Introduction: The Fever of International Health

Summary

In January 1929, just a few months after he returned to Mexico from his doctoral studies at the Johns Hopkins School of Hygiene and Public Health in Baltimore, Maryland, Rockefeller Foundation (RF) fellow Miguel Bustamante penned a heartfelt letter to his former dean, William Howell. Peppering his progress report with words of gratitude, Bustamante wrote of his new appointment as chief of the Port of Veracruz sanitary unit, Mexico's first attempt at “cooperative and systematic work for the improvement of the Public Health conditions in our Cities.” He relayed the “real effort” his country was expending and hoped that he would be “doing something good with the cooperation of our people.” Bustamante concluded, “Of course I recognize how much I own [sic] to our School and the Foundation and hope not to disappoint any of you.”

This missive, written by one of Mexico's most esteemed public health doctors, embodied the characteristics of the relationship between revolutionary Mexico and the RF: multifaceted interaction. Bustamante conveyed a mixture of national pride and know-how, the challenge of collaborating with the public, a reliance on modern public health methods, and his indebtedness to international patronage.

The principals in this three-decade public health partnership were the RF’s International Health Division (IHD; International Health Board until 1927) and the Mexican government's Department of Public Health (Departamento de Salubridad Pública; DSP). In addition, numerous other parties—ranging from traditional healers to national leaders, elite physicians to rural health officers, foreign philanthropists to small townsfolk—would also be involved. Different ideas would appear, some homegrown, some imported, some local, some international, some traversing back and forth. In the course of this complex involvement, there would be times of productive cooperation, appropriation, disdain, rejection, outright hostility, and bona fide accomplishment, making the survival of the relationship an achievement in and of itself.

This interaction took place between 1921 and 1951 through a series of projects centered in a handful of Mexican states and administered from Mexico City, New York, and several regional capitals. The RF-Mexico liaison began with a large-scale yellow fever campaign based along the Gulf Coast and extending into the Yucatán peninsula. In 1924, the yellow fever effort was converted into a lower-cost but intensive hookworm campaign that reached hundreds of thousands of people in small towns, mostly in the state of Veracruz, and, later, in Oaxaca and Chiapas.