“All Cubans are doctors!” news coverage of health and bioexceptionalism in Cuba

Abstract

In a multi-country study of media coverage of health, professionals often deem reporters as only interested in selling newspapers and criticizing physicians. Since the health system and the media are controlled by the socialist state, Cuba provides an interesting test case. Health, the key symbol of the Cuban revolution, is constantly characterized as unique. In this study I asked: will health media also exhibit bioexceptionalism—will coverage differ dramatically from that in capitalist countries? I compiled all health stories published in 2002 in three national newspapers, others appearing 2003–2011, plus television and radio coverage (totaling 961). I recorded interviews during fieldwork periods in 2005, 2006, and 2008 with health and media professionals and laypersons; ethnography focused on media and health institutions and lay reception. Cuban health news stories generally project knowledge as produced in biomedical institutions, circulated by media and health professionals, and received by laypersons, a model common in capitalist countries. A second type lauds “achievements of the revolution” but similarly subordinates lay participation. Nevertheless, avid reception of biomedical knowledge leads many Cubans to describe themselves as “frustrated doctors” who know as much as their physicians. Inviting charges of self-medication, lay reception most closely embodied bioexceptionalism. Stories projecting the quality, accessibility, and humanism of Cuban medicine gained importance as the post-Soviet “Special Period” catalyzed shortages of medications and services and greater inequality; nevertheless, the frustrated citizen-consumers described by researchers do not figure in health coverage or lay reception. Media constructions of laypersons as passive recipients of professional knowledge contradict appeals for popular participation and reveal how political ideologies and health policies often fail to match the way that media coverage differentially projects contributions by professionals and laypersons.