Anne-Emanuelle Birn and Raúl Necochea López have produced a well thought out book of essays that argues for a reevaluation of how Latin American medical and health professionals navigated the Cold War. As Gilbert Joseph notes in the book's preface, social and political historians have been reworking the old idea of the Cold War as a conflict between the United States and the Soviet Union, commencing after World War II. in which the rest of the world were mere passive observers. There is now consensus that the ideological conflicts that we associate with the Cold War have their genesis in the early twentieth century and that Latin American actors operated within a web of local, national, and international contestations. Scholars also question whether the term “Cold War” is apt, given that in much of the world it was neither “cold” nor so much a war as a campaign of extermination. The Cold War tensions and conflicts spilled over into many realms of life, including the scientific and medical.
Latin American health and medicine professionals navigated complex and multifaceted positions that defied bipolar visions and pressures. Reminiscent of their nineteenth-century forbearers, these professionals were open to diverse ideas, systems, and techniques, and they did not necessarily worry about the geopolitical implications. The contributors argue that medical and health professionals in the postwar period did not simply replace European with US North American influences. Rather, they studied and learned from a global community of medicine and health models. In many cases, the interest derived from a belief that regions outside of western Europe and North America had histories and conditions more analogous to their own national challenges—thus, for example, Mexican interest in the Soviet model. The edited collection also makes an important intervention into periodization by demarcating three distinct sub-periods within the Cold War.
The book is divided into three sections. The first section, “Leftist Affinities and US Suspicions,” includes three cases studies from Mexico and Bolivia where national health policy came to loggerheads with US actions that sought to block Soviet influence, both real and perceived. The second section, “Health Experts/Expertise and Contested Ideologies,” traces how health professionals in Puerto Rico, Cuba, and Brazil navigated and negotiated with the capitalist and communist countries. As the cases of Cuban psychiatry and Puerto Rican family planning suggest, health policy was often shaped by a willingness to embrace methods from across the geopolitical horizon. Such negotiation and flexibility were not always possible, as in the tragic case of the Brazilian parasitologist and social medicine advocate Samuel Pessoa whose work was cut short by the military government that categorized his globally acclaimed work as subversive.
The third section, “Health Politics and Publics, with and without the Cold War,” traces the complex ways that health workers negotiated the pressures of the global conflicts while working toward national health objectives. In Chile, Pieper Mooney locates “evidence of a social medicine praxis that expediently managed both to avoid some global political paradigms . . . and to engage with others . . . in promoting a public health approach to serve the needs of the Chilean nation” (189). As with the case of Pessoa, the Chilean project was crushed by a self-proclaimed anticommunist dictatorship. Leftist Argentine psychiatrists walked “a fine anti-imperial line as they attempted to secure resources, both material and ideological, from the superpowers while also imagining a sovereign, nationalist future without them” (213). Finally, in the case of Cuban medical assistance to Nicaragua after the 1979 revolution, we see that that the program was riven with conflicts and tensions that belied the anticommunist propaganda emanating from Washington, DC.
Birn and Necochea's epilogue lays out some intriguing future research areas. For a number of reasons, not the least of which is language, few scholars have looked deeply into the links between Chinese and Latin American medical counterparts. The editors also call for more research on a variety of topics that touch on health, including US-funded projects like the State Department's Institute of Inter-American Affairs, as well as philanthropic groups, women's and indigenous rights groups, and other lesser-known cases of healthcare solidarity. In sum, there is more work to be done to unpack the Cold War and its complex meanings.
It is difficult in a short review to give full descriptions of each of these excellent essays. They highlight how the conflicts and contestations of the Cold War went far beyond the bipolar vision taught to many of us in high school. Latin American actors forged new spaces and new projects, and demonstrated great originality. All of the authors take care to paint vivid pictures of the women and men who worked, often at great personal and professional risk, to reform public health and medicine.
