“We have to think like capitalists but continue being socialists”: Medicalized subjectivities, emergent capital, and socialist entrepreneurs in post‐Soviet Cuba

In Troubling Natural Categories (Essays in Honor of Margaret Lock). Eds. Naomi Adelson, Leslie Butt, and Karina Kielman, pp. 16-31. McGill-Queen’s University Press (Fall 2013).

Margaret Lock's path-breaking scholarship on the anthropology of the body, spanning her earlier work on demystifying the assumptions of the natural body to more recent work on the commodification of bodily life and the materiality of the body, has set a foundational precedent in medical anthropology for critically reworking the relationship between dominant ideologies and the lived experience of bodies (Lock

Bulletin of Latin American Research, 2013

At a time when the limitations of the capitalist system to deliver a minimum of wellbeing for all is being brought into relief, it might be high time we thought of how to organise our collective resources in ways that put human well-being in front of material wealth and profit maximisation. This book by Steve Brouwer explores the creation of a new universal healthcare system in Venezuela and constitutes a worthy analysis of that alternative to today's dominant capitalist system. What is interesting about the process of construction of a universal healthcare system is the contribution being made by Cuba's medical profession to the endeavour. Organised in twelve chapters, the book uses four of them to explore Cuba's healthcare system and to explain the deeply ideological connections between revolutionary ideals, human health and well-being, and the impetus for sharing this human capital in health with countries around the world. Other authors have explored these themes, notably Kirk and Erisman (2009), and as a result this part of the book may look familiar to some readers. The next five chapters are based mostly on the author's experiences in Venezuela witnessing the unfolding of the Barrio Adentro programme and its subsequent developments in action, exploring the changing conditions of work and its consequences for

New West Indian Guide, 2015

This is an open access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported (cc-by-nc 3.0) License.

This paper depicts Cuba as a relic of the Cold War. Its coverage of healthcare demonstrates steadfastness and success in surmounting hurdles of complacency and disregard to socialized medicine -an extension of Soviet patronage and third world alliances. The literature relays a mission of inclusivity underpinned by political ideology and a conviction to humanity. With the aid of endorsements, it speaks to contrasts and critiques in service and results by reflecting on the delivery of free healthcare for all Cuban citizens and its impression on the eradication of numerous diseases, reduced mortality rate and increased life expectancy. Punished by the longest trade embargo in modern history, the regime is in possession of limited resources to expedite remedy to its subjects. Such, much to the dislike of the authorities, elevates elements of distinction in association with the dispensation of service and drugs demonstrated by an evolving two-tier system for the disenfranchised and privileged clientele while simultaneously impacting the maintenance of facilities and equipment. Consequently, it recognizes harsh ramifications attributed to compliance with ideology and subtle adjustments to withstand external exertion. The Cuban replica is currently a tale of sorts awaiting a comprehensible definition for future generations.

Medical systems have travelled and influenced one another for as long as there has been trade between differing groups. The medical systems of China have been a particularly frequent traveller, facilitated by Chinese migration and trade throughout history. The transfer and subsequent integration of acupuncture into the Cuban health care system can be best understood in terms of various political and economic forces from the mid-nineteenth to the end of the twentieth century. This paper will demonstrate that how acupuncture was transferred to Cuba; why it was integrated into the national health care system of Cuba; and how acupuncture is currently understood and practised in the Cuban context can be best understood as a result of specific political and economic factors.

This paper explores the dynamics of health and health care in Cuba during a period of severe crisis by placing it within its economic, social, and political context using a comparative historical approach. It outlines Cuban achievements in health care as a consequence of the so- cialist transformations since 1959, noting the full commitment by the Cuban state, the planned economy, mass participation, and a self-critical, working class perspective as crucial factors. The roles of two external fac- tors, the U.S. economic embargo and the Council of Mutual Economic Cooperation (CMEA), are explored in shaping the Cuban society and economy, including its health care system. It is argued that the former has hindered health efforts in Cuba. The role of the latter is more com- plex. While the CMEA was an important source for economic growth, Cuban relations with the Soviet bloc had a damaging effect on the devel- opment of socialism in Cuba. The adoption of the Soviet model of eco- nomic development fostered bureaucracy and demoralization of Cuban workers. As such, it contributed to two internal factors that have under- mined further social progress including in health care: low productivit7 of labor and the growth of bureaucracy. While the health care system is still consistently supported by public policy and its structure is sound, economic crisis undermines its material and moral foundations and threatens its achievements. The future of the current Cuban health care system is intertwined with the potentials for its socialist development,

This paper focuses on the current healthcare system in Cuba and provides a description of an alternative healthcare provision. The information is based on a visit to the country in 2007 as a member of a health study tour. The purpose of the visit was to explore the functioning of a population-based health service and to interview key people. The data are compared with the literature on Cuba. The effects of the economic crisis, the US embargo and the absence of international debate about Cuba's health achievements are discussed.

The Lancet, 1980

responds to social and political transformations taking place in Latin America in the last twenty years. The role of Brazil as an emerging industrial power and the increasing political leverage of indigenous movements in Venezuela,

In Health Travels: Cuban Health(Care) on the Island and Around the World. Ed. Nancy Burke. University of California Press, Medical Humanities Series (in press, Spring 2013)

The cooperative efforts of Venezuela and Cuba, highlighted by their medical programs, are serving as the models for humanitarian relationships and fair economic exchange between the nations of the south.

Asian Medicine, 2010

Medical systems have travelled and influenced one another for as long as there has been trade between differing groups. The medical systems of China have been a particularly frequent traveller, facilitated by Chinese migration and trade throughout history. The transfer and subsequent integration of acupuncture into the Cuban health care system can be best understood in terms of various political and economic forces from the mid-nineteenth to the end of the twentieth century. This paper will demonstrate that how acupuncture was transferred to Cuba; why it was integrated into the national health care system of Cuba; and how acupuncture is currently understood and practised in the Cuban context can be best understood as a result of specific political and economic factors.

in Community Health Care in Cuba edited by Susan E. Mason, David Strug, and Joan Beder, (Chicago: Lyceum Books, 2009):24-38., 2009

Social Anthropology, 2020

Based on our collective ethnography of Cuba's socialist system for the provision of state-subsidised food, this article explores manners in which the state weaves itself into the fabric of people's everyday lives in state-socialist society. Instituted by Cuba's revolutionary government in the early 1960s, Cuba's 'state system for provisioning' is still today the backbone of household subsistence, propelling individuals into direct daily relations with the state via its neighbourhood-level network of stores that distribute food catering to citizens' 'basic needs'. Our ethnography brings together a series of studies conducted by the members of our team in different parts of Havana, charting the most salient aspects of people's interaction with the state in this alimentary context. We argue that the state becomes pervasive in people's daily lives not just because it is present in so much of it, but also as the basic normative premise on which people interpret and evaluate everyday comportments in the interactions food provisioning involves. Life in state socialism involves the constant and intricate comparison of its own realities against the normative ideals the state purports to institute. These 'vernacular comparisons' between life and state, as we call them, are the 'local knowledge' of state socialism in Cuba. S a c a n d o l o s m a n d a d o s : e n t r e l o n o r m a d o y l o r e a l e n e l s i s t e m a e s t a t a l s o c i a l i s t a d e a b a s t e c i m i e n t o c u b a n o A partir de nuestra etnografía colectiva del sistema del abastecimiento de alimentos subsidiados por el Estado cubano este artículo explora las formas en las que el estado se imbrica en el tejido de la vida cotidiana de las personas en el socialismo de estado. Instituido por el gobierno revolucionario cubano a principios de la década de 1960, el 'sistema estatal de abastecimiento' de Cuba es todavía hoy la espina dorsal de la subsistencia de los hogares, el cual impele a los individuos a establecer una relación cotidiana y directa con el estado a través de la red de establecimientos comerciales a nivel de barrio que distribuyen alimentos de acuerdo con las "necesidades básicas" de los ciudadanos. Nuestra etnografía reúne una serie de estudios llevados a cabo por los miembros de nuestro equipo en diferentes partes de La Habana, describiendo los aspectos más significativos de la interacción entre las personas y el estado en este contexto alimentario. Argumentamos que el estado se vuelve ubicuo en la vida cotidiana de las personas no sólo por estar presente en numerosos aspectos de la misma, sino también por ser el supuesto básico y normativo con el que la gente interpreta y evalúa sus comportamientos en las interacciones cotidianas relacionadas con el abastecimiento alimentario. La vida en el socialismo de estado involucra una constante e intrincada comparación entre los ideales normativos que el estado pretende institucionalizar y sus realidades. Estas 'comparaciones vernáculas' entre vida y estado, como las llamamos, son el 'conocimiento local' del socialismo de estado en Cuba.

Healthcare Policy | Politiques de Santé, 2008

About 40 years ago, Thomas McKeown demonstrated that the historic decline in the great killer diseases owed little or nothing to progress in medicine. A generation of research on population health followed, highlighting the large social gradients in health within populations. These vary greatly across societies, but appear largely unrelated to medical care. Medicine was acknowledged as "powerful, but within limits"; the major determinants of health lie elsewhere. We may have missed something. Cuba has achieved "first world" population health status despite a minimal economic base. Far from marginalizing medicine, Cuba has by far the world' s largest physician workforce. But doctors' roles are significantly expanded. The system seems to work.

Cuban Studies, 2016

An extensive literature on the Cuban health-care system has tradition the link between health outcomes in Cuba and select health strategies, i Polyclinic, the Family Doctor Program, and mass vaccination campa strategies represent only a portion of general Cuban health initiatives, public health strategies arguably linked to a range of important he article begins by documenting the degree to which these health strate tionalized in the post-Soviet era and the extent to which they corresp trends in health improvement. Focusing on the Cuban health system