Anne-Emmanuele Birn and Raul Necichea López (eds), Peripheral Nerve Health and Medicine in Cold War Latin America. Durham, NC: Duke University Press, 2020. 376 pp. ISBN 978-1-4780-0956-6
This is a collection of very distinct articles. Each focuses on a single country in Latin America and an aspect of health care or an individual health professional and the impact of the USA on their work. The majority of the authors and the two editors are based in the USA and Canada and one cannot help but observe that the book would have more value if health professionals and patients from Latin America had written some of the articles.
Some of the articles are easy to read. I enjoyed the article on Dr Pessoa, an expert in parasitology and public health in Brazil, who was also a member of the Communist Party of Brazil. The irony of Dr Pessoa attending an academic Congress in Brazil, where he was being honoured in the presence of the Health Minister for Brazil, while government security officers were looking to arrest him for being a Communist, is highlighted. His work in identifying the lack of health care for rural communities was outstanding. This is the only chapter written by two authors from Latin America.
Other chapters highlight US funding for medical schools in Bolivia being dependent upon their political attitude towards the US. The political climate in the US had a major effect on donors such as the Rockefeller Foundation. The two chapters on psychiatry in Cuba and Argentina would be better if they were linked. Two chapters on Mexico describe the pharmaceutical industry and rural health. One chapter on Puerto Rico focuses on family planning.
The chapter on Chile is fascinating in that President Salvador Allende was a doctor and had been a Health Minister. His comment in 1939 that “It is not possible to provide health and knowledge to a malnourished people, dressed in rags and working under merciless exploitation” is still as important now as it was then. The chapter describes the process of expanding health care in Chile and the role of the USA in preventing “socialised medicine”. The latter was (and still is) used as a way of dismissing the concept of universal health care as a Communist government plot.
The article on Cuba and Nicaragua highlights the contribution of Cuba towards improving health care in Nicaragua. However, it contains inaccuracies, such as suggesting that the Cuban assistance to Nicaragua was the greatest support given to another country by Cuba, when Cuba’s support to Venezuela was in fact significantly greater. The chapter talks of Cuban doctors defecting, whereas the term economic migrants would be more accurate. Cubans talk openly about the number of health professionals who choose not to return to Cuba, but instead stay abroad and work privately in order to earn more money. Cuba estimates that less than 2 per cent of health professionals choose to stay abroad, which illustrates the commitment of the Cuban health professionals to the revolutionary project.
The Epilogue describes Cuba’s international health initiatives in more detail. These included Operación Milagro (cataract surgery), Misión Barrio Adentro in Venezuela and ELAM (the Latin American School of Medicine) in Havana. These initiatives and others have transformed attitudes and healthcare in Latin America but are only briefly described. This is a major weakness in my view.