An difríocht idir athruithe ar: "Plé úsáideora:EÓMurchadha"
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Eomurchadha (plé | dréachtaí) →glaodhualgas: mír nua |
Eomurchadha (plé | dréachtaí) →cúba: mír nua |
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Líne 128:
cúntóirí sláinte - healthcare assisstant -
stad cairdiach -
== cúba ==
Beveridge
castro
sláinteThe Cuban model of public health has been evolving for 60years and parallels the
development of the British NHS. The vision outlined by Castro in his 1953 ‘history
will absolve’ echoes strongly of Beveridge’s vision for the British welfare state and
the ‘war’ on the five evil giants of want, ignorance, squalor, idleness and disease.
Significantly both men also recognised the importance of collective action in
achieving their goals. More recently, in 1984 it was to the British health system and
the GP model in particular that Cuba when it began a radical transformation and
reorientation of its health system towards primary care. Despite the serious problems
of economic and political isolation that it has encountered along the way, Cuba has
succeeded in achieving health outcomes comparable with the UK and other highincome
countries. Significantly although the Eastern European countries had
achieved remarkable health outcomes in the 1960; this trend started to wane through
the 70s and as Richard Wilkinson observed: “by the late 80s all the Western
European countries had higher life expectancy than every Eastern European
country.” (2005:114).
This paper draws on the findings of a case study (including 20 weeks fieldwork) to
explain the reasons for Cuba’s success in public health. Case study provides a strong
methodology for providing understanding of the dynamics within a particular setting
and a rich contextualised understanding, thereby minimising the risk for superficial
interpretation and personal bias. Research methods included participant and nonparticipant
observation, focus group and individual interviews. The original casestudy
concluded in 2006 and in the intervening years, research has focused on
Cuba’s innovative approach to ageing.
During the first week of fieldwork in Cuba (2005) a notice displayed in the window
of a house caught my attention it advertised: “Umbrellas repaired”. Around this
same time by coincidence, I was reading James Joyce’s book ‘ The Dubliners’ in
which a similar notice appears in a drapery shop window in the ‘Sisters' advertising:
“Umbrellas recovered.” (Joyce, 1992:3). In those early days, the juxtaposition of
the Cuban and Joycean notices yielded a narrow and superficial interpretation, on
Memorias Convención Internacional de Salud Pública. Cuba Salud 2012.
La Habana 3-7 de diciembre de 2012 ISBN 978-959-212-811-83
Dr Una Lynch una@sonrisa-solutions.com
my part, with the former seen to be symbolising the poverty and economic
deprivation of Cuba. With the passage of time, came more opportunity to gain entry
into the Cuban psyche and another more complete account of the symbolism
emerged. Whereas the Joycean notice advertises ‘recovering’ its Cuban counterpart
offers ‘repairs’. While ‘recovering’ will ensure that the umbrella is aesthetically
pleasing and in the latest style, it does not, however, guarantee that the inner
mechanism will be addressed. ‘Repairs’ on the other hand will fix, or replace, those
parts that are not working; rehabilitate those that need adjusting and preserve the
parts that are functioning, even though they may be deemed as dated by the
fashionistas.
The two approaches encapsulate the differences between contemporary (recovered)
and the Cuban (repaired) health systems. A recovered umbrella could potentially
continue for a number of seasons, with a constantly updated appearance and still
essentially remain the umbrella that it always was, although there is a high risk that
constant recovering will eventually take its toll. It is, therefore, likely that the
umbrella will one day collapse, leaving the owner stranded in a shower and having
to find a quick solution, most likely an expensive ‘new’ model. The repaired
umbrella by comparison may not always look so pretty, but over the years it has the
potential to be metamorphosed into something completely different and stronger, to
what it started out as. The constant maintenance and adjustment improves the
umbrella’s capacity to meet changing needs effectively, in the process, increasing
the likelihood that it will offer protection and support to various guardians and be
passed on intact to future generations.
The Cubans are interested in public health for the results that are produced. This
utilitarian philosophy is captured in the umbrella. In Cuba umbrellas are used in
equal measure for protection from the rain when they are called: paraguas and from
the sun: parasol. Umbrellas can protect one person or groups of people; they can
also double as a cane to provide support and the pointed end provides a potential
weapon in case of attack or a useful pointer to give direction. As such, the umbrella
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