- Medicine and Nation Building in the Americas, 1890–1940 by José Amador
The challenge proposed by the author is to present an entangled history of medicine and public health that contrasts with the histories anchored in nation-states, which, according to him, have characterized the historiography of medicine and public health in Latin America and the Caribbean. By using the notion of “tropical America,” the book examines the relations between public health campaigns and ideas on disease, race, and nation in Cuba, Puerto Rico, and Brazil and how they influenced Latin American intellectuals. As the author would have it, this tropical America is a transnational space characterized by the intersections, tensions, and sharing of ideas and practices, including nationalism, colonialism, and imperialism; more importantly, it is a space amalgamated by the emerging presence of the United States in the region in the first half of the twentieth century, most particularly of the Rockefeller Foundation’s International Health Commission. This histoire crusée of public health projects is meant to allow readers to recognize local agency within this transnational phenomenon, something ignored by national histories; help them understand discourses on race and nation as part of these projects; and prompt them to question the purely imperial, top-down nature of tropical medicine in these contexts. [End Page 558]
Organized into three parts and five chapters, the book claims to be “the first cultural and social history of public health” (p. 6) that takes an integrated approach in analyzing sources from Cuban, Puerto Rican, Brazilian, and U.S. archives. The first part (“Visualizations”) presents a single chapter, which deals with how Brazilian, Cuban, and Puerto Rican intellectuals reflected on the race issue in the postabolition period, based on new theories in bacteriology and tropical medicine; it also examines the impacts of their ideas on health policies and practice. The second part (“Crossings”) consists of three chapters, each addressing the dynamics of asymmetrical relations between the United States, the Rockefeller Foundation, and disease control and eradication programs in Cuba (yellow fever), Puerto Rico (hookworm), and Brazil (hookworm, yellow fever, malaria). The third part (“Legacies”), also consisting of a single chapter, examines how these public health initiatives had an impact on important intellectuals like Cuba’s Fernando Ortiz, Brazil’s Gilberto Freyre, and Puerto Rico’s Antonio Pedreira and on their positive and anticolonial yet ambiguous reflections on race, miscegenation, and national identity and their views on the possibility of civilization in the tropics.
The book’s announced promise of a new and entangled history of public health and medicine, however, goes unfulfilled. It is outlined in chapter 1 and partially explored in chapter 5, both of which address an intellectual history and a history of ideas. However, the three chapters dealing with health programs in Cuba, Puerto Rico, and Brazil do not advance beyond the national frameworks so heavily criticized by the author. The common elements and intersections in these stories are not concrete or convincingly presented and appear to be somewhat arbitrary choices sourced from very diverse national realities. For example, neither the long-lived centrality of Bailey Ashford in the campaign against hookworm in Puerto Rico and his visit to Brazil in 1916 nor the experience of some Latin American intellectuals at Columbia University authorizes or produces, a priori, entangled histories. The narratives presented were arrived at by drawing from primary sources and secondary literature in an overly selective fashion. For example, the proposed relation between public health projects and a racialized vision coming from the state of São Paulo is unconvincing, and the approach to Gilberto Freyre’s ideas oversimplified. This derives from the fact that the author offers no effective dialogue with the immense historical production that has addressed health and medicine in Latin America and the Caribbean and the history of ideas and intellectuals. Since the early 1990s, this prolific bibliography has postulated the very same core issues that appear in the book and has developed them based on the analysis of various local and national...