Natural and Traditional Medicine in Cuba: Lessons For U.S. Medical Education

Appelbaum, Diane; Kligler, Benjamin; Barrett, Bruce; Frenkel, Moshe; Guerrera, Mary P.; Kondwani, Kofi; Lee, Bennett B.; Tattelman, Ellen

doi:10.1097/01.acm.0000246681.34207.a7

Cited by 21 publications

(20 citation statements)

References 5 publications

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“…73 Garfield and Santana 1997, p. 18. 74 Applebaum, Kligler, Barrett et al 2006. 75 Garfield and Santana 1997, p. 17.…”

Section: Formal Integration As a Results Of International Political Ecmentioning

confidence: 99%

Slaves, Revolutions, Embargoes, and Needles: The Political Economy of Acupuncture in Cuba

Kadetz¹,

Delgado²

2010

Asian Med

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Medical systems have travelled and influenced one another for as long as there has been trade between differing groups. The medical systems of China have been a particularly frequent traveller, facilitated by Chinese migration and trade throughout history. The transfer and subsequent integration of acupuncture into the Cuban health care system can be best understood in terms of various political and economic forces from the mid-nineteenth to the end of the twentieth century. This paper will demonstrate that how acupuncture was transferred to Cuba; why it was integrated into the national health care system of Cuba; and how acupuncture is currently understood and practised in the Cuban context can be best understood as a result of specific political and economic factors. KeywordsCuba, TCM, acupuncture, political economy, China P. Kadetz, J. Perdomo Delgado / Asian Medicine 6 (2010-11) socialist state in a global neoliberal trade environment; and externally imposed trade restrictions, such as international embargoes, Cuba offers a noteworthy case, by which to examine the political economic factors influencing the integration and particular use of TCM practices, such as acupuncture, in a formal national health care system.Cuban public health has become a model for other developing nations with its structure of equal access, popular participation in health initiatives, and integrated approach. 2 The Cuban health care system has been able to achieve health status measures on a par with industrialised countries despite far more modest infrastructure investment. 3 For example, in 2003, Cuba was able to achieve an infant mortality rate equal to, or lower than, the Unites States and Canada, despite having less than one-sixth of their per capita gross national product and, as of 2006, spending only US$320 per person per annum on its health care system in comparison to the $6,714 per person spent in the U.S. 4 Cuba's post-revolutionary shift from curative care to preventative primary health care has been designated as central to its successful health outcomes. From the late 1970s, Cuba's community-oriented primary care programme evolved with the establishment of community clinics known as consultorios. 5 Under this programme, a doctor-nurse team provides both preventive and curative primary care for approximately 150 families in any given community. 6 The three-tiered Cuban health care system also includes secondary care polyclinics, offering a range of health care services from physician biomedical specialists, as well as non-biomedical health care practices known as Medicina Tradicional y Natural (MTN). 7 Tertiary care is provided by hospitals and speciality institutions. 8 Other qualities of the Cuban health care model identified as pertinent to its success include: 'accessibility, universality, comprehensiveness, quality, integration horizontally, primary care focus, integration across sectors (social, environmental focus, etc.), and a health promotion focus'. 9 Although the Cuban health care system has been pra...

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“…73 Garfield and Santana 1997, p. 18. 74 Applebaum, Kligler, Barrett et al 2006. 75 Garfield and Santana 1997, p. 17.…”

Section: Formal Integration As a Results Of International Political Ecmentioning

confidence: 99%

Slaves, Revolutions, Embargoes, and Needles: The Political Economy of Acupuncture in Cuba

Kadetz¹,

Delgado²

2010

Asian Med

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“…Australian universities have been slow to embrace CAM education programs for medical practitioners, unlike their counterparts in the UK, Europe, US and Cuba. In the Cuban model medical practitioners are trained to practise CAM themselves [83]. It is likely that the reach of most Australian programs will be to educate medical practitioners to be informed advisers, not to practise CAM.…”

Section: Discussionmentioning

confidence: 99%

CAM practitioners in the Australian health workforce: an underutilized resource

Grace

2012

BMC Complement Altern Med

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BackgroundCAM practitioners are a valuable but underutilizes resource in Australian health care. Despite increasing public support for complementary and alternative medicine (CAM) little is known about the CAM workforce. Apart from the registered professions of chiropractic, osteopathy and Chinese medicine, accurate information about the number of CAM practitioners in the workforce has been difficult to obtain. It appears that many non-registered CAM practitioners, although highly qualified, are not working to their full capacity.DiscussionIncreasing public endorsement of CAM stands in contrast to the negative attitude toward the CAM workforce by some members of the medical and other health professions and by government policy makers. The marginalisation of the CAM workforce is evident in prejudicial attitudes held by some members of the medical and other health professions and its exclusion from government policy making. Inconsistent educational standards has meant that non-registered CAM practitioners, including highly qualified and competent ones, are frequently overlooked. Legitimising their contribution to the health workforce could alleviate workforce shortages and provide opportunities for redesigned job roles and new multidisciplinary teams. Priorities for better utilisation of the CAM workforce include establishing a guaranteed minimum education standard for more CAM occupation groups through national registration, providing interprofessional education that includes CAM practitioners, developing courses to upgrade CAM practitioners' professional skills in areas of indentified need, and increasing support for CAM research.SummaryMarginalisation of the CAM workforce has disadvantaged those qualified and competent CAM practitioners who practise evidence-informed medicine on the basis of many years of university training. Legitimising and expanding the important contribution of CAM practitioners could alleviate projected health workforce shortages, particularly for the prevention and management of chronic health conditions and for health promotion.

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“…In 1996, it incorporated alternative health practices into its programs, and by 2002, 86 percent of Cuban physicians practiced some form of alternative medicine (Appelbaum et al 2006(Appelbaum et al : 1098. Therapies that are officially recognized include phytotherapy; apitherapy; acupuncture, acupressure, and other forms of Chinese medicine; thermalism and therapeutic hydrology; homeopathy; floral therapy (Bach and Chilean); naturopathy; ozone therapy; and therapeutic exercises such as t'ai chi and chi kung.…”

Section: Biomedicine and The Revolutionmentioning

confidence: 99%

“…Visiting a santero is not an anti-social act. The Ministry of Public Health routinely enlists the cooperation of yerberos and santeros in the coordination of major health education campaigns (Appelbaum et al 2006(Appelbaum et al : 1100. Hearn (2003: 57) argues that Santería is conditioned "by a convergence of distinct cultural and economic values in collaborative activities."…”

Section: Santería and Its Place In The Revolutionmentioning

confidence: 99%

Healing Practices and Revolution in Socialist Cuba

Gold¹

2014

Social Analysis

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More than a state ideology, the concept of 'Revolution' holds multiple meanings for Cubans. A historic moment, the government, the country, the people-Revolution is any one of these and all of them at once. How, then, do people experience a permanent Revolution in their daily lives? The interactions between biomedicine, alternative health practices, and the syncretic system of beliefs known as Santería have important implications for the socialist project of the Revolution. As a central concern of Revolution, health provides a particularly clear example of the interaction between revolutionary ideology and practice. This distinction elucidates the epistemological and experiential complexity of Revolution, providing the Cuban state with a powerful signifier that allows it to adapt to situations of crisis, continuously reinvent itself, and be in a permanent state of Revolution.

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Natural and Traditional Medicine in Cuba: Lessons For U.S. Medical Education

Cited by 21 publications

References 5 publications

Slaves, Revolutions, Embargoes, and Needles: The Political Economy of Acupuncture in Cuba

Slaves, Revolutions, Embargoes, and Needles: The Political Economy of Acupuncture in Cuba

CAM practitioners in the Australian health workforce: an underutilized resource

Healing Practices and Revolution in Socialist Cuba

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