Christopher R. Boyer
Human interaction with nature has shaped Latin American ecology and society ever since the first people arrived in the Americas more than fifteen millennia ago. Ancient Native Americans made use of the region’s immense biological diversity and likely contributed to a massive extinction of large animals at the end of the last ice age. Over the ensuing centuries, their descendants took cautious steps to shape the landscape to suit their needs. Colonialism ruptured this process of ecological and social co-evolution, as Europeans conquered the Americas, bringing with them new plants, animals, and diseases as well as a profit motive that gave rise to two economies that further reshaped the environment: the sugar plantation complex and silver mining/hacienda complex. These socio-environmental structures foretold the dynamic of resource extraction and reliance on a single major export destined to more developed countries that characterized most Latin American economies and ecologies after independence. Although most nations sought to break away from this neo-colonial syndrome during the 20th century, they typically did so by increased reliance on agro-industry and the extraction of minerals and petroleum, all of which came at a predictably high ecological cost. At the same time, calls for conservation of resources and biodiversity began to be heard. By the turn of the 21st century, scientists, urbanites, and rural people had become increasingly concerned about the costs of economic “development” and alternative ways of coexisting with nature.
Today, the death of women during pregnancy, childbirth or postpartum is considered simultaneously a public health, social inequality, and gender discrimination problem. In Mexico, approximately one thousand women die each year during pregnancy, childbirth, postpartum or from an unsafe abortion, experiencing a premature and sudden death in the midst of their most productive years, often with lasting consequences for their families and surviving children. As elsewhere, the great majority of these deaths would not have occurred if women had had prompt and unlimited access to quality emergency obstetric care, as well as easy access to contraceptives to prevent unwanted pregnancies. Most deaths are related to the substandard quality of available maternal healthcare services; services that are provided for free to most Mexican women in an overly saturated and underfunded public health system that also tends to overmedicalize and pathologize normal births. Their prematurity and abruptness, their occurrence in the process of giving life, the fact that these deaths exclusively affect women, and their avoidable nature make maternal mortality unacceptable in today’s social, political, and ethical arenas.
From an historical perspective, deaths in childbirth were much more common in past centuries than today; these deaths were considered inevitable and were accepted as natural occurrences until the late 19th century. However, surrounding rituals, the meaning attached to these deaths, related notions of womanhood and motherhood, and practices to prevent or avoid them, underwent changes according to broader sociocultural, political and religious transformations from Pre-Hispanic times to the 20th century.
As elsewhere, in Mexico maternal deaths declined considerably in the 1930s–1950s with the discovery of penicillin and the concomitant decline of puerperal fever; they reached a plateau in the 1960s and 1970s and began to slowly decline again in the 1980s–1990s with an even steeper decrease after the signature of the United Nations (UN) Millennium Development Goals in the year 2000; time when the reduction of maternal mortality became one of eight high-priority global public policy objectives, closely monitored by UN bodies.
Maternal deaths are a reflection of ingrained multiple social inequalities that characterize Mexican society at large; poor, rural, marginalized and Indigenous pregnant women face a 2–10 times higher risk of dying than the rest of Mexican women, because their access to contraception and to prompt and high quality obstetric emergency care is more limited. Today, research in the field of maternal mortality etiology, measurement and reduction includes the call for women-centered respectful maternal care, the elimination of discrimination in the provision of obstetric services and the application of a human rights perspective to health policies, programs, and care.
Nicole L. Pacino
During the pre-Columbian and colonial periods, Andean cosmological understandings shaped indigenous approaches to maternal health. Women typically gave birth at home with the assistance of a midwife (also called a partera or comadrona in Spanish). Birthing and post-partum care relied on local herbal remedies and followed specific social rituals. Women drank teas derived from anise or coca during the labor process, gave birth in a squatting position (toward Mother Earth, or Pachamama), and drank sheep soup after labor to replenish strength and warm the body. Rooms were kept dark because the common perception was that bright light injured newborn babies’ eyes. After labor, families buried or otherwise disposed of the placenta to keep the baby and mother healthy and facilitate lactation, as per Andean tradition.
Changes in maternal health rituals began in the 18th century, as colonial rule became more consolidated. The rise of a distinct medical profession and government interest in population growth gradually shifted responsibility for maternal health from the Catholic Church and charitable organizations to the state. Throughout the 19th and 20th centuries, the growing power and authority of the state and the medical profession led doctors and urban-based reformers to attempt to change long-standing Andean birthing practices, which they considered archaic and unsanitary. These reforms emerged from a desire to reduce infant mortality rates and to replace traditional healers with medical professionals who were trained, licensed, and regulated by the state. As reformers looked to replace Andean maternal health and healing practices with new scientific understandings of the female body and birthing process, they also worked to discredit and displace midwives’ knowledge and practices. In particular, they encouraged women to give birth in newly constructed hospitals and to seek the guidance of medical professionals, like obstetricians. However, these reforms met with limited success. In the Andes today, midwives still attend to roughly 50 percent of all births, and in some remote areas, the figure is as high as 90 percent. It is also more common today to see the merging of biomedical and ritual practices to increase women’s access to and acceptance of health services and to reduce overall mortality rates.
Before there was Mexico, there was oil. Millennia of organic matter that collapsed and liquefied into fossil fuel rested deep underground and underwater along the half-moon territorial formation that 19th-century geographers named the Mexican Gulf. Hidden by the lush tropical rainforests, marshes, and mangroves that occupied the landscape from the Pánuco River on the border between modern day Tamaulipas and Veracruz and the Bay of Campeche on the South, the oil seeped to the surface in small ponds, sometimes blackening the waters of streams and lagoons from Tabasco to the Huasteca. The human communities who inhabited that part of the globe thousands of years later knew about and utilized nature’s oozing sticky black tar.
The Olmec, who flourished in southern Veracruz from 1200 to 400
David Carey Jr.
With its diverse ecological zones and varied public health threats that ranged from lowland epidemic to highland endemic diseases, Central America is a challenging place to practice healthcare. In addition to topography and geography, social relations have also influenced the dynamic, contested, and negotiated process of healthcare in developing countries. Adversarial relations among indigenous people, African immigrants and slaves, and the state marked the region’s pasts. After the Spanish conquest established racist structures that favored Hispanic citizens by instituting forced labor mechanisms and limiting access to political, economic, and social power, colonists extracted land and labor from indigenous communities. Although most countries assumed that adopting Hispanic customs would improve the lives of indigenous and Afro-Central Americans, many elites felt such workers’ health was important only insofar as it did not impede their ability to labor.
Characterized by holistic approaches to health that took into account psychological, emotional, and physical well-being, indigenous and other traditional healing practices flourished even after states embraced the fields of bacteriology and parasitology in the late 19th and early 20th centuries. Primarily served by curanderos, midwives, bonesetters, and other traditional healers for generations, some remote rural communities were isolated from schooled medicine and its practitioners. In other rural communities and cities, hybrid healthcare offered patients palatable and efficacious healing options.
As doctors became politicians and states embraced science to modernize their nations, politics and public health became inextricably linked. Often with the assistance of multinational companies and nongovernmental organizations, governments deployed scientific medicine and public health campaigns to undergird assimilationist projects. Based on assumptions that traditional medicine was impotent and indigenous people and African descendants were vectors of disease, public health campaigns often discounted, rejected, or persecuted the healing practices of such peoples. When authorities embraced rather than problematized the confluences of race and health, they enjoyed some success. Yet neither authoritarian nor democratic governments could establish a medical monopoly.
Although their history can be traced further back to the study of heredity, variability, and evolution at the beginnings of the 20th century, studies on the genetic structure and ancestry of human populations became important at the end of World War II. From 1950 onward, the tools and practices of human genetics were systematically used to attack global health problems with the support of international health organizations and the founding of local institutions that extended these practices, thus contributing to global knowledge. These developments were not an exception for Mexican physicians and human geneticists in the Cold War years. The first studies, which appeared in the 1940s, reflect the emerging model of human genetics in clinical practice and in scientific research in postwar Mexico. Studies on the distribution of blood groups as well as on variant forms of hemoglobin in indigenous populations paved the way for long-term research programs on the characterization of Mexican indigenous populations. Research groups were formed at the Ministry of Health, the National Commission of Nuclear Energy, and the Mexican Social Security Institute in the 1960s. The key actors in this narrative were Rubén Lisker, Alfonso León de Garay, and Salvador Armendares. They consolidated solid communities in the fields of population and human genetics. For Lisker, the long-term effort to carry out research on indigenous populations in order to provide insights into the biological history of the human species, disease patterns, and biological relationships among populations was of particular interest. Alfonso León de Garay was interested in studying human and Drosophila populations, but in a completely different context, namely at the intersection of studies on nuclear energy and its effects on human populations as a result of World War II, with the life sciences, particularly genetics and radiobiology. In parallel, the study of chromosomes on a large scale using newly experimental techniques introduced by Salvador Armendares in Mexico in 1960 allowed researchers to tackle child malnutrition and health problems caused by Down and Turner syndromes. The history of population studies and genetics during the Cold War in Mexico (1945–1970s) shows how the Mexican human geneticists of the mid-20th century mobilized scientific resources and laboratory practices in the context of international trends marked by WWII, and national priorities owing to the construction movement of postrevolutionary Mexican governments. These research programs were not limited to collaborations between research laboratories but were developed within the institutional and political framework marked at the international level by the postwar period and at the national level by the construction of the modern Mexican state.
Andrés Ríos Molina
In Mexico, there were hospitals for the “demented” from the early years of the Spanish colony. It was not until the second half of the 19th century, however, that the first physicians interested in alterations of the brain published articles on the etiology, symptomatology, and treatment of mental illnesses. Within a larger context of health reforms launched during the presidency of Porfirio Díaz (1876–1911), known as the Porfiriato, healthcare officials decided to close the hospitals for the insane and construct a modern institution where psychiatry could grow as a discipline and where patients could be treated using scientific methods. Furthermore, along with the economic and cultural development that took place during the Porfiriato, there was an increase in the number of patients admitted to hospitals for the insane, while at the same time the number of doctors interested in the clinical treatment of mental illnesses increased, as well. The officials’ decision became a reality on September 1, 1910—just two months before the Revolution broke out—when La Castañeda General Asylum was opened. It was a complex of twenty-four buildings in the town of Mixcoac. In addition to being an institution for patient care, it was also where the first generations of Mexican psychiatrists and neurologists were trained. As early as the 1930s, the asylum began to have problems with overcrowding, unhealthy conditions, and deterioration of the facilities. The doctors there repeatedly called for the patient care system to be restructured. In 1944, a psychiatric reform called the “Castañeda Operation” began, seeking to decentralize psychiatric care and to use agricultural work as a therapeutic tool. The result was the creation of seven new hospitals and the permanent closure of the asylum in 1968. Recent historiography on psychiatry from its beginnings in the Porfiriato to the time of that reform have shown that it was a period marked by the rise and fall of a utopian dream, that of the therapeutic effectiveness of psychiatric internment. It was a transition from the single, large asylum in the capital city to a network of hospitals that relied on outpatient care, early detection, and medication as a way to dismantle the asylum model. As a result, La Castañeda General Asylum has held a privileged place in historical study as the stage for the beginning, the development, and the consolidation of Mexican psychiatry.
The prevention of communicable diseases, the containment of epidemic disorders, and the design of programs and the implementation of public health policies went through important transformations in Mexico, as in other Latin American nations, between the final decades of the 19th century and first half of the 20th century. During that period not only did the advances in medical science make possible the identification and containment of numerous contagious diseases; it was also a time when the consolidation of formal medical institutions and their interaction with both national and international actors contributed to shape the definitions and solutions of public health problems. Disease prevention strategies were influenced by medical, scientific, and technical innovations and by the political values and commitments of the period, and Mexico experienced profound and far-reaching political, economic, and social transformations: the apogee, crisis, and downfall of the long Porfirio Díaz regime (1876–1910), the armed phase of the Mexican Revolution (1910–1920), and the period of national reconstruction (1920–1940). Thus, during the period under consideration, and alongside the consolidation of an official medical apparatus as an integral part of public power, the promotion of public health became a crucial element to reinforce the political unification and the social and economic strength of the country.
The control and eradication of smallpox have been among the most studied and chronicled topics in histories of health and medicine, which is not coincidental considering the dramatic nature of the disease, the official measures developed to deal with it, and the declaration in 1980 by the World Health Organization of its global eradication. Smallpox first erupted in Mexico-Tenochtitlán in 1520 during the Spanish conquest, and in 1952 the health authorities and the federal government declared that that long-feared disease had finally been eradicated there. Numerous historical studies have perpetuated the image of a single smallpox campaign in Mexico, free from conflicts, problems, and inertia. Recent scholarship, however, has increasingly emphasized that smallpox vaccination efforts were not homogenous or consistent, that they were not pursued equally in all geographic and cultural regions, and that vaccination strategies and campaigns gradually became less coercive and more selective and persuasive.
“Technology” is the practical expression of accumulated knowledge and expertise focused on how to mediate and manipulate the world. Scholars and contemporary observers of Mexico have long characterized production methods there as unchanging and lagging well behind the standard in the Atlantic world, but there are few systematic studies of technology in Mexican history, and especially for the critical 19th-century era of early modernization.
Mexico’s first half century of independence (c. 1820–1870) saw relatively little technological change. In spite of a number of sustained efforts to introduce the technologies—such as railroads, steam power, and iron manufacturing—that were transforming economic life and production in Great Britain and the United States, production methods in Mexico remained small scale and artisanal. Textile manufactures were a partial exception, as there were several dozen large-scale factories, powered by water turbines and occasionally by steam, that spun and wove thread. But the substantial obstacles to innovation discouraged or undermined most attempts.
The next forty or so years, however, could not have been more different (c. 1870s–1920). As political stability slowly settled over most of the country, investment in economic activities picked up, slowly at first, then more rapidly into the 1880s and beyond. Initially focused on railroad transport and mining, new investments from both Mexican and foreign entrepreneurs diversified into a wide range of manufacturing enterprises, commercial agriculture, and urban infrastructure and commerce. Tightly linked to the concurrent dramatic expansion of the Atlantic economy—the so-called second industrial revolution—this expansion pushed demand for new technologies of production and swept across the country, transforming production, productivity, and the working and consuming lives of Mexicans at nearly all levels of society. The result was substantial modernization, manifest as economic growth as well as social dislocation.
Individuals and firms proved able to adopt and commercialize a wide range of new production technologies during this period. This success was not matched, however, by substantial local assimilation of new technological knowledge and expertise, that is, by a process of technological learning. Until the 1870s, Mexican engineers, mechanics, and workers had scant opportunities to work with and learn from production technologies appearing in the Atlantic world. When new machines, tools, and processes swept across Mexico thereafter, adopting firms typically hired technical experts and skilled workers from abroad, given the scarcity of expertise at home. This became a self-reinforcing cycle, perpetuating dependence on imported machines and imported know-how well into the 20th century.
Nahua peoples in central Mexico in the late postclassic period (1200–1521) and the early colonial period (1521–1650) had a sophisticated and complex system of healing known as tiçiyotl. Titiçih, the practitioners of tiçiyotl, were men and women that had specialized knowledge of rocks, plants, minerals, and animals. They used these materials to treat diseases and injuries. Furthermore, titiçih used tlapohualiztli (the interpretation of objects to obtain information from nonhuman forces) to ascertain the source of a person’s ailment. For this purpose, male and female titiçih interpreted cords, water, tossed corn kernels, and they measured body parts. Titiçih could also ingest entheogenic substances (materials that released the divinity within itself) to communicate with nonhuman forces and thus diagnose and prognosticate a patient’s condition. Once a tiçitl obtained the necessary information to understand his or her patient’s affliction, he or she created and provided the necessary pahtli (a concoction used to treat an injury, illness, or condition) for the infirm person. Finally, titiçih performed important ritual offerings before, during, and after healing that insured the compliance of nonhuman forces to restore and maintain their patients’ health.
Reinaldo Funes Monzote
In the summer of 1981 the cow named Ubre Blanca (White Udder), born on Isla de la Juventud (formerly Isla de Pinos) in the southern Cuban archipelago, became headline news for her high milk production. After achieving a national record, in the following months she was the focus of the country’s attention for her fast-track to becoming a world record holder, first in four milkings and later, in January 1982, as highest producer in three milkings, collection of milk in one lactation period, and fat content. For the leader of the Cuban Revolution, Fidel Castro, and scientists from the cattle industry, it was important to emphasize that it was not only a matter of this incredible cow’s personal achievement but also the fruit of many years of effort to reach a radical transformation of the country’s cattle industry, from an emphasis on beef production toward the priority for milk production and diversification of animal protein sources.
These politics required major changes in bovine herds from a genetic perspective, starting with major cross-breeding of Holstein cattle, of Canadian origin, with the Cebú, formerly dominant in Cuba, along with the creation of new infrastructure and other changes toward an intensive model of cattle ranching. Therefore, the history of Ubre Blanca is tied to that of the politics aimed at increased production and consumption of dairy products, presented as an achievement of the socialist Cuban model and with aspirations to bring dairy development to tropical areas and Third World countries. Although the ambitious goals announced in the 1960s were never reached, there was an increase in milk production and a general modernization of cattle ranching that, nevertheless, began a prolonged decline starting with the deep economic crisis of the 1990s.
This is an advance summary of a forthcoming article in the Oxford Research Encyclopedia of Latin American History. Please check back later for the full article.
Yellow fever was one of the most dreaded diseases in the Caribbean region from its first appearance in the 1650s until the confirmation of its spread via the bites of infected mosquitos in 1900. Fear of the disease resulted from not just its high mortality rate, but also the horrifying manner in which it killed its victims: after several days of fever, chills, and body aches, the skin and eyes of those who were most seriously infected would turn yellow as their livers failed, they would bleed from the eyes and nose, and they would succumb to the vomiting of coagulated blood. Because the virus caused only mild symptoms in children and a single episode confers lifetime immunity, the disease did not heavily impact natives of the region. Instead, it was newcomers in the Caribbean who suffered the worst ravages.