Federal
Affirming that the Government of Cuba's foreign medical missions constitute human trafficking.
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IV
116TH CONGRESS
1ST SESSION
H. RES. 136
Affirming that the Government of Cuba’s foreign medical missions constitute
human trafficking.
IN THE HOUSE OF REPRESENTATIVES
FEBRUARY 14, 2019
Mr. SIRES (for himself, Ms. SHALALA, Mr. DIAZ-BALART, Mr. ROONEY of
Florida, Mr. VARGAS, Mr. WALTZ, Ms. WASSERMAN SCHULTZ, and Ms.
MUCARSEL-POWELL) submitted the following resolution; which was re-
ferred to the Committee on Foreign Affairs
RESOLUTION
Affirming that the Government of Cuba’s foreign medical
missions constitute human trafficking.
Whereas, in 2015, the Government of Cuba maintained more
than 50,000 Cuban doctors and medical personnel in for-
eign medical missions in 67 countries under conditions
that represent forced labor;
Whereas the Department of States’ 2018 Trafficking in Per-
sons (TIP) report noted that Cuban authorities coerced
some participants to remain in the foreign medical mis-
sions, including by—
(1) ‘‘withholding their passports [and] restricting
their movement’’;
(2) ‘‘using ‘minders’ to monitor participants outside
of work’’;
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•HRES 136 IH
(3) ‘‘threatening to revoke their medical licenses’’;
(4) ‘‘retaliat[ing] against their family members in
Cuba if participants leave the program’’; or
(5) ‘‘impos[ing] exile if participants didn’t return to
Cuba as directed by government supervisors’’;
Whereas, between 2013 and 2018, more than 20,000 Cuban
medical professionals served in Brazil and had their sala-
ries garnished, movement restricted, and family visits
limited by the Government of Cuba;
Whereas investigative reporting by the digital platform Diario
de Cuba, through an access to information request, re-
vealed that Brazilian diplomatic cables detailed the terms
of the Government of Cuba’s medical missions to Brazil;
Whereas, in early 2012, the Government of Cuba proposed to
the Government of Brazil the establishment of a program
to send Cuban doctors to geographic regions of Brazil
that had an insufficient number of medical personnel;
Whereas, during subsequent negotiations, the administration
of former Brazilian President Dilma Rousseff proposed
an agreement between the two governments to be imple-
mented through coordination with the Pan American
Health Organization (PAHO) in order to avoid oversight
by the National Congress of Brazil;
Whereas the Government of Cuba stated that implementing
the agreement through the United States headquarters of
the Pan American Health Organization would present
risks for potential violations of United States sanctions;
Whereas, in July 2013, the Government of Cuba, acting
through the for-profit Cuban Medical Services Trading
Corporation (Comercializadora de Servicios Medı´cos
Cubanos, Sociedad Ano´nima, or CMS), signed an agree-
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•HRES 136 IH
ment with the Brazilian Ministry of Health to formalize
a commercial arrangement for Cuban doctors to provide
medical services in Brazil;
Whereas the agreement between the Government of Cuba and
the Government of Brazil established—
(1) that the administration of former Brazilian
President Dilma Rousseff would pay the Pan American
Health Organization a monthly fee, which would then pay
the for-profit Cuban Medical Services Trading Corpora-
tion (CMS) for the medical services provided by each
Cuban doctor serving in Brazil;
(2) that the for-profit Cuban Medical Services Trad-
ing Corporation (CMS) would pay each Cuban doctor ap-
proximately 25 percent of the monthly payment received
from the Pan American Health Organization;
(3) that the Government of Cuba, acting through
the for-profit Cuban Medical Services Trading Corpora-
tion (CMS), would retain approximately 75 percent of the
monthly payment received from the Pan American Health
Organization; and
(4) restrictions preventing participating Cuban doc-
tors from seeking employment in Brazil outside of the
formal structure of the program;
Whereas, in July 2013, the Government of Brazil announced
the creation of the Mais Medı´cos program, which in-
cluded the participation of Cuban doctors and doctors of
other nationalities;
Whereas the for-profit Cuban Medical Services Trading Cor-
poration (CMS) commenced contracting Cuban doctors
for the Mais Medı´cos program, and the first Cuban med-
ical professionals arrived in Brazil in August 2013;
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•HRES 136 IH
Whereas Cuban doctors were the only medical professionals
participating in the Mais Medı´cos program to have their
salaries directly garnished by their government, and doc-
tors of other nationalities serving in Brazil received the
full amount of their salary;
Whereas Cuban doctors participating in the Mais Medı´cos
program faced severe limitations on their ability to travel
inside Brazil and a prohibition on travel to neighboring
countries;
Whereas Cuban doctors participating in the Mais Medı´cos
program were prohibited from having their families ac-
company them while stationed in Brazil;
Whereas the Cuban doctors frequently had their passports
taken by Government of Cuba officials present in Brazil
in order to limit their ability to travel;
Whereas the Department of State’s 2018 Trafficking in Per-
sons (TIP) report documented how the Government of
Cuba also confiscated Cuban doctors’ passports in other
countries, and stated that ‘‘the Cuban government ac-
knowledges that it withholds passports of overseas med-
ical personnel in Venezuela’’;
Whereas the Pan American Health Organization’s external
auditor, the Spanish Court of Audit—
(1) stated in its January 2018 report that 198
Cuban doctors have presented 159 legal challenges in the
Brazilian court system since the start of the program in
July 2013 demanding extra free time in their contracts
and equal working conditions as doctors of other nation-
alities participating in the Mais Medı´cos program; and
(2) stated in its April 2014 report, in recognition of
the legal risks associated with the Mais Medı´cos program,
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that it would be ‘‘prudent that PAHO set a contingency
plan to face possible negative statements of [the] law-
suits’’;
Whereas the Government of Cuba has stated that Cuban doc-
tors unwilling to return to the country after their partici-
pation in foreign medical missions will not be permitted
to return to their homeland for eight years;
Whereas the Government of Cuba directly profits from ex-
porting the services of Cuban professionals, having
earned more than $8,000,000,000 from their work in
2016, of which foreign medical missions represent the
majority of the income; and
Whereas the term ‘‘severe forms of trafficking in persons’’ is
defined under section 103(9)(B) of the Trafficking Vic-
tims Protection Act of 2000 (22 U.S.C. 7102(9)(B)) as
‘‘the recruitment, harboring, transportation, provision, or
obtaining of a person for labor or services, through the
use of force, fraud, or coercion for the purpose of subjec-
tion to involuntary servitude, peonage, debt bondage, or
slavery’’: Now, therefore, be it
Resolved, That it is the sense of the House of Rep-
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resentatives that—
2
(1) the Government of Cuba subjected Cuban
3
doctors and medical professional participating in the
4
Mais Medı´cos program to state-sponsored human
5
trafficking;
6
(2) Cuban doctors participating in the Mais
7
Medı´cos program should have been permitted to
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work under the same conditions as all other foreign
1
doctors participating in the program;
2
(3) the Government of Cuba should compensate
3
Cuban doctors that participated in the Mais Medı´cos
4
programs for the full amount of wages that were
5
garnished by the Government of Cuba;
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(4) foreign governments that sign agreements
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with the Government of Cuba or the for-profit
8
Cuban Medical Services Trading Corporation (CMS)
9
or other companies affiliated with the Government of
10
Cuba to procure the services of Cuban professionals
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directly assume risks related to participation in
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forced labor arrangements;
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(5) the Pan American Health Organization
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must immediately provide greater transparency
15
about its participation in the Mais Medı´cos program
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and its agreement with the Government of Cuba and
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the for-profit Cuban Medical Services Trading Cor-
18
poration (CMS);
19
(6) the United States Department of State
20
must downgrade Cuba to Tier 3 in its annual Traf-
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ficking in Persons (TIP) report, given new evidence
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on Cuba’s foreign medical missions and the Govern-
23
ment of Cuba’s longstanding failure to criminalize
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most forms of forced labor; and
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(7) the Department of State must reestablish
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the Cuban Medical Professionals Parole (CMPP)
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program.
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Æ
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