“Social medicine”, a Latin American concept, notably developed by Salvador Allende in the 1930s, links up a broader model and ethos of public health with processes of social transformation. In recent years that influence has spread to Timor Leste, through a very large Cuban health cooperation and training program. This paper considers to what extent an endogenous “social medicine” might be developing in Timor Leste. Such a development would require transition away from the existing small, private clinic based model.
The paper accepts Guzman’s observation that Latin American social medicine is a wider, more dynamic and participatory model than that presented from European epidemiology – the ‘social determinants’ approach – but asserts that there are different forms of social medicine, conditioned by distinct histories and cultures.
This is an interpretive history, making use of past analyses, contemporary information on the Cuba-Timor Leste health program and the East Timorese responses. It includes a number of interviews and direct observations of pedagogy and practice. It concludes that a transition to social medicine in Timor Leste has some advantages: the large scale of the new training program; a sympathetic culture; and potential leadership. The ideas seem set to be absorbed into a domestic culture of community solidarity, inclusive Christianity and an independent spirit.
Social Medicine, 5(4)