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Revolutionary Doctors

Revolutionary Doctors: How Venezuela and Cuba Are Changing the Worlds Conception of Health Care

Copyright Date: 2011
Published by: NYU Press,
Pages: 240
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  • Book Info
    Revolutionary Doctors
    Book Description:

    Revolutionary Doctors gives readers a first-hand account of Venezuela's innovative and inspiring program of community healthcare, designed to serve - and largely carried out by - the poor themselves. Drawing on long-term participant observations as well as in-depth research, Brouwer tells the story of Venezuela's Integral Community Medicine program, in which doctor-teachers move into the countryside and poor urban areas to recruit and train doctors from among peasants and workers. Such programs were first developed in Cuba, and Cuban medical personnel play a key role in Venezuela today as advisors and organizers. This internationalist model has been a great success - Cuba is a world leader in medicine and medical training - and Brouwer shows how the Venezuelans are now, with the aid of their Cuban counterparts, following suit.But this program is not without its challenges. It has faced much hostility from traditional Venezuelan doctors as well as all the forces antagonistic to the Venezuelan and Cuban revolutions. Despite the obstacles it describes, Revolutionary Doctors demonstrates how a society committed to the well-being of its poorest people can actually put that commitment into practice, by delivering essential healthcare through the direct empowerment of the people it aims to serve.

    eISBN: 978-1-58367-268-6
    Subjects: Health Sciences

Table of Contents

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  1. Front Matter
    (pp. 1-4)
  2. Table of Contents
    (pp. 5-6)
  3. Acknowledgments
    (pp. 7-10)
  4. 1. Where Do Revolutionary Doctors Come From?
    (pp. 11-20)

    Even though he came to Cuba with a rifle slung over his shoulder and entered Havana in 1959 as one of the victorious commanders of the Cuban Revolution, he still continued to think of himself as a doctor. Five years earlier, the twenty-five-year-old Argentine had arrived in Guatemala and offered to put his newly earned medical degree at the service of a peaceful social transformation. Dr. Ernesto Guevara was hoping to find work in the public health services and contribute to the wide-ranging reforms being initiated by President Arbenz, but he never had much opportunity to work as a physician...

  5. 2. Solidarity and Internationalism
    (pp. 21-40)

    Che’s travels through the American hemisphere in the early 1950s were his first steps toward developing a revolutionary international consciousness. Over the next few years his desire to help the poor and the oppressed was transformed into a decision to stand in solidarity with them, and to join in their struggles to assert their dignity and humanity. When he arrived in Guatemala hoping to put his medical skills at the service of the people, there were no Latin American networks that promoted internationalism and solidarity on the part of young health professionals who wanted to work and live among the...

  6. 3. Creating Two, Three … One Hundred Thousand Che Guevaras
    (pp. 41-54)

    Before Che Guevara left for Bolivia in 1966, he wrote a letter to the nonaligned third world countries of Asia, Africa, and Latin America, encouraging them to unite in their efforts to escape from the historic domination of the colonialist and imperialist forces of Europe and North America. He recommended starting many revolutionary struggles and so much simultaneous resistance that the United States and its allies could not possibly subdue the forces of liberation. The letter was published the following year and the words of its title, “Create two, three … many Vietnams,”¹ were soon repeated around the world.


  7. 4. Medicine in Revolutionary Cuba
    (pp. 55-72)

    Cuba’s extraordinary ability to deliver health care and build new medical systems, in cooperation with Venezuela and other nations, was developed over a period of decades. To comprehend how a relatively small and poor country managed to make this commitment, it is necessary to understand how Cuba’s human resources, scientific knowledge, and social expertise were developed in the course of building its own medical system. Immediately after the triumph of the Revolution in 1959, Cuba made changes in the ways it delivered medical services and began to emphasize preventive care. With time, they also revamped the training of health professionals...

  8. 5. Barrio Adentro
    (pp. 73-94)

    In 2004, on my first trip to Venezuela, I was picked up at the Caracas airport by a young emergency care doctor, Michel. He was doing a favor for his sister Marcela, a radio reporter who was to be one of my guides around Caracas over the following two weeks. Michel chose to take a detour along the coast, driving past Monte Avila, the long mountain that rises out of the sea to form a 7,000-foot wall between the Caribbean and Caracas. He pointed out the ruins and debris along the deep ravines in the mountainside, the site of tremendous...

  9. 6. Witnessing Barrio Adentro in Action
    (pp. 95-110)

    Just a few days after my arrival in Venezuela in November 2004, my guide Marcela and I met with Juan Ramon Echeverria, a social worker and lifelong barrio resident, who gave us a short and effective political and social history of the Caracas barrio of Antímano, emphasizing that many years of social struggles and protests had developed a progressive political consciousness among the population long before the Bolivarian Revolution. He led us to one of theconsultorios populares, or neighborhood consulting offices, that were scattered all over the large barrio, a community of 250,000 that lies in the hills on...

  10. 7. New Doctors for Venezuela
    (pp. 111-128)

    On August 19, 1960, Che Guevara spoke to the Cuban militia about organizing “public health so as to provide treatment for the greatest possible number of people.” He explained that the practice of revolutionary medicine would be a vocation based on public service and revolutionary doctors would define themselves by their practice of solidarity and equality. He finished with his favorite quotation from José Martí:Hacer es la mejor manera de decir—“The best way of telling is doing.”

    The Cuban doctors working with Barrio Adentro are following in the spirit of Martí’s maxim: they are teaching by doing. In...

  11. 8. Building Community Medicine on a Daily Basis
    (pp. 129-152)

    Two or three times a week during my year in Venezuela, I would climb the mountainside above Monte Carmelo to visit the cooperative organic farm located on the slopes just below the cloud forest. One day as I made my way up the steep road, a motorcycle came roaring around a deeply rutted curve and disappeared down the mountain in a cloud of dust. I stopped to catch my breath and chat with the farmer who stood by the barbed wire fence next to two of his ten cows. “He’s off to class in Sanare,” he said as we watched...

  12. 9. Revolutionary Medicine in Conflict with the Past
    (pp. 153-174)

    “During the three years that a doctor remains here doing a postgraduate residency, he earns a salary that doesn’t permit him to live independently, to have his own house or vehicle, or raise a family.” This is how José, a traditional medical student enrolled at Universidad Central de Venezuela in Caracas, Venezuela’s most prestigious public university, explained why he was choosing to go to Spain in 2009 to do his residency training.¹

    Arelys, a young mother and nontraditional medical student enrolled in Medicina Integral Comunitaria in Sanare, state of Lara, explained why she was looking forward to a future of...

  13. 10. The Battle of Ideas and the Battle for Our America
    (pp. 175-200)

    When José Martí died in 1895, Cuba was on the verge of winning its war for independence and ending four hundred years of colonization by Spain. A few years earlier, Martí had warned that Cuba and “our America” (that is, all of America south of the United States) would be facing another threat. “The scorn of our formidable neighbor who does not know us,” he wrote, “is our America’s greatest danger.” When Spain was pushed out of the way in 1898, the colossus of the north was ready to encroach economically and politically, especially on its nearest neighbor. The United...

  14. 11. The War on Ideas: The U.S. Counterinsurgency Campaign
    (pp. 201-214)

    The efforts of Cuba, Venezuela, and the ALBA nations to meet social needs, provide health care, and educate their populations are progressing, not without mistakes and miscalculations, but for the most part with results consistent with the socialist egalitarianism and humanistic solidarity they espouse. The United States has taken note of the contending philosophy developing in the south, but it is not interested in engaging in a “battle of ideas” or intellectual debate with those whose concepts and values challenge the basic tenets of globalizing capitalism. Instead, it employs a strategy that could be best described as awar on...

  15. 12. Practicing Medicine, Practicing Revolution
    (pp. 215-230)

    The revolutionary doctors and medical students from Cuba and Venezuela and the rest of the Americas—and the nurses, physical therapists, sports trainers, and other skilled technicians who work with them—are offering a serious challenge to the rest of the world. By their daily deeds and commitment to socialist solidarity, they are demonstrating that humanity is capable of delivering medical care to everyone—not in the remote future, but right now—and they are accomplishing this while openly defying the logic of capitalist development that dominates most of the globe. Cuba and Venezuela have demonstrated that a model of...

  16. Notes
    (pp. 231-246)
  17. Index
    (pp. 247-256)