Response to Ambassador Dean Jonas- More should be done, Sir!

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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