This collection compares Russian and Soviet medical workers – physicians, psychiatrists and nurses, and examines them within an international framework that challenges traditional Western conceptions of professionalism and professionalization through exploring how these ideas developed amongst medical workers in Russia and the Soviet Union. Ideology and everyday life are examined through analyses of medical practice while gender is assessed through the experience of women medical professionals and patients. Cross national and entangled history is explored through the prism of health care, with medical professionals crossing borders for a number of reasons: to promote the principles and advancements of science and medicine internationally; to serve altruistic purposes and support international health care initiatives; and to escape persecution. Chapters in this volume highlight the diversity of experiences of health care, but also draw attention to the shared concerns and issues that make science and medicine the subject of international discussion.
Exploring the capacity and impact of decentralization within European health care systems, this book examines both the theoretical underpinnings as well as practical experience with decentralization.
How the Cuban health care system became the blueprint for accessible medical care around the world Quiet as it’s kept inside the United States, the Cuban revolution has achieved some phenomenal goals, reclaiming Cuba’s agriculture, advancing its literacy rate to nearly 100 percent – and remaking its medical system. Cuba has transformed its health care to the extent that this “third-world” country has been able to maintain a first-world medical system, whose health indicators surpass those of the United States at a fraction of the cost. Don Fitz combines his deep knowledge of Cuban history with his decades of on-the-ground experience in Cuba to bring us the story of how Cuba’s health care system evolved and how Cuba is tackling the daunting challenges to its revolution in this century. Fitz weaves together complex themes in Cuban history, moving the reader from one fascinating story to another. He describes how Cuba was able to create a unified system of clinics, and evolved the family doctor-nurse teams that became a model for poor countries throughout the world. How, in the 1980s and ‘90s, Cuba survived the encroachment of AIDS and increasing suffering that came with the collapse of the Soviet Union, and then went on to establish the Latin American School of Medicine, which still brings thousands of international students to the island. Deeply researched, recounted with compassion, Cuban Health Care tells a story you won’t find anywhere else, of how, in terms of caring for everyday people, Cuba’s revolution continues.
Finalist, PEN Center USA Literary Awards, Research NonfictionRich in oil and strategically located between Russia and China, Kazakhstan is one of the most economically and geopolitically important of the so-called Newly Independent States that emerged after the USSR's collapse. Yet little is known in the West about the region's turbulent history under Soviet rule, particularly how the regime asserted colonial dominion over the Kazakhs and other ethnic minorities.Grappling directly with the issue of Soviet colonialism, Curative Powers offers an in-depth exploration of this dramatic, bloody, and transformative era in Kazakhstan's history. Paula Michaels reconstructs the Soviet government's use of medical and public health policies to change the society, politics, and culture of its outlying regions. At first glance the Soviets' drive to modernize medicine in Kazakhstan seems an altruistic effort to improve quality of life. Yet, as Michaels reveals, beneath the surface lies a story of power, legitimacy, and control. The Communist regime used biomedicine to reshape the function, self-perception, and practices of both doctors and patients, just as it did through education, the arts, the military, the family, and other institutions.Paying particular attention to the Kazakhs' ethnomedical customs, Soviet authorities designed public health initiatives to teach the local populace that their traditional medical practices were backward, even dangerous, and that they themselves were dirty and diseased. Through poster art, newsreels, public speeches, and other forms of propaganda, Communist authorities used the power of language to demonstrate Soviet might and undermine the power of local ethnomedical practitioners, while moving the region toward what the Soviet state defined as civilization and political enlightenment.As Michaels demonstrates, Kazakhs responded in unexpected ways to the institutionalization of this new pan-Soviet culture. Ethnomedical customs surreptitiously lived on, despite direct, sometimes violent, attacks by state authorities. While Communist officials hoped to exterminate all remnants of traditional healing practices, Michaels points to evidence that suggests the Kazakhs continued to rely on ethnomedicine even as they were utilizing the services of biomedical doctors, nurses, and midwives. The picture that ultimately emerges is much different from what the Soviets must have imagined. The disparate medical systems were not in open conflict, but instead both indigenous and alien practices worked side by side, becoming integrated into daily life.Combining colonial and postcolonial theory with intensive archival and ethnographic research, Curative Powers offers a detailed view of Soviet medical initiatives and their underlying political and social implications and impact on Kazakh society. Michaels also endeavors to link biomedical policies and practices to broader questions of pan-Soviet identity formation and colonial control in the non-Russian periphery.
This book uses a variety of empirical cases on topics including drug development, egg donation, and governance of healthcare facilities, to investigate how actors navigate the uncertainties that permeate the interfaces of health, technologies, and politics in post-Soviet settings and what the implications of their chosen navigation routes are. Contemporary societies are imbued with uncertainties, but the authors focus on settings where uncertainties multiply, making decisions, practises, and relations in everyday life precarious. Two worlds are brought into dialogue throughout the chapters of this book with the aim of facilitating mutual learning from one another - the world of science and technology studies (STS) and the high-income liberal democracies of the West, on one hand, and studies of post-socialism on the other. In so doing, this book encourages critical learning on ensuring the resilience of individual and societal health in situations of profound uncertainties. This timely collection will be of great interest to scholars, practitioners and policy makes in the fields of sociology, biomedicine, political science and public and global health.
What madness meant was a fiercely contested question in Soviet society. State of Madness examines the politically fraught collision between psychiatric and literary discourses in the years after Joseph Stalin's death. State psychiatrists deployed set narratives of mental illness to pathologize dissenting politics and art. Dissidents such as Aleksandr Vol'pin, Vladimir Bukovskii, and Semen Gluzman responded by highlighting a pernicious overlap between those narratives and their life stories. The state, they suggested in their own psychiatrically themed texts, had crafted an idealized view of reality that itself resembled a pathological work of art. In their unsanctioned poetry and prose, the writers Joseph Brodsky, Andrei Siniavskii, and Venedikt Erofeev similarly engaged with psychiatric discourse to probe where creativity ended and insanity began. Together, these dissenters cast themselves as psychiatrists to a sick society. By challenging psychiatry's right to declare them or what they wrote insane, dissenters exposed as a self-serving fiction the state's renewed claims to rationality and modernity in the post-Stalin years. They were, as they observed, like the child who breaks the spell of collective delusion in Hans Christian Andersen's story "The Emperor's New Clothes." In a society where normality means insisting that the naked monarch is clothed, it is the truth-teller who is pathologized. Situating literature's encounter with psychiatry at the center of a wider struggle over authority and power, this bold interdisciplinary study will appeal to literary specialists; historians of culture, science, and medicine; and scholars and students of the Soviet Union and its legacy for Russia today.
The preeminent doctor and bioethicist Ezekiel Emanuel is repeatedly asked one question: Which country has the best healthcare? He set off to find an answer. The US spends more than any other nation, nearly $4 trillion, on healthcare. Yet, for all that expense, the US is not ranked #1 -- not even close. In Which Country Has the World's Best Healthcare? Ezekiel Emanuel profiles eleven of the world's healthcare systems in pursuit of the best or at least where excellence can be found. Using a unique comparative structure, the book allows healthcare professionals, patients, and policymakers alike to know which systems perform well, and why, and which face endemic problems. From Taiwan to Germany, Australia to Switzerland, the most inventive healthcare providers tackle a global set of challenges -- in pursuit of the best healthcare in the world.
Public health has had positive results in the last two centuries when it comes to reducing the impact and prevalence of infectious disease.However, much remains to be done to reduce non-communicable diseases such as heart disease and cancer, which make up the major disease burden of the WHO European Region. This book takes a broad but detailed approach to public health in Europe and offers the most comprehensive analysis of this region currently available. It considers a huge range of key topics in public health and includes chapters on the following topics: Screening Health Promotion Tackling social determinants of health Health Impact Assessment The Public Health Workforce Public Health Research In addition to these topics and themes the authors consider the existing public health structures, capacities and services across a range of European countries; identifying what needs to be done to strengthen public health action and improve public health outcomes.Reflecting the broad geographical scope of the entire WHO European region this book uses examples from a diverse range of countries to illustrate different approaches to public health. This book is essential reading for anyone studying or working in the field of public health, especially those with an interest in European practice. This title is in the European Observatory on Health Systems and Policies Series.
This book provides new and empirically grounded research-based knowledge and insights into the current transformation of the Russian child welfare system. It focuses on the major shift in Russia’s child welfare policy: deinstitutionalisation of the system of children’s homes inherited from the Soviet era and an increase in fostering and adoption. Divided into four sections, this book details both the changing role and function of residential institutions within the Russian child welfare system and the rapidly developing form of alternative care in foster families, as well as work undertaken with birth families. By analysing the consequences of deinstitutionalisation and its effects on children and young people as well as their foster and birth parents, it provides a model for understanding this process across the whole of the post-Soviet space. It will be of interest to academics and students of social work, sociology, child welfare, social policy, political science, and Russian and East European politics more generally.
