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Drive west from Doha’s bright bottle towers, accomplished two Apple Cup stadiums still beneath architecture and out into the desert, and you’ll eventually ability a baby hospital amidst alone by beach and shrubs.

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At its access adhere two flags bouncing in the baking breeze: one of Qatar, the added of Cuba.

The hospital belongs to the Qatar government, but its absolute medical agents – 475 doctors, nurses and technicians – is from the Caribbean island bisected a apple away.

The Cuban hospital, as it is clearly known, opened in 2012, boasting apple chic accessories and services. But there is one affair that is not up to all-embracing standards: the salaries the Cubans are paid.

At aloof over $1,000 (£778) a month, they accept as little as 10% of what added adopted medical professionals can accomplish alive in government hospitals in Qatar.

The butt of their balance are pocketed by the Cuban government beneath a abstruse accord with the Qataris.

Neither the Qatari or Cuban authorities would acknowledge capacity of the agreement, but sources with ability of the hospital appraisal Qatar pays Cuba amid $5,000 and $10,000 a ages for anniversary medical professional.

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Cuba has been sending doctors about the apple aback the aboriginal 1960s; there are currently an estimated 30,000 Cuban doctors and nurses alive in 60 countries. Starting with missions to Algeria and Chile, the programme has developed into a all-around exercise in bendable ability apprenticed by humanitarian, political and bread-and-butter goals. Cuban medical teams are generally at the beginning of adversity abatement efforts in Latin America.

Leasing doctors to added countries is the capital antecedent of adamantine bill for Cuba’s cash-strapped economy, earning the government $6-8bn a year – far added than it makes from tourism.

In the accomplished decade, partly prompted by crumbling acquirement from its medical programme in Venezuela, Cuba has angry to new countries with no curtailment of money: Qatar and Saudi Arabia.

Cuba is a absolute accompaniment with a basin of captive, low-paid workers calmly exploited as exportable commodities

In a agnate adjustment with Brazil, the Cuban government was reportedly paid about $4,000 a ages for anniversary medic, of which the doctors accustomed $1,000.

When the rightwing Jair Bolsonaro, an adversary of Cuba, took ability in Brazil aftermost year, bags of Cuban doctors larboard the country, bidding fears that poor areas of Brazil would be larboard afterwards acceptable medical care.

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Cuba is not the alone country that exports its citizens to acquire adopted currency. North Korea has additionally beatific workers to Qatar beneath a programme with some similarities.

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Although doctors assurance up voluntarily to booty allotment in the missions, US-based critics of the Cuban government say the programme is exploitative.

“I accept no agnosticism that they are accountable to a anatomy of accountable labour … Cuba is a absolute accompaniment with a affirmed basin of bound low-paid workers calmly exploited as exportable commodities,” says María Werlau, the administrator of Cuba Archive, a Miami-based thinktank adjoin to the Cuban administration.

Werlau says Cuba’s medics are victims of allowance theft, authorization confiscation, abundant surveillance and affected ancestors separation.

Amid breakable relations amid the two countries, the US has afresh added criticism of the medical missions.

In June, the Accompaniment Department downgraded Cuba to the everyman bank of its Trafficking in Persons report, saying: “The [Cuban] government did not booty activity to abode affected labour in the adopted medical missions programme, admitting assiduous allegations Cuban admiral threatened and apprenticed some participants to abide in the programme.”

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However, others altercate the medical missions are highly-coveted opportunities in a country area doctors acquire aloof $40 to $70 a month.

“I don’t accept that they are actuality exploited,” says John Kirk, assistant of Spanish and Latin American studies at Dalhousie University in Canada. “They are earning decidedly added than they would acquire at home. They accept been accomplished in a left-wing system, accept paid annihilation for their medical training, and accept that the above bulk paid to the Cuban government is acclimated to subsidise the healthcare arrangement aback in Cuba.”

The Guardian batten to several medics at the Cuban hospital and some dedicated the system.

“I accept we should advice everybody,” says one. “Based on that, yes it is fair, because I apperceive that the added bulk is acclimated to abutment our bloom and apprenticeship arrangement … but if you anticipate alone of yourself, of advance it’s not fair.”

But a medic who defected from the mission in Qatar says he “felt like a slave” on advertent that added doctors in the country were actuality paid added than him. “We were accomplishing the aforementioned affair and earning far beneath than them.”

One acumen doctors accompany the programme is that, alike acceptance for deductions fabricated by their government, Qatar charcoal a advantageous and approved announcement for Cuban healthcare professionals. With such paltry salaries at home, its allure is obvious.

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“Life in our country is actual adamantine and the bacon is actual bad,” says one medic at the hospital. “Here we acquire money for [Cuba] and for us too … One allotment for the country, and one allotment for anniversary person.”

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No one knows the exact bulk the Cuban government is earning from their labour, and some assume not to care. “The apprenticeship in Cuba is free. The government prepares us for abounding years and so the government needs to booty article for this,” says one.

Others complete beneath convinced. “I acquire about $1,100. It’s not the best, but its not bad.” Told that added adopted medical professionals acquire far added in Qatar, he nods in agreement, “Yes, but not Cuban people.”

The medics say their families are accustomed to visit, but not break – a action critics affirmation is a advised action to avert defections. Anyone who abandons a medical mission is barred from abiding to Cuba – and their ancestors – for a minimum of eight years, unless they are accommodating to acknowledge the civic bloom system.

“They are application what they adulation the best to accomplish them anticipate alert afore leaving. It’s cruel, it’s inhumane, it’s actionable and adjoin all-embracing law,” says Annarella O’Mahony, a affiliate of No Somos Desertores (“We are not deserters”), a accumulation that campaigns for the appropriate of Cubans who accept alone accompaniment affairs to acknowledgment home.

Anyone attempting to leave faces addition problem: on accession in Qatar, Cubans say they accept to duke over their passports, a convenance that is actionable in Qatar.

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Qatar afresh appear reforms to its labour laws, which for the aboriginal time may acquiesce workers to change jobs afterwards their employer’s permission, but it is cryptic whether the Cuban medics will be chargeless to acquisition added advantageous assignment abroad in Qatar’s healthcare system.

Up until 2017, Cuban medical professionals who capital to leave could seek cover in a US admiral beneath a programme alien by President George Bush in 2006. The backslider from the Cuban hospital, who larboard in this way, says he knows of 16 others who did the same, admitting he was apprenticed beneath by altitude in Qatar and added by the befalling for a new activity in America.

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Barack Obama withdrew the legislation aloof afore he larboard appointment in 2017 as allotment of efforts to normalise relations with Cuba. “Now they are trapped again,” says the defector.

Despite actuality cut off from his ancestors in Cuba, the backslider says he has no abjure about leaving. “I acquaint my mother back I allocution by buzz that, admitting all the difficulties and pain, I would do it again. I will never acknowledgment to Cuba. There is no approaching there.”

A agent for the Hamad Medical Corporation, the government anatomy that manages healthcare in Qatar, including the Cuban Hospital said: “As with agnate Cuban bloom programmes about the world, salaries of hospital agents are paid for by the Cuban government.”

The Guardian again approached the Cuban admiral in Qatar for comment, but accustomed no response.

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