Away from the glistening glass and steel skyscraper, in the middle of the Qatari desert stand a small hospital. The hospital belongs to the Qatari government. But its entire medical staff – 475 doctors, nurses and technicians are from Cuba.
The Cuban hospital, as it is officially known, opened in 2012, boasting world class facilities and services. But there is one thing that is not up to international standards: the salaries the Cubans staff are paid.
At just over USD1,000 (£778) a month, they receive as little as 10percent of what other foreign medical professionals can make working in government hospitals in Qatar.
The remainder of their earnings are pocketed by the Cuban government under a secret deal with the Qataris.
Neither the Qatari nor Cuban authorities would reveal details of the agreement, but sources with knowledge of the hospital estimate Qatar pays Cuba between USD5,000 and USD10,000 a month for each medical professional.
Cuba has been sending doctors around the world since the early 1960s; there are currently an estimated 30,000 Cuban doctors and nurses working in 60 countries.
Leasing doctors to other countries is the main source of hard currency for Cuba’s cash-strapped economy, earning the government USD6-8bn a year – far more than it makes from tourism.
Starting with missions to Algeria and Chile, the programme has grown into a global exercise in soft power driven by humanitarian, political and economic goals. Cuban medical teams are often at the forefront of disaster relief efforts in Latin America.
In the past decade, partly prompted by declining revenue from its medical programme in Venezuela, Cuba has turned to new countries with no shortage of money: Qatar and Saudi Arabia.
In a similar arrangement with Brazil, the Cuban government was reportedly paid about USD4,000 a month for each medic, of which the doctors received USD1,000.
When the rightwing Jair Bolsonaro, an opponent of Cuba, took power in Brazil last year, thousands of Cuban doctors left the country, prompting fears that poor areas of Brazil would be left without sufficient medical care.
Cuba is not the only country that exports its citizens to earn foreign currency. North Korea has also sent workers to Qatar under a programme with some similarities.
Although doctors sign up voluntarily to take part in the missions, US-based critics of the Cuban government say the programme is exploitative.
“I have no doubt that they are subject to a form of compelled labour … Cuba is a totalitarian state with a guaranteed pool of captive low-paid workers easily exploited as exportable commodities,” says María Werlau, the director of Cuba Archive, a Miami-based think tank opposed to the Cuban administration.
Werlau says Cuba’s medics are victims of wage theft, passport confiscation, heavy surveillance and forced family separation.
However, others argue the medical missions are highly-coveted opportunities in a country where doctors earn just USD40 to USD70 a month.
“I don’t believe that they are being exploited,” says John Kirk, professor of Spanish and Latin American studies at Dalhousie University in Canada. “They are earning significantly more than they would earn at home. They have been trained in a socialist system, have paid nothing for their medical training, and understand that the superior amount paid to the Cuban government is used to subsidise the healthcare system back in Cuba.”
The Guardian spoke to several medics at the Cuban hospital and some defended the system.
“I believe we should help everybody,” says one. “Based on that, yes it is fair, because I know that the other amount is used to support our health and education system … but if you think only of yourself, of course it’s not fair.”
But a medic who defected from the mission in Qatar says he “felt like a slave” on discovering that other doctors in the country were being paid more than him. “We were doing the same thing and earning far less than them.”
One reason doctors join the programme is that, even allowing for deductions made by their government, Qatar remains a lucrative and sought-after posting for Cuban healthcare professionals. With such paltry salaries at home, its attraction is obvious.
“Life in our country is very hard and the salary is very bad,” says one medic at the hospital. “Here we earn money for [Cuba] and for us too … One part for the country, and one part for each person.”
No one knows the exact amount the Cuban government is earning from their labour, and some seem not to care. “The education in Cuba is free. The government prepares us for many years and so the government needs to take something for this,” says one. (Source: The Guardian)