HELL IN HAVANA: Struggling SA medical students endure Cuba misery — US embargo blamed

Almost three decades ago, South Africa introduced the Nelson Mandela-Fidel Castro (NMFC) programme as a transformative pathway to medical careers, offering promising students state-funded opportunities in Cuba.

While it initially provided a vital alternative for those excluded by local university quotas, current participants report deteriorating conditions. Students on the programme describe living in cramped rooms with inconsistent water access, poor sanitation and food quality so compromised that it causes illness.

Under the watch of the Department of Health, the students based in Havana share a single toilet among as many as 13 people, sometimes going days without running water to flush toilets, or to bathe. Meals, meanwhile, have consisted largely of rice served with what students describe as watery, unseasoned soup.

Daily Maverick spoke to one of the students, who asked to remain anonymous for fear of recrimination. In a visibly low mood, the student described her experience, starting from the moment she landed in Havana in December 2024.

“I wanted medicine with everything in my heart, and when they told me that I am going to Cuba to study medicine, I was happy to a point where it didn’t matter if I had to leave my family… we got to the school, they took us into the quarantine thingy and like, it was bad…

“You are unable to shower because there’s no water, and the water, when it comes, it comes in intervals, and there was only one bucket. We were seven girls. Each of us went to bathe, but like we’re unable to; it got to a point where I was even depressed. There was no food down there,” said the student.

Once out of quarantine, conditions didn’t improve much. “It’s bad. I can just say that, I can’t describe it,” she said.

On the shared toilets, which she and 12 others rely on, she said, “You can’t flush. You have to go and fetch water with a bucket and flush the toilet.”

On the food, she said, “It’s like the water is the soup for the rice.” The student said the meat served at the cafeteria had left her with rashes and stomach illnesses severe enough to largely stop eating there, relying instead on bread bought with her own money.

“At some point I started feeling like I should just call our health attaché and tell him that I want to go back home. I’m from a poverty-stricken home. I know how poverty is, but this is bad, worse than my own situation back at home,” said the student.

The stipend is itself a source of anguish. Students are meant to receive roughly $200 a month, loaded on to a local card, but the student says the conversion rate severely erodes its value.

“You are unable to buy cosmetics because cosmetics (toiletries) right now have gone up extremely. Like roll-on only, you are buying it with R100; everything is just expensive. When students pushed for an increase, the department instead paid two months’ stipend as one lump sum. “It’s not going to help anything," she said. “That $400 is supposed to be for a month, not for two months.”

She says students have raised these issues repeatedly, with little result. “I do not have, I can’t do anything,” she recalled being told by the health attaché,  a response she says has become the norm rather than the exception.

Department of Health responds 

Confronted with these accounts, the Department of Health spokesperson Foster Mohale admitted to Daily Maverick that the department had not conducted a single oversight visit since 2022 to check on students’ living conditions.

“No oversight visit has been conducted since 2022, largely because of growing financial pressures and strict austerity measures,” said Mohale.

Asked what the department has done to help students, Mohale indicated food parcels, occasional double stipends and a health attaché who “engages continuously” with students, while placing the blame for conditions squarely on factors outside the department’s control.

US embargo ‘hits hard’

“Cuba is currently facing significant hardship, largely as a result of the intensified United States embargo, which affects nearly every aspect of daily life,” said Mohale.

He said the Department of Health had acknowledged the urgent need to increase the stipend to safeguard students’ welfare.

“The matter is currently under consideration. During a Joint Academic Meeting held in July 2026, participants discussed and agreed on a process for reviewing the stipend amount. Consultations with the relevant decision-making bodies are currently under way,” said Mohale.

The programme’s value has been openly contested in Parliament – by the Democratic Alliance’s Haseena Ismail, who has raised concerns in 2021. Speaking to Daily Maverick, Ismail said, “The DA is not opposed to South African medical students receiving training abroad where this delivers value for money and contributes meaningfully to addressing the country’s shortage of healthcare professionals.

‘Deeply concerning conditions’

“However, the continued reliance on the Cuban medical training programme raises serious questions about cost, value for money, outcomes and whether public resources are being used most effectively, particularly in light of the deeply concerning conditions in which some of our students have reportedly found themselves in,” said Ismail.

Economic Freedom Fighters’ Noluvuyo Tafeni said the programme was failing, pointing out that there were 303 programme graduates who remained unemployed in 2025 despite the state investing an estimated R606-million in their training.

“The number of unemployed graduates came as a surprise to me because the government invested heavily in training these students in Cuba to solve severe rural doctor shortages.

“Leaving them unemployed while public clinics remain desperately understaffed undermines the entire objectives of the NMFC programme and deprives vulnerable communities of essential healthcare.

“This situation is a failure of state planning and a massive waste of public investment,” said Tafeni.

Addressing graduate unemployment, the department’s Mohale said this stemmed from severe budget constraints, funded post shortages, and health-sector inflation, which hindered the absorption of NMFC graduates despite healthcare worker shortages.

Despite budget constraints, Mohale said the government viewed NMFC graduates as vital assets for implementing National Health Insurance.

He said continued investment in the programme remained a long-term strategy for healthcare equity, despite pressure to redirect funds to expand domestic medical schools and employ out-of-work graduates. DM