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2 Launching the Campaign suffice it to say that we cannot aspire to a place among the cultured peoples of the world as long as we have not put into practice the means of combating illnesses and reducing the death toll, up to the limits that science permits, and in that way assure the general welfare, which is the essential purpose of government! —Alberto de soldati, Diario-Senadores, september 23, 1905 in 1900, malaria “invaded” the city of santiago del Estero. Even in a region accustomed to epidemics, the virulence of this outbreak was alarming . Although only some 150 kilometers southeast of tucumán’s capital, the city had until that time been considered beyond malaria’s endemic zone.1 in fact, Cantón had not even bothered to mention santiago, Argentina’s oldest city, in his medical geography. lying at the edge of the vast Chaco plain, the somnolent, colonial-style city enjoyed a semi-arid climate and absence of marshlands, qualities that had once made it a refuge for malaria sufferers from tucumán.2 yet,by the time malaria reached its peak in the city in 1902, approximately 72 percent of its 11,409 residents had been infected,a rate far higher than any previously recorded in Argentina.3 As in salta and tucumán,santiago del Estero’s government was ill equipped to handle the epidemic. A hastily assembled board of hygiene, led by dr. Antenor Alvarez, conducted comprehensive epidemiological and topographic surveys to determine the source of the problem, not unlike the legendary actions of John snow during the 1854 cholera outbreak in london. Alvarez used epidemiological maps to pinpoint the principal breeding ground for malaria-carrying mosquitoes near the city’s center.4 this body of stagnant water adjacent to the río dulce was the unintended outcome of a badly planned levee,which had blocked an outlet for flood water.Alvarez arranged for the site to be drained, filled, planted to eucalyptus and other trees, and converted into a large city park. the sanitation of this site appeared to conclude the epidemic almost as dramatically as it had begun, with new malaria cases declining steeply after 1902. for years afterward, this incident would be cited in Argentina as the classic success story of malaria control through environmental sanitation.5 Alvarez himself, in future publications and con- 50 / Chapter 2 ference papers, would reflect on this apparent triumph and reinforce the association between wetland reclamation and malaria control.6 he would also parlay this public health success story into a political career, eventually representing santiago del Estero as governor and national senator. the santiago del Estero epidemic proved pivotal in the history of malaria control in Argentina. integrating important advances in international malaria science, Alvarez recognized the mosquito’s role in malaria transmission and applied that knowledge to control efforts for the first time in Argentina. discovering and scrutinizing the mosquito’s routines would become the fixation of malariologists worldwide for the next fifty years.yet in Argentina, at least, recognition of the mosquito’s role did not represent a clean break with past conceptions of the malaria problem.Just as miasmatic and microbiological frameworks coexisted through the 1890s, the role of the mosquito was rapidly accepted without completely displacing older concepts of malaria etiology.7 the mosquito connection simply offered a clarification of earlier views:that is, a more precise explanation of why certain landscapes, such as marshes, swamps, and other areas of standing water, became malaria hazards . more importantly,Alvarez’s sanitation efforts in santiago confirmed that drainage of infectious foci could rapidly reduce malaria incidence.thus, the emergence of the mosquito hardly altered conventional and commonsense notions of malaria’s place in the landscape and how to attack the disease at its source.the basic logic behind saneamiento was not questioned. the epidemic in santiago del Estero was crucial for another reason: to many prominent hygienists and politicians,it suggested that malaria was spreading from its source in the northwest to other parts of the country. Cantón’s medical geography, legislative studies of malaria in tucumán, and reports on salta’s sanitary situation, discussed in the previous chapter, generally portrayed malaria as endemic and entrenched, not a traveling epidemic. malaria had been seen as a constant presence in the areas where it was found,although its intensity could vary seasonally and from year to year.it was the product of the particular conditions of a place and characteristic of...

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