And on the other side of the wire at Guantanamo Bay, a prominent Cuban doctor has written a scathing denunciation of her country's use of hospitals, doctors and medicine to earn foreign exchange. The report by Dr Hilda Molina, a former member of the Cuban National Assembly and a distinguished doctor, was smuggled out of Cuba and published on a Norwegian website. In it she claims that over the last 12 years or so the government has established a system of "medical apartheid" in which top quality care is denied to Cubans and provided to medical tourists.

It is impossible to verify any of the unscrupulous practices alleged by Dr Molina, and they will surprise many, as Cuba is reputed to have an excellent health care system. She writes: "Since February of 1994, the negative practices I outlined earlier have become standard in all Cuban hospitals that sell medical services to foreign patients. The main objective of many Cuban hospitals is generating foreign currency, by any means necessary. International relationships are driven by business logic and the need to make a profit. Acting as intermediaries, unscrupulous foreigners promote Cuba's services and recruit patients, many of whom are subject to deception or fraud."

Often, she charges, even foreigners are given substandard treatment and false information about their conditions to increase their medical bills. As a neurologist, Dr Molina was using injections of embryonic tissue into the brains of patients with Parkinson's disease, a hazardous technique which is controversial enough on its own. But she claims that the government tried to force her "to perform numerous embryonic transplants on foreign patients to make the procedure a major source of foreign income". An even more disturbing allegation is that one doctor attempted to export foetal tissue from aborted babies. In the belief that tissue from dismembered aborted babies was inferior in quality, he organised unnecessary Caesareans.

From Dr Molina's report, it appears that the ultimate source of the problem is a shotgun marriage of Communist central planning with privatisation. In an isolated country desperate for foreign exchange, hospitals have been told that they can no longer depend on the government for financial support and that they must support themselves by selling services to foreigners. In her eyes, it is a base betrayal of what her government had always preached: "a central objective of the Revolution is the entitlement of free, quality medical care for everyone".