Cuban health care workers earned as little as $400 a month in salary, “a figure slightly lower than local averages”. Doctors worked six days a week, and were “required to see 50-70 patients daily, a number unattainable for most doctors who, in reality, average 10-20 patients”. Moreover, the US embassy added, “almost all applicants claim they are forced to doctor their statistics to meet these requirements”.

Though the doctors received room, board and toiletries, Havana reportedly “held” salaries until medical staff completed their two-year tour. One local legislator “with extensive contacts in poor neighbourhoods” reported that Cuban doctors had complained “bitterly” that the Castro regime held their families “hostage” while medical staff “relied on local donations to survive”.

One Cuban, “who managed to escape his mission for several hours”, and who was “clearly anxious to return before his supervisor realised he was gone”, told the US embassy that “they are always watching us, checking in with us at random times, asking what we are doing and calling us on our cell phones”. The Cuban source added that, while he had not been physically threatened during his stay in Venezuela, “it is a psychological battle that we must endure every day”.

A ‘harrowing’ ordeal

Reportedly, hundreds of Cuban doctors felt so out of sorts with their situation that they requested diplomatic asylum in Europe and the US. According to the US embassy, most individuals managed to get out of the South American country “but some undergo a harrowing ordeal before being able to exit”. Indeed, many who attempted to flee Venezuela were “forced to pay exorbitant bribes” of up to $1,000 to customs or Cuban officials en-route to Miami. Others were detained when they sought to depart and “presumably deported to Cuba”. Those Cubans granted so-called “humanitarian parole” by the US were meanwhile subjected to “some sort of harassment, ranging from passports being confiscated to physical and verbal abuse”.

One Cuban couple granted onward visas by the US embassy encountered severe difficulties when they attempted to travel. As the two sought to board a flight in the eastern Venezuelan city of Barcelona en route to Miami, they were questioned by immigration officials who turned them over to the National Guard. Once the military notified Cuban officials, the couple was moved to a hotel by Cuban “security” and told that they would be deported back to Havana. In a scene out of a Hollywood film, however, the two managed to escape their captors and fled to the US embassy.

The “traumatised” couple told US officials that the Cuban “police” who detained them were also “Barrio Adentro Mission officials”. The woman claimed that the “Cuban police” threatened to rape her and beat up her boyfriend. After witnessing such fraught escapes, some Cuban health officials who had received humanitarian parole from the US simply opted to travel over the Venezuelan border into Colombia, and from there on to the US, rather than risk being detained at local airports.

An uncomfortable discussion for the left  

Since Fidel Castro took power in Cuba more than 50 years ago, doctors from the Communist island nation have been deployed all over the globe to provide medical assistance to the neediest. Che Guevara, who was himself a medic, sought to create a system of “revolutionary medicine” by educating a new kind of doctor, and today Cuban health professionals continue Che’s legacy by treating the poor in earthquake-ravaged Haiti as well as poor Venezuelan barrios. With plenty of accomplishments to boast of in the health sector, Cuban doctors are viewed by many as one of the island nation’s most important human resources.

Politically, Hugo Chavez is more likely to continue Cuban health programmes than his opponent. The Venezuelan poor, who have been historically neglected and received scant medical attention, are no doubt hoping for a Chavez win in the upcoming election and the continuation of the Barrio Adentro program. Electoral politics aside, however, the debate is not whether marginalised sectors of the population should receive decent health care, but whether Cuban health professionals should be pressured at their jobs.

To be sure, the Cubans may have had reason to embellish their stories when speaking with US diplomats. Perhaps, the doctors may have believed that spinning lurid stories would provoke a reaction and thereby help their cases. Nevertheless, given the sheer volume of Cubans requesting asylum in Venezuela, it seems at least plausible that some doctors experienced coercion.

Not surprisingly, meanwhile, the left has chosen to stick with and report on the WikiLeaks revelations which serve to embarrass the United States, while ignoring those cables which cast ostensibly progressive Latin American nations in an unflattering light.

Nikolas Kozloff is the author of Revolution! South America and the Rise of the New Left. Visit his website here.

Follow him on Twitter: @NikolasKozloff