Breathing Democratic Socialist fire in the 1970s, then Prime Minister Michael Manley declared: “Jamaica will go through life on our feet and not on our knees.”

That was at the height of the ideological struggle between East and West which played out on Jamaican soil between the People’s National Party (PNP) backed by Fidel Castro’s Cuba, and the Jamaica Labour Party (JLP), supported by the conservative United States Government.

The current threat by the US Administration to cut visas for government officials and their immediate family members from countries participating in the Cuban medical missions to poor countries is arguably the sternest test of relations between Washington and Kingston since the 1970s.

Indeed, Jamaica, along with a number of other Caribbean nations which participate in the Cuban medical missions, is squarely on the horns of a dilemma. We are long-time friends of both Cuba and the US, our most important trading partner and second home to many migratory Jamaicans.

Of course, we hardly expect Prime Minister Dr Andrew Holness to be as combative as Mr Manley in the 1970s, not because Jamaicans should not go through life on their knees, but for the fact that these are times that call for much greater tact and diplomatic finesse in the face of President Donald Trump’s America First agenda.

There are obviously no easy answers, because Cuba tugs at the heart strings for all the good it has done for Jamaica during some of our worst days economically, at great sacrifice to the Cuban people. In addition to the nurses and doctors, the country has a popular eye-care programme; has built several schools like GC Foster College and José Martí High and provided scholarships, primarily in medicine.

Internationally, since its 1959 revolution, Cuba has dispatched medics to countries around the world, treating diseases that wreak havoc on poor countries, from cholera in Haiti to Ebola in West Africa, Reuters news agency reminds in a story.

To lose Cuban medical personnel at this time would be a great loss to our heath system, especially because those categories of professionals are already being lured away from Jamaica by rich countries.

Moreover, the governments of the beneficiary countries, including Jamaica, have insisted that they see no evidence of the Cubans being involved in forced labour in their states.

“Out of the blue, now we have been called human traffickers because we hire technical people who we pay top dollar,” said outgoing Trinidad and Tobago Prime Minister Keith Rowley, adding that he was prepared to lose his US visa.

St Vincent and the Grenadines Prime Minister Ralph Gonsalves noted that at least 60 people in his small island nation are on a Cuban-run haemodialysis programme.

“If the Cubans are not there, we may not be able to run the service,” he said. Dr Gonsalves disclosed that Cuban personnel are paid the same as locals and declared: “I will prefer to lose my visa than to have 60 poor and working people die.”

Last week, Jamaican Foreign Minister Senator Kamina Johnson Smith told journalists that the presence of 400 Cuban medical personnel here is of importance to our health-care system.

Barbados Prime Minister Mia Mottley has also declared that she would rather lose her US visa than sacrifice the Cubans who took them through the COVID-19 pandemic.

Truly, this is walking the tightrope.