The U.S. argues that some aspects of Cuba’s medical missions amount to labor exploitation, where Cuban doctors are sent abroad, often under strict rules, with limited freedom, and only a fraction of their pay reaching them while most goes back to the Cuban state. By revoking visas of leaders in Caribbean countries tied to these programs, the U.S. is signaling disapproval and trying to pressure governments to distance themselves from Cuba.
From a purely policy standpoint, the U.S. frames this as human rights protection, standing up against practices it perceives as forced labor.
But this U.S. approach doesn’t exist in a vacuum. For the Caribbean:
• Cuban doctors have been lifelines. They fill severe gaps in public healthcare systems, especially in rural or under-resourced communities.
• Many Caribbean leaders don’t see these programs as exploitation, but as mutually beneficial agreements that deliver essential services where local capacity is thin.
• For local populations, this is not an abstract geopolitical debate; it’s about whether there’s a doctor in the clinic tomorrow.
Here’s where the ethical question emerges:
• On one hand, visa revocations are a sovereign tool. Every nation can decide who enters its borders. The U.S. isn’t obligated to grant visas to anyone.
• On the other hand, when these revocations target Caribbean officials for policies exercised within their own sovereign states, it feels less like principled human rights advocacy and more like coercive diplomacy, a way of exerting pressure without open dialogue.
I call that a form of “bullying”: using the enormous weight of U.S. global influence to punish small states for partnerships the U.S. dislikes, even though the issue is not happening on U.S. soil.
To me, the fairness is questionable. If the U.S. truly cared about the welfare of Cuban doctors, it could:
• Engage multilaterally with Caribbean governments, Cuba, and organizations like the ILO (International Labour Organization) to ensure fair treatment and transparent agreements.
• Support Caribbean healthcare directly, help fund local medical training, expand scholarships, or provide aid to reduce dependency on Cuban doctors.
Instead, the visa revocations look more like a blunt instrument, a show of strength that risks alienating small states rather than winning them over. It may also backfire, deepening sympathy for Cuba and reinforcing the idea that the U.S. treats the Caribbean more as a sphere of influence than as a partner.
So, is it “fair”? In principle, a country can deny visas as it sees fit. But in practice, when the action doesn’t address the root problem, which in this case is the treatment of Cuban doctors, and instead punishes third-party Caribbean leaders, it feels less like fairness and more like geopolitical pressure, yes, a kind of bullying dressed in policy language.
Caribbean leaders have always had to walk a fine line: safeguarding sovereignty, ensuring essential services for their people, and balancing relationships with powerful nations like the U.S. What’s happening now is not new, but it does present a moment for the region to show unity and wisdom.
How do I think leaders might respond effectively? I say:
1. Defend Sovereignty with Firmness
• Leaders can reaffirm that healthcare agreements are sovereign decisions, negotiated to meet the needs of their populations.
• The U.S. has the right to manage its visas, but should not dictate regional healthcare partnerships.
• A collective CARICOM statement could highlight that the visa revocations are disproportionate and undermine respectful relations.
2. Acknowledge Legitimate Concerns
• Instead of outright rejecting the U.S. position, leaders can show maturity by saying: “Yes, we will ensure transparency and fairness for all workers, including Cuban doctors.”
• Commissioning independent reviews of the Cuban medical program in Caribbean countries would demonstrate credibility. If there are worker grievances, address them openly.
This takes away the moral high ground the U.S. claims and shows the Caribbean is not hiding from accountability.
3. Leverage Regional Unity
• Caribbean leaders are strongest when they act together. If one country is targeted, others can rally behind them to prevent “divide and conquer” tactics.
• A CARICOM health task force could be created to standardize contracts, protections, and benefits for all medical personnel (Cuban or otherwise).
• This way, the U.S. cannot accuse the region of exploitation without acknowledging proactive reform.
4. Engage the U.S. Constructively
• Open dialogue is better than confrontation. Leaders can invite U.S. officials to observe Caribbean healthcare challenges firsthand: understaffed hospitals, rural clinics, rising costs.
• Caribbean governments can propose joint solutions, such as:
• U.S. funded scholarships for Caribbean students in medicine.
• Partnerships with U.S. hospitals or universities to build local capacity.
• Emergency aid or grants to supplement healthcare budgets.
This shifts the narrative: If you object to Cuba’s model, help us find alternatives that don’t leave our people without doctors.
5. Champion Humanitarian Principles
• Leaders should emphasize that this isn’t just politics; it’s about people’s lives. The moral question is: do ordinary Caribbean citizens lose access to healthcare because of geopolitical games?
• By placing the patient at the center, leaders can appeal to international opinion, framing the U.S. measures as unnecessarily harmful to vulnerable populations.
To me the most powerful stance would be a blend of firmness and openness:
• Firm on sovereignty: “We choose our healthcare partnerships.”
• Open on human rights: “We’ll ensure all medical workers are treated fairly.”
• Forward-looking on solutions: “If the U.S. truly wants better alternatives, work with us to build them.”
That way, Caribbean leaders neither bow to pressure nor appear dismissive of worker welfare. Instead, they stand tall; principled, pragmatic, and united.
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While I definitely agree with this article, I think you are beating the proverbial dead horse. The US has always thought that might is right and seem to think that by revoking visas will really make an impact.
This really isn’t about “trafficking”. It’s about the US wanting to dictate and control everything around them much to their detriment as all they are doing is further alienating themselves.
This article is completely anti-USA and ignore facts. How many decades now the US have been talking about this abuse of workers by the Cuban government without laying any sanctions?
Why on earth would the caribbean Islands care about these Cuban workers when the caribbean Islands are benefitting from this abuse of Cuban medical professionals?
America is doing the right thing in this case, have you ever seen Antigua government officials standing up for anyone? Do you not hear how much they say to people I can’t help you. Do you not know individual politicians only care about their pockets and their family’s pocket?
The article completely ignore how local politicians think and act. They will never stand up for anyone or morality or legality unless they are benefitting or will lose something.
I would advise President Trump to even put travel restriction on US residents to travel to certain Caribbean Islands until these Island start to resist human trafficking, fraud in foreign labor, and abuse in labor.
America is not the only country in this world, stop putting everything on America. Start pressuring all other countries to take active participation in spreading democracy, merit, and freedom.
I completely disagree with the parts of the above article that I read so far. Sometimes folks need to feel to learn. Maybe my recommended action will cause politicians like Antiguan politicians to have some class, morals, and care for human rights. Instead of ignoring all the violations because they are benefiting.
If it is not the right way, I do not want it. Again, morality and legality is my way of living. I put myself last at all times for the betterment of others. That is why crime, terrorism and abuse victim advocacy and research is most important to me. I will stand up for the week, even if it cost me money, my job, my life. That is how I want my leaders to think.
In cases of human rights abuse such as “limited freedom” should be addressed if there are any, About the Cuba taking 50% of the salary sounds simply like a scare tactics because the wording instead of just calling it basically what it is, basically a tax which Max Hurst also stated the money deducted is just used to fund medical school in Cuba to keep medical school free to students. As long the agreed salary isn’t low where the net salary is salve wage is completely fine in my eyes since I believe Max Hurst also stated host government provide housing to doctors on missions and 50% income tax isn’t uncommon especially in the EU although it normally restricted to high earners since they use a progressive tax system.
Response 1 and 2 should not be foreign to political members or anyone engaging in important discussions.
I strongly agree on 3 since it gives foreign regions/ countries much harder push back which I would love to a return to regional union like what the West Indies federation was suppose to be.
I wouldn’t disagree or argue against 4 but I do doubt USA’s wiliness to provide an alternative under this administration where they have been cutting back on things like USAID and visas to countries they see as “shithole” countries.
This article reinforces the prevailing culture of don’t hurt us help us.
We took leadership on SIDS but it was not to long ago we had solar panels as illegal.
We have public policies that encourages individual auto ownership. But we are concerned about fossil fuel and global warning.
The Prime Minister testified before the ICJ recently that Antigua and Barbuda went into debt as a result of the Barbuda Irma hurricane. Housing ABLP supporters from Barbuda at Sir Vivian Richard stadium and at The Barrymore put Antigua in debt; while all the other donations are still not accounted for.
Do what do Irma have to do with the Cuban Brigade issue?
It’s an example of the misguided attempt when we want to play victim.
UWI has been producing doctors since the 1950s. The CXC and CASE results clearly says we are not preparing students for careers and professionals in scientific and engineering field.
The highest ranking graduate from NYU medical school this year is an Antigua Miss Micheal. She is going on to do several fellowships. She will never return to work in Antigua on a full time basis.
Defend Sovereignty with Firmness
• Leaders can reaffirm that healthcare agreements are sovereign decisions, negotiated to meet the needs of their populations.
• The U.S. has the right to manage its visas, but should not dictate regional healthcare partnerships.
Take a look at the history of the white Cubans who left Cuba and are now an important voting block in US politics
• A collective CARICOM statement could highlight that the visa revocations are disproportionate and undermine respectful relations.
CARICOM is dysfunctional in case you were not aware of it.
2. Acknowledge Legitimate Concerns
What legitimate concerns
• Instead of outright rejecting the U.S. position, leaders can show maturity by saying: “Yes, we will ensure transparency and fairness for all workers, including Cuban doctors.”
What leaders are you referring too? CARICOM? OECS? Who?
• Commissioning independent reviews of the Cuban medical program in Caribbean countries would demonstrate credibility. If there are worker grievances, address them openly.
This takes away the moral high ground the U.S. claims and shows the Caribbean is not hiding from accountability.
The Cuban Medical Brigade produces critical foreign exchange dollars. Who is going to review and tell the Cubans this is not dear what you are doing.
The moral is that without this money many may starve in Cuba. What moral high ground exists when the US is trying to squeeze them jbtivsubmission
3. Leverage Regional Unity
There is no regional unity. The Cuban Brigade issue is going to bring that about
• Caribbean leaders are strongest when they act together. If one country is targeted, others can rally behind them to prevent “divide and conquer” tactics.
CARICOM is much older than the E.U. Ecen when they don’t gave the cards they deal with Trump as a unit.
CARICOM just gave meeting. They just christened a mansion for the Secretariat a few weeks ago.
• A CARICOM health task force could be created to standardize contracts, protections, and benefits for all medical personnel (Cuban or otherwise).
Come on ! Standardize contracts are going to address Marco Rubio and his compatriots in Miami ?
• This way, the U.S. cannot accuse the region of exploitation without acknowledging proactive reform.
The does what it wants; right or wrong.
4. Engage the U.S. Constructively
How so? How so?
• Open dialogue is better than confrontation. Leaders can invite U.S. officials to observe Caribbean healthcare challenges firsthand: understaffed hospitals, rural clinics, rising costs.
• Caribbean governments can propose joint solutions, such as:
• U.S. funded scholarships for Caribbean students in medicine.
Begging again and ignoring the problem
• Partnerships with U.S. hospitals or universities to build local capacity.
That’s only a stop gap solution
• Emergency aid or grants to supplement healthcare budgets.
This shifts the narrative: If you object to Cuba’s model, help us find alternatives that don’t leave our people without doctors.
Begging again
5. Champion Humanitarian Principles
When Trump sends people to alligator Alcatraz do you think he is considering humanitarian oriciokes
• Leaders should emphasize that this isn’t just politics; it’s about people’s lives. The moral question is: do ordinary Caribbean citizens lose access to healthcare because of geopolitical games?
Thst going to get them very far when Trump has already called them What?
• By placing the patient at the center, leaders can appeal to international opinion, framing the U.S. measures as unnecessarily harmful to vulnerable populations.
Asked the ABLP guy “Troy Jones “ whose mother almost died in the emergency room until he called Faston
To me the most powerful stance would be a blend of firmness and openness:
• Firm on sovereignty: “We choose our healthcare partnerships.”
• Open on human rights: “We’ll ensure all medical workers are treated fairly.”
• Forward-looking on solutions: “If the U.S. truly wants better alternatives, work with us to build them.”
That way, Caribbean leaders neither bow to pressure nor appear dismissive of worker welfare. Instead, they stand tall; principled, pragmatic, and united.
So it would be interested in knowing how many doctors has UWI produced in the last 50 years. How many of them are practicing in CARICOM medical facilities.
That’s the data that is needed to begin to adress the problem.
When PM Golden of Jamaica was asked about UWI medical school graduates he said : We train them but they leave. There lies the problem.
That’s what gas to be addressed and it can be addressed but getting in the Cuban doctors was far easier and require less thought sbd wirk
Dean Jonas article as well as the response both speaks to the level of naive and denial that is endemic across the Caribbean.
I say help yourselves before you look for help from others.
Rather than casting dispersion on Marco Rubio, Trump and the US take an honest look at yourselves.
I’d ask why didn’t Dean Jonas write on this subject in July. Of course not, it was the season to party. Now the party is over we can turn to international relations.
Should anyone read this at any US embassy I’m sure they would laugh out loud.
Ask yourselves where all the people who were trained as Doctors at UWI? What has CARICOM achieved in its goal toward single market?
Here in Antigua the medical board acted as gate-keepers and did not allow Cuban trained doctors to practice.
Look internal Dean and the writer who responded to Dean.
The Cuban Brigade issue is part of the Americas politics.
In politics there is something called the third rail. In US politics Cuba is a third rail issue.
Both articles are playing to a level of resentment that currently exists today towards the US.
Look inwards. We live in a Country where we are afraid to identify who we are.
You criticize the Prime Minister and you become a target.As the French says: The Wale that blows gets harpooned first.
The Caribbean is a keeping up with the Jones society, and hope for a hand out to do so.
So if the US kicks out all black immigrants it’s ok for it’s a sovereign decision. What a crock of BS
Tge alternative is to incentivize UWI trained doctors to practice in the Caribbean
My question to Dean Jonas and the Response writer:
Why aren’t the Caribbean countries education system producing and retaining doctors to meet their needs.
What has CARICOM and or UWI done to address the problem ?
The fact is nothing.
Until Little Marco from Little Havana who hates the Cuban regime and built his political career against Cuba everyone was riding the gravy train
Neither of you understood the geopolitical or US politics that makes this a regional issue.
You are just as flamusked as the people waiting for the tick tok ban.
The bottom line is the USA wants to destroy the Cuban Regime by any means possible, that includes stopping the flow of revenue. They don’t care about nobody but their own self-interest. They don’t even respect the World Trade Organization, look so long they owe us money. The entire Caribbean should approach this issue as one body. Last few decades has shown that we longer needs the USA for survival . It is time to cut them out of the equation until Trump is voted out of office.
Feeling so grateful today. I was recently cared for at the hospital by a kind and professional Cuban woman, which reminded me of the importance of these medical missions to us in Antigua & Barbuda.
This is personal for my family, as some of my relatives actually studied medicine in Cuba. Seeing that legacy of compassion in action was truly special. These professionals are heroes, and their solidarity and selfless work keep our communities healthy. Let’s show them the love and appreciation they deserve!
#Gratitude #CubanMedicalMissions #CaribbeanHealthcare #SolidarityInHealth #AntiguaAndBarbuda #HealthForAll #MedicalHeroes
Wow…Carribbean people and leaders talking that they where slaves and part of slave scheme long time ago. And today they are firmly supporting slavery. Take a close look what are the 5 elements to be consider you are part of modern slavery. And you guy will realize those Cuban doctors fit 5 of 5 of them. You are part of this crap for your benefits.
Why you don’t hire those Doctors directly for a period of time, give them they salary the same way you guys paid local one, and let those Doctors be 100% part of your Healthcare system?
The way those Doctors are being used in the Caribbean and other part of the world violate a lot of rules of the World Labor Standards, and is considered as a Modern Slavery Scheme.
The same “slavery issue” you guys are claiming “Reparations” from UK and EU.
Dean Jonas is just looking for attention. The responding writer is just as naive
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