The gift of health: Cuba’s development assistance in the Pacific

Abstract

Since 2006, 50 Cuban doctors have worked in Pacific Island countries (PICs), while 250 Pacific islanders have studied medicine at the Latin American School of Medicine in Cuba, nearly doubling the medical workforce in some countries. Although Cuba has pursued an extensive South-South Cooperation (SSC) programme in health around the globe for 60 years, the relatively recent presence of Cuba in the Pacific is intriguing. The programme is based on what Cuba has called the “multiple coincidences” and shared experiences between Cuba and PICs as Small Island Developing States facing common challenges. Proponents argue Cuba’s expertise in providing community-based and human-capital oriented care health care in low-resource environments could provide a suitable model for meeting the health goals and needs of PICs. Moreover, Cuba’s medical cooperation is grounded in an ethics of solidarity and offers a clear example of social justice-oriented south-south cooperation which aims to both address immediate humanitarian need and to transform power structures that limit the accessibility and availability of sustainable health care within partner countries. Yet despite this there has been little research on Cuba’s approach to medical cooperation in the Pacific. This paper addresses this gap, drawing on Maussian gift theory to argue that the Cuban ‘gift of health’ provides much needed capacity in health while building the dignity of both partners. As a theory of solidarity with distinct Pacific roots and which links clearly to the solidarity-based model of Cuban cooperation based on egalitarianism and relationship, gift theory provides an explanation for the presence of Cuba in the Pacific and highlights the importance of equitable relationships and dignity in development partnerships, providing theoretical roots to the idea that there might an alternative to traditional models of aid and development in the region.

KEYWORDS:

• Gift theory
• south-south cooperation
• development
• health
• Pacific
• Cuba

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 The concept and vision of “Healthy Islands” was developed at the first meeting of the Ministers of Health for the Pacific Island Countries on Yanuca Island, Fiji in 1995. Since that time the vision has inspired a diverse range of projects, has served as a unifying theme for health protection and health promotion and has formed the foundation for meetings of the annual Ministers of Health meetings (Galea, Powis, & Tamplin, 2000).

2 This rapid increase in the number of doctors in the region has created considerable concern for Pacific Ministries of Health and other donors in the region. Key concerns include the capacity of Pacific island health systems to absorb the expanding medical workforce, and the technical and languages skills of graduates (Asante et al., 2014; Sweet, Young, & Kado, 2018; Werle, 2020). These are being addressed with support from the Australian and New Zealand governments, and the Fiji School of Medicine, and will be the focus of forthcoming publications from this project.