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21 C hapter two The Politics of Prevention The Maya, Smallpox, and Vaccination Campaigns } indecember1852,thedirectorofvaccinepropagationandconservationforthe state of Yucatán, Dr. Manuel Campos, wrote a resignation letter to Governor Barbachano in which he voiced his frustration with what he saw as a highly inept state bureaucracy. The forty-one-year-old Campos wrote that he felt like a tired and much older man, stating, “I have fulfilled my duties and cannot possibly devote any more time to an endeavor that seems to elicit little or no support.”1 Throughout his term as director of vaccine propagation and distribution between 1846 and 1852, Campos had pleaded with medical students and colleagues to take positions as subvacunadores (sub-vaccinators), even though he could promise them little pay and most needed to fill positions in locations far from their presumably urban homes.2 The salary for a sub-vaccinator was minimal, or in some cases, the job was accepted on a voluntary basis.3 To supply them, he had had to beg the government for money to buy new equipment, which had to be shipped to Yucatán from elsewhere, and had worked without pause to send the vaccines anywhere they were needed—only to learn that in many cases they never arrived or were never used. The mournful tone of his letter clearly reveals a deep sense of hopelessness. Despite all the potential offered by the vaccination campaign, he had seen that promise wasted and needless suffering and death from smallpox come about as a result.4 A native of Campeche, Campos had witnessed continual preferential treatment in state vaccination campaigns toward the urban center of Mérida and its surrounding towns. As founder of Campeche’s medical school in 1849, chapter two 22 Campos had always been a fierce advocate for the decentralization of education and culture from Mérida. An enthusiastic advocate and administrator of smallpox vaccine in the early years of his medical career, he noted that the number of epidemic deaths in his hometown seemed to be disproportionately greater than Mérida’s. Thus, in his career as a physician and public health administrator, he sought to mitigate these inequities. Campos was one among those of the peninsula’s policy makers and políticos who saw Méridanos as parasitic on the wealth and benefits brought to the entire peninsula by their port city of Campeche. Old regional rivalries resurfaced during smallpox epidemics as disparities in access and funds marked disparities in power and influence between the two urban centers.5 Campos eventually rebounded from his disillusionment with administrative duties, accepting an invitation three years later to teach general medicine and surgery at the University of Yucatán. He still took time to write in the press, advocating the benefits of disease prevention through vaccination campaigns.6 Many of Campos’s colleagues shared his dissatisfaction with the inefficiencies of Yucatán’s smallpox prevention campaigns. Regional differences aside, why did medical doctors keep encountering so many obstacles to rational medical therapy in a countryside eminently threatened with epidemics ? Why were their efforts to safeguard the most vulnerable members of their communities often repeatedly thwarted by lack of funding and miscommunication ? Embedded within these vaccination programs lie clues that point to the strategic function of vaccination programs in the state’s long-range program of civilizing the Maya and modernizing the region according to the European standards adopted by the creole elite. In this chapter, I take the smallpox prevention program to be paradigmatic of the role public health campaigns played in the process of modern state-building in postcolonial Yucatán. Ultimately, physicians and statesmen did try to mitigate the vulnerability of the vast Maya population to a plague that had intermittently caused such tremendous death and cultural havoc down through the centuries of Spanish rule; yet the success of the anti-smallpox campaigns was impaired by three interrelated factors. First, long-seated regional tensions between the urban port of Campeche and the capital of Mérida supervened upon the implementation of vaccination campaigns throughout the peninsula, creating rivalries and forms of sabotage that ultimately strained the relationship between Yucatán and Mexico City as well. Second, the elite contempt for and misunderstanding of the Maya, especially in regard to their own culture’s development of etiological precepts The Politics of Prevention 23 and therapeutic preferences, created a two-sided complex: on the one hand, the representatives of the government came to regard Maya practices as things to...


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