In the 12 years since Operation USA began directly providing humanitarian aid to Cuba’s main pediatric hospitals and its much-lauded international medical school, licenses have had to be obtained from both the U.S. Department of Commerce and the Office of Foreign Assets Control of the U.S. Department of the Treasury. The shorthand name for this licensure is the “Trading With the Enemy Act” (aka the Export Administration Act).

Aid groups working in Cuba are hardly alone in facing U.S. requirements for a license to donate agricultural products or medical supplies to Cuba’s main institutions. Think North Korea, Iran, Sudan, Somalia, Iraq, immediate postwar (1975-1991) Vietnam and Cambodia, Reagan-era Nicaragua, etc. But the U.S. government, through the past 10 presidencies, has been particularly vicious toward Cuba; it has sharply limited donating or selling even spare parts for Cuba’s pre-1959 U.S.-made infrastructure and has not allowed Cuban-Americans to send home adequate amounts of cash remittances to family members.

So it is hardly surprising that George W. Bush, with brother Jeb serving as Florida’s governor, would take a particularly hard-line position on travel, trade and aid to Cuba. This despite the fact that a majority in Congress — recently led by increasing numbers of farm-state Republicans — has been pushing for a vastly more open relationship with Cuba.

With Fidel Castro at or near retirement, now would be the ideal time to change course even if it involved standing up to the ever-generous political donors among the hard-line Cuban exile community. Unlike the rejectionists from the Cuban diaspora who left Cuba between 1959 and 1980, most Cuban migrants now leave principally for economic reasons and are interested in reaching back to those left behind. This group tends to be in favor of a more open and freer relationship with the island, and it is fast becoming the majority voice, even in Miami.

Does Bush see or hear any of this? It is doubtful that he cares what anyone else thinks is good politics or even good national security policy.

Recently, the influx of hard-line (and, in many cases, Cuban-American) hires at the Departments of State and Defense — which review Cuba export and travel licenses while they are being processed by the Departments of Commerce and Treasury — has made itself manifest in the rejection of a number of humanitarian licenses up for renewal. Last year’s license renewals banned most training of Cuban doctors and nurses by U.S. aid groups on the pretext that these medical professionals would be made to work as forced labor in the hospitals and clinics of Venezuela to earn hard currency and oil for the Cuban government. This year has seen sharp cutbacks or outright refusals of licenses (and visas to the U.S. in the case of prominent Cubans). Very few cultural or educational exchanges are being licensed, and nearly no visas allowing Cubans to attend professional meetings in the U.S. are being approved.

Operation USA’s recently expired licenses contained provisions limiting the donation and shipment of many kinds of medical product — computers have to be of the pre-Pentium 486 variety; laboratory and radiology equipment is mostly prohibited; equipment must be used and at least five years old; medicines’ end use — not just “for children” but for which specific diseases they will be applied — has to be characterized in advance of licensing approvals. All of the above materials are directed toward pediatric hospitals, but Commerce Department officials are telling relief groups that they have “evidence that such items are being diverted to military or other inappropriate uses.” No precise source is ever provided to back up these charges, and not one U.S. relief group active in Cuba has experienced a diversion of its aid by the Cuban government.

Currently, the Government Accountability Office of Congress (the GAO) and the inspector general of the U.S. State Department are investigating the misappropriation of $73 million in official funds from the State Department given willy-nilly to anti-Castro groups in Miami to purchase supplies to take to dissident groups in Cuba. The groups involved were provided Treasury and Commerce licenses on an expedited basis.

This would not amount to chopped liver if children were not dying as a result of the embargoes imposed by the U.S against Cuba and other nations over many years. In Iraq, one noteworthy study by Harvard University’s School of Public Health of the pre-2003, pre-U.S. invasion period found that up to 500,000 Iraqi children had died as a result of the U.S. trade and aid embargo (and the U.S.-led United Nations sanctions) in the aftermath of the 1991 Gulf War.

Washington’s Cuba policy in the coming year will be a measure of whether or not our political leaders have learned anything at all from their previous failings.

Richard M. Walden is founder and president of Operation USA, a Los Angeles-based international relief and development agency (

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