Castro's Medical Mercenaries

...............Physicians have been diverted to presidential palaces in the cases of the ailing 81-year-old Mugabe and onetime Sandinista boss Daniel Ortega of Nicaragua, according to Alcibiades Hidalgo, a ranking Cuban government official who defected to the U.S. in 2002. Saddam Hussein was treated for a spinal tumor by at least one Cuban surgeon while ruling Iraq, Hidalgo has written.

And then there's the money: Castro's doctors help to keep the Cuban regime equipped with hard currency. While a number of the destination countries are destitute, others make cash or in-kind payments to Cuba, and Castro maintains a firm grip on such inflow, say those who study Cuba's economy.

.........Leonel Córdova's story is extraordinary enough to have received notice in the south Florida press as it played out four years ago. But it shares origins in the experience of other young doctors in Cuba after the fall of its Soviet benefactors. As Córdova graduated in 1992 from Havana's High Institute of Medical Sciences, life in Cuba was changing for the worse. Starting as a family practitioner in Havana, he was making a few dollars a month in pesos. In earlier years, with billions of dollars in food, oil and other basics coming in from Cuba's big Communist ally, such meager pay would have gotten him by. But then staples became scarce. Castro blamed the U.S. embargo.

By the mid-1990s Cuba's vaunted medical program was crumbling as well. Hospital patients asked relatives in Miami to send bedsheets, pillowcases and cotton balls because Cuba's hospitals had none. Hospital hallways were dark because staff stole the lightbulbs in order to resell them. Some doctors complained they couldn't write prescriptions: no paper or pens. Córdova's frustrations mounted. Some days, he turned patients away. "You can make a diagnosis, but there's no medication to treat it," he says. "No penicillin, no aspirin. It is like a bad joke."

Yet at certain hospitals, such as Cira García in Havana, the shelves were well stocked with drugs and top-of-the-line equipment. Cira García strictly treated foreigners with hard currency and Cuba's ruling elite--doctors' families not included.

Life for Córdova, with a wife and two young children, was growing mean. People relied on cunning, often stealing--not just lightbulbs but chickens, vegetables and soap--to resell. In earlier years Córdova had been able to buy a refrigerator. Now he put the fridge to use, selling ice cream treats for 3 cents each, and chickens on the side. Doctor pals did similarly. By this time Córdova was earning about $20 a month from the government, the average medical salary in Cuba. Still not enough.

Yet as a physician Córdova did have one out. He could go abroad on a mission. Córdova had heard that by working overseas he could earn $100 per month--though a portion would be deposited in a Cuban bank account, touchable only on completion of the typical two-year stint.

In early 2000 Córdova flew to Harare with 100 other medics. It was his first trip outside of Cuba, and his government still clearly controlled his every move: During a layover in London the Cubans were not allowed to exit the plane. ...... Full article

The U.S. Congress is being asked to look into Swiss banking giant UBS amid questions over its handling of bank-note transactions for Cuba.

Newspapers have picked up on Florida Republican Representative Ileana Ros-Lehtinen's complaints that the bank hasn't satisfactorily explained the source of $3.9 billion processed for Cuba over a period of seven years. UBS paid a $100 million fine in 2004 for doing business with Cuba and other rogue states and hoped the issue would go away.

It hasn't. Ros-Lehtinen has sent a series of letters to the likes of Treasury Secretary John Snow and UBS Chairman Marcel Ospel. "We're trying to get to the bottom" of where the billions of dollars came from, says her spokesman. Some Cuban-Americans have their own ideas, citing cash obtained from illicit drug trafficking. A 2004 congressional hearing revealed almost nothing, says Ernesto Betancourt, a retired economist.

UBS denies any money laundering and says the amounts were consistent with tourism revenues to Cuba.

Oil for Doctors

Venezuela is Cuba's biggest and most important doctor deal, worth an estimated $1 billion to the island nation last year, second only to its tourism intake. At least 22,000 doctors have been sent there in the last five years.

The terms of the deal were hammered out between Fidel Castro and his friend and political ally Venezuelan President Chávez. An agreement signed in 2000 guaranteed that Venezuela would ship 53,000 barrels of oil per day to the Caribbean island, according to Cuban government reports; Cuba agreed to pay for the bulk of the shipment in cash and "services," including medical help.

But as crude prices climbed, Cuba failed to meet the cash portion of its obligation. So it began sending more of its workforce, including teachers and physical therapists, but primarily doctors. The pact was later revised, with even more oil now for Cuba, nearly 100,000 barrels per day, says Carmelo Mesa-Lago, emeritus economics professor at the University of Pittsburgh. And Chávez pays for the Cuban doctors. "It is a real bonanza for Fidel Castro," says Mesa-Lago.

What's more, some of the oil, he says, never even reaches Cuban shores: Crude is sold to buyers in Central America, with the proceeds, most likely in U.S. dollars, transferred to the Cuban central bank.

None of that matters to the people of Parroquia Caucaguita, just beyond view of the gleaming skyscrapers of Caracas. One of many shantytowns that house a large portion of the city's 5 million people, it gives a taste of the poverty of the Venezuelan countryside beyond.

In the barrio the Cubans are regarded as heaven-sent. "I don't care if I never see a Venezuelan doctor for the rest of my life," says Aida Márquez, a petite 72-year-old. She shook a plastic bag in the air. "Because of the Cuban doctors I get free medicines!" Another patient, Gilma López, 60, says one Cuban doctor diagnosed her as having an eye disease; she was sent to Cuba, gratis, where she got several days of treatment. "We ate seven meals a day, got free medicines, and we didn't have to pay for anything," she says.

"This is the first time that the government has been able to aid the poor population in Venezuela," chimes in Mirna Mucura, a social services staffer for Chávez's health department. "Past administrations never cared about doing anything like this."

But the presence of Cuba's doctors in Venezuela polarizes an already divided land. In July the Venezuelan Medical Federation protested in downtown Caracas, demanding that the médicos be expelled. The group, whose 60,000 doctors serve a nation of 25 million, says Venezuela doesn't need the medical help.

The Venezuelan doctors ask why Chávez doesn't put oil money into the country's own underfunded public health system. And some question the credentials of Castro's newly minted medical corps. Venezuela's El Nacional newspaper (hostile to Chávez) reported that 96 Cuban doctors in Brazil were sent home after a judge there ruled they weren't eligible to practice.

In addition, Venezuelan doctors complain that their salaries haven't budged in four years, while many are losing work to the Cubans. The imported doctors are resented in anti-Chávez quarters for being central to a growing Cubanization of the country under its radical leader. But they win favor with the lower-class families who keep Chávez in power. Chávez survived a hotly contested referendum on his tenure last year, says Eric Driggs, a researcher at the University of Miami's Institute for Cuban & Cuban-American Studies, after Castro sent in thousands of docs in the months leading up to the vote. A Chávez defeat would have been dire for Castro because the opposition had pledged to halt Venezuela's oil shipments.

When Otto Sánchez, a family practitioner, arrived in Venezuela in 2003, his duties included showing films that praised Cuba's health care system. "The films made it look like it was a very efficient program," says Sánchez, 39.

Propaganda was one task, self-preservation another. Where he was posted, Sánchez says, he locked up for the day just as the sun set. "You could not go out after that, for fear of being shot," he says. Cuban doctors are known in these neighborhoods as particularly good targets for thieves because they are paid in cash and are not permitted to open bank accounts. An attempted cover-up of one killing led indirectly to his pursuing a six-month escape to the U.S. He now lives in Miami and works with an organization, Solidarity Without Borders, that helps other doctors flee. His wife, also a doctor, and son, 9, remain in Cuba.

Venezuelan officials say they need the outside help for rural areas, that the Cubans are properly certified at home and that Chávez has said he intends to boost domestic doctor pay this year.

A few days of calls to Cuba's diplomatic mission in New York ultimately got a reply, not for attribution, that the global medical missions long predated any oil considerations. Any further comment to FORBES required an appointment, we were told.

Although economic conditions have improved somewhat for average Cubans since the dreariest days of the 1990s, doctor shortages and clinical privations remain a way of life. Another recent defector from a medical mission in Venezuela says that in his home city there were once seven clinics; now there is one.

In a society that was to have closed the gap between rich and poor, ordinary Cubans who have waited for years for, say, cataract surgery are often bumped aside so that patients flown in from other countries, presumably with cash, may be treated instead. Castro's people joke among themselves, says one longtime Havana resident, that if they are going to receive any type of medical attention, they'd best get themselves to where they can find some of those Cuban doctors.

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