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.
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.
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
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 being 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 a 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. On his part, 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 in a large scale using newly experimental techniques introduced in Mexico in the 1960 by Salvador Armendares allowed to tackle health problems regarding Down and Turner syndromes, and child malnutrition. 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.
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.