Revolutionary Medicine

Health and the Body in Post-Soviet Cuba

Revolutionary Medicine

Experimental Futures

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Book Pages: 288 Illustrations: 29 illustrations, 3 tables, 2 figures Published: March 2012

Anthropology > Medical Anthropology, Caribbean Studies, Latin American Studies

Revolutionary Medicine is a richly textured examination of the ways that Cuba's public health care system has changed during the past two decades and of the meaning of those changes for ordinary Cubans. Until the Soviet bloc collapsed in 1989, socialist Cuba encouraged citizens to view access to health care as a human right and the state's responsibility to provide it as a moral imperative. Since the loss of Soviet subsidies and the tightening of the U.S. economic embargo, Cuba's government has found it hard to provide the high-quality universal medical care that was so central to the revolutionary socialist project. In Revolutionary Medicine, P. Sean Brotherton deftly integrates theory and history with ethnographic research in Havana, including interviews with family physicians, public health officials, research scientists, and citizens seeking medical care. He describes how the deterioration of health and social welfare programs has led Cubans to seek health care through informal arrangements, as well as state-sponsored programs. Their creative, resourceful pursuit of health and well-being provides insight into how they navigate, adapt to, and pragmatically cope with the rapid social, economic, and political changes in post-Soviet Cuba.


Revolutionary Medicine is a an engaging and theoretically curious ethnography which masterfully connects global macroeconomic changes to the micropolitics of health in contemporary Cuba, and will speak to a wide range of disciplines and scholars within medical anthropology, public health, political sciences and Latin American studies.” — Eva Vernooij, Medische Antropologie

Revolutionary Medicine…represents an important contribution to an emergent anthropological literature on the Cuban State in the post-1990 era…It will be of interest to a broad range of readers, including undergraduates, graduate students and specialists in global health, medical anthropology, political theory and Latin American studies.” — Jennifer Lambe, Global Public Health

“In this excellent analysis of the impact of change since 1989, Brotherton provides a rich ethnographic picture of what this has meant in practice for both medical professionals and citizens seeking treatment…. This is a thought-provoking and sensitive study that will be of major interest both to public health professionals as well as scholars.” — Gavin O'Toole, Latin American Review of Books

“The book does a brilliant job of demonstrating the productive relationships between individual bodily practices and macro-level socioeconomic change. Brotherton makes valuable contributions to analytic understandings of medically mediated citizenship, subjectivity, and the limits of individual agency and state authority in a context of ongoing economic crisis. Revolutionary Medicine would be an excellent stand-alone text to read in graduate or undergraduate courses in Latin American studies, medical anthropology, global health, or the medical humanities.” — Amy Cooper, Somatosphere

“Others have studied the Cuban health system, but no one has delved into the political dynamics of Cuba’s universal health provision in the way that Brotherton has…. [T]his study… is an enormous contribution to our understandings of a tumultuous period of Cuban life and demonstrates the power of ethnographic analysis to those outside anthropology who belatedly discover Brotherton’s excellent analysis.” — Thomas F. Carter, Anthropological Quarterly

“Brotherton’s book is a comprehensive, engaging, and original account of the health landscape in Cuba from the outset of the ‘Special Period’ of the 1990s...This intriguing book, over a decade in the making, is worthy of the time invested in it--it makes a valuable contribution to the literature on health in Cuba.” — Elizabeth Kath, Bulletin of the History of Medicine

“Brotherton’s work has an important place within Cuban studies literature for two reasons. First, his attention to detail is phenomenal . . . The second important reason is that voices of dissent against the Cuban system, or against any system, are imperative for furthering our understanding of how policies and programs can shape the lived experiences of individuals.” — Robert Huish, Anthropos

“This is a must-read book for the important questions that it asks, the lens through which Brotherton examines the Cuban experience of the health care system, and the carefully collected and analyzed data.  . . . It is theoretically provocative, successfully problematizing conventional models of agency in health behavior and especially in the context of the Cuban health care system.” — Kathleen Musante Dewalt, American Ethnologist

“The book is based on more than 10 years of intermittent fieldwork and hundreds of interviews with medical professionals and patients. This wealth of ethnographic material is channeled into a fluent analysis that makes it an exceptional read…. The monograph possesses a literary quality (i.e. it is highly descriptive and showcases wonderfully compelling stories), provides plenty of complementary visual material, and it reads well despite the theoretical depth.” — Karina Vasilevska, Anthropological Notebooks

"Revolutionary Medicine is fabulous. In this intelligent, insightful, and nuanced book, P. Sean Brotherton takes health care as a window through which to view and understand the 'new Cuba,' which, as he notes, incorporates elements of the prerevolutionary period, the Soviet era, and the post-Soviet era. Both substantively and analytically, this is a book of very high quality." — Susan Eckstein, author of Back from the Future: Cuba under Castro

"In this unprecedented and daring journey into the lived contradictions of the world's most captivating biopolitical enterprise, P. Sean Brotherton powerfully illuminates the para-infrastructures of care and the ambiguous political subjectivities that emerge in the economic shadows of Cuba's revolutionary medicine. This thought-provoking ethnography is indispensable reading for all who are concerned with the political economy, practice, and theory of public health today." — João Biehl, author of Vita: Life in a Zone of Social Abandonment

"Using a sophisticated theoretical framework, P. Sean Brotherton weaves an intricate ethnographic tapestry representing the daily practice of medicine at the level of the city block, as well as the community's responses to changes in that practice. Revolutionary Medicine is a must-read for anyone interested in the health sphere in Cuba, the limits of the role of the state, social policy and politics, and medical anthropology." — Julie M. Feinsilver, author of Healing the Masses: Cuban Health Politics at Home and Abroad


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Author/Editor Bios Back to Top

P. Sean Brotherton is Assistant Professor of Anthropology at Yale University.

Table of Contents Back to Top
List of Illustrations ix
List of Tables xi
Prologue xiii
Preface. An Ethnography of Contradictions xv
Acknowledgments xxv
Introduction. Bodies in States of Crisis 1
Part I. Biopolitics in the Special Period 13
1. The Biopolitics of Health 15
2. Expanding Therapeutic Itineraries 35
Part II. Socialist Governmentality, Public Health, and Risk 55
3. Medicalized Subjectivities 57
4. Curing the Social Ills of Society 84
5. Preventive Strategies and Productive Bodies 111
Part III. We Have to Think Like Capitalists but Continue Being Socialists 145
6. Turismo y Salud, S.A.: The Rise of Socialist Entrepreneurs 147
7. My Doctor Keeps the Lights On 169
Conclusion. Bodies Entangled in History 182
Coda 191
Notes 193
Bibliography 219
Index 245
Sales/Territorial Rights: World

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Additional InformationBack to Top
Paper ISBN: 978-0-8223-5205-1 / Cloth ISBN: 978-0-8223-5194-8
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