The National Department of Health has admitted that it hasn’t conducted an oversight visit in Cuba for four years – this as shocking conditions have been described by South African students on the Nelson Mandela-Fidel Castrol (NMFC) medical training programme in that country, reports Daily Maverick.
Bad and inadequate food, one toilet for 13 students, days without water, and a barely survivable daily stipend are making their lives hell, they say.
The NMFC programme was launched three decades ago “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 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 bath. Meals, meanwhile, are largely rice served with what students describe as watery, unseasoned soup.
Daily Maverick spoke to one of the students, who asked to remain anonymous, and who said the misery started from the moment she landed in Havana in December 2024.
“I wanted to study medicine with everything in my heart, and when they told me that I am going to Cuba, I was happy …but when we got to the school, they took us into quarantine ..and it was bad…
“You are unable to shower because there’s no water, and the water comes in intervals, and there was only one bucket. We were seven girls. We were unable to bath … There was no food there.”
Once out of quarantine, conditions didn’t improve much, she said. “It’s bad. I can’t describe it.”
She said 13 of them share a toilet. “You can’t flush. You have to go and fetch water with a bucket and flush the toilet. The food is watery – like soup for the rice.” The student said the meat served at the cafeteria had given her rashes and stomach illnesses severe enough that she largely stopped eating there, relying instead on bread bought with her own money.
“At some point I felt I should just call our health attaché and tell him I want to go home. I’m from a poverty-stricken home. I know how poverty is, but this is bad, worse than my own situation at home.”
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 conversion rate severely erodes its value.
“You are unable to buy toiletries … roll-on costs R100; everything is just expensive. When students pushed for an increase, the department instead paid two months’ stipend as one lump sum. That’s not going to help,” 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.
Department of Health responds
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, but blamed this on “growing financial pressures and strict austerity measures”.
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.
“Cuba is currently facing significant hardship, largely as a result of the intensified United States embargo, which affects nearly every aspect of daily life,” he protested.
He said the department had acknowledged the urgent need to increase the stipend to safeguard students’ welfare.
“The matter is currently under consideration. During a Joint Academic Meeting in July, participants discussed and agreed on a process for reviewing the stipend amount. Consultations with the relevant decision-making bodies are currently under way.”
The programme’s value has been openly contested in Parliament – by the DA’s Haseena Ismail, who has raised concerns in 2021.
She told Daily Maverick: “The DA is not opposed to students receiving training abroad where this delivers value for money and contributes meaningfully to addressing the country’s shortage of healthcare professionals.
“However, the continued reliance on the Cuban 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.”
The EFF’s 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 R606m in their training.
“The number of unemployed graduates was a surprise to me because the government invested heavily in training these students in Cuba to solve severe rural doctor shortages,” she said.
“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.”
On 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 staff shortages.
But despite budget constraints, he 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.
See more from MedicalBrief archives:
Cuban training for new batch of SA medical students
SIU investigation into Cuban doctor training programme
Time to finally end SA/Cuba doctor training deal?