Testimonies by:

1.  Yague (doctor, Havana)

2. Sara Cue (doctor, Matanzas/Artemisa)

3. Adolfo Céspedes (doctor, mission in Zaire)

This dossier contrasts the official statistics of Cuba’s vast medical workforce with the reality of shortages at home and exploitation abroad. Testimonies from doctors like Patricia Yague, Sara Cue, and Adolfo Céspedes reveal a system where missions are no longer acts of solidarity but mechanisms of coercion. Sara recounts being confined in a hospital in Ayacucho without documents, cell phones, or freedom of movement, forced to treat wounded soldiers under surveillance. Adolfo describes missions as “semi-slavery,” with doctors treated as malleable products.

The report underscores how missions have transformed into a multi-billion-dollar business for the Cuban state. Doctors endure confinement, wage confiscation, intimidation, and constant surveillance. Hundreds have lost their degrees for defying regulations, while others escaped to freedom. Despite international condemnation of medical trafficking, Cuba continues to sign agreements with dozens of nations, exporting “white coats under red regulations.

See full report here 

Testimonies by:

1. Dr. Pereira (Holguín, Cuba; mission in Venezuela).

2. Dr. Montiel (Guantánamo, Cuba; former mission participant, now writing a book) 

This report analyzes how coercion defines the daily lives of Cuban doctors on internationalist missions. Dr. Pereira describes his mission in Venezuela as “torture,” with passports confiscated, monthly interrogations, strict curfews, and prohibitions on relationships or even casual friendships. Mission life resembled an “open-air barracks,” where regulations controlled both professional and personal aspects of existence. His experience caused family separation and psychological trauma, leaving him determined never to participate again.

Another testimony, from Dr. Montiel, reinforces the coercive structure of missions. He highlights absurd prohibitions, enforced deception (inflating patient numbers for revenue), and systemic wage skimming. Now writing a novel based on his experiences, he portrays the missions as a semi-slave system hidden behind the façade of “solidarity.” Together, these accounts reveal a system where surveillance, repression, and economic coercion strip Cuban doctors of their autonomy and rights, while the state profits.

See full report here

Testimonies by:

1. 1.   Dr. Mario Estévez (Cuba; participant in Milan COVID mission).

   2.   Dr. Víctor Guzmán (Cuba; veteran of three missions)

This report exposes how Cuba’s internationalist medical missions are governed by coercion, enforced through the “Internationalist Manual” and military-style regulations. Testimonies from Dr. Estévez detail indoctrination at the Loma Blanca training center and absurd prohibitions abroad, including bans on friendships, social media use, or relationships without authorization. Passports are withheld, and contracts give doctors only a fraction of what host governments pay.

Dr. Guzmán confirms that surveillance and paranoia are constant, describing being followed and monitored throughout his three missions. International bodies such as Human Rights Watch and the European Parliament have denounced the system as semi-slavery, and even the Bahamas withdrew from Cuban collaboration in response. Despite growing criticism, Cuba continues to expand its missions, prioritizing billions in revenue while sacrificing the rights and freedoms of its healthcare worker.

See full report here

Testimonies by:

1.  Dr. Gustavo Albarán (name withheld – likely fake for safety).

2.  Pinar del Río colleague (unnamed, victim reference).

3.  Archivo Cuba (exile organization documenting abuses).

This report, based on testimony from Dr. Gustavo Albarán, documents systemic coercion in Cuban medical missions. Doctors’ passports are confiscated abroad, salaries are drastically reduced, and surveillance is constant. Those who protest face punitive salary deductions, threats of family separation, or permanent bans from reentry.

The report situates these abuses in an international context: while some governments like the Bahamas moved to pay doctors directly, others such as Mexico continue to defend the contracts as legal. Exile groups like Archivo Cuba and an ICC lawsuit highlight mounting pressure to expose Cuba’s exploitation of its health professionals, which generated nearly $5 billion in 2022. Testimonies frame the system as “contemporary slavery,” with professionals used as bargaining chips for profit and diplomacy.

See full report here

Testimonies by:

1. Dr. Alejandro Palomino (testimony, former doctor turned small business owner).

2. Dr. Minerva Salcedo (victim of sexual coercion)

This report highlights two recurring coercive mechanisms in Cuban medical missions: political loyalty enforcement and sexual coercion. Political pressure is embedded in regulations requiring doctors to uphold Cuba’s official ideology, with penalties including expulsion from missions, permanent dismissal from the health sector, or long-term family separation for “deserters.”

Sexual coercion is reported as widespread, with 48% of defectors in Mexico citing it as their primary reason for abandoning missions. Testimonies include Dr. Palomino’s account of pervasive informant networks, and Dr. Minerva Salcedo’s case, where a mission coordinator pressured her to engage in sexual relations with a local political boss. Her refusal led to defamation and expulsion from the mission. The report concludes that such practices amount to modern slavery, combining political repression with gender-based exploitation, and that these abuses are systematically concealed by Cuban authorities and their allies.

See full report here

Testimonies by:

1.  Doctor from Holguín (anonymous, now in US) – testimony of indirect coercion.

2.  Nurse Mayelín (Holguín, last name withheld) – testimony of economic coercion.

3.  Jorge (neonatologist, now farmer) – testimony of political/party coercion.

The report questions whether participation in Cuban medical missions is voluntary or effectively mandatory. While officially framed as “voluntary solidarity,” testimonies reveal pervasive pressure through political, economic, and social coercion. Health workers face restrictive regulations (e.g., need for authorization for social activities, bans on free association), loss of professional opportunities if refusing, and sanctions under Cuba’s Penal Code for abandoning missions. UN Special Rapporteurs in 2019 warned that the conditions could amount to forced labor, citing excessive hours, restrictions on privacy, and threats. Testimonies from doctors and nurses indicate that “voluntariness” is a façade—many feel compelled by poverty, political pressure, or fear of reprisal. The report concludes that Cuban missions function as a straitjacket, blending economic exploitation, political control, and human rights violations, despite their humanitarian image.

See full report here  

Testimonies by:

1. Yurisel (medical psychologist, testimony).

2. Yumila (pharmacist on mission in Venezuela).

3. Lisandra (dentist, served in Bolivia).

4. César (general practitioner, returned from Venezuela).

The report documents how Cuban health personnel on missions abroad face deepening exploitation amid the island’s worsening economic crisis. Testimonies from pharmacists, dentists, and doctors illustrate how bonuses and stipends are increasingly devalued by inflation, leaving professionals with little benefit despite grueling sacrifices. Workers receive only about 20% of the salary paid by host countries, while 80% is confiscated by the Cuban government.

Rules regulating medical missions severely restrict freedoms of movement, association, and expression, while sanctions for disciplinary infractions include wage confiscation, expulsion, and return to Cuba with stigma. Those who abandon missions face an eight-year ban from returning to Cuba, effectively punishing their families. International organizations, including Human Rights Watch and UN Special Rapporteurs, have denounced the system as a form of forced labor, but the Cuban government denies all allegations, framing them as hostile propaganda.

See full report here   

Testimonies by:

1. Susana Antón – Granma journalist (state media).

2. Dr. Denis Derivet Thaureaux – quoted in Granma on IT program.

3. Dr. Miriam Escarcel – head of computerization at Carlos J. Finlay Hospital.

4. Claudia Sosa – IT technician, Santa Fe polyclinic.

5. Dr. Ramírez – deputy director, Santa Fe clinic; psychiatrist in training.

6. Dr. Celia Mansferrer – emergency room physician, Santa Fe clinic.

7. Yuniel – IT/statistics head, 28 de Enero polyclinic, Romerillo.

8. Dr. Mirurgia Martínez – deputy director, 28 de Enero polyclinic, party cadre.

The report analyzes the slow and troubled computerization of Cuba’s health sector, initially promoted in Granma (2019) with goals of digital medical records, telemedicine, and surveillance systems by 2030. While some hospitals (e.g., Carlos J. Finlay) have partial implementation of records, most local clinics lack infrastructure, training, or functioning equipment.

Testimonies from doctors and IT staff in Havana’s Santa Fe and Romerillo polyclinics reveal broken computers, outdated systems, unpaid leave for staff, and shortages so severe that doctors cut notebook pages for prescriptions. IT staff often work beyond their job descriptions, without pay, to prevent reporting delays. Leadership (e.g., Dr. Martínez) stresses the process as a Party directive but dismisses younger staff’s frustrations as impatience.

The piece highlights how digitalization is framed as modernization and efficiency but in reality reflects systemic neglect, underfunding, and political loyalty, with healthcare workers trapped in a system of scarcity and overwork.

See full report here  

Testimonies by:

1. Engineer Valton Tallapiedra – head of Computerization & Statistics, Manuel Fajardo Polyclinic.

2. Dr. Carla Villena – physician, with teleconsultation experience in Italy.

3. Maro Gainza Canberra – family doctor, Office 4 in Jaimanitas.

4. Dr. Danay Proenza – 65-year-old GP, unaware of digital medical records.

5. Dr. Llanio Navarro – Cuban doctor, wrote in a Spanish medical journal about digital medical records.

6. Tirso Cascarrieles – hospital worker, La Covadonga Hospital, Havana.

The report contrasts Cuba’s official narrative of progress in health sector computerization (digital medical records, teleconsultations) with the daily reality in local clinics, which remains primitive and dysfunctional.

At the Manuel Fajardo Polyclinic in Jaimanitas, Engineer Tallapiedra describes unreliable databases plagued by errors (duplicated IDs, invented names, missing COVID-19 data, exclusion of elite hospitals like CIMEQ). He dismisses teleconsultations and digital medical records as concepts that exist “on Google” but not in grassroots clinics.

Dr. Carla Villena recalls using teleconsultations in Italy, but stresses they do not exist in Cuba outside elite facilities for foreigners. Other Cuban doctors interviewed (Gainza, Proenza, Cascarrieles) confirm they have never seen functioning digital records or teleconsultations. They describe chaos: doctors writing prescriptions on notebook scraps, hospitals lacking syringes, IT staff without resources, and a healthcare system paralyzed by shortages.

The Ministry of Public Health insists Cuba is an “international power” in health computerization and publishes templates and guides for students, but in practice these serve only academic purposes, not real clinical use.

The article concludes that digital medical records and teleconsultations are unlikely under the current regime, as doctors are underpaid, demoralized, and overwhelmed. These innovations may only be feasible “when democracy and a constitutional order” return, allowing Cuban healthcare workers to function under normal conditions.

See full report here 

Testimonies by:

1. Vilma Cruz Ge (cataract patient, Santiago de Cuba).

2. Tania María Marine Pla (mother of Olek Omar Gutiérrez Marine, 7-year-old with dislocated hip).

3. Olek Omar Gutiérrez Marine (child patient).

4. Ezequiel Álvarez González (father).

5. Erika de la Caridad Álvarez Sarduy (daughter, pediatric brain tumor patient).

This report illustrates how Cuba’s collapsing health system leaves patients entirely dependent on donations, foreign aid, or family contributions for survival. Personal stories include:

• Vilma Cruz Ge, who regained sight only after relatives abroad sent surgical kits.

• Olek Omar Gutiérrez, a 7-year-old boy unable to walk due to a hip dislocation, whose mother had to seek supplies on the black market.

• Erika Álvarez Sarduy, a child with a brain tumor, whose father lists basic supplies (iodine, gloves, bandages, antibiotics) that the hospital lacks.

Examples highlight that donations from Djibouti, Spain, Italy, Japan, Switzerland, UNICEF, and other donors temporarily alleviate shortages but do not fix structural collapse. In 2023, Cuba received record international aid, yet ordinary Cubans still face desperation.

The report concludes that what was once portrayed as a “medical power” has become an unfathomable catastrophe, where the sick survive only if foreign donors, NGOs, or relatives abroad intervene. See full report here 

Testimonies by:

1. Manuel Posse (Alquízar resident, son of patient).

2. His 86-year-old mother (unnamed patient).

3. Human rights activist (unnamed) who intervened to secure an ambulance.

4. Dr. Lucía Venegas (mission participant in Guinea, 1964).

5. Her sister (also a retired doctor, unnamed).

6. Her children (former doctors, one became a taxi driver, another a grocer).

The report questions the Cuban government’s official claim of having 96,000 doctors and 85,000 nurses. Despite high numbers, ordinary Cubans face shortages of doctors, medicines, ambulances, and lab reagents. Testimony from Manuel Posse describes waiting two days for an ambulance for his 86-year-old mother, rescued only after a human rights activist intervened.

Retired doctor Lucía Venegas, who served abroad in the 1960s, reflects on how the “revolutionary dream” has withered. She questions official statistics, pointing out that many doctors are either:

• Sent on missions abroad,

• Deserting and emigrating, or

• Abandoning the profession due to extremely low salaries, turning instead to jobs as taxi drivers or grocers.

The report concludes that the medical exodus and systemic collapse contradict the government’s slogan of being a “Medical Power.” Instead, Cuba faces a healthcare crisis marked by neglect, shortages, and the professional disillusionment of its medical workforce.

See full report here  

Testimonies by:

1.  Dr. Dayli Coro (from Camagüey, testimony of coercion, exploitation, and danger during mission in Venezuela).

The report denounces Cuban medical missions as both a political propaganda tool and a major source of state revenue, despite functioning under conditions of exploitation. By 2024, nearly 49,000 Cuban collaborators were deployed in 63 countries.

Testimony from Dr. Dayli Coro (Camagüey) illustrates the reality: promised fair salaries and career advancement, she instead received only 6–15% of what host governments paid, while living in extreme danger in Venezuela’s Barrio Adentro program. She recounts being threatened by gangs at gunpoint, forced to treat injured fighters under duress, and even witnessing executions inside hospitals.

The report highlights the death toll of Cuban doctors abroad, including two kidnapped and killed in Kenya. Despite these abuses, the Cuban government glorifies its professionals as “Heroes in White Coats” and “Guardians of Human Virtue,” rhetoric that survivors and victims’ families find insulting. It concludes that while missions may appear prestigious or financially attractive to struggling Cuban doctors, in practice they combine exploitation, repression, and lethal risks—a stark contradiction to the humanitarian image promoted by Havana. 

See full report here  

Testimonies by:

1. Michael Cabrera – Director of the Central Unit for Medical Collaboration (UCCM), quoted in Granma.

2. Tania Saldívar – PhD in psychology, former mission doctor in Venezuela (testimony).

3. Dr. Esteban Salas – Havana hospital doctor, waiting for a mission abroad (testimony).

The report highlights how 2024 has become a record year for Cuban medical missions abroad, with 42,600 doctors deployed in 54 brigades, according to UCCM director Michael Cabrera. Official propaganda frames these missions as humanitarian solidarity and as financing Cuba’s national health system, but testimonies from returned doctors expose them as highly exploitative labor schemes.

• Historical context: Since 1963, Cuba has sent over 600,000 medical professionals to nearly 100 countries, turning medical collaboration into one of its most lucrative economic sectors.

• State narrative: Cabrera insists all revenues sustain Cuba’s health system.

• Reality (doctor testimonies):

  • Tania Saldívar (Venezuela mission, 2022) denounces blatant lies: despite billions earned, Cuban hospitals remain without syringes, IVs, X-ray machines, or even prescription paper.

  • Her husband, also a mission doctor, describes the same pattern of control, exploitation, and monitoring across countries. Both abandoned medicine after returning, shifting to private sector jobs (MSME, digital printing).

  • Dr. Esteban Salas (Havana hospital) longs for an overseas assignment just to escape the chaos of domestic hospitals, saying “I’m in!” to any mission.

While domestic healthcare collapses—with patients dying for lack of ambulances, beds, or medicines—the regime prioritizes signing new contracts abroad, treating doctors as a revenue-generating export commodity. For many health professionals, international missions represent both escape from Cuban reality and entry into another cycle of exploitation, confirming the paradox of Cuba’s “medical power.”

See full report here

Testimonies by:

1. Clara Martín – Mother, patient testimony (Havana hospital).

2. Esmerida – Mother, testimony about student consultations.

3. Caridad Montano – Mother from Romerillo, testimony of daughter treated with herbal remedies.

This report contrasts the export of Cuban doctors abroad with the absence of adequate medical care at home.

• Domestic testimonies:

  • Clara Martín brought her feverish child to a Havana hospital, only to find consultations run by students because the doctors were in Venezuela.

  • Esmerida criticized the paradox: Cuba exports skilled doctors while leaving children to be treated by students.

  • Caridad Montano’s three-year-old daughter was treated only with herbal teas and aloe vera, since local doctors were abroad and pharmacies lacked medicines.

• International expansion:

  • Dominica received new Cuban health collaborators in June 2024.

  • Angola: New hospital inaugurated in October 2024 with dozens of Cuban doctors; President Joa Lourenço praised the 16,500 Cuban doctors sent since 1975.

  • Mexico: Became the leading partner in 2024, signing contracts to import 3,800 more doctors, on top of 1,200 already present, completing 70% of staffing needs at 282 hospitals. Former President AMLO pushed the deal; Sheinbaum’s administration continues it.

• Criticism:

  • Prisoners Defenders (Madrid, 2022) denounced these missions as forced labor schemes, citing contractual conditions that violate international standards.

  • Meanwhile, Cuban citizens are left without access to qualified doctors, forced to rely on inexperienced graduates or folk remedies.

The central contradiction: while the Cuban government boasts of its global solidarity through medical brigades, the domestic population—especially children—suffers from a collapsed healthcare system, abandoned clinics, and student-run consultations. 

See full report here

Testimonies by:

1. Dr. Ariadna – returned from Peru, working at 28 de Enero Polyclinic.

2. Dr. Roberto Silva – from Isle of Youth, returned from Guatemala mission.

The article follows two Cuban doctors (Ariadna and Roberto Silva) who returned from missions abroad and found themselves back in the harsh Cuban reality: blackouts, lack of basic medicines, and dilapidated facilities.

• Dr. Ariadna (Peru, 14 months): described the mission as a respite from Cuba’s “lack of everything.” In Peru, doctors could strike and win demands—unlike in Cuba. Back home, she must tell patients to buy essential medications like Enalapril via WhatsApp black markets.

• Dr. Roberto Silva (Guatemala, 7 months): took the mission to finance home repairs, accepting the separation from his family and the “almost military” discipline of brigades. Now, he works in impoverished Mal País, writing prescriptions on notebook scraps, without power after Hurricane Rafael. He admits he has already signed up for another mission, viewing it as the only way to “catch another breath.”

The report underscores how missions abroad provide temporary relief for Cuban doctors, but expose them to exploitation and semi-slavery conditions. Upon return, they face shortages, natural disasters, and systemic collapse, often leaving them desperate to sign up for yet another mission abroad.

See full report here

Testimonies by:

1. Carlos Fernández – general practitioner, recalls a Venezuelan mission.

2. Unidentified mother in Bayamo – child with tumor, went to Havana with activist.

The report details the collapse of Cuba’s public healthcare system, worsened by the mass exodus of medical professionals and the export of doctors abroad under exploitative conditions. ONEI statistics show 13,303 fewer doctors in 2023 compared to 2022, with Comprehensive General Medicine hit hardest. Patients report closed offices, lack of home visits, and corruption where access to care requires bribes or gifts. Doctors describe nightmarish conditions during missions in rural Venezuela and highlight the system of favoritism for better-paid postings. Meanwhile, patients—including children with severe tumors—are left untreated in Cuba. Hospitals and pharmacies lack medicines, equipment, and supplies. The narrative of humanitarian missions is shown to be false, replaced by an export-for-profit scheme that violates labor rights and undermines the right to health for ordinary Cubans.

See full report here

Testimonies by:

1. Dr. Marta Álvarez – Neurologist in Havana (overworked, frustrated by lack of resources).

2. Nurse Roberto Hernández – Cuban nurse in Angola (well-equipped hospital but feels exploited and isolated).

3. Dr. Yaquelin – Emergency doctor in Cienfuegos (overwhelmed by shortages and staff exodus).

4. Nurse Fernando – Assists Yaquelin, highlighting chronic understaffing.

5. Yolanda – Yaquelin’s sister, also a doctor, who emigrated to Spain.

This report contrasts two realities: doctors like Marta Álvarez, who struggle in underfunded Cuban hospitals with crumbling infrastructure and shortages, and nurses like Roberto Hernández, who work abroad under restrictive contracts. The paradox: while Cuba exports thousands of professionals to earn foreign currency, its own system collapses due to lack of investment (only ~2% of budget vs. 30% for tourism) and massive staff losses (12,000 doctors lost in 2022–23).

• Dr. Yaquelin and nurse Fernando in Cienfuegos illustrate the daily overload—treating multiple patients simultaneously with minimal supplies.

• Statistical data (ONEI) confirm the exodus: from 312,409 health staff in 2022 to 281,098 in 2023.

• Dentists also fell by 3,246 in one year.

• Many professionals emigrate (Yolanda to Spain) or change professions for better pay.
  The result is long waits, poor care, reliance on students instead of doctors, and rising patient dissatisfaction. The narrative frames Cuba’s export of medical talent as a form of state-sanctioned exploitation, leaving domestic healthcare in collapse.

See full report here

Testimonies by:

1. Félix Hernández Rangel – General Practitioner (Venezuela 2016–2019; Haiti 2019–2020).

2. Odalis Rodríguez – Nurse (Venezuela 2017–2020).

3. Alcides Ramírez García – Physiotherapist (Venezuela 2018–2021).

4. Yaritza Quiala Ferrer – Physician (Venezuela 2019–2022).

5. Sixnali (Signali) Hernández González – Ophthalmologist (Venezuela 2016–2019).

The five testimonies presented in Bogotá reveal a coordinated, state-sponsored system of coercion disguised as humanitarian aid.

• Félix Hernández was stripped of documents and forced to meet quotas “belonging to the Revolution.”

• Odalis Rodríguez was ordered to invent patients and falsify records while facing gender discrimination.

• Alcides Ramírez endured 16-hour days, confiscated pay, and threats of eight-year family separation.

• Yaritza Quiala lived under total censorship and gender-based control—“I forgot the sound of my own voice.”

• Signali Hernández described corruption, surveillance, and extortion within the mission network, escaping “the moment I lost everything.”

All five now live in Colombia under precarious temporary protection, seeking legal regularization, degree revalidation, and recognition as victims of state-imposed trafficking.
Their consistent narratives align with patterns documented in previous OCLEP field reports, strengthening evidence that Cuba’s medical missions constitute forced labor and human trafficking under international law.

See Conference Report here

See YouTube Broadcast here

Testimonies by:

1. Andrés Morales – Orthopedic and Trauma Specialist.

2. Yanisleidy Collazo – Licensed Nurse.

3. Janiel Hernández Acosta – Health Technology Specialist.

Testimonies from the Santa Marta conference depict the economic manipulation and psychological coercion behind Cuba’s export of medical labor.

·       Andrés Morales earned only 20 USD per month in Cuba, faced confiscated passport and falsified statistics orders; fled seeking dignity and professional recognition.

·       Yanisleidy Collazo was promised “17 million pesos” but effectively paid ≈ 3 USD, deprived of food rations, and forced to forge medical reports.

• Janiel Hernández Acosta was reassigned from technology work to fabricating hospital data for four institutions—“reporting patients that never existed.”

All three survivors crossed into Colombia irregularly and now face precarious legal status and professional exclusion. Their experiences reinforce a documented pattern of state-driven forced labor and trafficking, evidencing violations of multiple international labor and human-rights conventions

See Conference Report here

See videorecord with transcript here

Testimonies by:

1. Rosalía Gómez López – Optometrist, missions 2014–2016, 2018–2021, 2023.

2. Eslinda (“Linda”) Yonarca – Nurse, missions 2015–2017 and 2019.

3. Arnoldo Pérez – General medicine and intensive-care specialist, mission 2022 (onward).

Three survivor testimonies presented at the Barranquilla Conference expose a state-organized system of coercive labor disguised as international medical aid.

·       Rosalía Gómez López describes working under fabricated statistics and social-media propaganda mandates that turned humanitarian service into digital servitude.

·       Eslinda Yonarca recounts fatal neglect within Venezuelan clinics and a 19-hour escape hidden in a bus luggage compartment—illustrating both physical and legal entrapment.

·       Arnoldo Pérez details fabricated performance targets, wage theft, and squalid living conditions that reduced patients to “numbers.”

All three remain in Colombia on precarious six-month salvoconducto permits, seeking legal status, degree revalidation, and protection from reprisals.
Their accounts corroborate consistent patterns previously documented in other OCLEP field reports—confirming that Cuba’s medical missions constitute a transnational forced-labor and human-trafficking scheme with systemic violations of international law.   See Conference Report here  

See YouTube broadcast here 

Testimonies by:

·   Dr. Aleyda Hernández (former mission member, Saint Lucia; real or verified name used publicly).

·   Dr. Roberto Hernández (pseudonym)

This report delivers an evidence-based analysis of the paradox embedded in Cuba’s medical-brigade model — a system lauded for humanitarian outreach yet condemned for institutionalized coercion. Her account quantifies the magnitude of exploitation: doctors receiving only 10–25 % of international payments, the remainder seized by the state under pretexts of logistical support. First-hand testimonies reveal patterns of surveillance, repression, and family reprisals consistent with forced-labor definitions under ILO and Palermo standards.

The report exposes a network of international complicity, notably PAHO’s role in channeling funds and masking irregular transactions, while some Caribbean governments begin reassessing their participation. Ávila frames the central dilemma: how to preserve global access to essential healthcare while ending the systematic abuse of Cuban professionals. Her conclusion calls for a transparent, rights-based reform of the medical-mission model, asserting that “true solidarity cannot rest on the violation of dignity.”

See full report here  

Testimonies by:

·   Dr. Rosa Suárez del Diezmero (testimony – changed name).

·   Dr. Sara Arrate (testimony – changed name).

·   Dr. Alexander Jesús Figueredo Izaguirre (real name, recognized public figure and dissident physician).

This investigation reinforced by both journalistic sources and survivor testimonies, exposes Cuba’s medical brigades as a state-controlled mechanism for foreign-currency extraction. The testimonies of Dr. Suárez del Diezmero, Dr. Arrate, and Dr. Alexander reveal a consistent pattern: deceitful recruitment, confiscated documents, heavy surveillance, family reprisals, and the confiscation of up to 90 % of earned income.

Statistical data cited from Prisoners Defenders confirm systemic coercion — 91 % of participants monitored by state agents, 89 % deployed without assignment details, and 57 % feeling compelled to serve. The account of Dr. Alexander Figueredo Izaguirre illustrates the extreme psychological and physical toll of repression, flight, and exile.

Correa concludes that Cuba’s public-health sector, once a symbol of pride, now sustains itself by exporting human labor under coercive conditions while domestic healthcare collapses. The report offers compelling evidence of state-organized forced labor and human trafficking, where both doctors and citizens at home suffer the human cost of a revenue-driven system.

Testimonies by:

·   Dr. Carlos Alexis Valdivia (former mission participant, escaped from Venezuela in 2018; now residing in Brazil).

·   Dr. Catherine Vilato (author of Magicians in White Coats: The Reality of a Cuban Doctor).

·   Dr. Octavio Benítez (commentator).

·   Dr. Sanders Orjuela (commentator).

This report presents a poignant human-centered narrative on the exploitation of Cuban healthcare professionals, combining personal testimonies and expert commentary. The case of Dr. Carlos Alexis Valdivia, who fled a Venezuelan mission in 2018, epitomizes the systemic coercion faced by Cuban medical workers — silenced, underpaid, and stripped of dignity. The testimonies of Dr. Catherine Vilato, Dr. Octavio Benítez, and Dr. Sanders Orjuela reinforce the conclusion that Cuba’s “internationalist” missions serve not humanitarian ends but a state apparatus of enrichment and propaganda.

The article underscores that while Cuba profits from one of its most lucrative exports — medical services — its domestic healthcare system collapses into scarcity and neglect. It highlights the moral contradiction between the regime’s global image of altruism and the lived experience of doctors treated as commodities. Figueredo’s narrative frames the export of medical labor as a violation of fundamental human rights and a sustained system of state-organized forced labor cloaked in revolutionary rhetoric 

See full report here   

Testimonies by:

1. Dr. Lidia Cabrera (testimony – pediatric specialist)

2. Dr. Luis Saldívar (testimony – former MINSAP doctor, resigned)

3. Dr. Juvencio Velásquez (commentator, Guantánamo / Havana)

The report merges statistical evidence from Cuban Prisoners Defenders (2023) with first-person testimonies to expose a pattern of coercion and economic exploitation within Cuba’s medical-brigade system. The testimonies of Dr. Lidia Cabrera, Dr. Luis Saldívar, and Dr. Juvencio Velásquez illustrate how doctors are silenced, surveilled, and deprived of most of their earnings—receiving only 10–25 % of the salaries negotiated between states.

Through vivid accounts of harassment by State Security, confinement abroad, and the collapse of Cuba’s domestic health services, the report portrays a profession transformed into an instrument of state profit and repression. Aguilera concludes that behind the rhetoric of “solidarity with the peoples of the world” lies a structure of institutionalized forced labor, sustained by fear and poverty, where even those who heal are denied their own basic human rights.

See full report here  

Testimonies by:

·   Mario Cafasqui Benavides (physiotherapist, mission survivor).

·   Dr. Benedicto Carratalá Pumariega (physician, commentator on ethics).

·   Dr. Medardo Sabaneta Morales (testimony, Ciego de Ávila; former participant in Venezuela).

·   Dr. Miguel Toirac Centella (testimony, Venezuela mission participant).

The report exposes the Cuban medical-brigade apparatus as a tightly controlled system of political and economic subjugation. Through testimonies of doctors such as Cafasqui Benavides, Sabaneta Morales, and Toirac Centella, it documents how Resolution 168/2010 institutionalizes behavioral surveillance, curfews, and moral restrictions — even regulating personal relationships and social interactions. The testimonies reveal a chilling pattern of coercion: falsified patient data, manipulation of statistics, and the use of expired medicines to sustain fabricated performance quotas. Doctors describe living under conditions akin to imprisonment, with 90-hour weeks, delayed pay, and fear of punishment for dissent. The report portrays the Cuban state as a “puppeteer” orchestrating both economic gain and ideological control through the medical-brigade system.

Vidal concludes that Cuba’s export of medical services represents not international solidarity but a hybrid system of forced labor and moral coercion, where healthcare professionals are transformed into tools of propaganda and revenue generation, stripped of autonomy, ethics, and dignity. 

  See full report here  

Testimonies by:

·        Dr. Julio Carlos Mendelayé – Cuban doctor, former medical brigades member.

·        Santa María de La Gracia – Cuban doctor, spouse of Julio Carlos.

·        Dr. Pedro Arrate – Primary care doctor in Havana.

·        Dr. Plinio Vásquez – Doctor from Contramaestre, Santiago de Cuba.

This report examines the continuing pattern of labor exploitation within Cuba’s international medical brigades, framed through testimonies of Cuban doctors who worked in Brazil and Venezuela. The narrative highlights a recent surge of interest among Cuban citizens in foreign labor opportunities—such as construction jobs in Brazil—due to the country’s extreme economic crisis. Experts note that these agreements replicate the same coercive labor model long used in medical missions: strict disciplinary regulations, punitive sanctions, and severe wage expropriation. Testimonies from doctors describe the systematic confiscation of passports upon arrival, individual intimidation sessions, extensive lists of prohibitions, and the retention of approximately 75% of their salaries by Cuban authorities.

Doctors recount living under constant fear of sanctions for minor infractions, forced ideological compliance, surveillance, and pressure to perform excessive overtime. The missions are portrayed as a highly profitable business for the Cuban government—generating more than USD 7.1 billion in 2022—while domestic healthcare deteriorates, clinics close, and medical personnel leave the profession. Former brigade members refer to themselves as “white-coat slaves,” emphasizing the contradiction between rhetoric of international solidarity and the reality of coercive labor. The report concludes that the totalitarian structure governing Cuba has built a sophisticated system for extracting maximum economic value from health workers while masking exploitation behind humanitarian discourse.

See full report here  

Testimonies by:

1. 1. 1. Dr. Roberto Fernández – cardiologist, now in Miami.

      2. Dra. Elsa Pérez – pediatrician from Holguín.

      3. Dr. Omar Fernández – Havana physician.

      4. Enfermera Yunielys Aguilera – nurse who served in Venezuela.

      5. Dr. Osmel Ramírez – physician monitored in Venezuela.

      6. Dra. María Caridad López – physician in Brazil.

      7. Dr. Luis Manuel – physician and activist.

This report reconstructs the lived experience of Cuban medical professionals as they navigate coercive recruitment, forced labor conditions abroad, and traumatic exile. Testimonies illustrate that rejecting a mission is not a neutral choice but a trigger for punitive consequences: reassignment to remote areas, salary cuts, denial of professional advancement, surveillance by Party and union authorities, and, in severe cases, revocation of medical credentials. Physicians describe being economically trapped—earning the equivalent of USD 40 per month in a country with hyperinflation—while the State charges foreign governments USD 3,500–10,000 monthly per doctor. The resulting social ostracism, guilt manipulation, and ideological pressure reveal the coercive nature of “internationalist duty.”

Once deployed, doctors face systematic rights violations: confiscation of passports upon arrival; strict surveillance in “mission houses”; prohibitions on contact with local civic actors; and punishing workloads of up to 16 hours per day. Many work without adequate medical supplies, witnessing preventable deaths. Their salaries undergo extreme expropriation—75% to 91% retained by the Cuban State depending on the country. To escape, many resort to clandestine routes, forged documents, or assistance from diaspora networks. Exile often brings new hardships: professional relicensing, trauma, and chronic guilt. As one doctor states, “solidarity cannot be built on exploitation.” The report concludes that Cuban medical missions, though framed as humanitarian contributions, operate through coercion, surveillance, financial exploitation, and ideological control—constituting a clear form of modern slavery.

See full report here  

Testimonies by:

1. 1. Anonymous Cuban woman (Europe, 1990s).

   2. Anonymous male maritime officer (Cuba).

   3. Anonymous Cuban prisoners (forced prison labor).

   4. Anonymous Cuban youth trafficked to Russia (for military use).

This report expands the focus of modern slavery beyond medical missions, demonstrating that a broad range of Cuban workers—artists, dancers, models, technicians, mariners, and even prisoners—face coercive labor practices facilitated or tolerated by the Cuban government. It documents widespread patterns of deception by foreign recruiters, confiscation of passports, surveillance by State Security (SE), wage theft, restricted movement, and reprisals targeting families in Cuba. Testimonies describe workers trapped abroad in exploitative schemes, isolated, monitored, and deprived of the ability to return home without punishment. The State’s public discourse of “zero tolerance for trafficking” is contradicted by a consistent absence of protection, protocols, or assistance for victimized Cubans who attempt to seek help.

The report highlights severe cases of forced labor at sea, in professional exchanges abroad, in State-controlled cultural delegations, and inside Cuban prisons, where inmates are compelled to work under dangerous conditions for minimal compensation. It also references the recent scandal involving hundreds of Cuban youths trafficked to Russia under false promises of construction jobs but ultimately sent to the front lines of the Russia–Ukraine war—some killed, others imprisoned. Across all testimonies, the common thread is the Cuban State’s systemic manipulation and exploitation of its citizens, prioritizing foreign revenue and political control over worker welfare. These practices mirror multiple internationally recognized indicators of forced labor and demonstrate that modern slavery for Cubans extends far beyond the health sector.

See full report here  

Testimonies by 26 exiled Cuban health professionals residing in Brazil provided testimonies in three organized meetings.

Between 23 and 25 November 2025, CFLCMM facilitated four structured consultations with 26 exiled Cuban health professionals residing in Brazil. Across diverse mission cohorts—including Mais Médicos and deployments in Venezuela—participants described consistent patterns of state-imposed forced labor: confiscation of passports, severe mobility restrictions, salary retention between 70% and 90%, ideological surveillance, threats of family reprisals, and contractual prohibitions on pregnancy, relationships, professional autonomy, or independent medical practice. Multiple witnesses also described indoctrination meetings, mandatory political participation, and situations of forced falsification of statistics. A subset of testimonies highlighted exploitation after leaving the official mission structure, especially in São Paulo, where irregular documentation exposes defectors to abusive intermediaries. Two cases of sexual coercion were reported, though participants noted these incidents are systematically underreported.

Beyond mission-related abuses, the meetings documented the current conditions of exiled Cuban professionals in Brazil: widespread underemployment, documentation instability, fear of deportation, and psychological distress stemming from prolonged family separation and political vulnerability. Survivors emphasized barriers to taking the Revalida exam, lack of access to healthcare and social protections, and persistent harassment by Cuban consular officials. Participants expressed strong interest in structured collaboration with CFLCMM and in forming a survivor-led professional and advocacy network. Additionally, one testimony described a forced-relocation route used against Cuban opposition members (Cuba → Nicaragua → Peru → Brazil), illustrating broader state-engineered mobility patterns relevant to trafficking analyses.

See full report here  

Testimonies by:

1. Luisa Tejeda – resident of Jaimanitas

2.  Dr. Elso Silva – Senior Specialist in Hygiene and Epidemiology, Municipal Directorate of Public Health (Playa)

3. Alcides Cobas – Delegate of People’s Power, District 71, Romerillo

4. Froilán Arencibia – Head of brigade, Arroyo Naranjo Community Services Company

5. Dr. Pedro Serguei Adamo – Deputy Head, Hygiene and Epidemiology Section, Provincial Health Directorate (Havana)

6.  Eladio Lara – street vendor, Santa Fe

7. Casilda Téllez – resident, Eléctrico neighborhood

8. Manrique Fis – worker at Antillana de Acero

This report documents the collapse of urban sanitation and public-health safeguards in Havana, where uncollected garbage, sewage overflows, and chronic power and water outages have fueled widespread arbovirus outbreaks, including dengue and chikungunya. Testimonies from residents, local officials, and public-health specialists describe how the state’s failure to provide basic services disproportionately affects elderly and marginalized populations, many of whom lack pensions or access to medicine. The report highlights the emergence of informal, pay-to-access sanitation practices, despite sanitation being a public service, illustrating economic coercion rooted in systemic neglect. Comparative epidemiological references underscore that while arboviruses are global, Cuba’s deteriorated hygiene infrastructure and secrecy around mortality figures exacerbate preventable suffering. The findings frame public-service collapse as a structural driver of vulnerability and coercive living conditions, consistent with broader patterns of state-enabled exploitation documented by OCLEP.

See full report here 

Testimonies by:

1. Manuela Gainza – resident, Jaimanitas

2. Pedro Velis – resident, Jaimanitas

3. Dr. María Eugenia Toledo Romaní – researcher, Pedro Kourí Institute of Tropical Medicine

4. Juana Carranza – resident, Jaimanitas

5. Ezequiel Laborde – elderly raw-materials collector

6. Carlos Vela – elderly raw-materials collector

7. Isolina Carreras – official, Playa Municipal Administration

8. Dioscórides Gainza – resident, Jaimanitas

9. Abelardo Valdés Rama – cultural promoter, dengue survivor

10. Zoila Saldívar Carrazana – resident, Primera Street

11. Carlos Puebla – glass factory worker, La Lisa

12. Miguel Mata – public services worker, La Corbata, La Lisa

13. Elisa Márquez – resident, Cerro municipality

14. Elena Casio – resident, Santa Fe

15. Joaquín Bustamante – security guard, Manuel Piti Fajardo polyclinic

16. Ernesto Tejeda – truck driver, Marianao community services company

17. Lázaro Drullet – sanitation worker

This report documents the escalation of arboviral diseases across Havana amid systemic sanitation failures, insufficient fumigation capacity, and the absence of medicines and diagnostic tools. Through testimonies from residents, workers, and health professionals, it illustrates how elderly and low-income populations bear the brunt of the epidemic, often resorting to informal labor and payments to secure basic services and documentation. The narrative reveals the informal monetization of medical certificates and the coercive mobilization of sanitation workers under urgent administrative orders, reflecting abusive labor practices linked to state incapacity. Comparative references to regional and global outbreaks underscore that while arboviruses are not unique to Cuba, the country’s structural neglect, secrecy, and erosion of public services intensify vulnerability and preventable suffering.

See full report here       

Testimonies by:

1. Nidia Vázquez – resident, Chibás neighborhood

2. Reinier – dengue patient (minor)

3. José Macuto – former head of anti-vector brigade, Old Havana

4. Bali Mosqueda – glass factory worker, La Lisa

5. Clara Serrat – laboratory technician, Manuel Piti Fajardo Polyclinic

6. Dr. Judith de la Torre Sieres – Gynecology and Obstetrics specialist

This report documents the deepening public-health collapse across Havana and surrounding municipalities amid a nationwide arbovirus epidemic. Testimonies from residents, medical specialists, and sanitation officials reveal a convergence of failures: chronic garbage accumulation, lack of potable water, ineffective vector control, medicine shortages, and prolonged blackouts that facilitate disease transmission. Families are forced into improvised coping mechanisms, illegal water connections, informal medicine markets, and unsafe hygiene practices, while health workers operate under emergency conditions with insufficient resources. The report highlights gender-specific health impacts linked to contaminated water and inadequate sanitation. Overall, the findings portray a structural health crisis driven by systemic neglect, with coercive living and working conditions that deepen vulnerability and expose the population to preventable harm.

See full report here      

Testimonies by:

1. Yirmara Torres Hernández – independent journalist (Matanzas)

2. Hansel – resident of Havana (testimony)

3. Silva – resident of Pinar del Río (testimony)

4. Claudia Gómez – resident of Cerro municipality, Havana

This report documents a nationwide public-health emergency in Cuba driven by the collapse of sanitation, water supply, and healthcare infrastructure. Accumulated garbage, prolonged blackouts, medicine shortages, and mass emigration of health professionals have created ideal conditions for explosive outbreaks of arboviral diseases, including dengue, chikungunya, and Oropouche. Testimonies from residents, journalists, and healthcare workers describe widespread avoidance of hospitals due to lack of diagnostics and treatment, reliance on self-medication, and disproportionate mortality among children and the elderly. The report situates the crisis within a longer trajectory of structural deterioration exacerbated by the export of medical personnel through international missions, framing current conditions as a severe abuse of vulnerability that heightens forced-labor risk and undermines fundamental rights to health, life, and dignified working conditions.

See full report here

Testimonies by:

1. Marta López – resident of Centro Habana

2. Marcial – resident of San Miguel del Padrón

3. Unnamed epidemiologist – quoted anonymously due to fear of workplace retaliation

This field report documents a silent but deepening public-health emergency in Cuba driven by the collapse of sanitation, waste management, and access to potable water. In densely populated urban neighborhoods, garbage collection cycles lasting weeks, open sewage, and chronic power outages have created ideal conditions for the spread of respiratory, gastrointestinal, and vector-borne diseases, including dengue, chikungunya, and sporadic Zika cases. Testimonies from residents and healthcare workers describe irregular fumigation, symbolic vector-control efforts, and pressure on medical staff to minimize diagnoses through generic classifications. The report highlights the disproportionate impact on children and the elderly, rising household expenditures on black-market medicines, and normalization of illness as a coping mechanism. Overall, the findings frame the crisis as a structural abuse of vulnerability that undermines fundamental rights to health, water, and dignified living conditions.

See full report here 

Testimonies by:

1. María Elena Jiménez – resident of El Fanguito, Havana

2. Roberto Vera – retired carpenter, El Fanguito

3. Dr. Raúl Méndez – retired epidemiologist, former MINSAP official

4. Yanelis Torres – grandmother of pediatric dengue patient

5. Jorge Luis Pérez – transport worker, Camagüey

This field report documents an island-wide public-health emergency in Cuba rooted in the collapse of sanitation, water infrastructure, housing, and healthcare services. Accumulated garbage, open sewage, power outages, and loss of potable water have created optimal conditions for the spread of dengue, chikungunya, Zika, cholera-like syndromes, and acute gastroenteritis, particularly among children and the elderly. Community testimonies and accounts from medical professionals reveal routine under-diagnosis, lack of reagents and medicines, hospital overcrowding, and pressure to conceal outbreaks through generic diagnoses. The report provides detailed evidence from marginal neighborhoods and slums across multiple provinces, illustrating how poverty, forced “normality,” and censorship amplify vulnerability and deepen structural coercion. Overall, the findings frame the health crisis as a systemic abuse of vulnerability that heightens forced-labor risk, undermines fundamental rights, and accelerates social disintegration and emigration.

See full report here

This investigative report documents the irregular migration route of Cuban medical professionals who abandon state missions in Venezuela and transit through Táchira into Colombia. Through the testimony of a former mission member, the article details systemic wage expropriation, document control, surveillance, and threats of repatriation that characterize Cuban medical missions, as well as the risks associated with desertion, including extortion by armed actors at informal border crossings. Once in Colombia, former mission members face legal limbo, discrimination in housing and employment, and limited access to regularization or refugee protection. The report situates individual testimonies within broader regional migration trends and corroborates findings by international organizations that Cuban medical missions reproduce indicators of forced labor and modern slavery, with long-term consequences extending beyond the point of exit from the mission.

See full publication here (external source)  

This report documents systemic, state-orchestrated forced labor in Cuba, spanning prison labor, labor export schemes, and international medical missions. Drawing on NGO findings and a detailed first-person testimony from a Cuban doctor, it demonstrates how coercion, deception, movement restriction, wage confiscation, and intimidation are embedded into official Cuban labor practices. The case of Cuban doctors in Italy illustrates the transnational dimension of these abuses, implicating foreign institutional actors as facilitators. The evidence aligns comprehensively with all ILO forced labor indicators and meets the legal threshold for trafficking in persons under international law.

See full report here 

This report argues that Cuba’s state-run medical missions systemically violates ILO labor-rights standards and functions as modern exploitation. It includes direct testimony from Dr. Julio Cuevas (Brazil mission) describing oppressive working conditions and coercive deployment, and from Dr. Mariela Echemendía describing surveillance, harassment, curfews, and sanctions for resistance. It also references international concern, including a late-2023 communication by the UN Special Rapporteur on contemporary forms of slavery, highlighting persistent concerns regarding Cuban workers in countries such as Italy, Qatar, and Spain. The report additionally alleges mission-director coercion to falsify medical records and misrepresent services—portrayed as both exploitative control and a risk to host-country health systems—while recommending host-government inspections, passport control protections, and wage transparency safeguards

See full report here 

This report documents the systemic exploitation of Cuban medical professionals, particularly through missions in Venezuela, highlighting how economic coercion, deceptive recruitment, passport confiscation, wage appropriation, and punitive migration laws convert ostensibly “voluntary” participation into forced labor. Drawing on multiple named testimonies, it shows how doctors endure extreme working hours, degrading living conditions, surveillance, and prolonged family separation. The report situates these abuses within Cuba’s broader labor-export model—expanded during COVID-19—and concludes that the program constitutes modern slavery and trafficking for forced labor under international law.

See full report here 

This report documents systematic economic exploitation within Cuban medical missions, focusing on extreme wage withholding, deceptive contracting, and abusive living and working conditions. Drawing on collective testimony from Cuban doctors in Angola, it shows how up to 95% of salaries are confiscated, payments are unilaterally converted into inaccessible forms, and professionals are deployed to remote, high-risk environments without adequate protections. The involvement of military-linked entities such as ANTEX and GAESA underscores the institutionalized nature of the exploitation, reinforcing the assessment that Cuban medical missions function as a state-run forced-labor and trafficking scheme under international law.

See full report here 

This report frames Cuban medical personnel abroad as hostages of a coercive state labor-export system, asserting that all 11 ILO forced-labor indicators are routinely applied across missions. It highlights recent developments—termination of cooperation in Antigua and Barbuda, collective resistance in Angola, and an escalating crisis in Venezuela where doctors are reportedly hiding after abandoning posts due to fear of reprisals. Drawing on independent media testimony, the report underscores intensifying insecurity, misinformation, and intimidation, and documents appeals for urgent international protection. Collectively, these developments reinforce the characterization of Cuban medical missions as a form of state-enabled forced labor and trafficking under international law.

See full report here 

This report examines Cuban medical mission contracts as instruments of coercion rather than protection, documenting systematic opacity, forced signing, lack of worker copies, and punitive consequences for refusal or abandonment. Drawing on named testimony, UN communications, U.S. government reporting, and ILO conventions, it argues that Cuban practices nullify any claim of voluntary participation. The analysis highlights violations of core labor rights—including freedom of association, collective bargaining, and protection from harassment—and concludes that Cuban medical missions operate in direct contradiction to international labor standards, raising fundamental questions for host states about ethical medical cooperation.

See full report here

Testimonies from Cuban health professionals

• No new individual Cuban doctors named directly in this report
  (relies on aggregated testimonies and previously documented cases)

Testimonies from other people

• Unnamed Cuban sailor (Swissinfo case, used illustratively to show parallel wage-withholding practices)

Brief Summary

This report identifies salary withholding and financial control as the economic core of Cuba’s medical-mission system. Drawing on NGO investigations and media reporting, it documents that 75–95% of doctors’ salaries paid by host countries are systematically retained by the Cuban state or its intermediaries, leaving workers economically dependent and legally trapped. The report frames this practice as a direct violation of ILO forced-labor conventions and the Palermo Protocol, arguing that wage confiscation—combined with restrictions on direct payment, contract negotiation, and alternative employment—constitutes a form of state-run economic coercion. It further situates Cuban medical missions within a growing global debate on supply-chain accountability, sanctions, and transnational justice for state-enabled forced labor.

See full report here

This ACL Brazil report links forced labor in Cuban medical missions abroad with the systemic collapse of healthcare inside Cuba. Drawing on testimonies from Cuban doctors deployed in Venezuela and patients within Cuba, it documents coercive control, extreme wage confiscation, intimidation, surveillance, and threats against families. The report presents medical missions as Cuba’s largest source of foreign currency—generating an estimated USD 6–11 billion annually—while demonstrating that only 2–5% of that income is reinvested in domestic healthcare infrastructure. As missions contract following Venezuela’s political shift, Cuba’s health system deterioration accelerates, revealing that medical exports function primarily as an economic and political instrument rather than a public-health strategy.

See full report here

This report presents testimonies from Cuban medical professionals who defected from missions in Venezuela and now reside in Brazil and Mexico. The accounts describe a system of strict surveillance and behavioral control imposed by mission authorities, including limitations on movement, curfews, and confiscation of passports. Doctors report that approximately 75% of their salaries are withheld by the Cuban state and that abandoning a mission can result in prison sentences or long-term bans on returning to Cuba. Testimonies also describe intimidation and retaliation affecting family members who remain on the island. The report frames these practices as part of a coercive system of labor control associated with Cuban international medical missions.

1)      Dr. Cecilia Salazar: Escaped from a Cuban medical mission in Venezuela and currently resides in Brazil. She describes strict surveillance and control by Cuban mission leadership, reports restrictions on movement, allowing travel only between residence and workplace, describes high levels of psychological stress caused by surveillance and restriction. According to her Cuban personnel monitored doctors’ activities and threatened them with expulsion from the mission if rules were violated.

2)      Dr. Mario Dueñas: Defected from a Cuban mission in Venezuela and now lives in Mexico. He reports passport confiscation, curfews, and constant surveillance, describes feeling trapped and isolated during the mission, states that doctors who abandon missions face eight-year bans from returning to Cuba or imprisonment. After his defection, his family in Cuba reportedly faced intimidation and social pressure.

See full report here

This report presents testimony from Cuban physician Carlos Mendieta Villafañe regarding his participation in a Cuban medical brigade deployed to Andorra during the COVID-19 pandemic. According to his account, Cuban authorities confiscated the passports of brigade members upon arrival and imposed strict regulations governing personal conduct, including romantic relationships and social interactions. The doctor reports being forced to terminate a relationship with a local resident after being threatened with disciplinary consequences by mission authorities. The testimony also suggests that refusal to participate in future missions can negatively affect a doctor’s professional record within the Cuban healthcare system. The account highlights the intrusive control exercised over Cuban medical personnel during overseas assignments.

See full report here

This report presents an analytical overview of the structural mechanisms governing Cuban international medical missions. It describes a system of control combining salary withholding, surveillance, restrictions on movement, and disciplinary regulations affecting both professional and personal life. Testimonies from medical professionals deployed in Africa, Brazil, Mexico, Venezuela, and other countries illustrate how family separation, confiscation of identity documents, and threats of punishment are used as tools of control. The report also highlights the economic dimension of the system, estimating that medical missions generate approximately $4.9 billion annually for the Cuban state while a large portion of doctors’ salaries is retained. These practices are presented as part of a broader framework that international observers have associated with indicators of forced labor.

Testimonies from Cuban Health Professionals

1)      Carmen (gynecologist): Served six years in Africa. She states that family separation was used as a mechanism of control, forcing doctors to return to Cuba in order to reunite with children.

2)  Ana (doctor stationed in Mexico): Describes uncertainty regarding salary deposits in accounts in Cuba. She reports that a portion of wages is withheld and accessible only after successful completion of the mission.

3)  Dr. Tatiana Carballo: Served in Brazil. She reports pervasive surveillance, including monitoring of relationships, friendships, and personal interactions. She describes lack of privacy due to shared housing and internal reporting networks among brigade members.

4)  Osmani (medical collaborator): Witnessed a colleague publicly reprimanded and humiliated for visiting a shopping mall and complaining about mission conditions.

5)  Dr. Dayli Coro: Assigned to work in a gang-controlled neighborhood in Venezuela. He suspended after refusing to manipulate clinical data for official statistics.

6)  Ramona Matos Rodríguez: Former medical collaborator who defected after missions in Bolivia and Brazil. She described a climate of fear among medical personnel participating in international missions.

See full report here

This report examines the mechanisms of surveillance, coercion, and punishment associated with Cuban international medical missions. Based on testimonies from multiple healthcare professionals who participated in missions in Bolivia, Venezuela, Central America, and other regions, the report describes a system characterized by passport confiscation, strict curfews, monitoring of personal relationships, and internal reporting networks among brigade members. Doctors report pressure to falsify medical statistics and political manipulation of healthcare delivery in some contexts. Family separation is identified as a central mechanism of control, with children and spouses remaining in Cuba serving as leverage to ensure the return of mission participants. The report also describes punitive measures applied to professionals who abandon missions, including prison sentences, long-term bans from returning to Cuba, and barriers to professional practice abroad.

Testimonies from Cuban Health Professionals

1)      Dr. Eduardo (pediatrician): Returned to Cuba after a three-year mission in Bolivia. He reports severe family disruption, with his child no longer recognizing him as a parent after prolonged separation.

2)      Patricia (dentist): Assigned to a mission in the Caribbean region. She required to report details about a romantic relationship with a local individual and forced to terminate the relationship under threat of disciplinary measures.

3)      Gustavo (cardiologist): Served in Venezuela. He describes digital surveillance, including inspections of personal phones and messages.

4)      Reinaldo (surgeon): reports existence of informant networks among colleagues, encouraging internal reporting of dissent.

5)      Yolanda (general practitioner): Served in Central America. She reports pressure to falsify patient statistics to meet required quotas of consultations.

6)  Dr. Fidel Cruz: Reports that doctors were pressured to condition medical services on political loyalty, including encouraging patients to support specific political actors.

7)  Roberto (surgeon who defected): Warned that abandoning the mission would prevent him from seeing his son for years due to entry bans and restrictions imposed on his family.

8)      Dr. Dayli Coro: Assigned to dangerous neighborhoods in Venezuela controlled by armed gangs and suspended after refusing to falsify clinical data.

9)      Ana (doctor in Mexico): Describes the emotional dilemma of choosing between personal freedom and the ability to reunite with family members remaining in Cuba.

See full report here

This report analyzes the legal and administrative framework governing Cuban international medical missions. It describes a system in which regulations issued by Cuban authorities impose strict controls over the personal and professional lives of medical personnel deployed abroad. Testimonies from doctors who participated in missions in Brazil and Venezuela describe passport confiscation, curfews, political monitoring, and pressure to manipulate medical statistics. The report also documents retaliatory measures affecting family members of defecting doctors and professional barriers imposed on those who leave the program. According to the analysis, these mechanisms form part of a broader system that international observers have associated with indicators of forced labor and coercion.

Testimonies from Cuban Health Professionals

1)     Dr. Tatiana Carballo: Participated in a mission in Brazil before leaving the program. She reports mandatory political meetings where doctors were monitored regarding political opinions and social interactions. She also describes pressure on medical staff to inflate healthcare statistics for reporting purposes.

2)     Roberto (surgeon): Defected from a mission in Venezuela and later crossed into Colombia. He reports that after his defection his son was repeatedly denied a passport, preventing family reunification for several years.

3)     Dr. Rusela Sarabia: Reports retaliation after her defection, including professional demotion of her son, who was reassigned from a medical role to pest control duties in Cuba.

See full report here

This report examines the regulatory framework governing Cuban medical missions and includes testimonies from doctors who participated in international deployments. According to the testimonies, the system imposes strict rules limiting personal autonomy, including restrictions on social activities, monitoring of communications, and disciplinary sanctions for perceived infractions. Mission participants report that the regulations governing their conduct discourage criticism and restrict their freedom of expression. The report also highlights the hierarchical structure of mission leadership, in which senior officials receive privileges unavailable to ordinary doctors. Concerns about these conditions have been raised by United Nations Special Rapporteurs, who noted allegations of coercion, excessive working hours, and restrictions on fundamental rights associated with the mission system.

Testimonies from Cuban Health Professionals

1)     Dr. Berto Anaya Silva: Participated in two international missions. He describes extensive limitations on personal freedom, including restrictions on visiting public places and participating in social activities without authorization. He states that doctors are expected to avoid criticizing working conditions or revealing information about the mission system.

2) Pedro Alcántara Estupiñán: Retired doctor who participated in three missions, including service in East Timor as deputy mission leader. He describes a hierarchical structure with privileges for senior officials, including the ability for mission leadership to bring spouses while ordinary doctors cannot and reports that healthcare workers are treated as part of a “regulated population.” He also indicates that disciplinary sanctions may include salary deductions, which are particularly severe given the limited portion of wages doctors receive and describes cases where doctors were punished for participating in social activities with local residents.

See full report here

The Bogotá roundtable brought together Colombian policy experts, congressional candidates, and exiled Cuban health professionals to discuss Colombia’s health system crisis and the governance implications of Cuban medical missions. Testimonies from Cuban professionals highlighted concerns regarding state-managed deployment structures, compensation retention practices, excessive workloads, and post-departure professional barriers. The discussion framed Cuban medical missions as a governance and labor standards issue requiring careful evaluation within the context of Colombian regulatory frameworks and international labor norms. Testimonies from exiled Cuban health professionals provided firsthand accounts of mission deployment structures, compensation practices, professional pressures, and post-departure challenges. These testimonies highlighted concerns regarding worker autonomy, transparency of contractual arrangements, and compliance with international labor standards within Cuban medical missions.

Testimonies from Cuban Health Professionals

Five exiled Cuban health professionals described their experiences during missions in Venezuela and their current circumstances in Colombia. Reported issues included:

• Coercive deployment structures within the Cuban health system.

• State-managed compensation arrangements where professionals did not receive full negotiated salaries.

• Pressure to manipulate statistics or prioritize quantitative targets over clinical standards.

• Excessive workload, extended shifts, and additional administrative obligations.

• Threats of sanctions for non-compliance with directives.

• Sexual harassment and abusive supervision in some cases.

• Barriers to credential recognition and employment after leaving missions.

• Legal and economic vulnerability for former mission members residing abroad.

Several participants described leaving missions for ethical reasons, including refusal to falsify data or administer expired medical supplies.

See full report here

This report argues that Cuban medical missions constitute an exploitative labor system sustained through opaque state-to-state agreements, wage retention, and restrictive mission regulations. It combines expert commentary with testimony from Cuban health professionals and references to prior UN concerns to highlight movement restrictions, threats of reprisals, poor labor conditions, and limits on freedom of expression. The report also links these practices to broader international concern over possible forced labor and trafficking-related elements.

Testimonies from Cuban Health Professionals:

1)      Testimony from Dr. Amancio Terán Benítez, who participated in two medical brigades, describing restrictive mission regulations, limitations on freedom of movement, authorization requirements for social activities, suppression of expression, and a control regime he characterizes as semi-slavery.

2)      Testimony from Carlos Mendive Hilario, retired health-sector professional and former brigade leader in East Timor, describing lack of transparency, hierarchical privileges within missions, and state retention of benefits.

3)      Indirect expert framing also provided by Dr. Javier Pérez Capdevila regarding wage deprivation, total submission, and non-compliant living and working conditions.

See full report here

This report examines the legal and practical responsibility of contracting states in Cuban medical missions, arguing that governments are aware of and, in some cases, complicit in exploitative labor arrangements. Drawing on testimonies from Cuban health professionals and legal experts, it highlights wage withholding, coercive conditions, lack of transparency, and risks of reprisals. The report also references international concern, including UN communications, and discusses evolving responses by some governments, ranging from termination of agreements to continued cooperation under contested conditions. 

Testimonies from Cuban Health Professionals:

1)      Testimony from Dr. Ramón Calderón describing forced labor conditions in missions, including deployment to dangerous and remote areas and receipt of only a fraction of contracted salary.

2)      Testimony from Dr. Manuel Antonio Arencibia Fernández (now based in Brazil) describing exploitation, lack of transparency, restrictions on workers, and risks of reprisals.

3)      Testimony from Dr. Carlos Juvenal Aralejo Vega (legal advisor background) highlighting systemic lack of transparency, knowledge of exploitation by contracting states, and structural conditions of semi-slavery.

See full report here

This report focuses on the lack of transparency in contracting arrangements for Cuban medical missions and draws heavily on UN and U.S. reporting to characterize the program as involving coercive and exploitative labor practices. It highlights wage withholding, confiscation of documents, movement restrictions, surveillance, and threats of reprisals, supported by testimonies from Cuban doctors and legal actions. The report also underscores the role of contracting states and evolving international responses, including U.S. policy measures aimed at accountability.

Testimonies from Cuban doctors (unnamed) indicating wage withholding (75–90%), confiscation of passports and professional credentials, restrictions on rights abroad, and repercussions for leaving missions. 

See full report here

This report provides a detailed account of coercive mechanisms within Cuban medical missions, emphasizing recruitment through pressure and limited incentives, lack of transparency in contracts, and systemic restrictions on workers’ rights. It highlights confiscation of documents, wage withholding, surveillance, and threats of reprisals, including against family members. The report also examines the role of host countries, arguing that contractual opacity and lack of oversight contribute to conditions consistent with forced labor and human trafficking.

References to Cuban healthcare workers describing confiscation of passports, coercive recruitment practices, lack of informed consent regarding contracts, wage withholding, and reprisals (including family harassment and restrictions on return to Cuba).

See full report here

This report provides a detailed legal and analytical assessment of Cuban medical missions, focusing on the responsibility and complicity of host governments. It presents evidence of systematic wage withholding, document confiscation, coercion, and surveillance, supported by international reports and financial data. The report argues that recipient states are not only aware of these conditions but may be legally responsible under international law for facilitating and benefiting from practices consistent with forced labor and human trafficking. 

References to testimonies documented by civil society organizations and defecting doctors (e.g., Brazil case), but not presented as direct individual testimonies in this text. 

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This report analyzes the international complicity of host governments in Cuban medical missions, arguing that knowledge of coercive labor conditions has long been established through contract structures and international reporting. It highlights wage withholding, document confiscation, surveillance, and threats, and frames these practices within international legal standards on forced labor and trafficking. The report emphasizes that recent contract cancellations reflect growing recognition of legal and ethical risks associated with these arrangements. 

Statement from Guyana’s Minister of Health (Fran Anthony) regarding contract termination and salary issues; analytical rather than personal testimony. 

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This expert report provides a multi-country analysis centered on Mexico, combining firsthand engagement, media sources, and policy developments. It documents wage withholding, document confiscation, lack of transparency, and the presence of irregular personnel within Cuban medical missions. The report also highlights a regional shift, with several countries terminating or modifying agreements, often following attempts to introduce direct payment mechanisms. Mexico remains a key case where cooperation continues despite mounting evidence and international scrutiny. 

Testimonies from Cuban Health Professionals:

1)      Anonymous testimony from a Cuban health worker in Jamaica describing mission leadership control, instructions not to sign independent contracts, and operational restrictions.

2)      Testimony from Cuban professionals (Dominica) describing forced salary transfers, disciplinary action for non-compliance, and direct cash handover requirements.

3)      Testimony (Mexico context) indicating confiscation of passports and denial of access to professional credentials.

4)      Indirect. Reports from Cuban doctors in Honduras indicating they received only a portion of contracted salary.

Testimonies from Other Individuals:

1)      Interview with Honduran Vice Minister of Health Eduardo Midence describing lack of transparency, presence of non-medical personnel, and wage discrepancies.

2)      Statements from officials (e.g., Guyana, Jamaica, Dominica) describing contract renegotiation attempts and structural issues (treated as quasi-testimonial policy evidence).

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This report provides a comprehensive analytical and testimonial overview of Cuban medical missions in Africa, focusing on Angola, Mozambique, and Namibia. It combines legal analysis with consistent testimonies describing wage withholding, surveillance, movement restrictions, and coercive pressure linked to family and professional consequences. The report emphasizes the concept of “constructive knowledge,” arguing that receiving states were aware or should have been aware of these conditions, and examines potential international responsibility for complicity in forced labor and exploitation. 

Testimonies from Cuban Health Professionals:

1)      Multiple testimonies (primarily Angola, Mozambique, Namibia) describing:

-        Wage withholding (host countries pay $3,000–$5,000/month; doctors receive $300–$500)

-        Movement restrictions (need permission to travel, restrictions on interaction)

-        Surveillance and monitoring by coordinators

-        Threats of sanctions and expulsion

-        Pressure related to family consequences in Cuba

-        Long working hours and precarious living conditions

2)      Specific Angola testimonies describing inability to leave without permission and constant supervision.

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