From Cooperation to Capacitation: Cuban Medical Internationalism in the South Pacific
| DOI | https://doi.org/10.13169/intejcubastud.5.1.0010 |
| Published date | 01 April 2013 |
| Date | 01 April 2013 |
| Pages | 10-25 |
| Author | Chris Walker,John M. Kirk |
| Subject Matter | 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) |
I J C S 5.1 S 2013
ACADEMIC ARTICLES
FROM COOPERATION TO CAPACITATION:
CUBAN MEDICAL INTERNATIONALISM IN THE
SOUTH PACIFIC
Chris Walker and John M. Kirk
Dalhousie University, Canada
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 international-
ism, 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-
IJCS5_1 10 20/02/2013 09:18
FROM COOPERATION TO CAPACITATION 11
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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.
One of the most significant aspects of Cuban medical internationalism is that
Cuba has more medical personnel serving in developing countries than those
of the G8 countries combined (through official missions), and more than those
employed by Doctors without Borders and the World Health Organization
(Kirk and Erisman 2009). This occurs despite the fact that Cuba, considered a
‘developing nation’, is only a small island of approximately 11 million people.
With over 38,000 medical personnel serving abroad,1 Cuban healthcare workers
are having a greater global medical impact than any other country.
IJCS5_1 11 20/02/2013 09:18
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