The ANC loves to name-check Cuba as a liberation-era ally and a model for developing countries to emulate.
One of the first acts of foreign policy by Nelson Mandela, when he was elected president in 1994, was to formalise diplomatic relations between South Africa and Cuba.
Cuba had been a reliable supporter of the ANC’s liberation struggle against the apartheid state, and directly fought the old regime in the Bush War in Angola.
Many anti-apartheid activists received military training or education in medicine and other sciences in Cuba.
President Cyril Ramaphosa has described relations between South Africa and Cuba as “solidarity in practice”. It is a key element of the ANC’s strategy of South-South cooperation, and of its ideology of “progressive internationalism”.
Progressive internationalism
“The African National Congress holds firm in its progressive internationalism, an approach to global relations anchored in the pursuit of global solidarity, social justice, common development and human security, etc.,” the organisation wrote in a 2022 discussion document on foreign policy. “It notes that progressive internationalism ‘envisages a just, equitable, non-racial, non-patriarchal, diverse, democratic and equal world system’. A bold and militant advocacy is required for the fundamental transformation of the global balance of forces, a radical restructuring of global governance, and a progressive global movement. These are the principles that have informed the stance of the ANC in its history as a liberation movement since its formation in 1912 and affirmed at successive conferences.”
This sounds, and is, classically Marxist. It could have been written 60 years ago.
Calling this sort of ideology “progressive” is a contradiction in terms. Nothing that has happened in the real world, including the collapse of the many socialist or communist projects of the 20th century, seems to change the rhetoric of the self-described progressive forces at all.
This ideological blind spot is why the government ignores the obvious successes of liberal democracies around the world, and instead continues to turn to failing communist states like Cuba for assistance and cooperation in areas such as healthcare, education, agriculture, infrastructure development, housing, and water and sanitation.
Medical brigades
Last year, the Department of Health publicly congratulated Cuba on celebrating 60 years of international medical support consisting of the deployment of dedicated medical brigades around the world.
“South Africa is amongst over 100 nations which benefited from social solidarity, excellent internationalism and medical cooperation with Cuba through medical doctors and specialists who immensely contributed to the country’s health system strengthening and pandemic response.”
Cuban doctors practise in South Africa, and South African medical students get sent to Cuba for training. One might surmise, therefore, a degree of excellence on the part of Cuba that simply isn’t to be found in South Africa, but this conclusion would be wrong.
The Cuban doctor programme, for example, is not so much a demonstration of solidarity as it is an exercise in servitude.
Recipient countries pay the Cuban government directly, and the press-ganged doctors receive only a small fraction of that amount. The Cuban government raises about $8 billion per year in precious foreign currency through these programmes, at the expense of its own doctors.
The doctors don’t really have a choice in the deployment, either. The alternative is to stay home. There, they can expect a much lower wage in the state-run healthcare system of between $15 and $30 per month. For context, a typical one-bed one-bath apartment in Havana costs between $200 and $300 per month.
The image of Cuban doctors as voluntary emissaries of communist healthcare was shattered in 2000, when two Cuban doctors deployed to Zimbabwe publicly denounced the Cuban government and sought asylum at the Canadian embassy in Harare. They were rounded up for repatriation, instead. At what was then called the Johannesburg International Airport, they slipped a note to an Air France official, claiming that they had been kidnapped and were in fear of their lives and the lives of their families in Cuba. Though Air France refused to let the Cubans board, the South African authorities sent them back to Harare, from where the doctors simply disappeared.
“The Cuban government imposes draconian rules on doctors deployed in medical missions globally that violate their fundamental rights,” said Human Rights Watch in 2020.
Cuban healthcare
Left-wing progressives worldwide have long admired the Cuban healthcare system. They point to impressive official health statistics – high life expectancy, low infant mortality and the third-highest doctor-per-capita ratio in the world – as evidence that the communist system works.
Underneath the official statistics lies a far grimmer reality, however.
Although healthcare is nominally free to Cubans, hospitals that do not cater to the elite suffer from “a lack of basic health care supplies, which are readily available from other countries, such as antibiotics and steroids,” according to a 2022 article by Daniel Raisbeck and John Osterhoudt in Reason magazine. “Cuban hospitals also have a shortage of beds and stretchers, and some were without water for six to 12 hours a day at the height of the pandemic.”
Crumbling health infrastructure and a shortage of equipment, supplies and medicine are often laid at the door of the US embargo against Cuba, but this is disingenuous, since Cuba is perfectly free to trade with countries in Asia, Europe, Africa and South America.
“The Cuban health care system is destroyed,” Rotceh Rios Molina, a Cuban doctor who escaped the country’s medical mission while stationed in Mexico, told Reason. “The doctors’ offices are in very bad shape.”
“People are dying in the hallways,” said José Angel Sánchez, another Cuban doctor who defected from the medical mission in Venezuela, also interviewed by Reason.
There is also evidence that on the one hand, Cuba’s high spending on public healthcare comes at the expense of other goods and services that in a state-run economy are simply not provided, and on the other hand, that the system creates incentives for healthcare professionals to fudge the numbers.
An analysis of Cuba’s statistics suggests, for example, that Cuban doctors frequently reclassify neonatal deaths as late foetal deaths, which reduces the child mortality rate and raises average life expectancy. Cuba also has a policy of forcing pregnant mothers to be sent to clinics, where their behaviour is controlled, and some are subjected to involuntary abortions – again to keep infant mortality statistics down.
General fitness of the population, another point of pride for the Cuban government, probably has a lot less to do with preventative healthcare, and more to do with the fact that very few Cubans can afford a car, so everyone gets plenty of exercise. The same harsh reality, along with strictly rationed food, is also responsible for the relatively low rate of lifestyle diseases such as obesity, diabetes, coronary heart diseases and strokes.
Poverty
Visitors to Cuba often report how happy the population appears to be. People often break out in spontaneous dancing, for example.
People who have travelled more extensively in Cuba, however, report that this is merely a façade for tourists. Cubans dance, yes, but mostly to convince tourists to take photographs of them, and they can earn a generous tip.
Once you leave the well-trodden tourist roads, impressions become grim. Dilapidated buildings, threadbare furniture, prostitution, alcoholism and refuse-strewn streets are never more than a block or two away from the colourful scenes most visitors see.
Visitors report feeling harassed by beggars, “guides” and “friendly locals”, and needing to flee back to their international hotels to escape the melee on the streets.
Others report that classic symptom of communist decay, flour shortages and bread queues.
The government, which runs most of the country’s economy, is riddled with people who got there by nepotism and never do any work. “Nobody has any incentive to do their job well or efficiently,” they say.
Black market
To make ends meet, Cubans are forced into the black market, both for work and for obtaining food and essential goods. After all, when a regular Cuban earns $17 per month on average, and a doctor earns $30 (or rarely $60), but an apartment costs $200, there’s only one way to survive and that is to secretly do private work for the small wealthy elite.
If Cubans need something, they have the choice of queueing at the official outlet, and perhaps waiting weeks for an item to become available. Or they can visit a black-market dealer, who is supplied by a connected politician, who diverts imports. There, they can illegally buy what they need, but at a much-inflated price.
Being able to afford such a corruption premium is another reason why Cubans routinely work black-market jobs, and are very, very friendly to foreign tourists.
The internet in Cuba is largely non-existent. People instead trade USB sticks, containing data such as classified adverts. The black market works on what used to be called sneakernet.
Cuba, once one of the biggest sugar exporters in the world, now imports sugar.
“Elections”
Cuba does hold “elections”, but they are not even remotely free and fair.
It is a one-party state, with the Communist Party of Cuba being the “superior driving force of the society and the state” – much as the ANC likes to think of itself.
Voters typically have a choice between two or three local delegates, all representing the same party. Those local delegates then elect members of the National Assembly of People’s Power. The candidates for this assembly are nominated by Communist Party committees. There is never more than one candidate for a seat, and no nominated candidate has ever lost an election.
The National Assembly only meets twice a year, but itself elects a 21-member “Council of State”, which exercises legislative power. It also elects the President, who in turn makes all executive and judicial appointments.
Disapproval
According to a July 2024 report by the Cuban Human Rights Observatory (OCDH), which surveyed 1 148 adults across the country, extreme poverty in Cuba rose to 89%, while disapproval of government rose five points to 91%. The number of Cubans who subsist on foreign remittances fell to 24%.
Only 4% report that they support the economic and social policies of Cuban president Miguel Díaz-Canel.
Seven out of ten Cubans have stopped having breakfast, lunch and dinner, due to lack of money or food shortages. Only 15% have been able to afford three meals a day without interruption.
Eighty-nine percent view Cuba’s public health system negatively. Thirty-three percent were unable to purchase the medicines they needed due to the price or scarcity. Only 2% could get them at state pharmacies.
In terms of the future national development, 53% of Cubans would like to follow the North American model, which goes up to 63% among younger Cubans (18- 30 years). A further 21% would choose the Spanish/European model. Only 3% believe that the current Cuban model should be the one to follow. And, despite the close relationship that the Cuban government has with Russia, this country is only a benchmark for 3% of those consulted.
The same organisation reports widespread repression of the population, ranging from arbitrary detentions, police brutality, abusive and unjustified fines, absence of press freedom, and the holding of political prisoners. In 2023, the Cuban government took an average of 10 repressive actions every 24 hours, the OCDH reported.
As you’d expect
Communism in Cuba has resulted in an economy that operates just about as well as you’d expect. There is extremely little scope for lawful private enterprise, but the black market supplies the incomes, and the goods and services, that the state sector fails to provide.
Propaganda about the excellent healthcare system or other public services in Cuba are just that: lies. The vast majority of Cubans are poor, hungry and ill-served by government services, as you’d expect from a communist state.
Despite frequent opinions to the contrary among left-wing elites, including in the academic literature, Cuba is not a model for other developing countries to emulate.
It is a throwback to the terrible communist tragedies of the 20th century. If the ANC, or the South African government, wishes to stand in solidarity with the Cuban people, it should stand for their liberation from their repressive communist government.
[Photo: Cuba.webp – A street scene in Old Havana. Cubans are poor and dissatisfied with their government. Photo by Jialiang Gao, used under a CC BY-SA 3.0 licence.]
The views of the writer are not necessarily the views of the Daily Friend or the IRR.
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