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Combatting Forced Labor in Cuban Medical Missions

Around 400,000 Cuban healthcare professionals are estimated to have been sent abroad to provide medical assistance during short-term health crises, natural disasters, and more recently, the COVID-19 pandemic (Granma, 2020), as part of the Cuban government's Foreign Medical Missions (CFMM) programme. Since its inception in 1962, the programme, which has been described as "a global exercise in soft power", has placed medical professionals in over 164 countries across Latin America and the Caribbean, Africa, the Middle East, Asia and Europe. Participants in the CFMM programme have been deployed to assist with crises such as the 2006 earthquake in Indonesia, the 2010 cholera outbreak and 2021 earthquake in Haiti, and the Ebola outbreak in various West African countries in 2014. 

During the first few months of the COVID-19 pandemic, Cuba sent roughly 1,500 medical professionals to more than twenty countries to assist with the unfolding emergency. Outside of crisis situations, Cuban health workers are also sent to bolster weak or strained healthcare systems, with a key example being the approximately 20,000 Cuban doctors that worked in poor or remote parts of Brazil until late 2018 (Time, 2018; Guardian, 2018).

For the countries that receive assistance from the CFMM programme, it is seen as a means of improving medical access to areas or situations that are otherwise under-served (Time, 2018; Gillies-Lekakis, 2021). However, international organizations and NGOs have raised concerns regarding the use of exploitative practices and repressive measures within the programme. For example, Human Rights Watch reports that for as long as these medical missions have operated, Cuba has crafted repressive norms that regulate the lives of those deployed abroad (see also BBC, 2019; Time, 2018, Prisoners Defenders, 2022). In November 2019, the UN special rapporteurs on contemporary forms of slavery and on trafficking in persons, especially in women and children, requested information from the Cuban government on the working conditions within the CFMM programme, noting that the conditions reported to them, including from first-hand sources, "could amount to forced labour".

This research project will explore the CFMM programme from the perspective of international labour and human rights law, analysing the working conditions of participants of the programme in host countries around the world through research across a wide range of sources. In doing so, it will examine the compliance of the CFMM programme with international legal standards with the aim of better understanding and documenting the lived experiences of participants of the programme.

The research will inform efforts to combat forced and exploitative labour in the CFMM programme, including advocacy activities. It will identify promising practices in host countries such as Mexico and Brazil, and issue recommendations on measures that will help Cuba and receiving States to ensure that the programme complies with international labour and human rights standards. The project will support relevant entities and individuals by providing capacity-building and networking opportunities.

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