The Nelson Mandela-Fidel Castro (NMFC) programme, established nearly three decades ago, provides state-funded opportunities for South African students to study medicine in Cuba. However, current participants report deteriorating living conditions, including cramped rooms, inconsistent water access, poor sanitation, and compromised food quality. A student, who wished to remain anonymous, described her experience since arriving in Havana in December 2024, citing difficulties with water, sanitation, and food.
The student shared that she and 12 others rely on a single toilet, which often cannot be flushed due to water shortages. Students have to fetch water with a bucket to flush the toilet, and meals consist mainly of rice with watery, unseasoned soup. The food has caused some students to fall ill, and the student reported having rashes and stomach issues after eating at the cafeteria. She relied on buying bread with her own money instead.
The stipend of roughly $200 per month, loaded onto a local card, has lost value due to the conversion rate, making it difficult for students to afford basic necessities. When students requested a stipend increase, the department provided a lump sum of two months' stipend instead of adjusting the monthly amount. The student expressed frustration, stating that the $400 is meant to last a month, not two.
The Department of Health spokesperson, Foster Mohale, acknowledged that no oversight visits have been conducted since 2022 due to financial pressures and austerity measures. Mohale attributed the poor conditions to the intensified United States embargo on Cuba, which affects daily life. He mentioned that the department has provided food parcels, occasional double stipends, and a health attaché who engages with students.
Mohale stated that the Department of Health acknowledges the urgent need to increase the stipend and is currently reviewing the amount. Consultations with relevant decision-making bodies are underway, following a Joint Academic Meeting in July 2026. The programme's value has been contested in Parliament, with concerns raised about cost, value for money, and outcomes.
The Democratic Alliance's Haseena Ismail and the Economic Freedom Fighters' Noluvuyo Tafeni have expressed concerns about the programme. Ismail raised questions about the programme's cost and effectiveness, while Tafeni pointed out that 303 programme graduates remained unemployed in 2025 despite the state investing an estimated R606-million in their training.
The Department of Health views NMFC graduates as vital assets for implementing National Health Insurance, despite budget constraints and severe post shortages. Mohale attributed graduate unemployment to budget constraints, funded post shortages, and health-sector inflation, which hinder the absorption of NMFC graduates despite healthcare worker shortages.
Key points
- The US embargo on Cuba has been blamed for the harsh conditions faced by South African medical students.
- Students on the programme report poor living conditions, including overcrowding, poor sanitation, and compromised food quality.
- The Department of Health is reviewing the stipend amount for students, citing urgent needs to safeguard their welfare.
