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Background: Venezuela is in the throes of a complex humanitarian crisis that is one of the worst in decades to impact any country outside of wartime. This case analysis describes the challenges faced by the ongoing Maracaibo Aging Study (MAS) during the deteriorating conditions in Venezuela. When the MAS began in 1997, it focused on memory-related disorders.

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The balancing act of societies and of clinical histories.

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National Academy of Medicine, Venezuela; Professor(E) of Dermatology and Immunology, Vargas School of Medicine and Instituto de Biomedicina, Central University of Venezuela. Electronic address:

Individuals and societies are, respectively, confederations of cells and individuals. They function well only if their constituents work in a complementary and harmonious way. This is regulated by control mechanisms.

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Drawing on ethnographic data collected over 13 months of fieldwork in family doctor clinics in Havana from 2004 to 2005, I examine the shifting moral and material economies of Cuban socialist medical practice. In both official ideology and in daily practice, the moral economy of ideal socialist medicine is based on an ethos of reciprocal social exchange-that is, the gift-that informs not only doctors' relationships with the Cuban state and with individual patients but also the state's policies of international medical service to developing nations. The social and economic upheavals after the fall of t Soviet Union, however, have compelled both the state and individual doctors to operate in a new local and global economy.

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