Negotiating horizontality in medical South–South cooperation : The Cuban mission in Rio de Janeiro’s urban peripheries

Abstract

For more than 50 years, Cuba has been one of the most important players in the field of international medical cooperation in the Global South. Between 2013 and 2016, Cuba maintained one of its largest cooperations with Brazil: nearly 11,400 Cuban physicians were sent to work within the framework of the Brazilian health programme 'More-Doctors-for-Brazil', which was implemented to improve Brazil's precarious public health sector. This paper inquires into the manifold challenges of horizontal connectivity in this medical South-South cooperation. We will trace these back to deep-rooted contentions about the epistemological approaches to medical practice and professional recognition within and between Cuban and Brazilian arenas of public health, which do not, however, conform to a simplistic socialism-capitalism dichotomy. Rather, this particular South-South cooperation reveals significant differences in how powerful the postcolonial legacies of medical assistance remain in Global Health settings. This paper explores how these legacies may impact on the moral and professional legitimacy of the individuals involved in South-South partnership. Using ethnographic findings in newly established family clinics situated in urban poverty regions in Rio de Janeiro's North, we will also show how prolonged local interactions may create new spaces of horizontal encounters and connectivity in international medical cooperation.