 If there's one thing they do right in Cuba, it's healthcare. When it may be surprising to see just how much the Cuban healthcare system is thriving. Cuba has the best healthcare system in the entire area. One thing that is well established in the global health community is the strength of the Cuban national health system. Despite being a poor country, Cuba has one of the strongest healthcare systems in the world. And in many respects, much better than the U.S. And so now, after all these years, one thing is clear. The Cuban people have free, universal healthcare. The Cuban national health system is destroyed. The consultants are in very bad conditions. The hospitals are broken. The people are dying in the corridor. The patients are without oxygen. Hospitals without electricity. I don't know if you've seen that in social media. That's pure reality. Since the 1959 communist revolution in Cuba, there have been hundreds of newspaper articles, magazine features, news segments and documentaries celebrating the marvel of its healthcare system. Even President Castro talks openly about Cuba's long list of economic mistakes. But everyone approves of at least one investment the government has made in free universal healthcare. All the independent health organizations in the world and even our own CIA believes that the Cubans have a pretty good health system. It's all part of an elaborate propaganda campaign that disguises the reality of Cuban healthcare. Its clinics lack most routine supplies like antibiotics, bandages, syringes and oxygen, and in some cases, running water. Their hallways are often occupied by ailing patients because there aren't enough doctors to treat their most basic needs. And its hospitals are unsanitary and decrepit. Cuban healthcare is exactly what you'd expect in a country impoverished by communism. The only thing that's changed is because of social media and the COVID-19 pandemic. The government's propaganda facade has finally started to shatter. And yet, in 2021, some journalists were falling for the claim that the Cuban government had set the model for its response to COVID. We begin today's show looking at how Cuba has successfully fought the pandemic. Since last year, only about 440 Cubans have died from COVID-19 giving the island one of the lowest death rates per capita in the world. Three months after that broadcast, Cubans took to the streets and to Twitter and Facebook in part to call attention to what the pandemic had actually meant for the island nation's healthcare system. In the past few weeks, Cuba has experienced its biggest spike in coronavirus cases yet. At the same time, it is getting harder to find food on the island. The protests that swept across Cuba, the largest in decades, stunned the communist-run government. In the 15 years since the release of Michael Moore's documentary, SICO, which celebrated Cuban healthcare. Their only sin when it comes to healthcare seems to be that they don't do it for a profit. Everyday citizens have been armed with smartphones, Twitter, Instagram, and Facebook, empowering them to tell the truth about what it's really like to walk into a Cuban hospital. So when you say that all you have to do to realize the truth about the Cuban healthcare system is actually go to Cuba, well, you have the example of someone who did go who was Michael Moore, and he came up with SICO, which obviously presents the Cuban healthcare system as a great triumph. I meant do not go on one of those stage Potemkin tours. Maria Wurla was an author, analyst, and the founder of the Cuba Archive, which promotes human rights through research. He went to a facility that was prepared to receive him that was part of this montage, you know, clearly. That wouldn't stand today because you have so many videos coming out, I think, from facilities in Cuba. Is that due to social media? It's due to social media and to telephones. People are, you know, it's almost daily. The thing is, it's mostly in Spanish, and mostly you have to look for them. But if you go on YouTube and, I mean, on Facebook, it's daily, daily people are posting this. So how did the Castro regime's propaganda machine manage to fool so many for so long? The answer lies with Cuba's foreign medical missions, which are teams of healthcare professionals dispatched to provide emergency and routine care to foreign countries. Your doctor has educated you in the idea of saving lives. The first medical mission was sent to Algeria in 1963. After the fall of the Soviet Union, when the government lost its major source of aid, the program was ramped up significantly as a source of revenue for the impoverished nation. The Cuban government has promoted the missions as a humanitarian endeavor and a demonstration of the community spirit and selflessness that's central to the communist project. In his 1960 speech on revolutionary medicine, the Marxist revolutionary Che Guevara said that individualism must disappear in Cuba. He recounted the story of a group of physicians in Havana who demanded remuneration before going into the country's rural areas to treat the sick. He dreamed of replacing them with a new class of doctors drawn from the peasantry who would run immediately and with unreserved enthusiasm to help their brothers. Our country will be able to send the doctors who need the darkest corners of the world. This will be a battle of solidarity against selfishness. Is a Fidel Castro quote inscribed on the wall at the medical school in Havana alongside a map showing all of the places in the world that the medical missions have served. Cuba produces a lot of physicians in this country. And you know where they go? They go to poor countries around the world doing a lot of good. They become known around the world as being one of the most generous countries in providing doctors and medical equipment to third world countries. It's a big show that Cubans get off the airplane wearing their white jackets, you know, after a long cross-Atlantic flight with their flags, you know, not even doctors without borders that has an amazing program has that kind of propaganda behind them. What fantastic work the Cuban doctors have done. That they should be nominated for a Nobel Peace Prize in 2021. For the Nobel Peace Prize for 2021. And I'm very happy to nominate them. Dr. Rodcer Rios Molina participated in the medical mission in Sierra Leone in 2013 where healthcare specialists from around the world came to help contain the Ebola epidemic. The members of the mission were told that when they returned to Cuba they would be received as heroes and that the government would give them each a new car. Dr. Rios says he did receive a stipend that went to cover his living expenses. Medical personnel from other countries on the other hand were generously compensated. Doctors from Spain, from Canada, even from here in the United States, from doctors without borders who were working there, they were volunteers too, but they paid for them. That was the difference. However, the other doctors from other countries who worked with me there, who had the opportunity to compensate, they won $7,000 monthly. I mean, they were playing their lives, but they were receiving a monetary compensation for what they were doing. Dr. José Ángel Sánchez, who was part of a medical mission in Venezuela and fled in 2015, points out that host countries are paying for these services and that the money is going to the Cuban government instead of the doctors who were doing the work. The myth of Cuban physicians as selfless healers started to fracture in 2000, when two doctors from the mission in Cebabue slipped a note to an airline official with the handwritten word, kidnapped. They had denounced the Castro regime and were being brought back to Cuba against their will, possibly to face jail time. Instead, they wound up in the US and were granted political asylum. In a 2020 report, Human Rights Watch said the Cuban medical missions violate doctors' fundamental rights, including the right to privacy, freedom of expression and association, liberty and movement, among others. They noted that many doctors feel pressure to participate in the missions and fear retaliation if they do not and that governments that accept Cuban assistance that includes the abusive conditions imposed by Cuba are becoming complicit in human rights violations. It starts from the recruitment and how it's done that is not fair, that is not transparent, that does not tell the doctors what conditions they're going to face when they go does not give them an option to say I want this or not or I agree to it or not to begin with the employment is a problem but then they're forced to leave their families in Cuba, they cannot bring them with them and if they abandon the mission or let's say they don't want to continue anymore to be in the mission and they want to stay in Brazil or Venezuela or South Africa or whatever, they are prevented from going back to Cuba for at least eight years. There's specific laws that they could be put in prison for years because they're considered traitors. For the past decade, the United States has encouraged Cuban doctors and nurses working outside Cuba to defect to the United States. In 2006, the George W. Bush Administration created the Cuban Medical Professional Parole Program granting healthcare workers stationed abroad permanent resident status. All they had to do was make it to a U.S. Embassy. Over 7,000 medical workers took advantage of the program. President Barack Obama cancelled this project due to the request of the Cuban government because obviously it was a project that took away or put in danger all this business and business that the Cuban government did. Dr. Julio César Alfonso is the president of the Miami-based Solidarity Without Borders, which helps Cuban doctors who have escaped. This program worked perfectly, it had some irregularities during the years it worked quite well. In 2014, the New York Times op-ed page published an editorial calling for an end to the program. American immigration policy should not be used to exacerbate the brain drain of an adversarial nation, it noted. In other words, the rights of doctors to decide where and how to live should be subordinate to what was best for the Cuban government. There is some possibility that it will be restored. And yet, there hasn't been much progress regarding this, but we continue to push through different contacts everywhere to try to restore some kind of program that benefits these professionals who escape from this slavery. But so far, there hasn't been much success, but the most positive is trying to eliminate what is still going on. And that is what the international community should be working on. After the mission in Sierra Leone, Dr. Rios was redeployed to a military base in Mexico. One day, he was sent with a group of doctors to buy some phone cards so they could connect with their relatives back home. He decided to make his escape. Dr. Rios found a job at a Mexican pharmacy to start saving money to pay a coyote to bring him into the U.S. He was picked up by the border patrol and taken to an immigrant detention center for 42 days. In 2018, a group of Cuban doctors who defected from the medical mission sued the Pan-American Health Organization, which is part of the World Health Organization, for aiding in human trafficking and for earning 75 million in fees for acting as a middleman. The medical missions are primarily a way of selling Cuban health care services abroad. But what's health care like for those living on the U.S. border patrols? The medical missions are primarily a way of selling Cuban health care services abroad. But what's health care like for those living on the island? Cuba, quite surprisingly, has a very advanced biopharma industry. Unlike the rest of the developing world, there's no doctor shortage in Cuba. We've seen wide improvements of Cuban health across the population. Providing a kind of care that's both personal and persistent. These are the heringues that are available on a daily basis to inject a patient. Speculation is the instrument that is used for vaginal tests for pregnant women or any other women. When they put a documentary, they put it in the best hospital, in the best hospital. For example, before I came here, I worked in a national clinic two years before I came. An international clinic, where tourists go. I worked in the international clinic two years before I came here. There, of course, the care is better. There are all the medicines. There are all the diagnostic means to make the patients. The beds are different. Of course, that's tourism. Look at a tourist, the first thing he's thinking is that he's going to give you $20. Because he's going to give you $20. With $20, you're going to have more than the salary you have in the whole month. So that patient, you prioritize it. That's the way you have to go forward. There are two systems of health in Cuba. One for the common population and the other for tourism and for the elite. Cubans tend to blame their hardships on the U.S. trade embargo. One of the biggest problems remains the embargo of medicine from U.S. pharmaceutical companies. But the deplorable conditions in Cuban hospitals have more to do with the lack of basic healthcare supplies which are readily available from other countries such as antibiotics and steroids. Cuban hospitals also have a shortage of beds and stretchers and somewhere without water for 6 to 12 hours a day at the height of the pandemic. But the law does stipulate that U.S. companies need a license in order to sell to Cuba and critics are correct to point out that this requirement adds red tape to the process. Total U.S. healthcare products purchased by Cuba from 2003 to 2021 averaged a mere $1.4 million annually in what should be a $50 to $100 million market. But it's not the licensing process that accounts for such poetry sales. Companies would gladly obtain a $50 to $100 million market to sell their products to Cuba if they could earn enough money to make it worth the effort. Cuba has a severe foreign currency shortage because it produces little in the way of goods and services that the rest of the world wants to buy. Promoters of Cuban healthcare often cite the country's infant mortality rate as evidence of its success. And yet the Cubans are able to have a lower infant mortality rate than the United States. Cuba has similar life expectancy and lower infant mortality than the United States. How is this possible that an American infant is by official statistics almost 50% more likely to die than a Cuban infant? Wrote Nicholas Kristoff in a 2019 New York Times column that looked at one of the most often-repeated figures in support of the claim that they're something exceptional about Cuba's healthcare system. While conceding that the figure should be taken with a dose of skepticism, Kristoff chose to interpret them regardless in support of his priors. Cuba has a variety of strategies for manipulating its infant mortality rate, such as seeing to it that fetuses less likely to survive outside the womb never get the chance. There are significant evidence that Cuban doctors coerce women into aborting fetuses shown to have abnormalities after routine ultrasounds. Cuba has a variety of strategies for manipulating its infant mortality rate, such as seeing to it that fetuses less likely to survive outside the womb never get the chance. We have to understand that the physicians in Cuba are a member of the army, and they have to meet certain targets in terms of infant mortality, and if they don't meet those targets, they face penalties. Vincent Galloso, who's an assistant professor of economics at George Mason University, co-authored a 2018 paper arguing that Cuba's low infant mortality rate in part is a result of misclassification using a different indicator known as late fetal deaths. Late fetal deaths are things that happened in early neonatal deaths in the first seven days. That means you reclassify the early seven-day deaths as late fetal deaths. That way they don't pop into the official statistics. And we can actually look at statistics of how their ratio of late fetal death to early neonatal death are for most western countries. The ratio is generally 4 to 1, 6 to 1. Whereas Cuba is like an outlier where it's 14 or 15 to 1, which is a clear sign of this distorted set of incentives. So there is, once you adjust for that, you find that Cuba's infant mortality rate goes as high as doubles, sometimes increases by half of what it is, sometimes twice what it is. Despite reports early in the pandemic that Cuba was an outlier in its success in combating COVID. Cuba has far surpassed the United States when it comes to COVID-19 and people surviving. By August of 2021, the New York Times was reporting that Cuba's healthcare system was reeling, with oxygen supplies running low, a shortage of syringes, and mortars and crematories overwhelmed. President Miguel Diaz-Canel blamed the U.S. trade embargo. He wants to say that it doesn't work. At this moment, the island collapsed. The health system collapsed. The hospitals overwhelmed, people dying in the corridors, patients without oxygen, hospitals without electricity have enough energy to treat this magnitude. Dr. Rios has three kids, ages 7, 12 and 16, still living in Cuba and he's hoping to bring them to the U.S. I told him that I wanted to be a doctor at the age of 9, but until that day I had to do what I had to do. And do you want me to be honest? It doesn't matter. I'm serious. The Cuban people are going to wake up and the Cuban people are going to get stronger than ever. The Cuban people realized that there wasn't an external enemy nor an earlier enemy. The Cuban people's enemy is the Cuban government.