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Health Travels: Cuban Health(care) On and Off the Island, edited by Nancy J. Burke

daily life, Globalization, greater Cuba, Health, new book No Comments »

Edited by Nancy J. Burke and including contributions by many ethnographers and EC scholars, Health Travels: Cuban Health(care) On and Off the Island, UC Medical Humanities 2013, is now available for purchase or full-text download via this link.

From the publisher:

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. Health Travels is the first collection of its kind to map the recent history of the Cuban healthcare system in rich ethnographic detail. This collection of essays challenges static and binary discourses regarding the healthcare system, bringing together contributions that paint a picture of the nuanced and dynamic intricacies of Cuban health(care) as it is represented and experienced both on the island and around the world. In each instance, papers address macro-forces – national policies and global strategies – as well as micro-practices that at times counter, and at other times support, state-level programs. Exploring the praxis at the juncture of daily bodily practices and global representations this collection highlights how the Cuban state is instantiated in different contexts and for various purposes. Illuminating the complexity of the divide between the state and el pueblo, contributors to this volume highlight contradictions in daily living and the “success” of the Cuban health care system.

Paperback | 978-0-9889865-1-0 | Spring 2013 | 279 | 24.95

Where No Doctor has Gone Before: Cuba’s Place in the Global Health Landscape, by Robert Huish 2013

Health, new book No Comments »

Here is a new book likely to be of particular interest to medical anthropologists: Where No Doctor Has Gone Before: Cuba’s Place in the Global Health Landscape, by Robert Huish, Wilfrid Laurier University Press, 2013.  While the author is a professor of International Development Studies rather than an ethnographer, the book is based on interview data.  Here is WLUP’s summary:

Tens of thousands of people around the world die each day from causes that could have been prevented with access to affordable health care resources. In an era of unprecedented global inequity, Cuba, a small, low-income country, is making a difference by providing affordable health care to millions of marginalized people.

Cuba has developed a world-class health care system that provides universal access to its own citizens while committing to one of the most extensive international health outreach campaigns in the world. The country has trained thousands of foreign medical students for free under a moral agreement that they serve desperate communities. To date, over 110,000 Cuban health care workers have served overseas.

Where No Doctor Has Gone Before looks at the dynamics of Cuban medical internationalism to understand the impact of Cuba’s programs within the global health landscape. Topics addressed include the growing moral divide in equitable access to health care services, with a focus on medical tourism and Cuba’s alternative approach to this growing trend. Also discussed is the hidden curriculum in mainstream medical education that encourages graduates to seek lucrative positions rather than commit to service for the marginalized. The author shows how Cuba’s Escuela Latinoamericana de Medicina (ELAM) serves as a counter to this trend.

An acknowledgement of Cuba’s tremendous commitment, the book reveals a compelling model of global health practice that not only meets the needs of the marginalized but facilitates an international culture of cooperation and solidarity.


Brotherton, Revolutionary Medicine: Health and the Body in Post-Soviet Cuba, Duke 2012

Cultural production, daily life, Health, new book No Comments »

Congratulations to Sean Brotherton for his just-released book, Revolutionary Medicine: Health and the Body in Post-Soviet Cuba!  The volume is certain to set a new standard for theoretically sophisticated and ethnographically sustained  research on Cuban health systems and practices, about which there has until now been relatively little published beyond Whiteford & Branch and Hirshfeld’s work.  Meanwhile, here is the publisher’s description:

Revolutionary Medicine is a richly textured examination of the ways that Cuba’s public health care system has changed during the past two decades and of the meaning of those changes for ordinary Cubans. Until the Soviet bloc collapsed in 1989, socialist Cuba encouraged citizens to view access to health care as a human right and the state’s responsibility to provide it as a moral imperative. Since the loss of Soviet subsidies and the tightening of the U.S. economic embargo, Cuba’s government has found it hard to provide the high-quality universal medical care that was so central to the revolutionary socialist project. In Revolutionary Medicine, P. Sean Brotherton deftly integrates theory and history with ethnographic research in Havana, including interviews with family physicians, public health officials, research scientists, and citizens seeking medical care. He describes how the deterioration of health and social welfare programs has led Cubans to seek health care through informal arrangements, as well as state-sponsored programs. Their creative, resourceful pursuit of health and well-being provides insight into how they navigate, adapt to, and pragmatically cope with the rapid social, economic, and political changes in post-Soviet Cuba.


After “In Sickness and Health: Encountering Wellness in Cuba and the U.S.”

By Paul Ryer, Conferences & CFPs, Health No Comments »

For the many ECers who were not able to attend the recent medical anthropology conference, “In Sickness and Health: Encountering Wellness in Cuba and the U.S.,” thanks to the University of California’s Cuba working group you can now find a useful write-up of the event here.  While we have not done many post-event postings, such a write-up  adds significant value to an event which brought together a number of esteemed medical anthropologists and specialists in Cuban health systems.  Something to keep in mind should you attend a similar event in the future, and have a bit of time to share your thoughts about it!

Update to Travel Insurance Requirements to Enter Cuba

By Ariana Hernandez-Reguant, Health, News and Views, travel 7 Comments »

Cuban consulates have publicized today the details about the new health insurance requirement to enter Cuba as of May 1st. I translate selectively from the e-mail text:

The policy should be purchased prior to traveling but policies will be offered at Cuba’s ports of entry as well.  Only those with valid policies for the entire duration of their stay will be allowed into the country. Valid policies are those by companies represented in Cuba by ASISTUR. Those who are residents of the United States, and travel from the U.S., will have to buy a policy prior to traveling from HAVANATUR-CELIMAR, through one of their affiliated agencies. There are three different policies with different levels of coverage and their respective cost is between 2 and 3 CUCs a day (roughly USD 3-5).

You can download the specific “tabla de beneficios” or coverage table, by clicking HERE.

You can read the original post about this new policy HERE.

Medical Insurance Required to Enter Cuba (as of May 1st)

By Ariana Hernandez-Reguant, Health, Licensing & visas 29 Comments »

UPDATE (4/7/2010): For an update on specific costs and procedures, go HERE

As of May 1st both tourists and temporary residents will have to purchase an insurance policy along with their visas. Up until know, if tourists sought medical attention, they were charged for services on the spot.  Temporary residents would presumably have been covered by the state system, at least if they were students. It was, however, a good idea to have a private insurance, so that you could be seen at the well-supplied hard-currency facilities, which otherwise charged US prices for the visit. (I personally contracted with a European insurance company called Europe Assistance, which had an agreement with its Cuban equivalent). Now, proof of valid insurance will be required from everybody entering the country. Obviously because of the US embargo, insurance policies with US companies are not valid for Cuba, but many international travelers’ insurance companies are (supposedly Cuba will publish a list of those).

Cuba has ASISTUR, which offers temporary policies to foreigners at competitive rates and also operates as a representative of non-Cuban companies, like the aforementioned Europe Assistance.  But will hospitals like Havana’s hard-currency Cira Garcia be ready for the increased number of patients (hey, if you get an insurance policy you might as well go check on those minor ailments you’ve been putting off…).  ASISTUR actually worked very well: since it is a Cuban company they cover everything upfront… But now with the avalanche of new insurees, will they be ready?

Although most of us, citizens of Europe and North America, might not have heard of such a regulation before anywhere (at least I had not), turns out that Europe has been imposing it since 2006. For visitors to the European Union from many countries, the requirements for a Schengen Visa (valid for all countries within the EU) include proof of a travel medical insurance. Such a health insurance must be recognized by the EU, have offices in a EU country, ensure cadaver repatriation costs, and medical expenses up to $42,888. Many US carriers like Blue Cross Blue Shield Wold wide services operate in Europe. Otherwise there are many companies that will offer insurance starting at $1/day. But because of the US embargo, this means an extra hurdle for US citizens visiting Cuba.

Here is the actual regulation as it appears in Cuba’s Gaceta Oficial:

You can read a translation into English HERE.

Concerning costs, rumors range from a few dollars a day to fifty dollars a month, but nothing has been officially set. Nothing is known as of yet concerning the international travel insurance companies that will be accepted. Currently, Havanatur (in the US, Marazul travel) sells travel insurance for $5/day (plus a service fee). For a more specific estimate of how much such an insurance currently costs if you have special needs, you can enter your data on the ASISTUR page designed to that effect.

* According to a Montreal-based blog written by a Cuban expatriate, in a post dated today (Sunday, march 7th), Cuban consulates abroad will add a “certification of insurance” to the visa. For Canadian residents and citizens, whose insurance covers them while abroad, including Cuba, the cost of such certification will be between 30 and 50 Canadian dollars. So they will not have to buy extra insurance if they already have a valid one, but they will still have to pay for the certification… U.S. nationals, obviously, will have to buy the extra insurance no matter what…

Primary Healthcare in Cuba (a book and more)

By Paul Ryer, Health, new book No Comments »

Somehow, despite the relatively small community of anthropologists working on some aspect of contemporary Cuba, this book has not received proper recognition.  Whether this was a subfield-derived oversight, a question of timing or some other factor, Primary Health Care in Cuba: The Other Revolution, by Linda Whiteford and Laurence Branch, Rowman & Littlefield 2008, is now available on paperback.   With only 117 pages of text, the book provides a succinct overview of the Cuban health system from a critical medical anthropology perspective.  Although clearly not as ethnographically rich as the work of P. Sean Brotherton and other specialists, and although a number of topics (such as the Cuban response to HIV/AIDS, or to the public health elements of state responses to “natural” disasters) are not given the space they deserve, this book would be accessible for an undergraduate course or course segment on contemporary Cuba and its distinctive health system.  While it is appropriately academic rather than polemic, the text paints an image of the Cuban health system sharply more positive than Katherine Hirschfeld’s, and it is not surprising that Hirschfeld’s review–like her book, presented as ethnographically authoritative–is scathing in its critique of the book’s lack of political critique.  Controversially–and to my mind in a rather tacked-on manner, given the scope of the volume–she also points to the authors’ omission of political dissidence as a major gap in their overview of a health care system.

Reviews of Katherine Hirschfeld’s Health, Politics and Revolution

By Paul Ryer, Health, new book No Comments »

health-politics-and-revolution-in-cuba-9781412808637Here is a political rather than academic  review of Katherine Hirshfeld’s book Health, Politics and Revolution in Cuba since 1898, published in 2007 by Transaction Publishers.  Although the book is more carefully framed and historicized than the dissertation version, in my reading, Hirshfeld’s conclusions, based on some months of fieldwork, still suffer from the sort of a priori assumptions and misreadings that plague the work of many political scientists and sociologists who do short-term fieldwork in Cuba.  I am not a medical anthropologist, but what concerns me here is that this text has been presented as ethnographically authoritative, precisely in counterpoint to other academic disciplines, yet still largely rests on the limited ethnographic work and arguably superficial interpretation of her dissertation research.  Is this too harsh an assessment?  Have others found it to be fair and balanced and worth reading?  The book has also gotten significant publicity in Miami, as exemplified by the above review, among others. Does that matter?  For comparison, here is another perspective on Hirschfeld’s work, which echoes my concerns.

As I think it over, the part of the text that raises these concerns is really chapter 4, “Fearful Interlude.”  E.g. the italicized phrases in the interview with “Brother Bob,” the drama of  “So they got you?” on p. 84.  To borrow a phrase from David Scott: whose fear, what cause?  Certainly the relation of researcher & state is complex and worth much more discussion, but this book seems a better fit for the predetermined categories of espionage than ethnography.

50 years of Revolution. Special Issues and Recent Ethnographies

Consumption & material culture, Cultural production, daily life, Gender & sexuality, Globalization, greater Cuba, Health, History, media, Miami, music, new article, new chapter/edited volume, Race, Religion, Sport, Tourism No Comments »

Journal of Latin American Studies

Latin American Perspectives

In addition you might want to check out the following recent publications:

* By Ruth Behar and Lucia Suárez, an edited volume: THE PORTABLE ISLAND: Cubans at Home in the World.  Palgrave 2008.

* By Ivor Miller, a book: Voice of the Leopard: African Secret Societies and Cuba, University Press of Mississippi.

* By Ariana Hernandez-Reguant:

Special guest edited issue of the Journal of Latin American Anthropology, including introduction (“Alternative Geographies”), and articles by Laurie Frederik Meer, P. Sean Brotherton, Kenneth Routon, and Helen Safa.

“Radio Taino and the Cuban Quest for Identi…que?“, in Doris Sommer’s Cultural Agency in the Americas, Duke University Press, 2006.

“Havana’s Timba. A Macho Sound for Black Sex.” In Deborah Thomas and Kamari Clarke. Globalization and Race. Duke University Press, 2006.

* By Kenneth Routon. “Conjuring the past: Slavery and the historical imagination in Cuba.”  American Ethnologist (p 632-649), Volume 35 Issue 4

* By Laurie Frederik MeerPlayback Theatre in Cuba: the Politics of Improvisation and Free Expression,” in The Drama Review, Winter 2007, Vol. 51, No. 4, Pages 106-120

* By P. Sean Brotherton.  “We have to think like capitalists but continue being socialists”: Medicalized subjectivities, emergent capital, and socialist entrepreneurs in post-Soviet Cuba.  American Ethnologist, Vol. 35, Issue 2, pp. 259-274.  June 2008.

* By Mette Berg:

Between Cosmopolitanism and the National Slot: Cuba’s Diasporic Children of the Revolution, Identities (vol. 16, issue 2), Pages 129 – 156.

“Homeland and belonging among Cubans in Spain.”  Journal of Latin American and Caribbean Anthropology, Vol. 14 no. 2, (pp. 265-290)

* By Katrin Hansing, (2009). “South-South Migration and Transnational Ties between Cuba and Mozambique,” in Transnational Ties: Cities, Migrations, and Identities. M. P. Smith and J. Eade. New Brunswick, Transaction Publishers: 77-90.

* Even if you are already familiar with Todd Ramón Ochoa‘s article, “Versions of the Dead: Kalunga in Cuban Kongo Materiality,” in Cultural Anthropology Vol. 22, No. 4, November 2007, you should check out this link from C.A., which includes study questions and an embedded video clip.

*By Kristina Wirtz:

Her book is entitled Ritual, Discourse, and Community in Cuban Santería: Speaking a Sacred World University Press of Florida, 2007.  (only on hard cover).

See reviews: McIntosh, Janet. “(Book Review) Ritual, Discourse, and Community in Cuban Santería: Speaking a Sacred World. University of Florida Press, 2007.” by Kristina Wirtz. Journal of Linguistic Anthropology vol. 18(1) 2009: 163-4. And a review byElina Hartikainen (citation only, full-text not available), in the Journal of Latin American and Caribbean Anthropology, Volume 13, Number 2, November 2008 , pp. 461-462(2). Also, here is another link to a review (again, citation only) by Paul Christopher Johnson in the Journal of Anthropological Research, vol. 64, no. 4.  If you know of other reviews, or have your own comments, please take a moment to leave an update or comment!

Kristina Wirtz, “Hazardous waste: the semiotics of ritual hygiene in Cuban popular religion,” in JRAI vol. 15, pp. 476-501, 2009.

Kristina Wirtz:  “Divining The Past: The linguistic reconstruction of “African” roots in diasporic ritual registers and songs,” in Journal of Religion in Africa Special Issue: “African diasporic religions.”  27(2): 240-272, 2007.  Introduced by Stephan Palmié.

Wirtz, K. (2007) Deep language and diasporic culture: Learning to speak the ‘tongue of the orichas’ in Cuban Santería. American Ethnologist 34(1): 108-126.  Her abstract:

“Enregistered memory and Afro-Cuban historicity in Santería’s ritual speech,” in Language & Communication special issue: “Temporalities of Text.” 27(3), 2007.

Finally, check out two related pieces by Wirtz, “Introduction: Ritual Unintelligibility” (pp. 401-407. Read introduction) and “Making sense of unintelligible messages: Co-construction of meaning in Santería rituals,” (435-462. Abstract) in a special issue of the journal Text & Talk on “Ritual Unintelligibility,” 27(4), 2007.

* By Tom Carter

(1)  “New Rules to the Old Game: Cuban Sport and State Legitimacy in the Post-Soviet Era,” in Identities: Global Studies in Culture and Power. 15 (2): 194-215, 2008.

(2)“Pitén en la Plaza: Some preliminary considerations on spatializing culture in Cuba” in Image, Power and Space: Studies in Consumption and Identity. Alan Tomlinson and Jonathan M. Woodham (eds). Aachen: Meyer & Meyer. Pp. 97-112.

(3)  “Of Spectacular Phantasmal Desires: Tourism and the Cuban State’s Complicity in its Commodification of its Citizens,” in Leisure Studies. 27 (3): 241-257, 2008.

(4) “Family Networks, State Interventions and the Experiences of Cuban Transnational Sport Migration,” in International Review of the Sociology of Sport. 42 (4): 371-389, (2007).

(5) “A Relaxed State of Affairs?: On Leisure, Tourism, and Cuban Identity” in The Discipline of Leisure: Embodying Cultures of “Recreation”. Simon Coleman and Tamara Kohn (eds). Oxford: Berghahn, pp. 127-145 (2007).

* By Martin Holbraad:

Definitive evidence, from Cuban gods,” in the Journal of the Royal Anthropological Institute, special issue The Objects of Evidence,vol. 14, issue s1, April 2008. Based on evidence collected during fieldwork among practitioners of Afro-Cuban religion in Havana, this paper seeks ‘recursively’ to redefine the notion of anthropological evidence itself. It does so by examining ethnographically practitioners’ concern with the ‘evidence’ deities give (e.g. successful divinations, divine cures, etc.), by virtue of which people’s relationships with deities are cemented. To the extent that this indigenous concept of evidence is different from notions of evidence anthropologists take for granted in their own work, it occasions the opportunity to transform those very assumptions. But such a procedure is itself evidential – pertaining to the relationship between ethnography and theory. The paper sets out the virtues, both ethnographic and theoretical, of this circularity.

Thinking Through Things: Theorising Artefacts Ethnographically, ed. by Amiria Henare, Martin Holbraad and Sari Wastell.  Routledge 2007.  The volume, as well as this exchange about the book between Martin Holbraad and Daniel Miller, is surely of general interest to those of us with an interest in consumption, goods, and so-called material culture.  Additionally, Holbraad’s chapter, “The Power of Powder: Multiplicity and Motion in the Divinatory Cosmology of Cuban Ifá (or mana, again)” also ought to be of interest for many ethnocuba readers. The book is also reviewed at Savage Minds, here.

Roulette anthropology: the whole beyond holism,” in Journal of the Finnish Anthropological Society, 32 (2). pp. 29-47 (2007). The paper builds an argument about holism in anthropological theory by drawing an ethnographic contrast between divination and gambling in Cuba.  Outlining the contrasting modes of prediction in each case, it is shown that while diviners’ predictions draw on cosmological models of the world, gamblers’ seek to source the cosmos itself.  Their concern with going beyond cosmology is bound up with their orientation (obsessive sometimes) towards what they call ‘cábalas’ – attention-grabbing coincidences of everyday life.  A similar contrast can be drawn with regard to anthropological notions of ‘holism’.  Available versions of holism are ‘cosmological’ inasmuch as they pertain to the role of models in anthropology.  Nevertheless, anthropologists too are as concerned with accessing the cosmos, allowing ‘the field’ to speak for itself in ethnography.  Like the gamblers (and unlike colleagues in more disciplined disciplines), anthropologists find that it is only when they stop reasoning in terms of pre-conceived cosmologies that worlds begin to reveal themselves as such.  So anthropology goes beyond holism by becoming more holistic than it already thinks it is: from cosmology to the cosmos.  It is oriented towards the underbelly of reason par excellence, ventriloquising itself into the cosmos at ‘ethnographic moments’ – coincidences – that can only register as ‘alterity’.  So a defence of radical ‘holism’, it is argued, is also a defence of a radical ‘exoticism’.

Expending Multiplicity: Money in Cuban Ifá Cults,” Journal of the Royal Anthropological Institute vol. 11 (2), pp. 231-254.  2005.

* By Maria Gropas

“Landscape, Revolution and Property Regimes in Rural Havana,” 2006. Journal of Peasant Studies, vol. 33 issue 2, pp. 248-277

The Repatriotization of Revolutionary Ideology and Mnemonic Landscape in Present-Day Havana,”  in Current Anthropology 48 (4), 2007. Includes commentaries by Virginia R. Domíguez, Nadine Fernandez, Martin Hall, Martin Holbraad, and Mona Rosendahl, as well as a reply by the author.  The conversation has an amplified on-line version, with additional color images, here.
*By Matthew Hill, “Re-Imagining Old Havana: World Heritage and the Production of Scale in Late Socialist Cuba” in Deciphering The Global: Its Scales, Spaces and Subjects, ed. by Saskia Sassen (2007).
* By Miguel de la Torre. 2003. La Lucha for Cuba: Religion and Politics on the Streets of Miami, University of California Press, by Miguel A. De La Torre. Reviewed Here by Laurie Frederik Meer’s in e-misférica.
* By Amalia Cabezas.  “The Eroticization of Labor in Cuba’s All-Inclusive Resorts: Performing Race, Class and Gender in the New Tourist Economy,” in Social Identities, Volume 12, Issue 5 September 2006 , pages 507 – 521.

* By Amy L. Porter, “Fleeting Dreams and Flowing Goods: Citizenship and Consumption in Havana Cuba” in PoLAR vol. 31, no. 1, pp. 134-149.  May 2008.
* By Noelle Stout.Feminists, Queers and Critics: Debating the Cuban Sex Trade,” in the Journal of Latin American Studies, vol 40, pp. 721-742 (2008).
* By Rogelio Martínez Furé. 2007. Eshu (oriki a mi mismo)  y otras descargas.
* By Valerio Simoni, “‘Riding’ Diversity: Cubans’/Jineteros‘ Uses of ‘Nationality-talks’ in the Realm of their Informal Encounters with Tourists” in Tourism Development: Growth, Myths and Inequalities, ed. by Peter M. Burns & Marina Novelli, CAB International, 2008, pp. 68-84.
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