From Cooperation to Capacitation: Cuban Medical Internationalism in the South Pacific

Article excerpt

Abstract

This article analyses Cuba's medical missions in the South Pacific and specifically in Timor-Leste (East Timor), the largest outside of Latin America. Here, the adaptation of Cuba's low-technology and low-resourced preventive-focused medical model (based on the development of human capital) is used to highlight lessons regarding effective medical cooperation. This article finds that these lessons should be drawn from the dynamic and creative adaptations of the Cuban medical model, which are assisting South Pacific medical systems by scaling up primary care workforces to target previously underserved areas. Thus, the contribution of Cuban medical personnel, bolstered by the education of indigenous South Pacific students (trained by Cuban professors, both in Havana and locally) has developed into unique medical models for South Pacific nations. Such models of cooperation are also clearly adaptable elsewhere.

Keywords: Cuba, developing countries, South-South cooperation, medical internationalism, capacity building, Cuban medical model, scaling-up of health workforce, South Pacific, Timor-Leste, human capital, ELAM, medical education, Pacific Island countries (PICs)

Introduction

Since its first comprehensive mission in Algeria in 1963 Cuba has continued to develop its medical internationalism assistance, and Cuban programmes are now operating in 68 countries of the developing world. This article analyses Cuba's medical missions in the South Pacific and specifically in Timor-Leste (East Timor), the largest outside of Latin America. It is here that Cuban medical international- ism has continued to spread and train students from Timor-Leste and its South Pacific neighbours. Cuba's low-technology and low-resourced medical model, focused on the development of human capital, is dynamic, creative, efficient and effective. Most important of all, it is independent and sustainable, rejecting traditional 'aid' models championed by G8 nations, and providing them with an alternative system of cooperation.

Cuba's medical collaboration programme in Timor-Leste is the first of its kind in the South Pacific, as has been pointed out in some excellent research by Tim Anderson (Anderson 2010a: 81). This article starts with some general thoughts on the nature of Cuba's approach to public health and its approach to medical education, since this constitutes the basis for the model exported elsewhere. The implementation of the Cuban medical model and medical education system in Timor-Leste will then be analysed to highlight some of the unique characteristics of this approach, its successes, and its challenges. Finally, the spread of Cuban medical internationalism from Timor-Leste to other South Pacific nations will be noted to show how these bilateral medical agreements could become a lesson in capacity-building and foreign aid for developed nations to employ in their own programmes.

This article illustrates the evolution and success of a radically different form of medical cooperation in this region, often ignored by academics. Clearly, traditional medical models have failed to become sustainable in the South Pacific - which is why Cuba was invited to cooperate in the realisation of a radical, extremely pragmatic medical system that can truly address the pressing health needs of the region. Our central argument is that the Cuban model is indeed different from forms of traditional aid, and instead is a programme of cooperation that, over time, begins the process of capacitating the host country's public health process to become independent and sustainable. It addresses the fundamental research question as to whether such a radically different model can be adapted to capacitate struggling medical systems in such diverse contexts. In sum, the paper is largely a descriptive analysis of the impact of Cuba's approach to developing a sustainable public healthcare system in the South Pacific, using Timor-Leste as its focal point. …

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