The regime's response to the doctor drain: a return to repressive immigration policies
Beginning on 7 December the Cuban Government will once again apply a policy requiring health professionals to seek permission from high-ranking authorities to travel abroad for personal reasons, and wait up to five years to leave the country with the intention of residing abroad, reported the official newspaper Granma on Tuesday.
The policy had ceased to be applied after the "revision" of the Immigration Act went into effect in January of 2013. In a statement published in the Communist Party's paper the regime used the current crisis of Cubans in Central America to justify its decision, while blaming US immigration legislation, especially the program that provides asylum to health professionals who act to emigrate while on missions abroad.
"In light of the need to ensure our people an efficient and quality health service, and mitigate the damage now being done as a result of the US's selective and politicized immigration policy towards Cuba, and the increased, unexpected hiring of Cuban doctors in other countries, the decision has been made to apply the regulations established in Decree 306, of 11 October 2012, governing private travel abroad for personal reasons by professionals in different specialized fields whose work is vital to the population's health services, and to scientific and technical activity," the Government announced.
It was not immediately clear whether the measure applies only to specialists or to all doctors.
The Government acknowledged that the emigration of professionals in the health sector has become "a concern."
"Specializations as important as anesthesia, general surgery, intensive care, cardiology, pediatrics, neurosurgery, nephrology, obstetrics and gynecology, orthopedics, traumatology and neonatology, among others, have been seriously affected by the unanticipated departure of vital medical staff," it added.
"To acquire the skills and knowledge in these highly specialized professionals called for by modern science, years of study and work experience are required, making it impossible to train them [new professionals] in a short time," the regime argued in its statement.
The Government also stated that the Parole Program for Cuban Medical Professionals, established in 2006 by the Bush Administration, is "the only one of its kind in the world," being "intended to damage the international medical cooperation programs" in Havana.
"It harbors the perverse objective of encouraging Cuban medical professionals to abandon their missions in other countries, actively facilitating their emigration through the use of embassies," he said.
The Government also declared that "the incentives offered to Cuban doctors by various countries, especially private clinics in them" has led to "the resettlement of qualified labor abroad." It assured that "networks have been detected dedicated to selecting them [Cuban physicians] and funding their departure."
As is typical, in its statement the regime did not mention the internal factors spurring many doctors to take advantage of their missions abroad to emigrate.
In addition to the difficult working conditions, the highest salary for a doctor in Cuba is equivalent to 66 dollars/month, corresponding to a second-degree specialist, according to the latest wage figures published by the Government in March 2014.
Neither did the statement mention that the sale of professional services, mainly medical, is one of the main sources of foreign currency for the regime, which retains about 75% of the salary that foreign governments and institutions pay.
Although complaints about poor service, the condition of facilities, deficient repairs at hospitals, and other problems have increased in recent decades, the Government insisted it was its "priority to ensure high levels in its health services for the Cuban people, to which significant human and material resources are allotted." And it blamed the US embargo for the on-going limitations suffered.
The Havana stated that its decision to reimpose limitations on the travel of medical professionals "does not mean that medical specialists cannot travel or live abroad," but that in the future "departure dates from the country will be analyzed, taking into account each professional’s replacement in order to ensure a staffing situation that guarantees the accessibility, quality, continuity and stability of these services. "
This is the second sign that the flight of health professionals has become a serious problem, frustrating the Government's plans.
Weeks ago the Ministry of Public Health announced that professionals who have abandoned the country, "including those who have been victims of deceptive policies that led them to abandon their missions" abroad may return. The official text on Tuesday reiterated that those who return will be "ensured a position similar to the one they had previously."
Havana devoted much of its statement seeking to relate its decision to the current situation in Central America, after Nicaragua decided to close its border with Costa Rica, blocking the passage of thousands of Cuban emigrants.
The Government said that on Monday, during another round of talks with Washington, "it presented again, unsuccessfully" its demand that the US’s Cuban Adjustment Act, "dry feet, wet feet" policy, and Parole Program for Cuban Medical Professionals all be rescinded, identifying them as "the root cause of illegal immigration," without acknowledging the lack of economic and social opportunities which leads many citizens on the island to seek a better future elsewhere.
Finally, neither did the Government's statement recognize the dramatic increase - around 77% - in the numbers of emigrants over the least year.