Calabria is opposed to the US push to end Cuba's medical missions in the region, saying the region can't afford to lose the doctors.
Italy’s southern Calabria region is the rare place in Europe where Cuba sends medical professionals under a long-running programme that the United States wants to stamp out.
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Cuba has more doctors per person than almost any country on Earth — around 9.5 physicians per 1,000 people according to WHO data, nearly three times the OECD average — and its community-based prevention model is studied by health systems worldwide.
The country has sent its doctors to developing nations such as Gambia and Venezuela for decades, particularly due to their skills in providing care with scarce resources.
Over 200 are working in remote hospitals across Calabria, Italy’s poorest region, where shortages of homegrown healthcare workers had forced some hospital departments to close.
“It was a disaster. I was keeping the emergency room open all by myself,” the chief physician of Polistena hospital, Francesco Moschella, told The Associated Press, recalling the days before the Cubans arrived in January 2023.
Their presence triggered a visit from United States officials amid criticism from Washington, which calls the programme a moneymaker for the socialist government that the Trump administration has isolated and sanctioned.
Calabria’s president has refused to shut down the programme. Even if Cuba’s socialism doesn’t fit with his political views, he says the region depends on the doctors.
Countries under US pressure
United States Secretary of State Marco Rubio has accused the Cuban missions of being a “form of human trafficking” — a reference to Cuba's government keeping most doctors' salaries and allegedly confiscating some passports.
The US head of mission to Cuba, Mike Hammer, flew to Calabria in February alongside the American consul-general in Naples.
“I had some pressures also during the Biden administration. But pressure grew under Trump,” Occhiuto said. He told Hammer his government is working on incentives to lure Calabrian doctors home.
“But at the same time, I have also reiterated to the US Ambassador Hammer that I needed to keep hospitals open and that I intend to keep the Cuban doctors who are currently in Italy in their posts,” Occhiuto said.
Italy is not the only country under US pressure to stop collaborating with Cuba. In March, Jamaica ended its 50-year medical cooperation agreement with the country, affecting nearly 300 healthcare workers. In the same month, Honduras expelled more than 150 Cuban medical staff.
Calabria’s strained healthcare system
Despite growing tourism and a strong farming economy, wages in Calabria are about 30% lower than the Italian average, and the unemployment rate is double the national rate.
The region ranks last in Italy in public healthcare access, according to the health ministry.
During the COVID-19 pandemic, Cuba sent doctors to several areas of Italy and Calabria continued employing them after the health emergency ended.
“For a first-world country, Europe, we had a completely different idea. We didn’t think that the shortage of doctors was so serious,” said Zoila Yakelin Arevalo Cruz, an emergency medicine specialist who left Cuba in 2023.
The emergency room where she works in Polistena sees 30,000 patients annually, and six Cuban doctors make up half its staff.
“In this hospital there were lines that lasted up to eight or 12 hours. Now, thanks to our work, in less than an hour a doctor visits you.”
The region pays Cuban doctors directly
Calabria signed individual contracts with the doctors and makes deposits in their Italian bank accounts rather than paying the Cuban government agency that runs the medical missions.
Cuban doctors told the AP they still send as much as half their salaries back to their government.
“We are all aware of the economic situation Cuba is going through. It’s a contribution that we make voluntarily because Cuba trained us, educated us and made us doctors,” Arevalo Cruz said.
Daisy Luperon Loforte, Cuban cardiologist, echoed that sentiment: “We do not consider ourselves modern-day slaves at all, as somebody called it. We love our country, we give an economic contribution and we are happy to do so.”
Occhiuto confirmed that 63 Cuban doctors, some of them previously involved in Cuba’s international medical mission, recently applied to work in its healthcare system independently.
