SOC330 Paper - Group 1
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Drexel University *
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Course
330
Subject
Medicine
Date
Jan 9, 2024
Type
docx
Pages
8
Uploaded by rhchoi
Robert Choi, Tyra Howell, Briana Leone, Avery Maudlin, Diane Nguyen, Sydney Zeve
Outline Doc: https://docs.google.com/document/d/1HSj049WcXs71yzc-
YDdZfd2JC3lDSJN35wqr7SeR7f4/edit?usp=sharing
Cuba’s Medical Internationalism: Foreign Policy or Exploitation?
I.
Intro (Tyra)
In March of 2020, the World Health Organization declared that the current SARS-Cov-19
(more commonly known as coronavirus) outbreak was a pandemic. A couple days later, President Donald Trump declared that the outbreak of coronavirus was a national emergency. States then began to issue stay-at-home orders as the cases began to grow exponentially. It did not take long for the medical staff to become completely overwhelmed. Many hospitals did not possess the proper amount of personal protective equipment, beds, or even staff members to properly handle such large amounts of patients
at once. In order to help with the growing need for many staff, many wealthy countries chose to import foreign doctors, many of which were from Cuba. This was especially beneficial because Cuban doctors are used to working with limited resources. While this may seem like a panacea, the Cuban doctors are often overworked and exploited. II.
Definition of the issue with evidence (Diane)
This issue of migrational labor is incredibly problematic, for semi-periphery and periphery medicinal labor are considered subpar until it is needed during desperate times, specifically with the COVID-19 pandemic. Because there are shortages of healthcare workers due to the pandemic, the United States and United Kingdom are recruiting doctors, nurses, rehabilitation specialists, and pharmacists from semi-periphery and periphery countries (SAMJ,
2020). Even in 2005, twenty-five percent of doctors in the United States were foreign-trained, and sixty percent of those doctors came from the periphery (SAMJ, 2020). With the COVID-
Robert Choi, Tyra Howell, Briana Leone, Avery Maudlin, Diane Nguyen, Sydney Zeve
19 crisis, there is a significant contribution of migrant healthcare workers in the United States and Canada to help meet the staggering demand (Scarpetta et al., 2020). The core is taking incredible measures to ensure they can receive migrant labor during this time, whether it be through renewing work authorization or through a fast-track process of foreign qualification recognition (Scarpetta et al., 2020).
Supporting the core is essentially what the periphery is used for. The semi-periphery labor force is exploited by the core, and during this pandemic, the Cuban medical labor force has been subjected to this exploitation. Cuba has sent its doctors to Italy and South Africa to fight the spread of COVID-19, and in the United States, they are trying to address ending the trade embargo and sanctions against Cuba in order to use their medical labor force (Dodds et al., 2020). When Cuba is not needed, the core turns its nose up at this state’s “alternative socialist visions of universal access to healthcare” (Dodds et al., 2020). However, during times of crisis, these countries are desperate for help from a country they do not usually consort with.
On top of this, once a pandemic is controlled, these migrant healthcare workers’ careers are up in the air; it is assumed they are sent back home where they will be ostracized for leaving their home (Vervoort, 2020).
Because of this issue, lesser developed countries are tossed to the side, losing valuable medical resources and health capabilities. Even though the United States has ten times the amount of doctors than low-income countries (SAMJ, 2020), the core continues to exploit poorer countries by recruiting their medical staff, taking from their understaffed industry and putting their already fragile health systems at risk. With the staff shortages in the core coupled with their migrant labor, there is an incredible burden on those poor, origin countries, (Scarpetta et al., 2020). In the periphery, some of them have fragile healthcare systems, thus
Robert Choi, Tyra Howell, Briana Leone, Avery Maudlin, Diane Nguyen, Sydney Zeve
emigration because of migrant labor is detrimental to said country. There are reductions in that workforce and many lives can be lost in those origin countries (Vervoort, 2020). Medical migration causes the periphery’s healthcare systems to weaken, limiting their abilities to respond to other issues within their communities, such as HIV and AIDS (Mullan, 2005). Thus,
while it may be beneficial for the core to utilize medical resources from the periphery, it is not uncommon for the Global South to be taken advantage of.
III.
Construction of the problem by various stakeholders (Briana)
In an interconnected, global economy, issues like international medical aid are important to analyze in both its sociopolitical and socioeconomic aspects and impacts. When a country’s medical system is unable to sustain the health needs of its population, it is not uncommon for governments to request aid or for aid to be sent to them by NGOs like Doctors Without Borders. However, in countries where medical aid comprises the majority of foreign action policies, like Cuba, medical export has wide sociopolitical and socioeconomic effects on
the country, like the workforce composition and the country’s overall indices (Feinsilver, 1989;
2010). As defined by Feinsilver (1989; 2010), Cuba’s medical internationalism has strengthened from its early stages under Castro’s initial provisions. Through a reinvestment in the public sector, Cuba has managed to improve its development status, with a healthcare system and statistics comparable to (if not surpassing) those of First World countries (Feinsilver, 1989; 2010). However, as much as Cuba’s doctors represent the elite of medical aid, they are well welcomed due to their comparative cheaper hiring contract prices, a new form of exploitation (Feinsilver, 2010). Cuba became a leader in medical diplomacy in the last
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Robert Choi, Tyra Howell, Briana Leone, Avery Maudlin, Diane Nguyen, Sydney Zeve
thirty years, which is why particular attention should be focused on Cuba’s medical internationalism under the COVID-19 pandemic. Given the international preference for aid from Cuban doctors already existed prior to the COVID-19 pandemic, it is worthwhile to analyze the ways in which Cuban medical aid continues to represent a form of exploitation, particularly considering the health systems across
the world, including Cuba’s own, have been overwhelmed by COVID-19. Many countries have
had their health systems overwhelmed by the COVID-19 pandemic, oftentimes being unable to
sustain the capacity of the COVID-19 domestic cases (cite here). Here, countries worst hit by the pandemic (for example, Italy) welcomed Cuban doctors with open arms, mainly as they were faced by the violent wave of COVID-19 cases, a health system on the brink of collapse, and scarcity of medical personnel (cite here). At a time where health resources were scarce, developed countries were willing to accept developing countries’ aid, in this case Cuba’s, but at what costs? The medical assistance lent to Italy at the height of the pandemic back in March was part of Cuba’s well-known free emergency medical aid, which received a World Health Organisation (WHO) Public Health Prize in 2017 (Yaffe, 2020). While the doctors were much appreciated by Italy and another fourteen countries receiving Cuban medical aid, the exploitation of Cuban medical personnel should be analyzed. While not intentional, countries accepting free medical aid from Cuba are essentially doing what European colonizers did: extracting resources from Cuba by using Cuban labor forces, without necessarily reinvesting in
the nation. The foregoing is true given Cuban doctors are sent to needing countries under contracts established by sending and receiving nations, the doctors’ help is then received and their stay is paid for by both the Cuban and the hosting country, but no extraordinary income is
Robert Choi, Tyra Howell, Briana Leone, Avery Maudlin, Diane Nguyen, Sydney Zeve
actually given to the doctors working, nor the Cuban government supplying said doctors (at least not in the time of COVID-19) (Yaffe, 2020). Hence, while Cuban aid comes at a time of need and stressed medical systems, it is important not to ignore the latent colonialist exploitation on the part of receiving countries. IV.
Extent + outcome of the problem (range of people affected, who it affects) - Avery
Essential workers are currently more vulnerable now than in any other time in modern history. This of course is due to the spreading concerns and dangers of a global pandemic. This year in Aprile alone there was approximately two hundred or so deaths of essential workers ultimately due to working conditions (The Lancet, 2020
)
A prominent issue regarding the outcome of all these problems is the
aftermath native people have been subjected to with very little help or resources from the outside world. Due to lack of planning, the laborers who have been exploited over the past months are left with little to no means of continuing their undervalued work and are subjected with difficult and often life changing decisions……...
A prime example of these injustices can be seen through the community of medical professionals being essentially commercialized from cuba.
V.
Consequences/outcomes of the problem (What is affected) (Robert) - still needs modification.
In an industry already short of workers, hospitals and healthcare facilities are facing serious staffing shortages in the face of the COVID-19 pandemic. As public officials in Washington and across the United States seek to increase the supply of medical equipment necessary to combat the virus, they
Robert Choi, Tyra Howell, Briana Leone, Avery Maudlin, Diane Nguyen, Sydney Zeve
should also enact policies that will expand the number of foreign-born healthcare workers available to fill shortages of personnel.
The COVID-19 pandemic has overwhelmed the capacity of some domestic healthcare systems, highlighting the need to allow scarce healthcare resources to move, including across borders, to where outbreaks emerge and are worse. Digital technologies, data, and cross-border e-health services like telemedicine have become important support mechanisms in the response to the pandemic. Allowing temporary movement of health professionals could also help alleviate capacity constraints on domestic health systems.
In the short-term, countries can adopt measures to help alleviate national shortages of medical providers and facilitate the use of telemedicine in response to the COVID 19 pandemic. Some of the factors include removing or lowering restrictions on the movement of healthcare professionals across borders, even if temporarily; and reducing barriers to telemedicine, including allowing the use of insurance in foreign clinics. For medium-term measures, it could focus on strengthening the global health system and building
resilience to future crises. These factors include allowing foreign entry of health-related suppliers in order
to bring additional resources, new technologies, and new management techniques. In addition, this includes increasing cross-border coordination and collaboration between major research centers for disease prevention and control. Lastly, this includes improving digital connectivity in order to provide better support for healthcare systems (Gillson, I., & Muramatsu, K.)
VI.
Solutions/response - Sydney Z
As we’ve learned it is not uncommon for doctors to be imported to a country when extra help is needed. However, when this process becomes exploitation of medical professions who otherwise may not be treated with the same respect, a problem occurs. The core countries should not export or exclude medical workforces from the periphery nations. In addition, if they do wish
to import doctors from semi-periphery and periphery nations, they should be treated and offered
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Robert Choi, Tyra Howell, Briana Leone, Avery Maudlin, Diane Nguyen, Sydney Zeve
the same opportunity even when there is not a global pandemic like COVID-19. Before COVID-
19, nationalism excluded medical workers from low and middle-income countries, but now during COVID-19, they are using them only because of self-interest (J Fagan, Johannes, Cairncross, et. al 2020). During the process of bringing doctors into the United States, visas are expedited and the US is recruiting thousands of medical professions for their own best interest as cases continue to grow (J Fagan, Johannes, Cairncross, et. al 2020). There is a reliance on foreign professionals from periphery and semi-periphery countries coming into core countries. Governments and medical associations of core countries must ensure they address the larger world health problems, especially with understaffed medical professionals in low-income countries. (J Fagan, Johannes, Cairncross, et. Al 2020). If resources and people are going to be used in periphery countries at the benefit of core countries, these core countries should be pushing for equity and funding in the periphery countries (J Fagan, Johannes, Cairncross, et. Al 2020). The entire global
approach must be in place to support and strengthen one another, especially in a global pandemic
like we are facing with COVID-19. In response to COVID-19 having a global impact, a way that core countries can repay back periphery countries for the support they have provided to core countries would be to provide the vaccine for free to those countries when it comes. Core countries have the money and resources to import doctors from around the world when help is needed, however, this may come at a cost for the periphery country they are coming from. With the United State’s resources, they have seen many vaccine trials moving forward (Kaur, S. P., & Gupta, V. 2020). With that being said, with the exploitation of Cuban doctors and many other medical professionals from around the world, the core countries should be promoting a more equal
Robert Choi, Tyra Howell, Briana Leone, Avery Maudlin, Diane Nguyen, Sydney Zeve
healthcare system in these countries and should provide pandemic relief while they continue to utilize their resources and people. VII.
Conclusion - Tyra The current coronavirus outbreak has put a strain on healthcare systems, especially in the United States, that has not been seen since the Spanish Flu 1918 pandemic. While doctors
from low-income countries are smart and incredibly resourceful, the way that countries like the United States utilize them is incredibly exploitative. The host countries bring these doctors away from their families and their home country, while they have to work long hours and are treated as outsiders. They do all of this while people in their own countries are suffering because of a lack of access to proper healthcare. If wealthy countries insist on using foreign health workers, they need to pay back the low-income countries in a bigger way than just paying some of their doctors. These wealthy countries need to mitigate the effects of these countries losing doctors by providing medical supplies and monetary support.