Chagas: A Hidden Affliction (review)

Chagas disease is a zoonotic disease whose natural hosts are skunks and armadillos. It can spread to humans when their living and housing conditions become so degraded that they are similar to those of the natural hosts. It is a disease of poverty present all over Latin America. Close to twenty million people carry this disease, which annually inflicts fifty thousand deaths.

Years of persistent local governments’ and international organizations’ control measures have succeeded in reducing Chagas transmission in many areas. Still, it is estimated that 25 percent of the Latin American population is at risk. The disease is mainly spread by insects through contact with feces, but can also be passed through pregnancy or birth from mother to child, as well as through blood transfusion. There are few visible symptoms, which often times do not appear until 10 to 20 years after infection takes place in children’s bodies. At that point treatment is too late and Chagas disease may degenerate into fatal heart maladies. There is no medical cure for most sufferers and in most cases only treatment of symptoms is possible. The historiography on Chagas disease has been in full development in the last 15 years, with discussions centered on the conditions in which specific knowledge about the disease was produced. It is mainly biomedical history with some efforts at social and cultural contextualization.

Chagas: A Hidden Affliction deals with the well-known association between the disease and rural poverty but also makes an important contribution vis-à-vis its current globalization. In doing so, it stresses a number of key issues, including problems present in some Latin American countries as well as in the U.S. and Western Europe: the health status of international migrants leaving Chagas-plagued rural areas; the lack of Chagas infection testing before blood transfusions; the existence of blood banks that do not check if their donors have Chagas; the lack of control on Chagas infection among women of child-bearing age; and the rampant ignorance in U.S. and Western European medical circles about Chagas-related cardiac problems affecting sectors of the Latin American immigrant communities.

This is not the first time Chagas disease has caught the attention of filmmakers. The 1995 film, Houses of Fire, offered a narrative in part historical and in part fictional, depicting the unsuccessful efforts of the Argentinean physician Salvador Mazza to control the disease throughout northwestern Argentina during the 1920s and 1930s. Ricardo Preve’s documentary, on the other hand, mainly focuses on people’s experiences with the disease and on the need to deal with them in a more global perspective, stressing an agenda aimed at mobilizing governments, international agencies, and the public at large. Perhaps its most convincing argument on the current Chagas globalization trends is the tragic trajectory of one of Preve’s informants, a legal migrant from Costa Rica with more than 20 years’ residence in the United States, who died of Chagas during filming. Equally illuminating are his U.S. doctor’s comments, revealing not only how ill-informed and unequipped he was –and continued to be— when trying to help his patients, but also the new urgencies this disease is posing to areas of the world where Chagas used to be considered an exotic disease, a distant public health problem of the Americas’ Southern Hemisphere.