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For much of the nineteenth century and all of the twentieth, the per capita rate of suicide in Cuba was the highest in Latin America and among the highest in the world--a condition made all the more extraordinary in light of Cuba's historic ties to the Catholic church. In this richly illustrated social and cultural history of suicide in Cuba, Louis A. Perez Jr. explores the way suicide passed from the unthinkable to the unremarkable in Cuban society. In a study that spans the experiences of enslaved Africans and indentured Chinese in the colony, nationalists of the twentieth-century republic, and emigrants from Cuba to Florida following the 1959 revolution, Perez finds that the act of suicide was loaded with meanings that changed over time. Analyzing the social context of suicide, he argues that in addition to confirming despair, suicide sometimes served as a way to consecrate patriotism, affirm personal agency, or protest injustice. The act was often seen by suicidal persons and their contemporaries as an entirely reasonable response to circumstances of affliction, whether economic, political, or social. Bringing an important historical perspective to the study of suicide, Perez offers a valuable new understanding of the strategies with which vast numbers of people made their way through life--if only to choose to end it. To Die in Cuba ultimately tells as much about Cubans' lives, culture, and society as it does about their self-inflicted deaths.
This study examines Cuba's medical system from the inside out and illuminates what the numbers cannot--how the system works and what Cuban life is like. Through qualitative interviews and participant observation, the everyday realities of the Cuban experience are revealed and through them, the values and ideologies of the revolution. This book shows how universal access to medical services can make the difference in the lives of poor people. Cuba does more than provide free services however; it has redefined what medicine is and what doctors and nurses can be. This work deepens the scholarship on Cuban medicine. It is the first to focus solely on the community based primary care system--Comprehensive Family Medicine and its activist health care professionals--the family doctors and nurses. Caring for Them from Birth to Death is based on interviews and observations conducted in the field over three years in Cuba. The book challenges assumptions about the health of poor populations and demonstrates the global importance of the Cuban model.
Tens of thousands of people around the world die each day from causes that could have been prevented with access to affordable health care resources. In an era of unprecedented global inequity, Cuba, a small, low-income country, is making a difference by providing affordable health care to millions of marginalized people. Cuba has developed a world-class health care system that provides universal access to its own citizens while committing to one of the most extensive international health outreach campaigns in the world. The country has trained thousands of foreign medical students for free under a moral agreement that they serve desperate communities. To date, over 110,000 Cuban health care workers have served overseas. Where No Doctor Has Gone Before looks at the dynamics of Cuban medical internationalism to understand the impact of Cuba’s programs within the global health landscape. Topics addressed include the growing moral divide in equitable access to health care services, with a focus on medical tourism and Cuba’s alternative approach to this growing trend. Also discussed is the hidden curriculum in mainstream medical education that encourages graduates to seek lucrative positions rather than commit to service for the marginalized. The author shows how Cuba’s Escuela Latinoamericana de Medicina (ELAM) serves as a counter to this trend. An acknowledgement of Cuba’s tremendous commitment, the book reveals a compelling model of global health practice that not only meets the needs of the marginalized but facilitates an international culture of cooperation and solidarity.
There is a vast literature for and against privatizing public services. Those who are against privatization are often confronted with the objection that they present no alternative. This book takes up that challenge by establishing theoretical models for what does (and does not) constitute an alternative to privatization, and what might make them ‘successful’, backed up by a comprehensive set of empirical data on public services initiatives in over 40 countries. This is the first such global survey of its kind, providing a rigorous and robust platform for evaluating different alternatives and allowing for comparisons across regions and sectors. The book helps to conceptualize and evaluate what has become an important and widespread movement for better public services in the global South. The contributors explore historical, existing and proposed non-commercialized alternatives for primary health, water/sanitation and electricity. The objectives of the research have been to develop conceptual and methodological frameworks for identifying and analyzing alternatives to privatization, and testing these models against actually existing alternatives on the ground in Asia, Africa and Latin America. Information of this type is urgently required for practitioners and analysts, both of whom are seeking reliable knowledge on what kind of public models work, how transferable they are from one place to another and what their main strengths and weaknesses are.