Michael Abrahams | Thank you, Cubans

Over the past 60 years, Cuba has deployed over 400,000 health workers across 164 countries to mitigate short-term crises, and for long-term arrangements, as part of the Government’s Foreign Medical Missions (CFMM) programme.

Apart from assisting those in need, the programme is also part of a campaign to generate revenue to help the country survive a 66-year-long US embargo (which has been condemned by the United Nations (UN) General Assembly for 33 consecutive years) targeting the country’s economic development. The missions have significantly bolstered Cuba’s economy and have become the country’s largest source of foreign income.

On March 5, the Government of Jamaica, through the Ministry of Foreign Affairs and Foreign Trade, announced the cessation of its nearly 50-year medical brigade programme with Cuba. The decision came after both governments failed to reach a consensus on new terms for a cooperation agreement following the previous one’s expiration in February 2023. Jamaica said the Ministry of Health and Wellness could instead hire the Cuban workers individually under local labour laws.

In a March 7 release, the Ministry said there were no problems with working conditions, housing, leave, or freedom of movement for the Cuban personnel. However, it expressed concerns that the workers did not hold their own passports and that Jamaica paid their salaries in US dollars to Cuban authorities rather than directly to them. Jamaica requested that workers receive direct payment and retain control over their travel documents, stating that the existing arrangement conflicted with Jamaican law and international conventions. When no agreement was reached, Cuba withdrew its medical personnel.

In response, Cuba’s foreign ministry said that the decision of the Jamaican Government to cease cooperation was due to pressure from the United States, “which is not concerned about the health needs of the Caribbean brothers”. The Jamaican Government denies yielding to pressure from the US, stating that it began formal discussions with Cuban authorities in July of last year, with further communications in October and December, but that it received “no substantive response” from Cuba.

My views on this issue are nuanced, as the situation is multifaceted. I am very disappointed that the programme has ended. The Cubans have been of enormous help to our people. Their foreign ministry stated that “over the past 49 years, more than 8,176,000 patients have been treated, 74,302 surgical procedures performed, 7,170 births attended to and more than 90,000 lives saved”. Also, through the Operation Miracle eye programme, the sight of nearly 25,000 Jamaicans has been restored or improved. In addition, we received assistance from Cuban medical personnel during the COVID-19 pandemic and after Hurricane Melissa. The Cubans have bridged critical gaps in our health system, and their departure has already begun to adversely impact some health institutions and patients. I also empathise with the Cuban medical professionals, as they will be returning to a country that is feeling the effects of severe US sanctions and a regime that allows them less freedom than they had while in Jamaica.

However, I also acknowledge the fact that there are legitimate concerns regarding the way Cuba conducts these missions, and the concerns did not just start yesterday and are not confined to the US. Several international organisations and countries have raised concerns regarding the use of exploitative practices and repressive measures within the programme. For example, Human Rights Watch has reported that “the Cuban Government imposes draconian rules on doctors deployed in medical missions globally that violate their fundamental rights” , that the country has “crafted repressive norms that regulate the lives of those deployed abroad”, and that their rules “severely restrict health workers’ freedom of expression, association, movement, and privacy”.

In 2018, Brazil terminated its agreement with Cuba over concerns regarding forced labour. In 2021, the European Parliament passed a resolution condemning the medical missions’ practices as “modern slavery”. The UN Special Rapporteurs on Contemporary Forms of Slavery and Trafficking in Persons have also expressed concerns that the nature of and conditions during medical missions meet the definitions of forced labour and human trafficking. In December 2025, the British Institute of International and Comparative Law (BIICL) published the findings of a project Combating Forced Labour in Cuban Medical Missions and reported, among other things, “systemic or structural exploitation” in the missions.

However, I do not believe that pressure from the US did not influence the Government’s decision. Over the past year, there has been renewed US pressure on countries to phase out Cuban medical missions. In February last year, US Secretary of State Marco Rubio announced that Washington would restrict visas, targeting “forced labour” linked to the Cuban labour export programme, and when he visited Jamaica the following month, the issue was on the agenda. In August 2025, the US announced that it was revoking the visas of Brazilian, African and Caribbean officials over their ties to Cuba’s medical missions programme. More recently, US President Donald Trump has ramped up his actions and rhetoric regarding Cuba, cutting off oil shipments from Venezuela to the country, and stating that after the war in Iran, Cuba will be “next” and has even suggested a “friendly takeover” of the country.

Prime Minister Andrew Holness has come under fire for terminating the programme. But he is between a rock and a hard place. Ending the programme will hurt us, but the consequences of failing to comply with the United States’ wishes could be worse. The US can be harsh toward uncooperative states. Travel bans, visa restrictions, trade embargoes and other sanctions could be imposed on Jamaica, affecting all of us.

It would be remiss of me, however, as a Jamaican, to not express gratitude. So I take this opportunity to say a big “thank you” to the many Cuban health workers who have assisted in caring for my people over the past five decades. Your efforts have been greatly appreciated by the Jamaican people, and I hope that arrangements can be made for those of you who wish to remain here to do so.

Michael Abrahams is an obstetrician and gynaecologist, social commentator, and human-rights advocate. Send feedback to columns@gleanerjm.com and michabe_1999@hotmail.com, or follow him on X , formerly Twitter, @mikeyabrahams