Notes
157 Notes to Preface 1 All dollar currencies are US dollars unless otherwise noted. Notes to Chapter 1 1 Translated literally as “The Jewel of the Weeds.” This is a town in Ecuador’s Amazon, located 80 km from the city of Coca. 2 Cuba’s provision of medical services has been labelled as “medical diplomacy,” “medical export,” and “trading doctors for oil.” There are, however, flaws with these, and other, definitions. This book employs the term “Cuban medical internationalism” as defined by Huish and Kirk (2007). The idea is that Cuba’s medical efforts around the world are a convergence of two evolutionary trends in public health and foreign policy. This definition emphasizes that the reasons for, and impacts of, medical internationalism are not just limited to public health or foreign policy. Rather, there are impacts and benefits within both sectors, and they cannot be divorced from each other. 3 “Forward innovation” refers to the development of pharmaceutical products that currently do not exist for treatment therapies. “Backward innovation” refers to the process of researching existing products and reproducing their recipes for low-cost use. 4 The Declaration of Alma-Alta is the 1978 international agreement that declares health to be a human right and that universal health care would be a reality by the twenty-first century. 5 The word “tokenism” refers to highly symbolic, media-ready, short-term interventions that do little to create transformative health benefits on the ground. 6 The breakdown of Canadian government aid to Haiti following the earthquake was as follows: $43 million to the World Food Program for food assistance, air transportation , emergency telecommunications, and logistics; $33 million to match Canadian citizens private donations to the Red Cross for foreign debt relief programs; $30 million to Canadian organizations for short-term recovery and reconstruction projects; $16.5 million to a police training program; $10 million towards Haitian justice and security institutions; $5.8 million in support of the November 2010 elections ; $4.5 million to support an agricultural credit financing program; and $500,000 to CANADEM (an association of Canadian technical experts) for deployment of Canadian experts to United Nations organizations (Aid Facts on Haiti, 2011). 7 It is currently illegal for a Canadian physician to provide both private and public health-care services (although many travel clinics get away with it). The idea that a second tier of health-care services could increase efficiency is madness: such a system would certainly retain more physicians for the needs of those who could afford NOTES 158 NOTES to pay a higher price than it would retain doctors in the public system. It is not as if Canada, or any nation, can increase public efficiency through a reserve army of doctors waiting to be unleashed to off-load patient demand by market liberalization. For more explanation on the politics and history of the Canada Health Act and medicare in Canada, see Steven Lewis et al. (2001) and Greg Marchildon (2005). 8 By 1965, Cuban physicians largely went on salary (though some stayed on the feefor -service model). Cuban medical students in the 1960s took a pledge upon graduation that they would not bill for services. Notes to Chapter 2 1 Martí’s work on “Nature” is tremendously important to understanding his later, more radical, understandings of society. The use of the word “Nature” is not taken to mean natural flora and fauna, but meant as a broader understanding of the connections between humans and their lived worlds. 2 The 1992 Torricelli Act prohibits the sale of medicine and food to Cuba directly from the United States. The 1997 Helms–Burton law goes a step further to allow US corporations to sue foreign corporations that maintain business relations with the United States while also exporting goods to Cuba. It is a loose law, as many exports do make it to Cuba, but the export of medical resources and pharmaceuticals remains under attack. In one case, a Canadian exporter served four years in federal prison in the United States for selling water purifiers to Cuban hospitals. Notes to Chapter 3 1 MEDICC is Medical Education and Cooperation with Cuba, an NGO out of Oakland, California. They offer both news and scholastic publications on Cuban health care. 2 These clinics are staffed by both Cuban and local health-care workers. 3 Interviews took place in January 2010 with students studying at Mbarara University, a medical school the Cuban government helped to establish in 1989. 4 Assuming return...
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