Cuban medical diplomacy

"This matter, with the Cuban doctors and nurses," said Barbados' prime minister Mia Mottley in an address to her country's parliament on March 12, "should tell us everything that we need to know."

The US administration announced its intention on February 25 to "restrict visa access" to government officials that the US decides to have participated in accommodating Cuban doctors and nurses in Caribbean public health systems.

As President Trump remakes the US government to his satisfaction, Caribbean leaders should be guided by the tough stance taken by the Republican president with his closest island neighbours.

Secretary of State Marco Rubio described the use of Cuban medical professionals as "forced labour" and a form of human trafficking.

The response from Caribbean leaders has been robust and immediate. Dr Rowley, Ms Mottley and Ralph Gonsalves each expressed their willingness to lose their US visas over the issue.

Idi Stuart, president of the TT National Nursing Association said his colleagues could recall no indications among Cuban medical professionals to support the US position.

The Caribbean has quietly ignored the economic US blockade and isolation of Cuba for six decades.

Caricom has encouraged regional trade relations with Cuba throughout its existence, and the Cuban success story has been its capable cadre of medical professionals.

The number of Cuban medical professionals working abroad has dropped by more than half since 2017's high of more than 50,000. There are currently 24,180 Cuban doctors working in 56 nations, including the islands of the Caribbean.

Jamaica alone hosts more than 400 Cuban doctors, nurses, biomedical engineers and technicians.

Both Dr Rowley and Ms Mottley confirmed that Cuban medical professionals are paid the same as their local counterparts. That's a critical element in the conversation.

At home in Cuba, medical professionals earn significantly less, while supporting the country's universal free medical care. A top-tier, specialty medical professional makes 5,600 pesos or around TT$1,900. Many have a non-medical side hustle to make ends meet.

There are legitimate concerns about how Cuba crafts financial arrangements with its overseas citizen-workers.

Since 2006, an estimated 7,000 doctors have failed to return to Cuba at the end of their assignment, risking severe punishment.

The US once embraced these defections with the Cuban Medical Professional Parole programme established in 2006. The project was abruptly shut down in 2017.

While there should be some regional pressure to ensure that Cuban doctors retain their earnings, there seems little question that sovereign decision-making in the region is paramount.

The EU, a fractious aggregation of nations, seems to have found a rallying point for greater unity in the union following Mr Trump's foreign policy positions.

Caricom should take a cue from that and move decisively to implement overdue legislation to create a more integrated Caribbean region.