Nicaragua
FACTS
Health workers: 549 (290 for Covid-19)
Cumulative: 2,000 (since 1976)
Mission status: Active
AGREEMENTS
MOST RECENT AGREEMENT
DURATION: 5 years
STARTED: 2015
AGREEMENT SIGNER: Jamaicans Ministry of
Health and Well-being

PREVIOUS AGREEMENTS
Technical Cooperation Agreement (1976)

ADDITIONAL INFORMATION
Geographic areas: Throughout Jamaica, with a
larger presence in South-East and Western
regions.
Health areas: Intensive and internal medicine,
hematology, general comprehensive medicine,
ophthalmology, nephrology, neonatology, and
stomatology; nurses specializing in intensive
therapy, hemodialysis, emergencies,
neonatology, primary care; pharmacists and
medical technology engineers.
Documented Cases: Yes
Documented Agreements: No
Current facts:
• Active personnel: 549
• Defections: 75 (estimated)
• Did not return to Cuba: 75 (estimated)
• Prohibited from returning: 20 (estimated)
Official statistics available: Yes
Most relevant violations: Workers are not
given a copy of their contract, have their
passport taken, are not allowed to take their
diplomas; strict curfews, workload of over 50
hours per week; are not allowed to live by
themselves – they must live with others to
better control their movements; must pay for
their own return, and lose benefits, if they end
their participation before the mission
concludes; must pay for their own lodging and
food.

SUMMARY

Cuba’s medical cooperation with Nicaragua first took place on two occasions, in 1972 and 1988, when Cuba sent, respectively, 48 and 39 members of the Henry Reeve Brigade. Cuba sent 15 medical workers from the same brigade in 1992, following a volcanic eruption in Nicaragua, and in 1998 it sent 64 workers to assist in the wake of Hurricane Mitch. From 2000-2003, Cuba sent 26 medical workers during the Dengue epidemic. Since 2007, members of the Che Guevara Medical Brigade have been added to the 46 workers who were already in the country as part of the region-wide “Operation Miracle.” In 2010 the Todos con Voz program was launched, focused on persons with disabilities. More than 1,200 Nicaraguan doctors have graduated from the Havana-based Escuela Latinoamericana de Medicina (ELAM). To graduate, these doctors must join a Cuban medical brigade in their sixth year. The typical duration of a mission in Nicaragua is two years. Medical specialists earn a monthly wage of around $1,100, of which they get 25 percent while having to give $800 to the Cuban government. Between the stipend ($300), a magnetic card for their families ($50), and the salary they would receive in Cuba, which they continue to earn ($50), they receive a total of $400, which is 60 percent of what a Nicaraguan doctor earns. 1

DOCUMENTED CASES

Anonymous: 4
Documented violations: Yes
Not anonymous: None
Public (media): 2
Findings: The medical workers are not given a copy of their signed contract; their
passport is taken; they are subjected to Resolution 168; they are placed under
curfew; they are forced to carry out “acts of repudiation” (e.g., harassment,
violence) against colleagues who break rules; they do not take the month of
vacation provided; they are subject to being prohibited from returning to Cuba
for eight years if they defect or leave the mission early; they are made to carry
out political work among the population; and they are threatened constantly.

NAMES OF CHIEFS OF MISSIONS

2020 – Dr. Michel Cabrera, Chief of Cuban Medical Brigade responding to Covid-19
2014 – César de Jesús Comas García, Chief of Che Guevara Medical Brigade
2007-2011 – Alfredo Rodríguez, Chief of Che Guevara Medical Brigade

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