Document Type

Honors Project

Abstract

How can something as commonplace as going to the doctor influence international politics? In Bolivia, medicine is bound in politics. The political structure of a country both influences the approach to health care, and determines how that approach is most effectively implemented internationally. Building upon a framework of conceptual difference between capitalist and socialist health systems, this paper examines “effective” models of US and Cuban international health care on both a political and individual level. Drawing on fieldwork conducted in a Bolivian hospital, interviews with doctors working internationally, and current literature, I seek to discern what defines “effective” international health care, in terms of political goals, patient care, and sustainability. Bolivia’s recent shift to the left enabled favorable political relations with socialist Cuba, and strained relations with the United States. By examining approaches to international health, the influence of national politics comes to light. Cuba’s “medical diplomacy” is a means of solidifying trade relationships through the exchange of doctors. However, local doctors who do not share socialist ideology resent the loss of jobs. While tensions with Cuban doctors cast a shadow on international medicine, US doctors and organizations reported more successful operations. Given tense political relations with Bolivia, effective US medical programs seek to integrate their work into Bolivian society in order to avoid expulsion from the country. Understanding the interaction of politics and health care can aid in the design and implementation of effective public health projects, the world over.

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