Living the revolution: Cuban health workers

The cuban government has placed a very high emphasis on health since 1959 and vaccination and health education campaigns, as well as access to a comprehensive free healthcare system, have contributed to dramatic improvements in the population's health status. Much that has been written about the Cuban health service has relied on published sources, but this article is based on 18 months spent carrying out ethnographic fieldwork in the country, with particular emphasis on the daily lives of women employed in the health sector. Data were collected by participant observation, interviews and life-story work. Family doctors are usually young women completing their specialist training. They work in health centres in apartment blocks in which they also live. They work closely with nurses and other health and social service workers. Health workers are expected to live and work in their own communities, to act as role models for their patients, and to be available at all times. Whilst this has led to an extremely well-informed population and accessible healthcare, it has brought costs to healthcare workers in terms of very high expectations, a feeling that they do not have a private life, and stress caused by the inability to meet patient demands in the face of shortages of medicines and other supplies as a result of the continuing US trade blockade. These pressures and frustrations for healthcare workers may have parallels in Western healthcare services which are subject to resource constraints.