Best regards, Andrew Stewart
Begin forwarded message: > From: H-Net Staff via H-REVIEW <[email protected]> > Date: June 1, 2021 at 11:08:52 AM EDT > To: [email protected] > Cc: H-Net Staff <[email protected]> > Subject: H-Net Review [H-LatAm]: Gutiérrez on Rodríguez, 'The Right to > Live in Health: Medical Politics in Postindependence Havana' > Reply-To: [email protected] > > Daniel A. Rodríguez. The Right to Live in Health: Medical Politics > in Postindependence Havana. Envisioning Cuba Series. Chapel Hill > University of North Carolina Press, 2020. 282 pp. $34.95 (paper), > ISBN 978-1-4696-5973-2; $95.00 (cloth), ISBN 978-1-4696-5972-5. > > Reviewed by John A. Gutiérrez (John Jay College) > Published on H-LatAm (June, 2021) > Commissioned by Casey M. Lurtz > > Early in his important and wide-ranging new book, _The Right to Live > in Health: Medical Politics in Postindependence Havana_, Daniel A. > Rodríguez recounts the inauguration of the new headquarters of the > Cuban Academy of Science. The ceremony took place late in the spring > of 1902, just five days before the birth of the Cuban republic, and > included, among others, the new nation's soon-to-be first president, > Tomás Estrada Palma, and the head of the US Military Government of > Cuba, General Leonard Wood. The academy had existed since the 1860s, > but the conversion of a former convent into what the Cuban physician > Enrique Barnet would later call a "new temple of science" seemed to > signal, as Rodríguez writes, that "an age of rationalism and > national science had eclipsed colonial superstition and empiricism" > (p. 48). > > Perhaps no branch of Cuban science more completely and significantly > symbolized this transition than did medicine and its application > through the emerging discipline of public health. Medical research > and practice had deep roots in Havana. By the end of the nineteenth > century, the capital city boasted a robust medical community that > could well be described, as Steven Palmer noted several years ago, as > a "colonial medical metropolis."[1] Cuban physicians and medical > researchers investigated, treated, and debated the diseases that > afflicted the Cuban masses, but the significance of their work > extended beyond the limits of biomedicine. For these physicians, the > pursuit of medical knowledge was intimately intertwined with the > development of an independent Cuban nation. By the time the Spanish > surrendered control of the island, key figures in Cuba's medical > community believed that they, and the work they did on behalf of the > Cuban people, were "key to an independent and prosperous Cuban > Republic" (p. 58). This incipient "medical nationalism," as > Rodríguez describes it, was "a cultural revolution meant to reshape > Cuban ideas and habits, transform the Cuban state, and build lasting > health institutions" (p. 71). > > The intersection of medicine and nationalism in the pivotal first > decades of the twentieth century has enjoyed increasing attention > from historians of Cuba in recent years.[2] Yet what we understand by > "medical nationalism" is often difficult to pin down. Rodríguez > acknowledges and embraces this ambiguity, arguing that the "the > capaciousness of this project was the key to its strength" (p. 58). > He adds: "Some medical nationalists emphasized the responsibility of > individuals for their own health, while others looked more to the > state; for some medical nationalists, a modern and prosperous Cuba > depended on the whitening of the island through greater European > immigration, while others directed their health work to the problems > most affecting poor Cubans, black or white. Nevertheless, medical > nationalists were united in their belief that medicine and science > were the keys to national progress, and that a combination of popular > hygienic education and strong state action was essential for > achieving hygienic modernity" (pp. 58-59). > > Rodríguez's book offers readers a window onto the development of > medical nationalism by focusing on a series of discrete moments in > Cuba's history when public health was "a central site of struggle and > negotiation over the meanings of health, modernity, and independence > in the decades after independence" (p. 13). Starting with the > complicated relief and recovery efforts in the immediate aftermath of > Spain's notorious reconcentration policy and continuing through to > the _conflicto médico_ of the 1920s and 1930s that pitted Cuban > doctors against Spanish mutual aid societies, Rodríguez offers a > series of compelling examples of the ways medical practice and public > health policy were imbricated in and shaped by Cuban debates about > race, gender, class, and national origin. In this way, the book > operates as a series of interrelated vignettes, each deftly placing > the reader at the center of a particular moment of crisis and > conflict from which we glean much about Cuba's complicated formative > years as a republic. > > One of the finer examples of this approach is Rodríguez's > examination of the bubonic plague outbreak that threatened Cuba in > 1914. Carefully combining accounts from leaders of the Cuban medical > establishment and Havana's various partisan newspapers, he tells the > story of not only how the island's health authorities attempted to > control the spread of the disease but also how those policies exposed > and amplified already-existing tensions between Cubans and a growing > and economically powerful Spanish immigrant population. When the > disease appeared in Havana, it did so in the center of the city's > "Spanish commercial district" (p. 114). Soon enough, Cuban sanitary > officials argued that the disease found refuge in the > Spanish-dominated areas near Havana's port because of its residents' > unhygienic living conditions and sanitary practices. Juan Guiteras, > the island's secretary of health, went further and accused Spanish > authorities of "infecting her former colonies with the disease by > hiding the existence of the Plague epidemic in the Canary Islands" > (p. 100). The local Spanish press and the Spanish merchants who > dominated the city's commerce rejected these claims and accused the > Cuban authorities of acting recklessly. Those complaints only > increased when Guiteras ordered the quarantine of nearly twenty city > blocks in the infected district and the evacuation of some seven > thousand residents. One member of the pro-Spanish press wrote that > the forced relocation of men, women, and children evoked "scenes from > the reconcentration" (p. 109). Spanish merchants demanded > compensation for their losses and, ultimately, succeeded in getting > the Cuban authorities to "moderate their tactics" (p. 113). What is, > at first glance, a simple story of disease control becomes, in > Rodríguez's hands, a much richer history of the ways a deadly > pathogen laid bare the deep fault lines that cleaved postindependence > Havana. > > Rodríguez's decision to focus on Havana is a logical one. The city > was the epicenter of Cuban medical practice, and its population > density, insufficient infrastructure, and lack of adequate housing > made it a breeding ground for various diseases. The city was also > home to the greatest number of doctors on the island and a thriving > medical press. Still, the richness of Rodríguez's narrative for the > Cuban capital leaves us asking how medical nationalism influenced the > practice of medicine and the development of public health in the rest > of the island. While the documentary evidence there may be more > difficult to access, the possibilities for comparative analyses with > Havana are enticing. Rodríguez has written an invaluable account of > the history of medicine and public health in Cuba, an account that > should become a point of reference for future studies in this growing > and vibrant field. > > _The Right to Live in Health_ is written in clear but theoretically > rich prose and would be valuable to undergraduate and graduate > students alike. The book will be especially appreciated by historians > of Cuba and historians of health and medicine in Latin America. > > Notes > > [1]. Steven Palmer, "Beginnings of Cuban Bacteriology: Juan Santos > Fernández, Medical Research, and the Search for Scientific > Sovereignty, 1880-1920," _Hispanic American Historical Review_ 91, > no. 3 (August 1, 2011): 447. > > [2]. See, for example, Mariola Espinosa, _Epidemic Invasions: Yellow > Fever and the Limits of Cuban Independence, 1878-1930 _(Chicago: > University of Chicago Press, 2009); Jennifer L. Lambe, _Madhouse: > Psychiatry and Politics in Cuban History_ (Chapel Hill: University of > North Carolina Press, 2017); and the collection of essays in "Dossier > #2: New Approaches to the History of Health, Medicine, and Disease in > Cuba," _Cuban Studies_ 45 (2017): 275-340. > > Citation: John A. Gutiérrez. Review of Rodríguez, Daniel A., _The > Right to Live in Health: Medical Politics in Postindependence > Havana_. H-LatAm, H-Net Reviews. June, 2021. > URL: https://www.h-net.org/reviews/showrev.php?id=55830 > > This work is licensed under a Creative Commons > Attribution-Noncommercial-No Derivative Works 3.0 United States > License. > > -=-=-=-=-=-=-=-=-=-=-=- Groups.io Links: You receive all messages sent to this group. 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