By Juan Forero
Washington Post Foreign Service
Tuesday, February 20, 2007
BOGOTA, Colombia -- Ariel Perez was, like thousands of fellow Cuban doctors, a devoted soldier in Fidel Castro's most important overseas mission -- providing medical care to the poor in oil-rich Venezuela, Cuba's most vital ally. But last year, Perez and two Cuban companions, carrying rucksacks with a few belongings and holding just $1,300 among them, sneaked across the Colombian border and promptly defected.
"From the moment I got there, I thought of it -- leaving," Perez, 36, said in an interview in Bogota, where about 40 Cuban physicians and other medical professionals are living after fleeing from Venezuela.
Now, Perez and the other Cuban defectors are providing a rare inside look at a program that has helped define the close relationship between Washington's two most formidable adversaries in the Americas, the 48-year-old communist government in Cuba and the populist administration of President Hugo Chávez in Venezuela.
Cuba has dispatched more than 20,000 doctors, as well as thousands of other specialists such as sports trainers and therapists, to Venezuela. Chávez's government has paid for the service by providing Cuba with nearly 100,000 barrels of oil a day, filling the void left by the Soviet Union, Havana's longtime benefactor during the Cold War.
Bringing medical personnel to once-forgotten shantytowns of Venezuela has been among the more popular of Chávez's many social programs, and has helped consolidate Venezuela's self-styled revolutionary government. Working from small brick modules, the Cubans examine newborns, provide care for the elderly and make house calls -- all for free.
"Anyone who gets sick here can go at midnight to where the Cuban doctors are, and they attend to you right away," Isalenis Arevalo, 24, who lives in a poor neighborhood, said in a recent interview at her home in Caracas. Before the Cubans arrived, she said, medical services were practically nonexistent for residents in her district.
"You had to buy the medicines," said Arevalo, whose 7-month-old baby, Adriana, receives regular checkups. "You had to go to the clinics and pay high prices. The doctors didn't want to come to the barrios."
Chávez and other government officials have declared the program, called Inside the Barrio, a success. But a Venezuelan medical association critical of the Chávez government has expressed reservations about the Cuban doctors' qualifications, and political opposition leaders have criticized the program for its lack of transparency. Cuban doctors are not permitted to talk to foreign journalists or diplomats. They must seek permission to travel outside of their assigned municipalities, and doctors who have defected say Cuban and Venezuelan intelligence operatives kept close tabs on their whereabouts.
The doctors in Bogota spoke of the pride they felt delivering care to the poor in the name of their small country, which has made health care a priority since Castro took power in 1959. But they also talked of being terrified working in Venezuelan neighborhoods buffeted by crime.
Most jumped at the chance to work overseas, seeing it as an opportunity to earn far more than the $15 a month they were paid in Cuba. But the workload was heavy -- from early morning until night, sometimes seven days a week. And the pay -- around $200 a month -- quickly evaporated in a country with high prices and double-digit inflation.
Although it is unclear how many have defected, Western diplomats in Bogota said that in 2006 there were 63 Cubans, most of them presumed to be medical professionals, who sought asylum in this country. That group does not include those who headed straight to the U.S. Embassy seeking help. U.S. authorities here referred questions about the Cubans to Homeland Security officials in Washington, who did not return telephone calls.
But Ana Carbonell, chief of staff for Rep. Lincoln Diaz-Balart (R-Fla.), a Cuban American and a staunch opponent of Castro and Chávez, said that "it's safe to say it's hundreds" of Cubans assigned to Venezuela who have sought asylum in recent years.
The Bush administration, which has tried to further isolate Cuba and provided tacit support for a failed coup against Chávez in 2002, has tried to encourage more defections. In August, U.S. officials announced a new policy that allows Cuban medical personnel -- identified by the Department of Homeland Security as doctors, physical therapists, lab technicians, nurses, sports trainers and others -- to apply for entry to the United States at U.S. embassies in the countries where they serve. Worldwide, as many as 500 Cuban medical personnel and their dependents have applied, Carbonell said. About a third have been accepted.
Although a Homeland Security fact sheet on the new policy, the Cuban Medical Professional Parole program, said adjudication of requests for entry to the United States "may take two weeks or longer," some of the medical personnel in Bogota have been waiting months. Several have been rejected after undergoing extensive U.S. background checks meant to weed out, among others, suspected spies.
"I don't know if it's going to come out," said one doctor, Cesar Rodriguez, speaking of his request to reside in the United States. "The embassy doesn't tell you anything."
Rarely are defections made public. Embassies in Latin America that receive requests keep quiet to protect the asylum-seekers and not fuel the indignation of the host government. Still, details seep out -- such as an internal U.N. report in 2003 that said 100 Cubans were trying to seek asylum at the U.S. Embassy in Caracas.
"It's common, but no one ever sees it or knows about it," said Nora Garcia, 46, an orthodontist who is among those who defected to Bogota. "You don't talk about desertions."
Yovany Ciero, 29, a sports trainer who is among those who defected to Colombia, said he planned to abandon his post from the moment he was told he was going to Venezuela.
In Tachira state, on the border with Colombia, he lived in a house with seven other Cubans, working 10 hours a day, seven days a week, he said. "I felt like merchandise, to be exchanged for petroleum," he said. "It's a situation where you're not valued as a professional, you don't get a dignified salary."
Ciero said his life was suffocatingly routine. Politics, and his view of Cuba's government, were off-limits in his daily dealings with Venezuelans. "You cannot talk about the Cuban reality with anyone," he said.
In September 2005, after five months in Venezuela, he crossed the border into Colombia. But Ciero said his dreams are unfulfilled. American officials have denied his request for entry into the United States.
"Where do I go?" he said, sitting in a cafe in an elegant district of Bogota with two other Cubans. "What door do I knock on?"
The Cubans in Colombia have come to understand the cold realities of geopolitics -- that, though Colombia's government is conservative and close to the Bush administration, it also places a priority on maintaining cordial relations with Cuba and Venezuela.
International relations, though, were the last thing on Ariel Perez's mind when he, Jorge Mulet, 29, a physical therapist, and Jorge Antonio Fong, 35, a physician, asked authorities for permission to leave the small town where they were assigned and go shopping in Caracas. Instead, they bought bus tickets to the Colombian border.
There were doubts, Perez recalled. "You think, do you want to do it? Do we go back?" But once they crossed into Colombia, he said, there was no turning back.
Now, Perez lives with Mulet and Garcia, the orthodontist, in a small, two-bedroom apartment in a working-class neighborhood. The furnishings are on loan. Their clothes were donated by relief agencies or mailed by Cuban exile relatives in the United States. Perez spends his days volunteering at a nearby public hospital.
But he and the others say their patience is wearing thin. Garcia, whose husband is in the United States, said she dreams of the day she can leave.
"I want the freedom to work, freedom to say what I think politically," she said. "I want to decide for myself what I want to do for myself. That no one decides for me."