Botswana is paying nearly P55,000 a month for each Cuban specialist doctor working in the country, while the physicians themselves receive about P13,400, according to a report released this week by the human rights organization Prisoners Defenders.
The report, published on Aug. 25, accuses Botswana of knowingly supporting what it describes as a system of “modern slavery” involving Cuban medical professionals deployed abroad under state-run programs.
According to Prisoners Defenders, a 2024 agreement between Botswana and Cuba stipulates that Botswana pays US$4,094.65 (about P54,865) per month for each Cuban specialist doctor. The doctors, however, allegedly receive only US$1,000 (about P13,399), with the remainder going to the Cuban government.
“The Cuban professional receives only US$1,000 (24.42%),” the report states, describing the arrangement as evidence of “slave wages.” It argues that the payment structure enables the Cuban state to capture most of the economic value generated by the medical professionals.
The organization says that roughly 75.6 percent of the contractual payment is withheld from the doctors.
“The Cuban professional receives only US$1,000 (24.42%),” the report states, describing the arrangement as evidence of “slave wages.” It argues that the payment structure enables the Cuban state to capture most of the economic value generated by the medical professionals.
Prisoners Defenders estimates that a contingent of 90 Cuban medical professionals would cost Botswana about US$350,500 (P4.7 million) each month, or US$4.2 million (P56.4 million) annually. The organization notes that this figure exceeds the original annual ceiling of US$2.89 million (P38.7 million) contained in the agreement and raises questions about whether additional financial arrangements were approved to accommodate the larger workforce.
The report argues that Botswana cannot claim ignorance of how the funds are distributed because the agreement reportedly requires invoices to separate payments destined for individual professionals from those transferred to the Cuban state.
It also cites parliamentary records from April 2025 indicating that Botswana was paying €3,500 per month for Cuban specialist doctors and €2,800 for auxiliary medical personnel. Those records further showed that Botswana had paid approximately P419.4 million to Cuba over the previous decade.
Prisoners Defenders contends that parliamentary disclosures did not make sufficiently clear that these payments were not direct salaries to the doctors themselves. “The State of Botswana … knows the separation of both items, establishes the differences, pays the fee and, therefore, materially supports the feudal scheme of vassalage of the Cuban regime with its medical professionals,” the organization said in the report.
According to the report, Botswana provides accommodation and transportation for the doctors and determines their deployment, while Cuban authorities retain control over the professionals and decide how much of the contractual payments they receive.
The organization also highlighted a set of regulations allegedly signed on July 3, 2026, by the head of the Cuban medical mission in Botswana, Dr. Pablo Ricardo Betancourt Álvarez.
The rules, according to the report, restrict doctors from leaving their assigned districts without authorization, receiving overnight visitors, staying away from designated residences, visiting other Cuban nationals, participating in unauthorized recreational activities, or acquiring and driving vehicles without permission. They also reportedly prohibit late-night outings without prior approval and allow mission officials to conduct surprise inspections.
Prisoners Defenders argues that such restrictions strengthen its claim that Cuban medical missions operate under coercive conditions.
The report says Cuban specialists received about US$800 a month in 2020 and approximately US$1,000 a month in 2026, despite Botswana paying more than US$4,000 per specialist during the latter period.
The report says Cuban specialists received about US$800 a month in 2020 and approximately US$1,000 a month in 2026, despite Botswana paying more than US$4,000 per specialist during the latter period.
Based on those figures, the organization calculates that the annual contractual payment for each doctor amounts to about US$49,136 (P658,385), while the physician receives roughly US$12,000 (P160,792). The difference, pproximately US$37,136 (P497,594) per doctor each year, is retained by the Cuban state, according to the report.
Prisoners Defenders also says interviews with Cuban medical personnel in Botswana revealed allegations of passport confiscation, restrictions on movement, mandatory political meetings, limits on family visits and holidays, and threats of punishment for those who abandon their assignments.
Some doctors reported working between 56 and 64 hours a week, with an average of 57.6 hours, the report said. The organization further alleges that Cuban professionals who leave their missions face an eight-year ban on returning to Cuba, which it cites as evidence of coercion. Prisoners Defenders argues that the combination of low remuneration, restrictions on movement, passport controls, threats of punishment and the inability of doctors to freely terminate their assignments amounts to forced labor.
