Title: Affirming that the Government of Cuba's foreign medical missions constitute human trafficking.
Policy area: International Affairs

Summary:
This resolution expresses the House of Representatives's sense that Cuba is engaging in state-sponsored human trafficking through Mais Medicos, a Brazilian government program that brings doctors from other countries, including Cuba, to serve in Brazil. The resolution also urges the Department of State to downgrade Cuba to Tier 3 in its annual Trafficking in Persons report and to reestablish the Cuban Medical Professionals Parole program, which allowed certain Cuban medical personnel in countries other than Cuba to apply for parole to enter the United States.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H. Res. 136 Introduced in House (IH)]

<DOC>






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 referred 
                  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 foreign medical missions in 67 
        countries under conditions that represent forced labor;
Whereas the Department of States' 2018 Trafficking in Persons (TIP) report noted 
        that Cuban authorities coerced some participants to remain in the 
        foreign medical missions, including by--

    (1) ``withholding their passports [and] restricting their movement'';

    (2) ``using `minders' to monitor participants outside of work'';

    (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 salaries 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, revealed 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 implemented 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 Medicos Cubanos, Sociedad Anonima, or CMS), signed an 
        agreement 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 
Corporation (CMS) for the medical services provided by each Cuban doctor 
serving in Brazil;

    (2) that the for-profit Cuban Medical Services Trading Corporation 
(CMS) would pay each Cuban doctor approximately 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 Corporation (CMS), would retain approximately 75 
percent of the monthly payment received from the Pan American Health 
Organization; and

    (4) restrictions preventing participating Cuban doctors 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 Medicos program, which included the participation of Cuban doctors 
        and doctors of other nationalities;
Whereas the for-profit Cuban Medical Services Trading Corporation (CMS) 
        commenced contracting Cuban doctors for the Mais Medicos program, and 
        the first Cuban medical professionals arrived in Brazil in August 2013;
Whereas Cuban doctors were the only medical professionals participating in the 
        Mais Medicos program to have their salaries directly garnished by their 
        government, and doctors of other nationalities serving in Brazil 
        received the full amount of their salary;
Whereas Cuban doctors participating in the Mais Medicos 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 Medicos program were prohibited 
        from having their families accompany 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 Persons (TIP) report 
        documented how the Government of Cuba also confiscated Cuban doctors' 
        passports in other countries, and stated that ``the Cuban government 
        acknowledges that it withholds passports of overseas medical 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 nationalities 
participating in the Mais Medicos program; and

    (2) stated in its April 2014 report, in recognition of the legal risks 
associated with the Mais Medicos program, that it would be ``prudent that 
PAHO set a contingency plan to face possible negative statements of [the] 
lawsuits'';

Whereas the Government of Cuba has stated that Cuban doctors unwilling to return 
        to the country after their participation in foreign medical missions 
        will not be permitted to return to their homeland for eight years;
Whereas the Government of Cuba directly profits from exporting 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 Victims 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 subjection to 
        involuntary servitude, peonage, debt bondage, or slavery'': Now, 
        therefore, be it
    Resolved, That it is the sense of the House of Representatives 
that--
            (1) the Government of Cuba subjected Cuban doctors and 
        medical professional participating in the Mais Medicos program 
        to state-sponsored human trafficking;
            (2) Cuban doctors participating in the Mais Medicos program 
        should have been permitted to work under the same conditions as 
        all other foreign doctors participating in the program;
            (3) the Government of Cuba should compensate Cuban doctors 
        that participated in the Mais Medicos programs for the full 
        amount of wages that were garnished by the Government of Cuba;
            (4) foreign governments that sign agreements with the 
        Government of Cuba or the for-profit Cuban Medical Services 
        Trading Corporation (CMS) or other companies affiliated with 
        the Government of Cuba to procure the services of Cuban 
        professionals directly assume risks related to participation in 
        forced labor arrangements;
            (5) the Pan American Health Organization must immediately 
        provide greater transparency about its participation in the 
        Mais Medicos program and its agreement with the Government of 
        Cuba and the for-profit Cuban Medical Services Trading 
        Corporation (CMS);
            (6) the United States Department of State must downgrade 
        Cuba to Tier 3 in its annual Trafficking in Persons (TIP) 
        report, given new evidence on Cuba's foreign medical missions 
        and the Government of Cuba's longstanding failure to 
        criminalize most forms of forced labor; and
            (7) the Department of State must reestablish the Cuban 
        Medical Professionals Parole (CMPP) program.
                                 <all>