The Social Medicine Portal

Health for All: Alma Ata is Alive and Well in Venezuela: Social Medicine V3N4

We have just published a new edition of Social Medicine / Medicina Social which is available in English at www.socialmedicine.info and in Spanish at www.medicinasocial.info.  In this issue guest editors Joan E. Paluzzi and Fernando Arribas García offers a unique, detailed look at the health reforms currently taking place in Venezuela.

Health for All
Alma Ata is Alive and Well in Venezuela

Mothers & their children at a graduation celebration for children who have exclusively breastfed for at least 6 months (San Rafael, Venezuela)

Editorials

Health for All: Alma Ata is Alive and Well in Venezuela:Joan Elizabeth Paluzzi, Fernando Arribas García (PDF)

“Misión Barrio Adentro is one of the many widespread social sector programs (Missions) developed within the framework of the ongoing Bolivarian Revolution and initiated following the election of President Hugo Chávez in 1998. Barrio Adentro can be translated “inside the neighborhood”, a concept which establishes the ‘street credentials’ of the Venezuelan reform as a legitimate exemplar of an engaged model for social medicine in the 21st century.”

Venezuelan Health Reforms

National Training Program for Comprehensive Community Physicians, Venezuela: Eugenio Radamés Borroto Cruz, Ramón Syr Salas Perea (PDF)

“Cuban experience with community oriented medical education and global health cooperation was drawn upon to develop curriculum and provide faculty for the new National Training Program for Comprehensive Community Physicians, begun in 2005 in cooperation with six Venezuelan universities. The program differs from previous Venezuelan medical education models by adopting a stated goal of training physicians for public service, recruiting students who had no previous opportunity for university-level education, and concentrating the weight of their training on a service- and community-based model of education, relying on practicing physician-tutors.”

Neoliberal Policies and their Impact on Public Health Education: Observations on the Venezuelan Experience: Oscar Feo (PDF)

“In Venezuela, like other countries of the American continent, public health schools had been transformed from institutions under the direction of the Ministry of Health to a model in which training took place under market conditions. Education in public health became a private good for individual consumption, and schools, lacking official funding, survived by offering courses in a market that did not necessarily respond to a country’s health needs. The conclusion discusses the currrent Venezuelan experience in which the State has resumed control of the training of specialists in public health, making it more democratic, and adoptng an educational model centered around practice and whose purpose is the mass training of leadership teams to bolster the National Public Health System.”

Venezuela’s Barrio Adentro: participatory democracy, south-south cooperation and health care for all: Carles Muntaner, Francisco Armada, Haejoo Chung, Mata Rosicar, Leslie Williams-Brennan, Joan Benach (PDF)

“The need of the population for better access to health services became exceedingly evident in Caracas during 2002 through demands made by organized community groups, corroborated by social studies conducted by the city council of the municipality of Libertador. To meet these requirements, the city council designed a plan to provide basic health care through “Casas por la Salud y la Vida” (Houses of Health and Life) in certain metropolitan areas (“marginal neighborhoods”) that were lacking any type of public services. In January 2003, the government of the municipality invited local doctors to participate in the new program. The response was minimal and justifications given included concerns about personal safety and lack of the infrastructure needed to practice medicine. Based on the humanitarian support provided by Cuba during the Vargas tragedy, Caracas Mayor Freddy Bernal, with the support of President Chávez, agreed on a pilot project with the Cuban government. In April 2003, 58 Cuban doctors specializing in integral general medicine (a form of family medicine) were established in several peripheral neighborhoods (barrios) of Caracas, to provide primary health care. “

Venezuela’s Misión Barrio Adentro “Inside the Neighborhood”: Joan Elizabeth Paluzzi (Slideshow)

Adentro Barrio Adentro: An American Medical Student in Venezuela: Rebecca Trotzky Sirr (PDF)

“I decided I had to see it for myself. Had Barrio Adentro been successfully implemented so quickly in such a large and diverse geographic setting? Surely there would be important lessons learned for health care providers across the globe. What worked well? What should be done differently? Applying for a Fulbright grant to study medicine in Venezuela was like sending a message in a bottle to my future self: “Dear Jaded Future-Self, do not give up your dreams of social justice in medicine. Check out the health care system transformations in South America. Love, Idealistic Former-Self.” I wanted to gain direct exposure to the Barrio Adentro program, interview Cuban physicians, and understand the perspective of Venezuelan physicians who often saw Barrio Adentro as a threat to professional organized medicine.”

Themes and Debates

Social Determinants of Health: Perspective of the ALAMES Social Determinants Working Group: Oliva López Arellano, José Carlos Escudero, Luz Dary Camona. (PDF)

“On the basis of these reflections and our perspective we would like to highlight a series of problems in the Commission’s Report which we feel should be further discussed: [...]

• The report is silent about problems which produce destruction, mass death, and enormous suffering in populations: imperial wars, genocide, and the manipulations of transnational pharmaceutical and food companies, among others.
• The report does not discuss the limitations onthe reduction of social and health inequalities imposed by capitalism in general and by specific capitalist formations. In other words, there is no discussion about the contradiction posed by adopting a “politically correct” concern over poverty, which proposes to reduce social and health differences, while at the same time, ferociously defending the market economy.
• In summary, the Commission’s report amply fulfils its purpose of gathering evidence on health and socioeconomic inequalities, and of stressing the importance of socioeconomicdeterminants. But it falls short of advancing an understanding of the origin of these problems, what Benach and Muntaner have called “the causes of the causes of the causes.”

News & Events

Global Health Watch 2 (PDF)

posted by Matt Anderson