Paper- document

Cuba In Transition

Cuban Doctors Abroad

The Economic and Political Tools of Cuban Medical Diplomacy

Christina La Fleur11-25-2014

Christina La Fleur Cuban Doctors Abroad 2

1.0 Introduction

The Cuban government deploys teams of medical workers in response to intense need and

disasters. These foreign missions are important elements of Cuban foreign policy. Cuban

medical diplomacy is lauded internationally, and the presence of Cuban doctors across the global

South has extended the nation's international connections to include more allies, admirers, and

well-wishers than ever before. There are more doctors per capita in Cuba than anywhere else in

the world. More than just for their numbers and spread, Cuban doctors are well known for their

hands-on, personal approach to healthcare.

Cuba's rapid and massive response to the Ebola crisis has generated praise from even the

United States, and Cuba has been able to contribute dozens of doctors even while sustaining

several ongoing long term medical programs around the world.27 But both the speed and scale of

Cuba's reaction bring up important issues revolving around the ethics of their policy. Observers

have questioned whether doctors are truly volunteers and marvel at how little of the money host

countries pay for their presence actually goes back to the workers.

It appears likely that all the personnel who are sent by the Cuban government to West Africa

and to locations around the world are in fact volunteers, although that position could certainly be

debated in the face of little evidence and strongly worded and emotional defector anecdotes.

“Volunteer” may be a relative term. However, there are powerful incentives, mostly stemming

from Cuba's otherwise restrictive pay and travel policies, pushing medical professionals abroad,

even in the face of less than ideal working conditions. These workers are tools of the Cuban

government, which reaps huge economic and political benefits from the health missions. The

doctors are traded much like commodities in a Cuban export of medical professionals, and

doctors are given very little flexibility in their plans or posts.


Below, I will briefly describe the history of medical diplomacy in Cuba and outline active

programs. The next portion, Section 3, will deal with the training of doctors and their lives in

Cuba, before moving onto their lives abroad. Section 4, "The Trade," will discuss what medical

professionals are traded for and what the Cuban government receives in the exchange, before

reaching the conclusion in Section 5.

2.0 History

Before and during the Cuban Revolution in 1959, half the doctors of the nation either fled or

refused to practice in opposition to the new government.14 Doctors were some of the many

intellectuals who arrived in the first wave of immigrants to Miami. Fidel Castro reacted by

putting a new emphasis on health and training medical professionals. The 1976 Constitution

included universal healthcare, and Cuban leadership's rhetoric drew lines between individual

health as a "basic human right" and the health of the nation and revolution.7 Castro's government

politicized the health system early on by infusing it with revolutionary values and priorities.

The first ever Cuban medical mission abroad was to Chile in 1960 in response to an

earthquake,26 although the first long term mission was to Algeria in 1963, where medical teams

were sent for 14 months.12 During the 1980s, Cuban medical diplomacy ballooned with Soviet

patronage, and began producing doctors "beyond the needs of its own healthcare system," for

international purposes.7 Soviet funding provided for the expansion of the programs' duration and

into more locations. The fall of the Soviet Union and the beginning of the Special Period lead to

a temporary slow-down, for the economy as a whole as well as for foreign missions, but the

friendship of Chavez and the oil-for-doctors agreement with Venezuela has allowed medical

diplomacy, and the economy to some degree, to recover. Over 50 years, Cuba has sent at least


113,000 doctors abroad to 103 countries (and up to 325,000 to 158),20 in addition to training

thousands of students from around the world in Cuban universities, many on partial or full

scholarships.7 In spite of growing complaints at home of doctor shortages, the Cuban

government has yet to show any desire to scale back medical programs.

2.1 Programs

Cuban medical diplomacy includes both long and short term missions, from temporary

disaster relief to building schools and training doctors in countries of the global South. Medical

missions have served hundreds of thousands, mainly in Latin America and Africa. Cuban

doctors tend to arrive first, in the biggest numbers and, when needed, stay the longest.

Operacion Milagro is among the international long term programs. Through the program,

over 170,000 from across Latin America have received vision restoring or improving surgeries.15

Additionally, scholarships to ELAM, the Latin American Medical School, have provided

thousands of foreign students with medical educations in Cuba. In fact, foreign Latin American

students dominate the roster: 22% of the students in 2006 were Bolivian nationals.7 Finally,

Cuba has expanded its Comprehensive Health Program to eight nations in Latin America and 18

in Africa.7 The program provides medical training and support in the host country, and ensures a

long term presence of Cuban doctors in areas which need their assistance to develop stable and

effective systems. These long term programs largely target the health system as a whole or a

specific chronic health issue, aiming to improve both the health and living conditions of the host

country’s citizens into the future.

Cuba has provided doctors for long term programs through bi- and trilateral trade agreements

as well. For example, South African funding paid to send 100 Cuban doctors to Mali in 2004.


However, the Venezuelan agreement, negotiated in 2000 and 2005, is by far the most

controversial, studied, and discussed. In 2005, Cuba agreed to provide 30,000 medical

professionals, 600 health clinics, 600 rehab and physical therapy centers, 35 high tech diagnostic

centers, training for 40,000 doctors and 5,000 healthcare workers in Venezuela, and full

scholarships to Cuban schools for 10,000 Venezuelan students,7 in exchange for a low, fixed, but

unknown price on 53,000 to 100,000 barrels of oil a day.4 The history of the Cuban-Venezuelan

medical relationship began in 1999, when Chavez agreed to pay for Cuban medical services with

oil.4 The Barrio Adentro program in Venezuela employs thousands of Cuban doctors, and one of

the consequences of the trade is that Cubans note "reduced access to primary care physicians" at

home.4

In addition to services in Venezuela, Cuba "also provides similar medical services in Bolivia

on a smaller scale at Venezuela’s expense as part of the Bolivarian Alternative for Latin

America."14 The Bolivarian Alternative for Latin America is the English name for ALBA, an

economic integration organization. The oil-for-doctors agreement was a foundational alliance

for ALBA. The term "Bolivarian," referring to the independence era revolutionary who

campaigned for Latin American unity, highlights the Venezuelan-Cuban mentality towards the

missions: more than just charity, medical diplomacy provides an opportunity to unify Latin

America through cooperational development and encouraging exchange. Through trilateral

agreements, Cuba is able to negotiate profitable medical diplomacy and establish a relationship

with two nations, while both Cuba and the funding nation profit from the prestige and reputation

won by their aid.

Short term programs usually take the form of disaster relief operations, like the first ever

Cuban mission to Chile. Most recently, the Ebloa crisis has attracted battalions of medical


soldiers from the island. Past disaster missions have also included medical “cleanup” and care

after floods, mudslides, and hurricanes. Traditionally, these short term programs provide

immediate relief with the possibility to expanding into long term missions down the line,

depending on the medical needs of the host country.7

After the end of Soviet funding, medical diplomacy marks an important success of an

otherwise limping economy, "wracked by slow growth, shortages and chronic

underinvestment."26 Observers point out that doctors, "an exportable resource" that even little

Cuba can produce on a large scale, generate income and praise for what could otherwise have

been a marginal socialist island.1

3.0 Doctors at Home: Training and Working in Cuba

Cuba has 83,000 doctors for a little over 11 million people, the highest proportion in the

world and, despite the inadequate supply of medicine and old equipment, the Cuban government

has been able to keep training more doctors in the personal, time consuming service style praised

by observers as fundamentally different from the Western approach.1 From style to shortages,

the life and training of a doctor in Cuba is dramatically different from in that in most Western

countries.

While in school, Cuban medical students use out of date textbooks. Both students and

professionals have to deal with "a lack of modern equipment and, often, of drugs and diagnostic

tools taken for granted in developed countries."17 This lack could be costly for Cuban doctors

today and in the future, as their training often does not cover recent scientific developments or

include the most modern tools. Exemplifying the political nature of all aspects of Cuban life,

even health, "hospitals produce a list of drugs and equipment they have been unable to access


because of the American embargo."19 Even shortages provide opportunities to denounce United

States’ imperialism. Restrictions on travel and interaction cut down the ability for Cuban doctors

to "attend conferences and to read journals on the latest medical advances as their peers in other

countries," making it hard to keep up with the latest advances.16 Some host countries have noted

that even the doctors' years of training do not close the gap between their outdated textbooks and

journals and modern medicine. This makes the workers less useful as resources for modernizing

the hosts' medical systems and also slows down multi-national operations, where Cubans must

learn new procedures.

Despite limited resources, Cuban students are taught a "prevention-focused holistic model,

visiting families at home, proactively monitoring maternal and child health."19 For the countries

Cubans work in, this has led to huge improvements in lowering mortality, and part of the duties

of the mission teams is to train local medical personnel to the Cuban standard. Doctors are

expected to be available if needed 24 hours a day, 7 days a week. In comparison to Western

countries, observers note "more human and less rushed" interactions with patients.17 In line with

this more personal method, in Cuba "every square block is assigned a family doctor" who lives

and works in the neighborhood, and treats his or her patients on the ground floor of their home.16

Medicine shortages and lengthy deployments do stress this relationship, and both health workers

and patients complain about how many doctors, especially specialists, are sent abroad.

At home, most doctors make under $75 a month, and most depend on foreign missions to earn

more. Compared to employees of the tourism industry, medical professionals make very little

for a lot of work, and some have chosen "jobs as taxi drivers or in hotels, where they can earn

CUCs" rather than to continue to work for such low pay.8 It isn't just the Cuban doctor's


approach that is different from Western tradition: in Cuba, doctors are paid so little some would

rather be waiters than surgeons.

Somewhere between 13% and 50% of Cuba's doctors are abroad at any given time. This large

range is due to the fact that the number of Cuban doctors is fairly well established, but sources

differ on how many are committed to foreign programs. There are some Cuban issued figures,

but sources largely agree that the official accounts are mis-estimated, although they disagree

whether they are under or over.8,11,23 Regardless, there are definitely thousands of Cuban medical

workers abroad, and some of these men and women spend months alone in remote locations,

facing overwhelming poverty and disease, without the chance of seeing their families, or even

leaving the area without permission.

3.1 Doctors Abroad

Cuban medical diplomacy programs are massive, spread throughout the South and earning

Cuba a reputation for goodwill. At a speech to the United Nations General Assembly in

September, Cuba's Minister of Foreign Affairs Bruno Rodriguez Parrilla proudly claimed that

since the revolution, "325 000 Cuban health workers have assisted 158 nations of the South,

including 39 African countries…[and] 38 000 medical doctors have been trained, free of charge,

from 121 countries…" and announced plans to expand programs in Africa with volunteers.20 The

question is whether these workers are truly volunteer, and what factors drive doctors to choose to

work in dangerous locales far from their families.

As explained earlier, Cuban medical workers are deployed on missions in a variety of

capacities and for a range of time. Most recently, Cubans have arrived in Sierra Leone, Liberia,

and Guinea to combat Ebola, and while not all workers have yet arrived, the doctors from Cuba


are by far the largest single country group.1 Even when arriving in large units to serve side by

side with other medical teams, which doesn't always happen on shorter relief missions or when a

doctor is assigned to a remote post on his or her own, doctors face enormous risks, not the least

of which is contracting a deadly disease or experiencing physical harm due to conflicts in the

region or being deployed to dangerous area. Some sources claim that when medical students

graduate, "students are under legal obligation to initially work for the Cuban government…[,so]

wherever the government decides they are to be sent…[is where they go, and] they have no

choice in the matter," although the specific requirements of the program after graduation are

unclear.19

When going abroad, deployment preparations do include training on the region, disease, and

safety risks of the country the workers will arrive in. For the Ebola crisis, doctors took part in a

"boot camp," "an intense training program where for a minimum of two weeks, doctors and

nurses are drilled on how to treat patients while not exposing themselves to the deadly virus."18

Even with this preparation, Cuban doctors are known to "go where other doctors do not,”21 in

"areas in which no local doctor would work, make house calls as part of their medical practice

and are available free of charge 24/7," bringing their personal brand of healthcare to the most

remote and dangerous areas of the global South.7 Julio Cesar Alfonso, a defected Cuban doctor

in the United States, says of the missions: "the Cuban government sends these doctors to the

worst cities or towns, where they are not protected, where they are not safe."9 When abroad,

Cuban doctors are not allowed to leave their assigned areas without permission, and are not

allowed to speak to journalists.19 In contrast to medical personnel from other nations, Cubans

who get sick while abroad are not returned home, but kept in the country in separate facilities or

sent to countries which can provide adequate care, to recover or die. This means that Cubans


dying abroad are not given the opportunity to see their families again.18 To be a Cuban doctor

abroad is to be isolated.

Despite the dangers and discomforts, there are several incentives for Cubans to volunteer.

First and foremost is pay: doctors can triple to nonuple their income per month abroad. New

consumer goods, like TVs, become available with the raise. At the same time, the increases in

pay are nothing compared to what Cuban doctors could make working in the United States.

There are some who use their position abroad to get access to foreign embassies and obtain

asylum in the US or other countries. The Cuban Medical Professional Parole Program in the

United States provides fast track admittance to the country for Cuban health workers, although

with booming demand for the program, "fast" had become relatively slower over the last few

years.9 Posts in Venezuela are common launch points among those who request asylum through

the CMPP. Some host countries are now facing the problem of whether or not to accept Cubans

seeking asylum in their own country, an issue of legitimacy, relations with Cuba, and global

scrutiny. Brazil, "Latin America’s largest democracy," is at a political impasse, and "confusion

has persisted over whether the Cuban doctors arriving [t]here will be able to request political

asylum."21

While few doctors defect, the Cuban government takes precautions. Dr. Ramirez, a Cuban

who fled to the United States while on a foreign mission, said that when he arrived, "he

surrendered his passport to security personnel at Cuba's embassy [and that] Cuban doctors also

had to turn over other identification documents like driver licenses," which would make it more

difficult for doctors to flee.14 This kind of suspicious treatment is unheard of for medical workers

from other countries. Additionally, Ramirez and others recall meetings when the workers were

threatened that their families would be "punished" if they left, and Ramirez himself claims that


his wife, left in Cuba, lost her job when his defection was discovered, and he worries about her

and his family being “blacklisted” by the government.14 Often, the doctors that come back

"return from years abroad because they must, both contractually and to avoid repercussions for

their relatives…then must accept whatever assignments the government gives them..."8 There

does not seem to be a lot of flexibility for doctors, and even if they volunteer to go abroad, they

have little choice in where they are sent and when they are brought home.

Some returners may bring back more than just experience. Doctors coming home from Brazil

"carry with them the seeds of new perspectives after witnessing Brazil’s efforts to respond to the

recent street protests and other forms of political dissent," perspectives which could be

dangerous to the government in the heads of dissatisfied, underpaid, educated medical workers.21

Approved medical spokespersons (there are those few doctors who are allowed, with prior

approval, to address foreign journalists in supervised settings) point out educational and travel

benefits of foreign missions. For most Cubans, travel is highly restricted, and foreign missions

provide an opportunity for medical professionals to travel, learn new languages, and study how

healthcare works around the world. On the onset of the Ebola crisis, news sources happily

announced a deluge of 15 thousand volunteers.1 Reuters quoted Adrian Benitez, a government

approved doctor-spokesperson, saying, "there have been fights breaking out, heated arguments,

with some doctors asking, 'How come my colleague gets to go and I can't?’"23 The World Health

Organization notes Cuba's special ability to mobilize massive teams quickly, and attributes this

talent to "the experience of the physicians and the political will to do so," rather than, as some

suggest, that the doctors are forced.25

If medical workers are jumping out of their seats to get a spot on the missions, it seems odd

that a Foreign Minister, addressing the United Nations, would make the point of saying "our


medical and paramedical staff will do it [work in Africa] on a voluntary basis," unless the

availability of choice was under question.20 It is fully possible that doctors go abroad out of

genuine passion for helping people, or for the revolution. Money, travel, and learning about your

trade could be huge draws. Some people may want to get away, and so volunteer to get the

opportunity to leave the country. But the stories of asylees do cast some doubt as to whether the

doctors are volunteers at all, and restriction of media access as well as present, if subtle,

insistences by the Cuban government doesn't help.

4.0 The Trade

This section will go over what happens at the international level when Cuban doctors are sent

abroad. While the Cuban government claims that its missions are driven by goodwill for the

people of the global South, there are distinct economic and political benefits for Cuban

government’s side of the trade. Antonio Guedes, a Cuban doctor living in the United States, says

that Cuba has three main reasons to pursue medical diplomacy: "first and foremost to polish its

political image, secondly for economic reasons, and thirdly, so that countries that have received

their help will vote in Cuba's favor in international forums like the United Nations…"25

Essentially, this section will go over the benefits for the government from agreements discussed

in 2.1.

When doctors go abroad, most often the host country or another funding country will pay a

set amount per medical worker to the Cuban government, as well as for airfare and living

stipends directly to the doctors when they have arrived.7 For example, Brazil pays $4,255 for

each doctor, but the workers "receive only a fraction of their monthly salary…The rest is paid to

Cuba’s government, providing it with a new source of hard currency."21 Doctors do receive their


education and healthcare for free, as do their families and all Cuban citizens, and this does

alleviate some of the burden of their low income, but the fact is that the Cuban government

pockets most of their salary.

Doctors abroad are important revenue generators for the government. Associated Press called

doctors "the front lines of the country's foreign policy" to generate "desperately needed foreign

exchange."26 Jon Lee Anderson, writing for The New Yorker, points out "Castro’s medical

internationalism has been a huge financial boon to the island,"1 earning an estimated $8.2 billion

in 201422 of a $68 billion GDP.2 There is little data on the dollar amount of investment that Cuba

puts in per doctor, so it is difficult to compare payouts with investment, but medical diplomacy

does represent a financial boon to the small country. But there are additional non-income

benefits for the Cuban government as well.

When medical mission agreements are signed, alliances are born. For example, trade with

Venezuela has resulted in a massively subsidized, and guaranteed, quantity of oil. The oil helps

meet Cuba's domestic requirements and the discounted prices have led to decades of savings.

However, the agreement also pulled Venezuela and Cuba closer, both economically and

politically, and Cuba had a trade patron for the first time since the fall of the USSR.

Additionally, the doctor trade can be a step towards "exert[ing] influence in Cuba as the

authorities…expose the island nation's economy to market forces."21 Brazil has been trying this

tactic. Market reforms in Cuba have begun to draw in hopeful investors, and establishing a

medical partnership could bring Cuba closer.

Cuba's activism, both militarily and medically, has made it a leader in the Non Aligned

Movement. Its continued missions and impressive health climb help highlight the David and

Goliath story promoted by government rhetoric, making Cuba seem benevolent and small against


the US embargo. The presence of well-trained, personal and available health workers around the

world, "project[s] Cuba's image abroad as increasingly more developed and technologically

sophisticated…" and "has garnered symbolic capital (prestige, good will, and influence) for this

small, developing country way beyond what would otherwise have been possible and has helped

cement Cuba’s role as a player on the world stage."6

Additionally, health tourism could be an important source of income for decades to come, as

Cuba opens up to foreign investment and its reputation for great doctors continues to grow.19 At

the same time, students from all over the world training and working in Cuba return home with

an education, a relationship with the country, and new ideas about how a government could

work. Students are a force multiplier for Cuban ideas, even as doctors may bring home new

foreign ones from the students' home nations. The exchange is part of a dialogue which has been

changing outlooks on both sides. The missions can also be a relief valve, giving doctors who

disagree with the government a chance to get out of the country for a while (or for good).

Finally, medical missions give the Cuban government a more flexible foreign policy.

Medical aid provided, as Cuba transitioned out of the Cold War, a way to get involved in a non-

military capacity around the world. It can be an avenue to economic or political agreements (to

build connections, or even buy time before such agreements are politically viable options) or a

South-South team building tool. Labor rather than capital intensive, the rollercoaster of post-

revolutionary Cuban finances has had less of an effect on medical diplomacy, and the process of

training the huge numbers of doctors fits perfectly into the socialist ideals of the Cuban

government and constitution, such as ensuring free healthcare and education is available to all.

On the whole, the government sees huge and varied benefits from its medical diplomacy

program, while it seems doctors get the short end of the stick. Medical diplomacy matches


existing priorities, and lends the government flexibility in its international relations. It is not in

the Cuban government's economic interest to keep doctors at home, whether or not they are

needed. Missions are part of a public relations campaign with the world, and little Cuba could ill

afford to abandon its medical diplomacy, lest it begin to slip into the relative obscurity most of

Latin America as a region has been facing in international relations.

5.0 Conclusion

Doctors in Cuba are poorly paid, work intensive schedules, and are feeling the strain of

shortages, as many of their colleagues are sent on medical missions abroad and medicine

continues to be difficult to obtain. It is hard to be a Cuban doctor anywhere, at home or abroad,

but the Cuban government especially benefits from the medical diplomacy initiative. While the

government announced, along with their estimate of revenue from foreign missions, that salaries

for medical professionals would be raised to $44 a month, doctors do not see most of the money

host countries pay for their presence, and their special brand of 24/7 at home care in dangerous

areas puts the doctors themselves in harm's way.22 Due to the lack of media access, most of the

anecdotes available are either from government approved spokespersons or angry bloggers

abroad, neither of which are highly credible sources. Data is largely unavailable.

Are Cuban medical workers, in all senses of the word, "volunteers?" It's difficult to say for

sure what about the foreign missions would draw volunteers, but sentiment and financial gain are

likely incentives. Some may use their posts to escape. The sheer size of the forces assembled,

and how quickly they are deployed, does bring into question whether the doctors are truly free

agents. Additionally, stories from defectors and reassuring commentary by Cuban officials cast

further doubt, but nothing can be proven.


Regardless, it is certain that the Cuban government profits, in alliances, support, prestige, oil,

and cash, from the export of medical workers, even while doctors work in conditions and places

no other group is willing to go. While abroad, Cubans are subject to measures intended to keep

them from fleeing, like being told that their families could be punished, having their papers taken

away, and needing to request permission to leave their assigned area. Their families are also not

allowed to go with them, nor are they able to return to Cuba if they fall ill. While they do

receive extensive training prior to deployment, they are essentially trapped in their location, and

no amount of time spent in bunny suits can prepare a doctor to deal with the conflict and physical

violence he or she is at risk of encountering. It appears that at some level the health, security,

and choice of doctors is at risk or restricted while on missions abroad. At home, other than the

intended raise, increased revenues have not lightened the burden of shortages or low. The

benefits of medical diplomacy are largely absorbed by the Cuban government.

Over time, as Cuba opens more to foreign influence and becomes more welcoming to foreign

media, more data and information about medical diplomacy, the experiences of doctors at home

and abroad, and the income, both in political and economic capital, generated for the Cuban

government by missions abroad may come to light. As more tourists come to Cuba, and

expansion of medical diplomacy leads to more interaction with Cuban doctors, it may become

easier to identify the relationship between the doctors and the foreign missions.


Works Cited

1. Anderson, Jon L. "Cuba's Ebola Diplomacy." The New Yorker. Conde Naste, 4 Nov. 2014. Web. 18 Nov. 2014.2. "Cuba GDP 1970-2014." Tradingeconomics.com. Web. 23 Nov. 2014. <http://www.tradingeconomics.com/cuba/gdp>.3. Ellis, Edward. "Mission Milagro." Rock around the Blockade. N.p., 30 July 2010. Web. 18 Nov. 2014.4. Erikson, Daniel P. The Cuba Wars: Fidel Castro, the United States, and the next Revolution. New York: Bloomsbury, 2008. Print.5. Erisman, H. Michael. "Beyond the Superpowers: Cuban Globalism, 1972-1985." Cuba's Foreign Relations in a Post-Soviet World. Ed. John M. Kirk. Gainesville: U of Florida, 2000. 79-104. Print.6. Feinsilver, Julie M. "Cuba as a "Medical Power": The Politics of Symbolism." Latin American Research Review 24.2 (1989): 1-34. Jstor.org. The Latin American Studies Association. Web. 18 Nov. 2014.7. Feinsilver, Julie M. "Oil-For-Doctors: Cuban Medical Diplomacy Gets a Little Help from a Venezuelan Friend." Nueva Sociedad (2008): n. pag. Www.ghd.org. Web.8. Garrett, Laurie. "Castrocare in Crisis." Foreign Affairs. The Council on Foreign Relations, July-Aug. 2010. Web. 18 Nov. 2014.9. Gibson, William E. "Cuban Doctors Flee Foreign Missions to Florida." Sun Sentinel: Health. Sun Sentinel, 05 Oct. 2014. Web. 18 Nov. 2014.10. Kickbusch, Ilona. "Global Health Diplomacy: How Foreign Policy Can Influence Health." Global Health Diplomacy: How Foreign Policy Can Influence Health (n.d.): n. pag. Graduateinstitute.ch. Global Health Program, Graduate Institute of International Studies. Web. 18 Nov. 2014.11. Kirk, John M., and H. Michael Erisman. Cuban Medical Internationalism: Origins, Evolution, and Goals. N.p.: Palgrave Macmillian, n.d. Google Books. 09 June 2009. Web. 18 Nov. 2014.12. Krull, Catherine, and Sorya Castro Marino, eds. Cuban Studies. Vol. 41. Pittsburgh: U of Pittsburgh, 2010. Cuban Studies. Google Books. 11 Jan. 2011. Web. 18 Nov. 2014.13. Lakhani, Nina. "Cuban Medics in Haiti Put the World to Shame." The Independent. Independent Digital News and Media, 26 Dec. 2010. Web. 18 Nov. 2014.14. Millman, Joel. "New Prize in Cold War: Cuban Doctors." The Wall Street Journal. Dow Jones & Company, 15 Jan. 2011. Web. 18 Nov. 2014.15. "Miracle Operation: A Major Solidarity and Medical Success in 2005." Operacionmilagro.com. N.p., 23 Dec. 2005. Web. 18 Nov. 2014.16. Newman, Lucia. "The Truths and Tales of Cuban Healthcare." Al Jazeera. Al Jazerra, 18 June 2012. Web. 18 Nov. 2014.17. Ojito, Mirta. "Doctors in Cuba Start Over in the U.S." The New York Times. The New York Times, 03 Aug. 2009. Web. 18 Nov. 2014.18. Oppmann, Patrick. "Cuban Doctors Train, Then Fight Ebola in Africa." CNN. Cable News Network, 12 Oct. 2014. Web. 18 Nov. 2014.19. Plant, Hanna. "The Challenges of Health Care in Cuba." Global-Politics.co.uk. Global Politics: An International Affairs Magazine, n.d. Web. 18 Nov. 2014.


20. Rodriguez Parrilla, Bruno. "We Live in a Globalized World Which Moves toward Multi-polarity." Digital Granma Internacional. Ed. Gustavo Becerra Estorino. Granma International, 29 Sept. 2014. Web. 18 Nov. 2014.21. Romero, Simon, and Victoria Burnett. "Brazil Forging Economic Ties With Cuba, While Hiring Its Doctors." The New York Times. The New York Times, 29 Dec. 2013. Web. 18 Nov. 2014.22. Sabo, Eric. "Cuba Forecasts $8.2 Billion From Doctors Abroad This Year." Bloomberg.com. Bloomberg, 21 Mar. 2014. Web. 18 Nov. 2014.23. Trotta, Daniel. "Cuban Doctors Proud to Risk Lives in Mission to Halt Ebola." Reuters. Thomson Reuters, 21 Oct. 2014. Web. 18 Nov. 2014.24. Wagstaff, Steve. "A Chance Encounter with Operacion Milargro." Cuba Solidarity Campaign : Cuba Si. Cuba Solidarity Campaign, 01 June 2009. Web. 18 Nov. 2014.25. Walker, Jan David, and Nadia Pontes. "Cuban Doctors Fight Ebola in West Africa 'voluntarily' | News | DW.DE | 25.10.2014." DW.DE. Deutsche Welle, 25 Oct. 2014. Web. 18 Nov. 2014.26. Weissenstein, Michael. "Cuba Sends 91 More Doctors to Fight Ebola." AP: The Big Story. Associated Press, 21 Oct. 2014. Web. 18 Nov. 2014.27. Westcott, Lucy. "Samantha Power Praises Cuba's Ebola Response, Defends U.S. Quarantine Guidelines." Newsweek. Newsweek LLC, 31 Oct. 2014. Web. 18 Nov. 2014.

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