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Recent developments concerning the winding down of Jamaica’s long-standing Cuban medical cooperation programme have stirred understandable emotions across the country. For many Jamaicans, this story is not merely diplomatic or administrative.

It is personal.

For me, it certainly is. Over the years, I have been a direct beneficiary of Cuban medical assistance. Members of my own church family, as well as countless residents of Port Antonio and the wider parish of Portland, have received care from Cuban physicians and nurses whose dedication and conspicuous competence earned the deep respect of our community.

To speak plainly: their presence mattered. They strengthened our hospitals, steadied our clinics, and brought reassurance to families facing illness and uncertainty.

Expressions of gratitude are therefore entirely appropriate.

Yet this moment also invites sober reflection. The conclusion of this long-standing programme forces Jamaica—and indeed the wider Caribbean—to examine some uncomfortable but necessary questions about how small states sustain their healthcare systems in an increasingly competitive global labour market for medical professionals.

Several reflections arise.

Recognising Cuba’s Extraordinary Contribution

For nearly half a century, Cuban medical cooperation has supported healthcare systems across the developing world, including Jamaica.

The model rested on several distinctive elements:

• Large-scale medical training. Cuba deliberately trained far more doctors than its domestic population required.
• Strong emphasis on primary care. Physicians were trained to work closely with communities and preventive health systems.
• Deployment abroad. Thousands of Cuban medical professionals served internationally where shortages were most acute.
• Integration of nurses and allied professionals. Cuban nurses have been indispensable partners in delivering care.

In Portland, this was evident every day. Cuban doctors and nurses worked quietly and diligently in our hospitals and clinics. Their professionalism and compassion became part of the fabric of community life.

For that service, Jamaica owes them sincere thanks.

A Personal Observation from the A-QuEST Experience

My involvement with the A-QuEST initiative has reinforced for me the importance of deliberate investment in human capital.

Over the years, many A-QuEST scholars have pursued advanced training in diverse disciplines around the world. Yet one particularly significant chapter in our journey involved Cuba.

Approximately fifty members of the A-QuEST community were deliberately educated and trained in Cuba, especially in fields such as:

• Medicine
• Dentistry
• Engineering
• Agriculture
• Agricultural engineering

These placements were intentional. They reflected a recognition that Cuba had developed remarkable training capacity in practical professional disciplines linked directly to national development.

The results have been impressive. Many of these graduates now serve their professions and communities with distinction.

The Caribbean’s Structural Medical Workforce Challenge

The present moment also exposes a deeper structural reality.

Caribbean healthcare systems face persistent physician shortages due to several factors:

• Small national populations, which make it difficult to maintain every speciality locally.
• Migration of trained professionals to wealthier countries offering higher salaries and research opportunities.
• Long training pipelines, since producing a specialist physician often requires eight to twelve years.

The result is a recurring cycle:

1. Caribbean institutions train doctors.
2. Some migrate abroad.
3. Governments recruit foreign professionals to fill the gaps.

For decades, Cuban medical cooperation helped stabilise this cycle.

Global competition for doctors is intensifying

Another reality must be acknowledged: the global demand for physicians is rising sharply.

Countries such as:

• the United States
• Canada
• the United Kingdom,

are themselves experiencing physician shortages driven by ageing populations and growing healthcare demand.

As a result, they actively recruit internationally trained doctors.

Small states, therefore, compete in a global labour market where wealthier countries hold clear advantages.

Training capacity alone cannot solve the problem quickly

Expanding local medical education is essential but not sufficient.

Institutions such as the University of the West Indies have played a crucial role in producing Caribbean physicians. Yet several constraints remain:

• limited teaching hospital capacity
• shortages of specialist instructors
• financial pressures on higher education

Even when training programmes expand, the benefits take years to materialise.

Medical education is necessarily a long-term investment.

Lessons from the Cuban example

The Cuban experience nevertheless offers an instructive lesson.

Even a relatively small country can exert global influence when it commits itself to developing large numbers of highly trained professionals in strategically important fields.

The Cuban approach emphasised:

• sustained investment in medical education
• strong primary healthcare systems
• integration of training with community service
• recognition of human capital as a national asset

Few countries may replicate the entire system, but its underlying principles deserve careful study.

A Caribbean opportunity

Looking forward, the Caribbean may benefit from deeper cooperation in healthcare workforce development.

Possible strategies include:

• expanded regional training programmes
• shared specialist services across island states
• collaborative research and education initiatives

Such cooperation is not unprecedented. The University of the West Indies itself stands as one of the region’s most successful examples of collective institutional development.

Healthcare workforce planning may increasingly require similar imagination.

Gratitude and responsibility

As Jamaica navigates this transition, two attitudes should guide us.

First, profound gratitude.

Cuban doctors and nurses served Jamaica with dedication and professionalism. Communities such as Port Antonio and the wider parish of Portland know this not from policy papers, but from lived experience.

Second, clear-eyed responsibility.

The structural challenges facing Caribbean healthcare—professional migration, training capacity, and global labour competition—require thoughtful and sustained policy responses.

Gratitude alone cannot resolve these issues. But gratitude can inspire the seriousness with which we address them.

A Closing Reflection

When I think of the Cuban medical professionals who served in Portland, my mind does not first turn to geopolitics or diplomatic negotiations.

I think instead of ordinary moments.

• A worried mother waiting outside a clinic in Port Antonio.
• A church member reassured after a careful examination.
• A nurse whose calm competence steadied a frightened patient.

These are quiet acts of service. Yet they are precisely the acts that give meaning to a healthcare system.

For decades, Cuban doctors and nurses performed such work with dignity and dedication across Jamaica. Communities like ours in Portland know this not from theory, but from lived experience.

As Jamaica now navigates a new chapter in its healthcare history, that legacy should not simply be remembered with gratitude. It should also inspire responsibility.

If the Cuban example has taught us anything, it is that the health of a nation ultimately rests upon the strength of its human capital—upon the doctors, nurses, engineers, agricultural scientists, and other professionals whom we deliberately train and encourage to serve.

In that sense, the story does not end with the departure of Cuban medical missions.

It continues with the choices we make about the next generation.

And in Port Antonio, where many of us first witnessed the quiet power of Cuban medical service, that lesson remains vividly alive.