Integrating health and human security into foreign policy: Cuba&apos;s surprising success

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International Journal of Cuban Studies

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Integrating health and human security into foreign policy: Cuba's surprising success

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Author(s): Robert Huish , Jerry Spiegel

Publication date (Print): 1 June 2008

Journal: International Journal of Cuban Studies

Publisher: Pluto Journals

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Abstract

Human security has been thoroughly debated as a concept and discourse that is more sensitive to the needs of disadvantaged populations; however it has been only marginally implemented in the foreign and domestic policies of the countries where its application has been most actively discussed. We feel that it is unfortunate that energy has primarily focused on theorization of the term rather than examination of empirical examples where human security is or could be put into practice. To provide a stark contrast to the much talk but little action on human security, we offer a case study of Cuba's foreign policy initiatives in primary health-care provision. Cuba sends thousands of health-care professionals to under-serviced regions of the world, and trains physicians from modest and humble backgrounds. The Cuban experience demonstrates how a policy committed to combating structural violence in the developing South leads to a practice that provides basic needs and enhances capabilities for the marginalized - at root a central concern of human security! Cuba has done a great deal to develop such policy, but this has come with internal challenges, political turmoil, and at times questionable outcomes, amid limited recognition. Nevertheless, Cuba's 48-year foreign policy of providing assistance and security at the individual level is a fitting example of human security beyond rhetoric for the twenty-first century.

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Author and article information

Journal

Journal ID (jstor): intejcubastud

Journal ID (doi): 10.2307/j50005551

Title: International Journal of Cuban Studies

Publisher: Pluto Journals

ISSN (Print): 17563461

Publication date (Print): 1 June 2008

Volume: 1

Issue: 1

Pages: 42-53

Article

DOI: 10.2307/41945989

SO-VID: 5473f362-1614-4915-a9ad-18d97d8261f6

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ScienceOpen disciplines: Literary studies,Arts,Social & Behavioral Sciences,History,Cultural studies,Economics

References

S. Allende, 'Charla Ofrecida a Los Empleados Del Ministerio De Salud Pública'. Tribuna Médica de Cuba, marzo-junio, 1961), 1961: pp 13 - 19.
L. Axworthy, 'Canada and Human Security: The Need for Leadership". International Journal, Spring, 1997: pp 183 - 96.
---, 'Human Security and Global Governance: Putting People First'. GLOBAL GOVERNANCE, 7(1), 2001: pp 19 - 23.
R. Beaglehole, and M.R. Dal Poz, 'Public health workforce: challenges and policy issues'. Human Resources for Health, 4(1), pp 1 - 7.
J. R. Boulet, et al., 'The International Medical Graduate Pipeline: Recent Trends in Certification and Residency Training'. Health Affairs, 25(2), 2006: pp 469-77.
J. P. Burgess, and T. Owen, 'Special Section - What Is 'Human Security'? Security Dialogue, 35(3), 2004: pp 345-72.
A. J. F. Cardelle, 'Health Care Reform in Central America: Ngo-Government Collaboration in Guatemala and El Sadvador'. Coral Gables, Fla.: North-South Center Press at the University of Miami, 2003.
J. Carrizo Estévez, 'Mensaje De Rector'. 2007. http://www.elam.sld.cu
F. Castro, 'At this moment, Cuba is training more than 12,000 doctors for the Third World'. Granma International, 2005: August 20.
S. Cohen, 'Cuba and the Liberation of Southern Africa'. Monthly Review, 46(September), 1994: pp 17 - 25.
N. L. Eckhert, 'The Global Pipeline: Too Narrow, Too Wide or Just Right'? Medical Education, 36(7), 2002: pp 606-13.
ELAM Web, 'Matrícula'. 2007. http://www.elam.sld.cu P. Farmer, 'An Anthropology of Structural Violence'. Current Anthropology, 45(2004: pp 305 -26.
J. Feinsilver, 'Cuban Medical Diplomacy: When the Left Has Got It Right'. COHA Report, 2006: October 31.
E. H. Galeano, 'Century of the Wind'. Memory of Fire. 3 vols. New York: Pantheon Books, 1985.
J. Galtung, and T. Hoivik, 'Structural and Direct Violence: A Note on Operationalization'. Journal of Peace Research, 8(1), 1971: pp 73 - 76.
J. Gideon, 'Accessing Economic and Social Rights under Neoliberalism: gender and rights in Chile'. Third World Quarterly, 27(7), 2006: pp 1269 - 1283.
P. Gleijeses, 'The First Ambassadors: Cuba's Contribution to Guinea-Bissau's War of Independence'. Journal of Latin American Studies, 29, 1997: pp 45 -88.
---, 'Cuba's First Adventure in Africa, 1961 - 1965'. Journal of Latin American Studies, 28(1), 2006: pp 159 - 95.
Granma International, 'Más De 32 Mil Colaboradores De La Salud Cubanos Trabajan En 76 Países'. Granma International, 2007: June 16.
D. Harvey, 'A brief history of neoliberalism'. Oxford: Oxford University Press: 2005.
J. A. Hallock, S. S. Seeling, and J. J. Norcini, 'The International Medical Graduate Pipeline'. Health Affairs, 22(4), 2003: pp 94-96.
R. Horton, 'The Health of Peoples: Predicaments Facing a Reasoned Utopia'. International Journal of Health Services, 33(3), 2003: pp 543-68.
R. Huish, and J. M. Kirk, 'Cuban Medical Internationalism and the Development of the Latin American School of Medicine'. Latin American Perspectives, 34(6), 2007: pp 77 - 92.
MEDICC, 'Latin American School of Medicine - How to Apply'. 2007. http://www.elam.sld.cu
I. Mgbeoji, 'The Civilised Self and the Barbaric Other: Imperial Delusions of Order and the Challenges of Human Security'. Third World Quarterly, 27(5), 2006: pp 855 - 69.
C. Muntaner, et al., 'Challenging the Neoliberal Trend - the Venezuelan Health Care Reform Alternative'. Canadian Journal Of Public Health-Revue Canadienne De Sante Publique, 97(6), 2006: pp 119-124.
A. F. Musah, 'The Privatization of security, arms proliferation and the process of state collapse in Africa'. Development and Change, 33(5), 2002: pp 911 - 933.
S. Ogata, and A. Sen, 'Human Security now (Final Report)'. New York: United Nations Commission on Human Security: 2003.
T. Owen, 'Human Security - Conflict, Critique and Consensus: Colloquium Remarks and a Proposal for a Threshold-Based Definition'. Security Dialogue, 35(3), 2004: pp 373-87.
---, In All but Name: The Uncertain Future of Human Security in the Un'. Ed. UNESCO: Commissioned UNESCO publication, 2006.
G. Reed, 'Cuban Medical Teams in Global Disaster Relief'. MEDICC. http://www.medicc.org
J. B. Riddell, 'The Face of Neo-Liberalism in the Third World: Landscapes of Coping in Trinidad and Tobago'. Canadian Journal of Development Studies-Revue Canadienne D'Etudes Du Développement, 24(4), 2003: pp 593-615.
P. Schwab, 'Cuba: confronting the U.S. embargo'. New York: St. Martin's Press: 1999.
S. Schmeidl, '(Human) Security Dilemmas: Long-Term Implications of the Afghan Refugee Crisis'. Third World Quarterly, 23(1), 2002: pp 7 - 29.
J. M. Spiegel, 'Commentary: Daring to Learn from a Good Example and Break the 'Cuba Taboo". International Journal of Epidemiology, 35, 2006: pp 825-26.
The Economist, 'Dr. Diplomat'. The Economist, 382(8513), 2007: pp 35.
The World Health Organization, 'The World Health Report Working Together for Health'. Geneva: The World Health Organization, 2006.
A. Ugalde, and N. Homedes, 'Neoliberal Health Sector Reforms in Latin America: Unprepared Managers and Unhappy Workers'. Revista Panamericana De Salud Publica- Pan American Journal of Public Health, 17(3), 2005: pp 202 - 09.
---, 'Why Neoliberal Health Reforms Have Failed in Latin America'. Health Policy, 71(1), 2005: pp 83 - 96.
United Nations Development Programme, United Nations Human Development Report 2005: International Cooperation at a Crossroads - Aid, Trade and Security in an Unequal World'. New York, 2005.
S. Willett, 'Insecurity, Conflict and the New Global Disorder'. IDS Bulletin - Institute of Development Studies, 32(2), 2001: pp 35 - 45.

Comments

Comment on this article

[1] S. Allende, 'Charla Ofrecida a Los Empleados Del Ministerio De Salud Pública'. Tribuna Médica de Cuba, marzo-junio, 1961), 1961: pp 13 - 19.

[2] L. Axworthy, 'Canada and Human Security: The Need for Leadership". International Journal, Spring, 1997: pp 183 - 96.

[3] ---, 'Human Security and Global Governance: Putting People First'. GLOBAL GOVERNANCE, 7(1), 2001: pp 19 - 23.

[4] R. Beaglehole, and M.R. Dal Poz, 'Public health workforce: challenges and policy issues'. Human Resources for Health, 4(1), pp 1 - 7.

[5] J. R. Boulet, et al., 'The International Medical Graduate Pipeline: Recent Trends in Certification and Residency Training'. Health Affairs, 25(2), 2006: pp 469-77.

[6] J. P. Burgess, and T. Owen, 'Special Section - What Is 'Human Security'? Security Dialogue, 35(3), 2004: pp 345-72.

[7] A. J. F. Cardelle, 'Health Care Reform in Central America: Ngo-Government Collaboration in Guatemala and El Sadvador'. Coral Gables, Fla.: North-South Center Press at the University of Miami, 2003.

[8] J. Carrizo Estévez, 'Mensaje De Rector'. 2007. http://www.elam.sld.cu

[9] F. Castro, 'At this moment, Cuba is training more than 12,000 doctors for the Third World'. Granma International, 2005: August 20.

[10] S. Cohen, 'Cuba and the Liberation of Southern Africa'. Monthly Review, 46(September), 1994: pp 17 - 25.

[11] N. L. Eckhert, 'The Global Pipeline: Too Narrow, Too Wide or Just Right'? Medical Education, 36(7), 2002: pp 606-13.

[12] ELAM Web, 'Matrícula'. 2007. http://www.elam.sld.cu P. Farmer, 'An Anthropology of Structural Violence'. Current Anthropology, 45(2004: pp 305 -26.

[13] J. Feinsilver, 'Cuban Medical Diplomacy: When the Left Has Got It Right'. COHA Report, 2006: October 31.

[14] E. H. Galeano, 'Century of the Wind'. Memory of Fire. 3 vols. New York: Pantheon Books, 1985.

[15] J. Galtung, and T. Hoivik, 'Structural and Direct Violence: A Note on Operationalization'. Journal of Peace Research, 8(1), 1971: pp 73 - 76.

[16] J. Gideon, 'Accessing Economic and Social Rights under Neoliberalism: gender and rights in Chile'. Third World Quarterly, 27(7), 2006: pp 1269 - 1283.

[17] P. Gleijeses, 'The First Ambassadors: Cuba's Contribution to Guinea-Bissau's War of Independence'. Journal of Latin American Studies, 29, 1997: pp 45 -88.

[18] ---, 'Cuba's First Adventure in Africa, 1961 - 1965'. Journal of Latin American Studies, 28(1), 2006: pp 159 - 95.

[19] Granma International, 'Más De 32 Mil Colaboradores De La Salud Cubanos Trabajan En 76 Países'. Granma International, 2007: June 16.

[20] D. Harvey, 'A brief history of neoliberalism'. Oxford: Oxford University Press: 2005.

[21] J. A. Hallock, S. S. Seeling, and J. J. Norcini, 'The International Medical Graduate Pipeline'. Health Affairs, 22(4), 2003: pp 94-96.

[22] R. Horton, 'The Health of Peoples: Predicaments Facing a Reasoned Utopia'. International Journal of Health Services, 33(3), 2003: pp 543-68.

[23] R. Huish, and J. M. Kirk, 'Cuban Medical Internationalism and the Development of the Latin American School of Medicine'. Latin American Perspectives, 34(6), 2007: pp 77 - 92.

[24] MEDICC, 'Latin American School of Medicine - How to Apply'. 2007. http://www.elam.sld.cu

[25] I. Mgbeoji, 'The Civilised Self and the Barbaric Other: Imperial Delusions of Order and the Challenges of Human Security'. Third World Quarterly, 27(5), 2006: pp 855 - 69.

[26] C. Muntaner, et al., 'Challenging the Neoliberal Trend - the Venezuelan Health Care Reform Alternative'. Canadian Journal Of Public Health-Revue Canadienne De Sante Publique, 97(6), 2006: pp 119-124.

[27] A. F. Musah, 'The Privatization of security, arms proliferation and the process of state collapse in Africa'. Development and Change, 33(5), 2002: pp 911 - 933.

[28] S. Ogata, and A. Sen, 'Human Security now (Final Report)'. New York: United Nations Commission on Human Security: 2003.

[29] T. Owen, 'Human Security - Conflict, Critique and Consensus: Colloquium Remarks and a Proposal for a Threshold-Based Definition'. Security Dialogue, 35(3), 2004: pp 373-87.

[30] ---, In All but Name: The Uncertain Future of Human Security in the Un'. Ed. UNESCO: Commissioned UNESCO publication, 2006.

[31] G. Reed, 'Cuban Medical Teams in Global Disaster Relief'. MEDICC. http://www.medicc.org

[32] J. B. Riddell, 'The Face of Neo-Liberalism in the Third World: Landscapes of Coping in Trinidad and Tobago'. Canadian Journal of Development Studies-Revue Canadienne D'Etudes Du Développement, 24(4), 2003: pp 593-615.

[33] P. Schwab, 'Cuba: confronting the U.S. embargo'. New York: St. Martin's Press: 1999.

[34] S. Schmeidl, '(Human) Security Dilemmas: Long-Term Implications of the Afghan Refugee Crisis'. Third World Quarterly, 23(1), 2002: pp 7 - 29.

[35] J. M. Spiegel, 'Commentary: Daring to Learn from a Good Example and Break the 'Cuba Taboo". International Journal of Epidemiology, 35, 2006: pp 825-26.

[36] The Economist, 'Dr. Diplomat'. The Economist, 382(8513), 2007: pp 35.

[37] The World Health Organization, 'The World Health Report Working Together for Health'. Geneva: The World Health Organization, 2006.

[38] A. Ugalde, and N. Homedes, 'Neoliberal Health Sector Reforms in Latin America: Unprepared Managers and Unhappy Workers'. Revista Panamericana De Salud Publica- Pan American Journal of Public Health, 17(3), 2005: pp 202 - 09.

[39] ---, 'Why Neoliberal Health Reforms Have Failed in Latin America'. Health Policy, 71(1), 2005: pp 83 - 96.

[40] United Nations Development Programme, United Nations Human Development Report 2005: International Cooperation at a Crossroads - Aid, Trade and Security in an Unequal World'. New York, 2005.

[41] S. Willett, 'Insecurity, Conflict and the New Global Disorder'. IDS Bulletin - Institute of Development Studies, 32(2), 2001: pp 35 - 45.