How has Cuba, a small, developing country, achieved its stunning medical breakthroughs? Hampered by scarce resources and a long-standing U.S. embargo, Cuba nevertheless has managed to provide universal access to health care, comprehensive health education, and advanced technology, even amid desperate economic conditions. Moreover, Cuba has sent disaster relief, donations of medical supplies and technology, and cadres of volunteer doctors throughout the world, emerging, in Castro's phrase, as a "world medical power."
In her significant and timely study, Julie Feinsilver explores the Cuban medical phenomenon, examining how a governmental obsession with health has reaped medical and political benefits at home and abroad. As a result of Cuba's forward strides in health care, infant mortality rates are low even by First World standards. Cuba has successfully dealt with the AIDS epidemic in a manner that has aroused controversy and that some claim has infringed on individual liberties—issues that Feinsilver succinctly evaluates.
Feinsilver's research and travel in Cuba over many years give her a unique perspective on the challenges Cuba faces in this time of unprecedented economic and political uncertainty. Her book is a must-read for everyone concerned with health policy, international relations, and Third World societies.
Julie M. Feinsilver is Visiting Assistant Professor of Political Science at Oberlin College.
"Engaged but objective, this comprehensive study offers a rich mine of data to social scientists and health experts alike. . . . [It] will inform and surprise even the Cuba 'experts' inside Cuba . . . and may also help explain why the revolution has been able to endure."—Saul Landau, Institute for Policy Studies, Washington D.C.
"Superbly researched. . . . Feinsilver's book is for anyone interested in understanding why Castro weathered the global anti-communist storm between 1989 and 1991 and in learning about how social policies can be effective in the Third World."—Susan Eckstein, Boston University
"Feinsilver's book admirably reconstructs the capacity of Cuba's public health system to meet the health needs of its people. Her analysis of the evolution of Cuban government policy in the health field should be of particular interest to public health professionals in various countries. I have learned much from this book and am certain that others will too."—Jorge Domínguez, Center for International Affairs, Harvard University
"Whatever the political views of the readers, Julie Feinsilver's scholarly analysis of the Cuban health care system in the Castro period, within the framework of specifically Cuban health policy, will be exciting and rewarding reading. The view of the social policy process whereby a small, poor country managed to develop a complex health services infrastructure that zealously provided comprehensive medical care for the entire population and succeeded in daring adventures in the provision of medical care in a half dozen foreign countries as well, is a fascinating story. And most fascinating of all is the evidence that the care given was good!"—George A. Silver, Yale University