In a defiant stance that echoes the region's historical struggles for sovereignty, Caribbean leaders are pushing back against U.S. Secretary of State Marco Rubio's threats to revoke visas from officials who support Cuba's medical missions program, with several prime ministers declaring they would rather forfeit their access to American soil than compromise healthcare for their citizens.
"I will prefer to lose my US visa than to have 60 poor and working people die," declared St. Vincent and the Grenadines Prime Minister Ralph Gonsalves, highlighting the critical dialysis treatments that Cuban doctors provide to patients in his nation.
His sentiment was swiftly echoed by Trinidad and Tobago's Prime Minister Dr. Keith Rowley, who proclaimed at a recent public event to thunderous applause: "I just came back from California, and if I never go back there again in my life, I will ensure that the sovereignty of Trinidad and Tobago is known to its people and respected by all."
The diplomatic standoff escalated last month when Rubio announced an expanded policy targeting what he termed Cuban "forced" labor, particularly focusing on the island nation's overseas medical missions.
The policy would impose visa restrictions on current or former Cuban government officials "believed to be responsible for or involved in the Cuban labour export programme," which Rubio characterized as "exploitation of Cuban workers."
For Caribbean nations, however, the Cuban medical partnership represents a lifeline. With approximately 24,180 Cuban doctors serving in 56 countries worldwide, their presence has been instrumental in bolstering healthcare systems throughout the region, especially in nations with limited medical infrastructure.
Jamaica's Foreign Minister Kamina Johnson Smith emphasized this reality at a recent press briefing, noting that her island hosts more than 400 Cuban medical professionals, including doctors, nurses, biomedical engineers, and technicians whose services are "of importance to our health care system."
Grenada's Prime Minister Dickon Mitchell highlighted the historical context of this support, stating, "We have a legitimate partnership with the government and people of Cuba who have over several decades provided support to the people of Grenada in the medical field."
Acknowledging his nation's particular challenges in securing specialist doctors, Mitchell affirmed, "We will continue to support and defend the partnership."
The controversy has prompted high-level diplomatic engagement, with foreign ministers from the 15-member Caribbean Community (CARICOM) recently meeting with U.S. Special Envoy for Latin America Mauricio Claver-Carone in Washington, D.C. Guyana's Foreign Minister Hugh Todd acknowledged the importance of the U.S. as "a strategic partner to CARICOM" but stressed that "this very important issue has to be dealt with at the level of heads of government."
Prime Minister Rowley of Trinidad and Tobago pointed out the hypocrisy in the U.S. position, recalling the challenges faced during the COVID-19 pandemic: "Remember what happened during Covid when vaccines were required, and we couldn't buy one even though we had the money? And even where we paid the money, those we paid put us at the back of the line?"
He went on to defend his nation's medical staffing practices, explaining that specialists from countries including India, the Philippines, and primarily Cuba are paid "top dollar—equal to local rates," yet his government is "now being accused of taking part in a programme where people are being exploited."
According to Commissiong, these leaders responded by asserting their sovereignty: "We are sovereign independent nations, and we will decide for ourselves what nations we will have relations with."
Commissiong characterized Rubio's current policy as "part of this continuing U.S. vendetta against Cuba," aimed at "regime change," and referenced a 1960 State Department memo by Deputy Assistant Secretary Lester Mallory, which allegedly acknowledged the popularity of Castro's revolution and proposed making "life uncomfortable for the people in Cuba" by undermining the government.
Adding to the regional concerns, Commissiong highlighted that the United States has withdrawn its traditional assistance to the Pan American Health Organization (PAHO), the regional arm of the World Health Organization upon which Caribbean nations depend heavily in matters of health policy etc.
"The United States, having withdrawn itself from PAHO, will have a tremendous implication for all of us in the Caribbean, and you now turn around and say we must reject the much needed and critical health assistance being given to us by Cuba!" he remarked incredulously.
Cuba's Foreign Minister Bruno Rodríguez has not remained silent on the matter, accusing Rubio of putting his "personal agenda" ahead of U.S. interests and describing the policy as an "unjustified aggressive measure."
As this diplomatic tension unfolds, Caribbean leaders continue to prioritize their nations' healthcare needs and sovereign decision-making, demonstrating that regional solidarity and public health concerns outweigh the threat of U.S. visa restrictions.
The stance of these leaders reflects a broader historical pattern of Caribbean resistance to external pressure, particularly when it threatens essential services for their citizens.
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