Confronting colonial legacies and neoliberal hegemony in global health and development : creative Cuban social medicine adaptions from Venezuela to Timor-Leste

Abstract

Despite recent and significant declines in health outcomes and health services in Cuba as well as a retreat of Cuba's medical internationalist program, this dissertation argues that there is a potential wealth of lessons to be learned from Cuba's successes and challenges in both Timor-Leste and Venezuela, particularly throughout the 2003-2020 era. Cuba provides particularly important considerations, especially in its assistance to developing Venezuela’s <i>Misión Barrio Adentro</i> (<i>MBA</i>) primary public health programme, that could help overcome fragmented Global North healthcare systems which struggle with the hospitalization of primary care to reimagine a truly patient-centred, team-based, proactive/preventive primary care and education system. Cuban efforts in Timor-Leste also have significant potential internationally in development efforts which could capacitate, through their creative medical education programmes, those in the Global South to meet their own health needs in an effort to buttress against future pandemics and global health challenges. In both examples, Cuba accomplished these feats with comparatively far less material and financial resources than Global North development efforts. However, Cuba's subaltern healthcare example has often been dismissed by many, either explicitly as part of a larger neoliberal geo-political project, or unconsciously, assumed by many to be too poor or undeveloped a country to learn from. As such, with the help of a political economy framework, this dissertation will evidence how health outcomes cannot be separated from power and inequality, nor can subaltern / oppressed voices reach those who would benefit from their knowledge in the current8 neoliberal hegemony.