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.

Health services have long been characterized by inequities and contradictions urban concentration of health resources versus a dearth of rural services and, within the urban situation, relatively efficient services f a few large institutions versus the conglomeration of small, inefficient, and largely autonomous units. Using the Cuban system as a model, Danielson discusses the ingrredients involved in the transformation into an equitable medical sys­tem. The sociopolitical formation of new health workers, the continuous emphasis on rural and primary services, the involvement of all groups, including specialists, in the general fanning process, and a pragmatic style of politically inspired leadership t all levels of organizations are examined in this context. The author so considers the need for heavy economic investments and popular support for social reform as prerequi­sites for establishment of equitable medical services. According to Dan­ielson, medical and social revolution are closely linked. Throughout his exposition, there is a rare quality of sympathy and com­passion for all the earnest and honest health reformers, physicians, andmedical faculty of Cuba, regardless of their political orientation.

"Revolutionary Doctors gives readers a first-hand account of Venezuela's innovative and inspiring program of community healthcare, designed to serve--and largely carried out by--the poor themselves. Drawing on long-term participant observations as well as in-depth research, Brouwer tells the story of Venezuela's Integral Community Medicine program, in which doctor-teachers move into the countryside and poor urban areas to recruit and train doctors from among peasants and workers. Such programs were first developed in Cuba, and Cuban medical personnel play a key role in Venezuela today as advisors and organizers. This internationalist model has been a great success--Cuba is a world leader in medicine and medical training--and Brouwer shows how the Venezuelans are now, with the aid of their Cuban counterparts, following suit. But this program is not without its challenges. It has faced much hostility from traditional Venezuelan doctors as well as all the forces antagonistic to the Venezuelan and Cuban revolutions. Despite the obstacles it describes, Revolutionary Doctors demonstrates how a society committed to the well-being of its poorest people can actually put that commitment into practice, by delivering essential healthcare through the direct empowerment of the people it aims to serve"--Provided by publisher.

On the outskirts of Havana lies Mazorra, an asylum known to--and at times feared by--ordinary Cubans for over a century. Since its founding in 1857, the island's first psychiatric hospital has been an object of persistent political attention. Drawing on hospital documents and government records, as well as the popular press, photographs, and oral histories, Jennifer L. Lambe charts the connections between the inner workings of this notorious institution and the highest echelons of Cuban politics. Across the sweep of modern Cuban history, she finds, Mazorra has served as both laboratory and microcosm of the Cuban state: the asylum is an icon of its ignominious colonial and neocolonial past and a crucible of its republican and revolutionary futures. From its birth, Cuban psychiatry was politically inflected, drawing partisan contention while sparking debates over race, religion, gender, and sexuality. Psychiatric notions were even invested with revolutionary significance after 1959, as the new government undertook ambitious schemes for social reeducation. But Mazorra was not the exclusive province of government officials and professionalizing psychiatrists. U.S. occupiers, Soviet visitors, and, above all, ordinary Cubans infused the institution, both literal and metaphorical, with their own fears, dreams, and alternative meanings. Together, their voices comprise the madhouse that, as Lambe argues, haunts the revolutionary trajectory of Cuban history.

As health care concerns grow in the U.S., medical anthropologist Linda M. Whiteford and social psychologist Larry G. Branch present their findings on a health care anomaly, from an unlikely source. Primary Health Care in Cuba examines the highly successful model of primary health care in Cuba following the 1959 Cuban Revolution. This model, developed during a time of dramatic social and political change, created a preventive care system to better provide equity access to health care. Cuba's recognition as a paragon of health care has earned praise from the World Health Organization, UNICEF, and the Pan American Health Organization. In this book, Whiteford and Branch explore the successes of Cuba's preventive primary health care system and its contribution to global health.

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

After Fidel Castro came to power in 1959, his second declaration, after socialism, was that Cuba would become a leader in international science. In biotechnology he would be proven right and, today, Cuba counts a meningitis B vaccine and cutting-edge cancer therapies to its name. But how did this politically and geographically isolated country make such impressive advances? Drawing on a unique ethnography, and blending the insights of anthropology, sociology, and geography, The Cuban Cure shows how Cuba came to compete with U. S. pharmaceutical giants—despite a trade embargo and crippling national debt. In uncovering what is distinct about Cuban biomedical science, S. M. Reid-Henry examines the forms of resistance that biotechnology research in Cuba presents to the globalization of western models of scientific culture and practice. He illustrates the epistemic, social, and ideological clashes that take place when two cultures of research meet, and how such interactions develop as political and economic circumstances change. Through a novel argument about the intersection of socioeconomic systems and the nature of innovation, The Cuban Cure presents an illuminating study of politics and science in the context of globalization.