Medicine and Public Health in Latin America: A History by Marcos Cueto and Steven Palmer (review)

Over the last twenty years or so, new theory, methods, and transnational dialogues have transformed the history of medicine and public health in Latin America. What has emerged is a sociocultural history of health, which connects health discourses and practices to dynamically changing historical themes of race and ethnicity, nationalism, gender, sexuality, and class, with a related move away from medical antiquarianism and triumphalist histories of scientific and technological progress. Two of the avatars of this scholarly boom, Marcos Cueto and Steven Palmer, offer a valuable synthesis of this expanding field in their impressive new book, Medicine and Public Health in Latin America: A History.

Cueto, from Peru, works at the Fundación Oswaldo Cruz in Rio de Janeiro, perhaps the leading South American center of research in the history of medicine. Cueto has authored dozens of books, articles, and reviews (including groundbreaking histories of the Rockefeller Foundation’s activities in Latin America) over the last twenty-five years, while leading productive efforts to build a transnational research community focused on the history of public health in the Americas. Palmer, the Canada Research Chair in the History of International Health at the University of Windsor, is a specialist in history of public health in Central America (especially Costa Rica) and the Caribbean. Combining their scholarly skills, insight, and expertise has led to an authoritative and highly readable account of a potentially unwieldy subject, over 500 years of the history of medicine and health across the vast expanse of Latin America and the Caribbean.

At the risk of being too parochial, in this review I will concentrate on what Cueto and Palmer’s book has to offer Latin Americanist geographers. Those of us who have done health-related research in the region–a group that also includes Joseph Scarpaci, Cynthia Pope, and Barney Warf, to name just a few–work at the periphery of many peripheries: of geography, of the social sciences of health, of Latin American studies. Never a group large enough to develop a critical mass, our scholarly interventions can be sporadic and it is difficult to make sense of the whole field. From this perspective, Cueto and Palmer’s book serves a fundamental purpose, as a go-to reference for just about anything related to medicine, public health, and health policy in Latin America. While they rely mainly on the work of fellow historians, Cueto and Palmer draw from a breadth of humanities and social science fields (particularly medical anthropology), while subtly embedding their historiographical critique within a compelling and coherent narrative.

And this isn’t merely history: Cueto and Palmer bring the story to a close in the present day, with discussions of the response to the 2009 H1N1 influenza (swine flu) epidemic that originated in a commercial hog farm in Mexico; vital campaigns of politically organized HIV patients in Brazil, lobbying for their right to life-saving medications; and the geopolitics behind the new “global health” model that reflects a kind of neoliberal humanitarianism, with an enhanced role for private-public partnerships and a reconfiguration of ideas of citizenship and the right to health.

In addition, Medicine and Public Health in Latin America delves into many subjects that have long been of interest to Latin Americanist geographers, helpfully filling gaps in our knowledge and offering different perspectives. For example, geographers such as William Denevan and George Lovell have reconstructed the history of native demographic collapse after European conquest, and the concomitant impact on nature and society in the region. After the early, massive epidemics of smallpox, measles, and other infectious diseases, what happened afterward in public health in the European colonies of the Americas has been of relatively little interest to geographers. Cueto and Palmer cover the darkest decades of...