Cuba, one of the few communist dictatorships left, is sticking to its revolutionary principles. That means the place is a police state, the economy is a mess and the government still wants to export these revolutionary ideas to other countries. Since the Soviet Union collapsed in 1991, and withdrew lavish subsidies for their communist showcase in the Caribbean, the Cuban economy has shrunk by 40 percent. Currently, the main source of wealth is gifts of cash sent by relatives in the United States. But one thing the Cubans have maintained since before the 1959 revolution is the highest level of medical care in Latin America. At the time of the revolution, Cuba had the lowest infant mortality rate in Latin America (and the 13th lowest in the world), and the third highest number of physicians and dentists per capita (comparable to the Netherlands and higher than in the United Kingdom). Since the revolution, Cuba has produced more doctors, built more hospitals and clinics and managed to keep the level of medical care high. Well, at least primary medical care. Cubas communist economy could not produce the hard currency needed to buy a lot of medical equipment and medicines. Some hospitals have this stuff, but these are reserved for senior members of the Communist Party.
Cuba's communist government also built a lot of schools, and increased it's literacy rate, which was already one of the highest in Latin America before the revolution. But food consumption per capita has declined, as has access to media (which is all state controlled) and consumer goods. Except for the elite of the Communist Party, everyone is now poor. Being offered an assignment in a foreign country, to provide medical care, was an offer few Cuban medical professionals could turn down. In addition to more food, access to more media, making more money than at home and a chance to do good works, there was also the possibility of defection.
There was a catch, of course. Many of the administrative members of the brigades belonged to the secret police. These "minders" were there to make sure brigade members gave their patients a dose of pro-Cuba communist propaganda along with the medical care. The minders also kept on the lookout for defectors. While it was easier to defect when outside Cuba, arrangements had been made with the local governments to help the Cuban government retrieve any of its citizens who attempted to break their contract with the brigade. That contract often included financial arrangements with the host country that paid the Cuban government a lot more than the $30 a month they paid doctors back in Cuba. The brigade personnel were made to understand that things could go badly for their families if they tried to defect.
The purpose of the brigades, in addition to providing medical care where it was needed, and making money for the cash starved communist government back home, was to make communist Cuba look good, to encourage local people to follow revolutionary Cuba's example, and to collect detailed military and political intelligence on the host country.
Nowhere has this worked out better than in Venezuela, where the largest Medical Brigade (over a thousand personnel) is providing medical care, and political indoctrination, to those Venezuelans who need it most. But the current president of Venezuela, Hugo Chavez, has most of the population trying to get him thrown out of office. When Chavez was elected in 1999, he promised a revolutionary program to clean up the corrupt and inefficient practices that had long hampered the economy's growth. Chavez was revolutionary all right, but he trashed the economy, using it more for patronage than any of his predecessors. A compelling speaker, Chavez also stirred up class war, telling poor Venezuelans that all their problems could be blamed on the rich. Three years ago, Chavez made a deal with Cuba to supply cut rate oil (worth half a billion dollars a year at market rates.) Cuba paid for little of the oil, now owes nearly $800 million and is not expected to ever pay the debt (mainly because Cuba simply hasn't got the cash.) In addition to the medical brigade, Cuba has sent military, police, political and media advisors to help Chavez out. Who says dictators (even elected ones) don't have friends?
The Cuban Medical Brigades are doing what the American Peace Corps was always accused of doing (mixing politics, espionage and good works.) But the majority of Peace Corps volunteers were either neutral, or leftist, politically. Hardly good recruiting material for a covert operation. Actually, many Peace Corps veterans did later go to work for the CIA. But when they were in the Peace Corps, they concentrated on helping the people of their host country, not working to spread revolution and financially prop up a police state back home.
Cuba does have about a thousand military "Special Forces" troops, and these are often used to teach the techniques of guerilla warfare and terrorism in foreign countries.
Cuba has gone the American Special Forces one better, and developed a cheap, effective to spread the ideas of communist revolution without using highly trained soldiers. Instead, the Cubans send "Medical Brigades" of underemployed doctors and medical technicians to poor countries that need the medical assistance, but are not as keen on the revolutionary propaganda the accompanies the medical care. But Cuba offers the services at bargain prices (sometimes for free), with the propaganda seen as the equivalent of commercials on TV (a necessary evil.) Cuba currently has medical "brigades" (of 200-1,000 personnel each) in Haiti, Venezuela, Guatemala, Honduras, Ghana and Zimbabwe. Cuba has also sent Medical Brigades to other countries for limited periods, to help deal with natural disasters. The medical brigades have been out there for over two decades.