bogota, colombia —
Hector Zelaya carefully walks through an abandoned eye clinic in Honduras at the slow pace of someone still learning to see.
The sturdy, middle-aged man was scheduled for cataract surgery in April at a clinic in Catacamas, on the lowest slopes of a bushy hill about four hours east of the capital, Tegucigalpa.
But his surgery was abruptly canceled when the Honduran government terminated its contract with Mission Miracle in March. The program, a Cuban public health program that sends thousands of medical staff to developing countries, has been criticized by the United States and other countries for involving forced labor.
The order came from conservative President Nasry “Tito” Asfulura, who was backed by U.S. President Donald Trump in last year’s election, who said the sending of Cuban doctors, nurses and other medical professionals to Honduras did not comply with local regulations.
Honduras is one of several countries in the Americas to announce the termination of its contract with the Cuban Medical Mission, a foreign policy linchpin and important source of foreign currency for the socialist island nation.
Jamaica, Guyana, Guatemala and even Venezuela, which has sent the most Cuban doctors over the past two decades, have also terminated or are in the process of terminating their contracts with the Cuban medical mission.
Havana criticized the decisions, claiming they were “orders from Washington,” as the Trump administration presses full-scale diplomatic and economic pressure on Cuba. Last week, the US government indicted 94-year-old former Cuban President Raúl Castro, mirroring steps taken prior to the ouster of former Venezuelan President Nicolás Maduro.
U.S. Secretary of State Marco Rubio, the son of Cuban immigrants, strongly opposes the plan, saying in February 2025 the U.S. would impose visa restrictions on third-party government officials responsible for medical missions in Cuba.
Action continued rapidly, and last year he announced visa restrictions for officials from Central America, Africa, the Caribbean and Brazil.
The State Department has “taken steps to restrict the issuance of visas to Cuban nationals and government officials and individuals from third countries involved in Cuba’s exploitative labor export program, promoting accountability against the Cuban regime for its oppression of its citizens and those who profit from forced labor,” Rubio said.
But Zelaya said that for many low-income rural workers like himself, Cuba’s program is their only chance of getting affordable health care.
Depending on the region, the average monthly salary in Honduras ranges from $400 to $800, and the Cuban clinic in Catacamas was the only public health option for eye surgery in the country’s largest province.
Zeleya said her family ultimately paid $2,250 for surgery at a private clinic.
“Most people here won’t be able to pay for it,” he says.
Fusion of politics and health
Medical dispatch to Cuba has long been a subject of debate. Meanwhile, the brigades – as they are known in Cuba as deployments – are seen as a way to extend public health to remote areas such as Catacamas. Critics, on the other hand, see them as PR tools in the service of authoritarian dictatorships dating back to the 1960s.
In April, a lengthy report from the Inter-American Commission on Human Rights acknowledged the brigade’s positive contributions while also seeking to set the record straight, alleging forced labor practices and coercive methods by the Cuban leadership.
Health workers are routinely underpaid, receive a fraction of what host countries pay for health services, are not allowed to leave or develop relationships with the communities they are assigned to, and are expected to express political messages on behalf of revolutions and local governments, the report said.
Cuba has long denied similar accusations, and the Cuban government did not respond to a series of questions from CNN about its mission.
Mission officials speaking publicly from Cuba, where freedom of expression is restricted, say they support the brigades as a way to promote international solidarity.
In 2022, the left-wing portal Breakthrough News interviewed Cuban doctors who worked in Guatemala, Liberia, Italy and Portugal, at a time when European Union countries were welcoming missions during the coronavirus pandemic.
“Our philosophy is to help everyone we can,” said Dr. Juan Alemán, outlining the medical brigade’s history since its creation in the 1950s as an altruistic act by Cuba’s late leader Fidel Castro.
However, the reality is more complex, as Cuba also uses brigades to raise government funds. According to the State Department’s website, Cuba is estimated to earn as much as $4 billion a year, but Havana disputes this figure.
Last year, Cuban President Miguel Diaz-Canel defended Cuba’s “right to use medical cooperation as a source of income.” Cuba is under a U.S. embargo, which limits trade opportunities, making medical brigades an export like any other product, he argued.
Two former Cuban medical professionals working in Venezuela confirmed the IACHR’s claims to CNN. Both men, who requested anonymity to protect their families, said they joined the mission in search of economic opportunities not available in Cuba, but were disillusioned by the exploitation of their superiors and the system.
One of them, a 35-year-old physical therapist, worked in two different assignments in the province from 2017 to 2024, before returning to Cuba at the end of his assignment. He left the country permanently last year.
“In Cuba, we joke that your salary can pay for food, clothes, or shoes, but you can’t pay for all three at once…I was able to save money through my assignments, but then I decided to retire,” he told CNN.
The physical therapist first visited Venezuela when he was 26 years old, and it was the first time he had set foot in Cuba. Although Venezuela suffered an economic crisis in 2017, it still impressed him. “I remember the first time I went to the supermarket, I couldn’t believe I could buy anything I wanted with my salary,” he told CNN.
He was able to save over $6,000 during his first deployment, which is a significant amount of cash for a Cuban.
He then moved to Colombia and, thanks to the training he received from the mission, was able to find work in a private clinic.
He said the brigade’s medical skills remain important, but the idea of carrying out public health missions in the country’s geopolitical interests is outdated.
“Cuba is like a bubble, and when you’re inside you’re told that the rest of the world is bad. In fact, it’s only when you leave Cuba that your eyes start to open,” he said. “My dream is to go back someday, but to go back it will have to be a different Cuba.”
