It's a little known fact that Cuban doctors offer free medical care for the poor and needy around the world in what appears to be a Cuban version of the Peace Corps. But also little known is that these doctors are actually propping up the Castro regime back home.
When disaster struck Haiti in January, the first physicians to reach the island nation were from Cuba. It took the Cuban medical brigade three days to reach the town of Leogane, the epicenter of massive earthquake.
In the weeks that followed, Cuba sent hundreds of more doctors, and their Haiti brigades quadrupled to more than 1,500 medical professionals.
But Cuban doctors are a familiar sight in Haiti. They have been working there for 12 years.
"The institution as such is going to stay as long as needed. It could be years," said Dr. Jorge Balseiro Estevez, the Cuban field hospital director.
World Renowned Medical Team
Haiti is not the only country to host Cuba's medical ambassadors. They are also in rural Guatemala, where a Cuban clinic welcomes patients looking to have cataract surgery.
"We call this a miracle. A miracle, because to make someone see, who can't see. Cuba gives these people the opportunity for a free operation without any commitment. The objective is that the light would come, that's all," explained Dr. Delgado, a Cuban eye doctor.
Delgado is one of 600 Cuban doctors providing free medical services in Guatemala. Their goal is to reduce blindness -- one surgery at a time.
"'Operation Miracle' publicly gives us great satisfaction, because we have results. Here in Guatemala, specifically, we've had a million operations," explained Dr. Carmen Maria Pérez, another Cuban doctor.
Viva la Revolución
Waiting rooms in Cuban clinics display revolutionary slogans and portraits of Fidel Castro. Since Castro took power in 1959, the Cuban government has sent as many as 185,000 medical workers overseas.
"(There are) probably 30 to 40 countries in Africa that receive this assistance, in addition to about 30 in Latin America and the Caribbean," Vision Americas' Roger Noriega said. Noriega served as a former U.S. ambassador to the Organization of American States.
"And then we have to take into account Asia," he added. "So this is a global program, a very ambitious global program that Castro has used for 40 or 50 years."
Noriega also served as an assistant Secretary of State in the second Bush administration. He explained that Castro had much more than humanitarian goals in mind when he launched his medical brigades.
"The guy is bright, thinks strategically. Saw it as a way to build sympathy for his government, his regime," he explained.
'Renting' Castro's Doctors
Cuban doctors in Guatemala earn goodwill among the poor and with the government. Vice President Rafael Espada, a surgeon himself, is pleased to see Cubans serving where Guatemalan doctors won't go.
"The financial compensation for general practitioners in the rural area was extremely low, so no physicians wanted to really go to those parts," he said.
However, orthopedic surgeon Dr. Manuel Alzugaray, a Cuban exile in Miami, said the host countries also pay Cuba a fee for each doctor they receive.
"They are renting them, charging in dollars, paying them in Cuban pesos, and getting richer and richer and richer. Because that money doesn't go to the people," Alzugaray said.
Noriega said it's a form of slave labor.
"He insists - Castro does - that their families don't leave the country, can't leave the country, because they are held essentially as hostages to try to dissuade these doctors from defecting," he said.
Asylum for Doctors
But many Cuban doctors have escaped to freedom. A special U.S. State Department program has given political asylum to some 1,500 Cuban doctors and their families since 2006.
Alzugaray recalled meeting one of the early Cuban brigades in Nicaragua.
"From the 100 members, 75 left the brigade and came to freedom through Costa Rica and then to the United States," he said.
While the Cuban government uses its doctors to earn favor abroad, ordinary Cubans are paying the price back home.
"Medical installations in Cuba are a disaster. Most hospitals and health centers are in ruins -- the ones, of course, for the common people," Dr. Julio Cesar Alfonso, a Cuban exile, explained.
"Because there are centers and modern health services with a degree of technology designed to care for the tourists, for those who pay with hard cash, for elite government personnel," he said.
Alfonso fled Cuba after medical school. He said Castro's brigades do much more than medical work.
"Intelligence and political personnel accompany the medical brigade, and do their work," he explained.
That work is done quietly, while the doctors themselves create goodwill for Cuba. In fact, their presence in foreign countries deflects criticism, and helps assure Cuba's political survival.
And with benefits like these -- Cuba is unlikely to bring its doctors home anytime soon.
**Originally published September 3, 2010.