Thomas D. Rogers
The Portuguese took sugarcane from their Atlantic island holdings to Brazil in the first decades of the 16th century, using their model of extensive agriculture and coerced labor to turn their new colony into the world’s largest producer of sugar. From the middle of the 17th century through the 20th century, Brazil faced increasing competition from Caribbean producers. With access to abundant land and forest resources, Brazilian producers generally pursued an extensive production model that made sugarcane’s footprint a large one. Compared to competitors elsewhere, Brazilian farmers were often late in adopting innovations (such as manuring in the 18th century, steam power in the 19th, and synthetic fertilizers in the 20th). With coffee’s growth in the center-south of the country during the middle of the 19th century, sugarcane farming shifted gradually away from enslaved African labor. Labor and production methods shifted at the end of the century with slavery’s abolition and the rise of large new mills, called usinas. The model of steam-powered production, both for railroads carrying cane and for mills grinding it, and a work force largely resident on plantations persisted into the mid-20th century. Rural worker unions were legalized in the 1960s, at the same time that sugar production increased as a result of the Cuban Revolution. A large-scale sugarcane ethanol program in the 1970s also brought upheaval, and growth, to the industry.
The Association of Communitarian Health Services (ASECSA) and the Role of Religion and Health in Central America
The Association of Communitarian Health Services (ASECSA) is a transnational, religiously influenced health program in Central America created during the Cold War. ASECSA was founded in 1978 by a small group of international health professionals with ties to programs started by Catholic and Protestant clergy and laity in Guatemala’s western highlands in the 1960s. It introduced a model of healthcare in which Maya health promoters and midwives became partners in healing rather than objects to be cured. Support for the health programs and ASECSA came from secular and religious international agencies, including the United States Agency for International Development (USAID), German Misereor, Catholic Relief Services, and the World Council of Churches. ASECSA was founded to disseminate knowledge of popular health education strategies used by health promoters and midwives to provide preventive and curative medical services to their communities. The education methods grew from Paulo Freire’s Pedagogy of the Oppressed and its use by religious agents influenced by liberation theology. Although it was founded in Guatemala, ASECSA’s publications and meetings attracted participation by health professionals and paraprofessionals from Mexico, Central America, and even the Caribbean. Ecumenical religious centers affiliated with liberation theology in the 1960s and 1970s facilitated the development of popular health programs that played a defining role in the region.
Gisela Mateos and Edna Suárez-Díaz
On December 8, 1953, in the midst of increasing nuclear weapons testing and geopolitical polarization, United States President Dwight D. Eisenhower launched the Atoms for Peace initiative. More than a pacifist program, the initiative is nowadays seen as an essential piece in the U.S. defense strategy and foreign policy at the beginning of the Cold War. As such, it pursued several ambitious goals, and Latin America was an ideal target for most of them: to create political allies, to ease fears of the deadly atomic energy while fostering receptive attitudes towards nuclear technologies, to control and avoid development of nuclear weapons outside the United States and its allies, and to open or redirect markets for the new nuclear industry. The U.S. Department of State, through the Foreign Operations Administration, acted in concert with several domestic and foreign middle-range actors, including people at national nuclear commissions, universities, and industrial funds, to implement programs of regional technical assistance, education and training, and technological transfer.
Latin American countries were classified according to their stage of nuclear development, with Brazil at the top and Argentina and Mexico belonging to the group of “countries worthy of attention.” Nuclear programs often intersected with development projects in other areas, such as agriculture and public health. Moreover, Eisenhower’s initiative required the recruitment of local actors, natural resources and infrastructures, governmental funding, and standardized (but localized techno-scientific) practices from Latin American countries. As Atoms for Peace took shape, it began to rely on newly created multilateral and regional agencies, such as the International Atomic Energy Agency (IAEA) of the United Nations and the Inter-American Nuclear Energy Commission (IANEC) of the Organization of American States (OAS).
Nevertheless, as seen from Latin America, the implementation of atomic energy for peaceful purposes was reinterpreted in different ways in each country. This fact produced different outcomes, depending on the political, economic, and techno-scientific expectations and interventions of the actors involved. It provided, therefore, an opportunity to create local scientific elites and infrastructure. Finally, the peaceful uses of atomic energy allowed the countries in the region to develop national and international political discourses framing the Treaty for the Prohibition of Nuclear Weapons in Latin America and the Caribbean signed in Tlatelolco, Mexico City, in 1967, which made Latin America the first atomic weapons–free populated zone in the world.
In the long view of history, the charlatan is a merchant in unconventional knowledge defined on the basis of his itinerant existence. Traveling from one marketplace to another, dealing in exotic objects and remedies, organizing shows and exhibitions, performing miraculous healings by appealing to the curative power of words and liniments, charlatans have traversed Europe since early modern times.
Charlatans also crossed the boundaries between popular and learned cultures. Both celebrated and opposed by physicians, scientists and philosophers, the rich and the poor, women and men, they circulated and traded knowledge and artifacts, penetrating the most diverse cultural spheres. Far from being confined to certain countries or regions, they were everywhere, repeating almost the same sales strategies, words, and performances. The repetition of fictitious stories down the centuries and on different continents raises the question of assessing the persistence of tradition in such different contexts.
Charlatans were able not only to discover what local people liked but also to speak their “local language,” as well as adopting the most sophisticated technological innovations as part of their performances. They were sharp observers of traditions and habits in the settings they visited, and they reacted quickly to what was new for attracting audiences and customers. One can say that charlatans combined very ancient products with the most innovative media.
The Mexican government’s civil aviation program implemented elite development strategies during a period of national reconstruction. In the decades following the revolution, political leaders and industrialists attempted to strike a balance between preserving a unique national identity and asserting their country’s place in global affairs as a competitive, modern nation. Nation builders were primarily concerned with improving the nation’s communication and transportation capabilities, although they quickly learned to exploit the spectacle of aviation through the mass media and in public ceremonies, as well. The symbolic figure of the pilot proved an adept vessel for disseminating the values championed by the country’s ruling party. Aviators validated the technological determinism underpinning the government’s development philosophy, while projecting an image of strength abroad.
This article traces the trajectory of aviation development from 1920s through the 1950s. In the process it demonstrates how the social and cultural significance of technology in Mexico changed over time. The establishment of the Department of Civil Aeronautics under the Secretariat of Communications and Public Works (SCOP), in 1928, reflected the ambitions of reform-minded officials who were intent on modernizing the country. Although the onset of the Great Depression slowed aviation development for about a decade, policymakers recommitted to the technology during World War II. President Manuel Ávila Camacho (1940–1946) used it to achieve two of his primary goals: securing the country from the threat of international fascism and shifting the nation from an agrarian to an industrial economy. Wartime aid alleviated material obstacles hamstringing national aviation development, and the rapid growth of tourism to the country in 1940s and 1950s benefited commercial airlines. Presidents Miguel Aléman (1946–1952) and Adolfo Ruiz Cortines (1952–1958) touted the success of the aviation industry as a consequence of their development policies. The near financial collapse of the country’s largest airline, Compañía Mexicana de Aviación (CMA), at the end of the decade nevertheless hinted that the country’s sustained economic growth was less miraculous than officials and foreign observers liked to believe.
Bradley Skopyk and Elinor G. K. Melville
The onset of Spanish imperial rule in Mexico in 1521 had profound consequences well beyond the political and cultural spheres. It also altered Mexico’s environment, reconstituting the region’s ecology as new fauna, flora, and microorganisms were added and as the population dynamics of native Mexican biota fluctuated in response to Old World arrivals. While the consequences of myriad interactions between native and non-native species were vast and complex, it was the decimation of indigenous persons by pathogens that was one of the first biological consequences of colonization (in fact, occurring first in 1520, one year before the fall of the Aztec state) and one of the most important. Mexican human populations were reduced by 80 to 90 percent, effecting cascading ecological consequences across the physical and biological geography of Mexico. Forests regenerated, terraced slopes degraded, and much of the Mexican landscape lost its anthropogenic aspect. Simultaneously, ungulate introductions transformed Mexican flora and likely initiated soil erosion in some regions that, when transported to fluvial environments, disrupted the flow of rivers. On the other hand, pigs, sheep, goats, horses, and other ungulates altered plant communities through selective seed dispersion. New economic pursuits such as brick making and silver mining increased demand for heat energy that, in an unprecedented manner, encouraged intensive forest usage and, probably, regional deforestation, although empirical data on historical forest cover are still lacking.
Severe climate variability, of a scale not experienced for at least five hundred years and perhaps many millennia, occurred simultaneously with colonial-induced ecological change. A significant conquest-era drought was followed by one of the coolest and wettest periods of the Holocene; a strong pluvial in the Mexican context lasted from 1540 to around 1620. Subsequent anomalies of both temperature (cold) and precipitation (either wet or dry) occurred in the 1640s and 1650s, and from the 1690s until about 1705. Together, these climate anomalies are known as the core Little Ice Age, and initiated agrarian transitions, hazardous flooding, prolonged droughts, epidemics, epizootics, and recurring agrarian crises that destabilized human health and spurred high rates of mortality. Soil degradation and suppressed forest cover are also likely outcomes of this process. Although debate abounds regarding the timing, extent, and causes of soil and water degradation, there is little doubt that extensive degradation occurred and destabilized late-colonial and early-Republic societies.
María Rosa Gudiño Cejudo
In August 1940, President Franklin D. Roosevelt, concerned with Nazi infiltration in the Americas and continental defense, created the Office of Inter-American Affairs (OIAA) and appointed Nelson Rockefeller coordinator. To strengthen ties between the United States and Latin America, including Mexico, Rockefeller implemented cultural programs that included Health for the Americas and Literacy for the Americas to teach illiterate rural inhabitants to read and write in Spanish, and to inform them about health, prevention, and hygiene. Both programs used educational cinema as their main teaching tool, and the OIAA hired filmmaker Walt Disney to produce the films. The health series included thirteen animated cartoons with an average duration of ten minutes, dubbed in Spanish and Portuguese. The themes were drawn in part from the guidelines set out at the XI Conferencia Sanitaria Panamericana (Eleventh Pan-American Health Organization Conference; Rio de Janeiro, Brazil, 1942) to address health care and sanitation. A group of psychologists, cartoonists, health authorities, teachers, and OIAA representatives carried out surveys and field work in various countries before production and test screening began. In this process, Mexico differed from the other countries involved because of Walt Disney’s connections with Mexican schools. Eulalia Guzmán, representative of the Secretaría de Educación Pública (Secretary of Public Education), led in reviewing the educational films, and Disney attended classes with local teachers to discuss the use of film as a teaching tool. In 1943, through the Programa Cooperativo de Salubridad y Saneamiento (Health and Sanitation Cooperative Program) of the Secretaría de Salubridad y Asistencia (Ministry of Health and Assistance, the films were shown in health campaigns throughout Mexico.
Pablo F. Gómez
In the early modern Spanish Caribbean, ritual practitioners of African descent were essential providers of health care for Caribbean people of all origins. Arriving from West and West Central Africa, Europe, and other Caribbean and New World locales, black healers were some of the most important shapers of practices related to the human body in the region. They openly performed bodily rituals of African, European, and Native American inspiration. Theirs is not a history uniquely defined by resistance or attempts at cultural survival, but rather by the creation of political and social capital through healing practices. Such a project was only possible through their exploration of and engagement with early modern Caribbean human and natural landscapes.
Alexandra Minna Stern
Eugenics emerged in Latin America in the early 20th century on the intellectual foundations of 19th-century social Darwinism and positivism, and expanded in contexts influenced by Catholicism, nationalism, and transnational scientific exchange. Although the extent and objectives of eugenic policies, practices, and organizations varied across the region, Latin American eugenicists tended to subscribe to neo-Lamarckian principles of environmental modification, foreground puericulture or infant and maternal care, and support new techniques of human measurement associated with biotypology. Overall, eugenics in Latin America was less extreme than in Anglo and Nordic countries, rarely resulting in sanctioned policies of compulsory sterilization or euthanasia. It was an integral component of programs designed to combat infectious ailments, especially sexually transmitted diseases, and to ameliorate national health indicators. This overlap meant that eugenics sometimes was less visible as a stand-alone movement, and that its tenets were absorbed with little friction into public health and social welfare infrastructures and campaigns. At the same time, eugenic racism was expressed in calls for immigration restriction that reverberated across Latin America, most notably in the 1910s and 1920s. In retrospect, eugenics in Latin America contributed both to exclusionary policies that stigmatized certain social groups and to overarching campaigns for health and wellness that were backed by a diverse political spectrum that could include feminists, Socialists, and military leaders.
At the beginning of the 19th century, Colombian physicians thought of food as an essential factor in shaping human character and corporeality. Framed in a neo-Hippocratic system, health and racial differences were related not only to climate but also to the connection between food qualities and humoral fluids. For example, it was believed that the tendency to eat cold and moist food, as well as greasy substances, was one of the reasons why people in warm regions of Colombia were choleric, phlegmatic, and indolent. By midcentury, it was further argued that each regional type—a local racialized categorization based on geographic determinism—had certain diet habits and physiological characteristics that explained its character (sober, obedient, lazy, industrious, etc.), and that made this type “naturally” suitable for different kinds of work. During this period, the working population’s diet was not perceived to be a social problem requiring regulation, at least not by the government. In the midst of liberal reforms, the political elites were more focused on the economic and genetic integration (“whitening”) of highland Indians, and to a lesser extent blacks, than on producing a supposed “better race” through nourishment.
But by the late 19th and the early 20th centuries, however, a new cultural framework that crossed the boundaries of thermodynamics, political economy, experimental physiology, and eugenics had begun to emerge in Colombia, converging in the social problem of nutrition. Centered on the analogy of the human body as a heat engine that transforms energy, local scientists began to conduct surveys of the eating habits of the “working classes,” analyses of the chemical and caloric composition of their foods, and studies on the metabolic characteristics of different regional populations. The results of these investigations were used to push the government to “restore the energies” of an impoverished population that was consistently thought to be weak and racially inferior, but capable of physiological and hereditable improvement. The cry of conservative elites for political and moral “regeneration” at the turn of the century also had a biological component—the optimization of the human motor. In the 1920s and 1930s, several campaigns and institutions were created for this social engineering, aimed at producing a modern, healthy, and industrious citizen. These campaigns gained special political force after the Liberal Party returned to power in 1930.
Gregory T. Cushman
Agrarian societies in Latin America and the Caribbean have accomplished some of the most important and influential innovations in agricultural knowledge and practice in world history—both ancient and modern. These enabled indigenous civilizations in Mesoamerica and the Andes to attain some of the highest population densities and levels of cultural accomplishment of the premodern world. During the colonial era, produce from the region’s haciendas, plantations, and smallholdings provided an essential ecological underpinning for the development of the world’s first truly global networks of trade. From the 18th to the early 20th century, the transnational activities of agricultural improvers helped turn the region into one of the world’s primary exporters of agricultural commodities. This was one of the most tangible outcomes of the Enlightenment and early state-building efforts in the hemisphere. During the second half of the 20th century, the region provided a prime testing ground for input-intensive farming practices associated with the Green Revolution, which developed in close relation with import-substituting industrialization and technocratic forms of governance. The ability of farmers and ranchers to intensify production from the land using new cultivars, technologies, and techniques was critical to all of these accomplishments, but often occurred at the cost of irreversible environmental transformation and violent social conflict. Manure was often central to these histories of intensification because of its importance to the cycling of nutrients. The history of the extraction and use of guano as a fertilizer profoundly shaped the globalization of input-intensive agricultural practices around the globe, and exemplifies often-overlooked connectivities reaching across regional boundaries and between terrestrial and aquatic environments.
Giuseppe M. Messina
In Argentina, the provision of health care is divided into three components: a highly decentralized universal public sector, funded from general taxation; a constellation of compulsory collective insurance schemes, financed by contributions withdrawn from the salaries of workers in the formal labor market; and a system of private insurance companies used primarily by the middle and upper classes. Regarding the delivery of medical services, the configuration is mixed, as the weight of public and private providers is roughly equal. This complex structure, which derives from the historical development of particular institutions, produces high costs and unequal access to care according to a person’s geographical residence, occupational status, and purchasing power.
Since the early 20th century, Brazilian public health has focused on rural areas, the people living there, and the so-called endemic rural diseases that plague them. These diseases—particularly malaria, hookworm, and Chagas disease—were blamed for negatively affecting Brazilian identity (“a vast hospital”) and for impeding territorial integration and national progress. For reformist medical and intellectual elites, health and educational public policies could “save” the diseased, starving, and illiterate rural populations and also ensure Brazil’s entry into the “civilized world.” In the mid-20th century, public health once again secured a place on the Brazilian political agenda, which was associated with the intense debates about development in Brazil in conjunction with democratization following World War II (1945–1964). In particular, debate centered on the paths to be followed (state or market; nationalization or internationalization) and on the obstacles to overcoming underdevelopment. A basic consensus emerged that development was urgent and should be pursued through modernization and industrialization. In 1945, Brazil remained an agrarian country, with 70 percent of the rural population and a significant part of the economy still dependent on agricultural production. However, associated with urbanization, beginning in the 1930s, the Brazilian government implemented policies aimed at industrialization and the social protection of organized urban workers, with the latter entailing a stratified system of social security and health and social assistance. Public health policies and professionals continued to address the rural population, which had been excluded from social protection laws. The political and social exclusion of this population did not change significantly under the Oligarchic Republic (1889–1930) or during Getúlio Vargas’s first period in office (1930–1945). The overall challenge remained similar to the one confronting the government at the beginning of the century—but it now fell under the umbrella of developmentalism, both as an ideology and as a modernization program. Economic development was perceived, on the one hand, as driving improvements in living conditions and income in the rural areas. This entailed stopping migration to large urban centers, which was considered one of the great national problems in the 1950s. On the other hand, disease control and even campaigns to eradicate “endemic rural diseases” aimed to facilitate the incorporation of sanitized areas in agricultural modernization projects and to support the building of infrastructure for development. Development also aimed to transform the inhabitants of rural Brazil into agricultural workers or small farmers. During the Cold War and the anti-Communism campaign, the government sought to mitigate the revolutionary potential of the Brazilian countryside through social assistance and public health programs. Health constituted an important part of the development project and was integrated into Brazil’s international health and international relations policies. In the Juscelino Kubitschek administration (1956–1961) a national program to control endemic rural diseases was created as part of a broader development project, including national integration efforts and the construction of a new federal capital in central Brazil (Brasilia). The country waged its malaria control campaign in conjunction with the Global Malaria Eradication Program of the World Health Organization (WHO) and, to receive financial resources, an agreement was signed with the International Cooperation Agency (ICA). In 1957 malaria eradication became part of US foreign policy aimed at containing Communism. The Malaria Eradication Campaign (CEM, 1958–1970) marked the largest endeavor undertaken by Brazilian public health in this period and can be considered a synthesis of this linkage between development and health. Given its centralized, vertical, and technobureaucratic model, this project failed to take into account structural obstacles to development, a fact denounced by progressive doctors and intellectuals. Despite national and international efforts and advances in terms of decreasing number of cases and a decline in morbidity and mortality since the 1990s, malaria remains a major public health problem in the Amazon region.
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.