The estimated 460 Cuban doctors deployed to west Africa to participate in the fight against the Ebola outbreak developing there last year have not been paid the car, home, or World Health Organization (WHO) salaries they were promised if they returned from the mission healthy.

Moreover, a Cuban doctor waiting for his salary tells the Spain-based Diario de Cuba that those told they had won an award for their service have yet to receive the promised medals due to a “lack” of physical awards to hand out.

The group of Cuban doctors dispatched to Liberia, Sierra Leone, and Guinea last year to help treat Ebola patients returned in March, receiving high praise from African officials in the media who expressed gratitude for the extra hands. WHO also commended the Cuban communist government for sending doctors abroad.

Six months later, however, one doctor says he has not been paid and does not know of any of his colleagues receiving their promised salaries, as well as a home and a car doctors were told they would receive upon arrival. The reward would be contingent upon the doctors remaining healthy; those who contracted Ebola would not be allowed to return to the island.

Diario de Cuba notes that they have not received any money for their work in west Africa. The WHO had promised payments of $8,000-$10,000 a month for those deployed, a far greater sum than the state-mandated $64 a month doctors typically make. The doctor speaking to the newspaper says he received $70-$100 from the United Nations during his time in West Africa, but so far, that has been the only income they have seen. They were forced to live on their savings otherwise. Most doctors traveling abroad are believed to make less than the allotted $64 a month they would domestically, as the government only provides a living stipend.

The communist Cuban government typically makes an estimated $7.6 million a year on what some have dubbed “medical slavery,” which it also uses to elevate its status among sympathetic nations around the world. Diario de Cuba estimates that Cuba may have made as much as $26.4 million on the Ebola mission alone, yet doctors have not been paid any money for their services.

Time estimates that there are more than 50,000 Cuban medical professionals working abroad and being paid “living” stipends for their work.

While Cuban doctors receive praise from leftist groups on a routine basis, doctors working at home make extremely low salaries and are often forced to work with a dire lack of tools necessary for their trade. Before the recent raise to $64 a month, Cuban doctors made a salary of $18 a month. One Cuban doctor defecting in the 1990s explained his decision to leave by noting that he would regularly be awoken by his own hunger pangs and could not afford to eat “an egg a day”on his salary.

In addition to their own poverty, the poverty of the hospitals and clinics in which Cuban doctors work makes their job extremely difficult. Among the medical tools that have disappeared from pharmacies and hospitals nationwide are thermometers, bandages, gauze, and cotton. “We are told we are a medical potency, sending doctors out to fight Ebola, but we don’t have thermometers to measure a simple fever,” a customer at a Havana pharmacy complained to independent news outlet 14 y Medio.

The scarcity in Cuban medical facilities has resulted in a decline in the quality of Cuban doctors and medical education. While African nations have embraced Cuban doctors, nations like Tuvalu have opted not to send for Cuban doctors and are refusing to send their doctors to Havana to receive training, citing the incompetence of those educated there.