RESPONSE TO REVIEW FOR SUSPENSION OF TITLE III OF

C O N F I D E N T I A L ASUNCION 000843

SIPDIS

STATE FOR WHA/CCA DMCFARLAND, CA/VO/F/P PMARIGLIANO AND
WHA/BSC MDASCHBACH

E.O. 12958: DECL: 12/31/2033
TAGS: ETRD ETTC PREL KDEM CVIS PHUM PREF CU PA
SUBJECT: RESPONSE TO REVIEW FOR SUSPENSION OF TITLE III OF
THE LIBERTAD ACT

REF: A. STATE 126578

B. ASUN 373

C. ASUN 720

Classified By: DCM Michael J. Fitzpatrick for reasons 1.4 (b) and (d).


1. (U) This cable responds to questions regarding
implementation of Title III of the LIBERTAD Act and the
relationship between the Cuban and Paraguayan governments
(ref A and B).


2. (C) Has the host country, in Post's opinion, worked to
promote the advancement of democracy and human rights in Cuba?

Paraguay's government changed hands in August after national
elections in April. That said, neither Paraguayan government
has actively worked to promote the advancement of democracy
and human rights in Cuba. The Paraguayan and Cuban
governments have cordial bilateral relations that emphasize
mutual assistance. Although the Paraguayan government
expresses a commitment to democracy and human rights, it
typically opposes initiatives that promote the advancement of
democracy and human rights in Cuba. Paraguay supported the
removal of the Cuban embargo in the 63rd United Nations
General Assembly. Paraguay enjoys the benefits of a number
of Cuban medical support and educational programs. These
Cuban programs may well be expanding in the coming months.


3. (C) Has the host country made other public statements or
undertaken other governmental actions?

Paraguay has not made public statements or undertaken other
governmental actions in support of the advancement of
democracy and human rights in Cuba.


4. (C) Have there been any high-level diplomatic visits
between Cuba and host country in the past six months?

Cuban Vice President Jose Machado Ventura attended the August
15 inauguration of President Fernando Lugo.


5. (C) Did the host country offer or deliver humanitarian or
other assistance to the Cuban people in the wake of the major
damage caused by Hurricanes Gustav and Ike?

No.


6. (U) What is the nature of investments that host country
businesses have in Cuba?

Paraguayan businesses do not have substantial investments in
Cuba, and Paraguay conducts little bilateral trade with Cuba.
The 2008 balance of payments between Cuba and Paraguay was
negligible according to Paraguayan Central Bank figures.


7. (U) Are there any bilateral trade agreements or other
cooperative agreements between host country and Cuba?

Paraguay and Cuba signed a bilateral agreement in 2002 to
promote trade and investment. Cuba and Paraguay initially
signed an agreement in 1999 allowing Cuban doctors to operate
in Paraguay; the agreement was renewed in 2004 but expired in
2006 -- even as a number of Cuban medical programs exist in
country today. The two countries also signed a convention in
2002 on cultural and educational exchanges that provided the
legal basis for Cuban medical doctors to operate in Paraguay
and Paraguayan students to study medicine in Cuba. Both
countries are 2007 co-founders of the Bank of the South.


8. (C) Are there any exchange programs between host country
and Cuba?

The Cuban government offers Paraguayan students full-ride
scholarships to study medicine for three years in Cuba.
However, Paraguayan medical students returning from Cuba face
difficulties entering the local medical field because the
Paraguayan government refuses to issue medical licenses to
students who graduate from Cuban medical schools. The Health
Ministry confirmed December 12 that over 500 Paraguayans are
now studying in Cuba and that at least 130 graduates have
returned to Paraguay. (NOTE: Paraguayan medical licenses
require at least four years of academic study, and Paraguayan
medical students returning from Cuba lack one year of
requisite training. The returnees, furthermore, are said not
to have anything close to required standards or substantive
knowledge to operate as doctors. END NOTE.) The Health
Ministry announced October 25 that it would establish a
special training program for medical students returning from

Cuba that allows them to earn their Paraguayan medical
licenses after completing one-year internships in local
health facilities.

The Cuban government offers paid medical travel for
Paraguayans to receive medical treatment and surgeries in
Cuba, including cataract surgery. The press reported
December 14 that over 5,000 Paraguayans took advantage of
this program. (NOTE: The U.S. Embassy's medical diplomacy
initiative provides a counter-balance to Cuban and Venezuelan
medical programs. This initiative helps facilitate the
donation of medical supplies to the Health Ministry, local
clinics, and medical assistance NGOs that locally perform
free eye surgeries, follow-up care, and other related medical
treatment (ref C). END NOTE.)

Although the bilateral medical agreement expired in 2006,
Cuba continues to provide medical assistance to the
Paraguayan government. Cuban medical experts provide
training and support to the Ministry of Public Works and
Communications' Epidemiology Surveillance Section. Whenever
Paraguay experiences epidemiological outbreaks -- including
recent yellow fever and dengue outbreaks -- the Cuban
government offers to send doctors, medicines, and vaccines to
treat and innoculate Paraguayans. The Cuban government sent
three Cuban doctors to treat Paraguayans in Asuncion, San
Pedro Department, and Caaguazu Department during the February
yellow fever outbreak. Cuban epidemiologists also assist with
the analysis of clincial cases and vector control efforts
during dengue fever outbreaks.

The municipal government of Maria Auxiliadora, Itapua
Department, signed an agreement in 2006 with the Cuban
government that allows Cuban doctors and support staff to
provide eye surgery and other health care (ref C). The
agreement permits the local NGO Cuban Medical Services to
operate a local eye care center on behalf of the Cuban
government. The center is affliated with "Miracle Mission,"
a Venezuelan-sponsored program that offers free eye surgeries
and other medical treatment in Cuba and Venezuela (ref C).
Approximately 17 Cubans reside in Maria Auxiliadora as part
of this agreement, and the Cuban government provided eye
surgery equipment to the center.

President Lugo visited the eye care center in Maria
Auxiliadora December 14 and praised the work of the eye care
center and "Miracle Mission" Program. Although Lugo has been
personally supportive of Cuba's medical missions in Paraguay,
Health Ministry officials expressed concern regarding the
center. Dr. Luz Marina Quintana, director of the Health
Ministry's Ocular Health Program, expressed concern in July
that the eye care center operates without Health Ministry
oversight (ref C). The Health Ministry announced October 8
that it will launch its own eye surgery campaign in
cooperation with local NGO Fundacion Vision, which receives
assistance from the U.S. Embassy. The Health Ministry and
Fundacion Vision plan to perform up 4,000 eye surgeries
annually.

Most Cuban doctors who worked in Paraguay under the 1999
bilateral agreement returned to Cuba after the agreement
expired in 2006. Of this initial wave of Cuban doctors, 18
Cuban doctors and their families residing in Paraguay have

applied for admission to the United States under the Cuban
Medical Professional for Significant Public Benefit Parole
Program. Of these, nine have been approved by DHS, five
denied, and one cancelled. Three have pending applications.


9. (U) POC for this request is Embassy Asuncion Human Rights
Officer Michael Edwards, telephone: 011-595-21-213-715,
e-mail: edwardsmg@state.gov.

Please visit us at http://www.state.sgov.gov/p/wha/asuncion

AYALDE