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This collection of essays challenges static and binary discourses regarding the Cuban healthcare system, bringing together papers that paint a nuanced and dynamic picture of the intricacies of Cuban health(care) as it is represented and experienced both on the island and around the world.
This Element highlights the pivotal role of corporate players in universal health coverage ideologies and implementation, and critically examines social innovation-driven approaches to expanding primary care in low-income settings. It first traces the evolving meanings of universal health/healthcare in global health politics and policy, analysing their close, often hidden, intertwining with corporate interests and exigencies. It then juxtaposes three social innovations targeting niche 'markets' for lower-cost services in the Majority World, against three present-day examples of publicly-financed and -delivered PHC, demonstrating what corporatisation does to PHC, within deeply entrenched colonial-capitalist structures and discourses that normalize inferior care, private profit, and dispossession of peoples.
Challenging many of the assumptions scholars have made about the Cuban Revolution's impact on healthcare, this volume recounts one anthropologist's quest to discover the truth behind the complicated relationship between Cuba's revolution, politics, and healthcare system. Katherine Hirschfeld became interested in Cuba in the mid-1990s, after reading numerous laudatory books and articles describing the Castro regime's achievements in health and medicine. Cuba's population health indicators seemed to be far superior to those of neighboring countries, the national health costs low, and medical care free at point-of-service to the entire people. Historical records indicated that most of these positive health trends resulted from the changes instituted by Castro in 1959. Few of these authors, however, had actually spent time on the island. Thus, Hirschfeld found that academic writing on Cuba was often long on praise, but short on empirical research about what exactly had changed in Cuban medicine since 1959.After much bureaucratic wrangling, Hirschfeld managed to secure permission to conduct long-term ethnographic research in Cuba, where she lived with families from Havana and Santiago, conducted clinic observations, interviewed doctors and patients, and was treated in a Cuban hospital during an epidemic of dengue fever. The reality of the Cuban healthcare system turned out to be different than the scholarly ideal: it was bureaucratized, authoritarian, and repressive, and most people preferred to seek healthcare in the informal economy rather than endure the material shortages, red tape, and political surveillance of the public sector. Written in the form of a first-person narrative, Health, Politics, and Revolution in Cuba Since 1898 not only critically reevaluates Cuban healthcare after the 1959 revolution; it includes chapters detailing Cuban health trends from the Spanish-American War (1898) through the fall of Fulgencio Batista in 1959 and into the
How the Cuban health care system became the blueprint for accessible medical care around the world Quiet as it’s kept inside the United States, the Cuban revolution has achieved some phenomenal goals, reclaiming Cuba’s agriculture, advancing its literacy rate to nearly 100 percent – and remaking its medical system. Cuba has transformed its health care to the extent that this “third-world” country has been able to maintain a first-world medical system, whose health indicators surpass those of the United States at a fraction of the cost. Don Fitz combines his deep knowledge of Cuban history with his decades of on-the-ground experience in Cuba to bring us the story of how Cuba’s health care system evolved and how Cuba is tackling the daunting challenges to its revolution in this century. Fitz weaves together complex themes in Cuban history, moving the reader from one fascinating story to another. He describes how Cuba was able to create a unified system of clinics, and evolved the family doctor-nurse teams that became a model for poor countries throughout the world. How, in the 1980s and ‘90s, Cuba survived the encroachment of AIDS and increasing suffering that came with the collapse of the Soviet Union, and then went on to establish the Latin American School of Medicine, which still brings thousands of international students to the island. Deeply researched, recounted with compassion, Cuban Health Care tells a story you won’t find anywhere else, of how, in terms of caring for everyday people, Cuba’s revolution continues.
Drawing upon the empirical scholarship and research expertise of contributors from all settled continents and from diverse life settings and economies, Viral Loads illustrates how the COVID-19 pandemic, and responses to it, lay bare and load onto people’s lived realities in countries around the world. A crosscutting theme pertains to how social unevenness and gross economic disparities are shaping global and local responses to the pandemic, and illustrate the effects of both the virus and efforts to contain it in ways that amplify these inequalities. At the same time, the contributions highlight the nature of contemporary social life, including virtual communication, the nature of communities, neoliberalism and contemporary political economies, and the shifting nature of nation states and the role of government. Over half of the world’s population has been affected by restrictions of movement, with physical distancing requirements and self-isolation recommendations impacting profoundly on everyday life but also on the economy, resulting also, in turn, with dramatic shifts in the economy and in mass unemployment. By reflecting on how the pandemic has interrupted daily lives, state infrastructures and healthcare systems, the contributing authors in this volume mobilise anthropological theories and concepts to locate the pandemic in a highly connected and exceedingly unequal world. The book is ambitious in its scope – spanning the entire globe – and daring in its insistence that medical anthropology must be a part of the growing calls to build a new world.
"The Affordable Care Act set off an unprecedented wave of health insurance enrollment as the most sweeping overhaul of the U.S. health insurance system since 1965. In the years since its enactment, some 20 million uninsured Americans gained access to coverage. And yet, the law remained unpopular and politically vulnerable. While the ACA extended social protections to some groups, its implementation was troubled and the act itself created new forms of exclusion. Access to affordable coverage options were highly segmented by state of residence, income, and citizenship status. Unequal Coverage documents the everyday experiences of individuals and families across the U.S. as they attempted to access coverage and care in the five years following the passage of the ACA. It argues that while the Affordable Care Act succeeded in expanding access to care, it did so unevenly, ultimately also generating inequality and stratification. The volume investigates the outcomes of the ACA in communities throughout the country and provides up-close, intimate portraits of individuals and groups trying to access and provide health care for both the newly insured and those who remain uncovered. The contributors use the ACA as a lens to examine more broadly how social welfare policies in a multiracial and multiethnic democracy purport to be inclusive while simultaneously embracing certain kinds of exclusions"--Publisher's website.
In Cuban Revelations, Marc Frank offers a first-hand account of daily life in Cuba at the turn of the twenty-first century, the start of a new and dramatic epoch for islanders and the Cuban diaspora. A U.S.-born journalist who has called Havana home for almost a quarter century, Frank observed in person the best days of the revolution, the fall of the Soviet Bloc, the great depression of the 1990s, the stepping aside of Fidel Castro, and the reforms now being devised by his brother. Examining the effects of U.S. policy toward Cuba, Frank analyzes why Cuba has entered an extraordinary, irreversible period of change and considers what the island's future holds. The enormous social engineering project taking place today under Raúl's leadership is fraught with many dangers, and Cuban Revelations follows the new leader's efforts to overcome bureaucratic resistance and the fears of a populace that stand in his way. In addition, Frank offers a colorful chronicle of his travels across the island's many and varied provinces, sharing candid interviews with people from all walks of life. He takes the reader outside the capital to reveal how ordinary Cubans live and what they are thinking and feeling as fifty-year-old social and economic taboos are broken. He shares his honest and unbiased observations on extraordinary positive developments in social matters, like healthcare and education, as well as on the inefficiencies in the Cuban economy.
This book provides a clear, broad, and provocative synthesis of the history of Latin American medicine.
The extraordinary account of the Cuban people’s struggle for survival in a post-Soviet world In the aftermath of the fall of the Soviet Union, Cuba faced the start of a crisis that decimated its economy. Helen Yaffe examines the astonishing developments that took place during and beyond this period. Drawing on archival research and interviews with Cuban leaders, thinkers, and activists, this book tells for the first time the remarkable story of how Cuba survived while the rest of the Soviet bloc crumbled. Yaffe shows how Cuba has been gradually introducing select market reforms. While the government claims that these are necessary to sustain its socialist system, many others believe they herald a return to capitalism. Examining key domestic initiatives including the creation of one of the world’s leading biotechnological industries, its energy revolution, and medical internationalism alongside recent economic reforms, Yaffe shows why the revolution will continue post-Castro. This is a fresh, compelling account of Cuba’s socialist revolution and the challenges it faces today.