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.
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.
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.
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.