GEORGETOWN, Guyana (AP) — Cuban officials are preparing to withdraw the nation’s medical brigade from Guyana after it moved to provide full salaries to doctors and nurses from the island instead of sending most of the payments to the Cuban government.

Cuban doctors have worked in African, South American and Caribbean nations for decades under diplomatic agreements that earned the Cuban government money while providing medical care in places where it was otherwise scarce. But the Trump administration has sharply criticized it, with U.S. Secretary of State Marco Rubio describing it as forced labor.

Guyana Health Minister Frank Anthony told reporters Monday that Cuban authorities have chosen to end the program after nearly 50 years and recently asked their brigade of more than 200 doctors to prepare to leave the South American nation.

“We have been engaging the Cuban authorities and they chose to terminate or withdraw the Cuban doctors who were here,” Anthony said. He said that despite the fallout between both governments, Guyana is prepared to hire Cuban doctors who remain in the country through individual contracts.

Cuba’s decision to remove its medical mission from Guyana comes as the Trump administration takes other measures to isolate Cuba’s communist government that include a blockade of oil shipments to the island.

The medical missions are also leaving other countries.

Last week, Jamaica’s government ended a Cuban medical mission that had been in the country for decades as both nations disagreed on a plan to pay doctors directly. Cuban doctors also left Honduras last week after its government suspended a contract for the Cuban medical teams to work there, saying the program no longer met regulations.

Several other Caribbean countries including The Bahamas, Antigua, Dominica and St. Lucia have also said they are interested in changing how they pay Cuban doctors.