Jonathan Ablard

Professor and Latin American Studies Coordinator, History


Disease and Health in Latin America

Disease and Health in Latin America/Spring 2010

T Th 10:50am-12:05pm / Williams 224

Office Hours: T, 1-3pm, F 1-2:30pm and by appointment

* Syllabus may be revised during the semester. 

Jonathan D. Ablard

Muller 403


In the last decade, there has been a tremendous growth in historical scholarship on topics relating to disease and health in Latin America. Influenced by the growing field of the social history of medicine, many of these works challenge assumptions about the motives, design and implementation of public health initiatives since the period of early independence. Scholars have demonstrated that popular and professional notions of health and illness were not static but changed over time in response to an array of social, political and economic forces. By the late nineteenth-century, health and disease had transcended biological categories, and were frequently discussed within broader discussions about racial degeneration, gender norms, sexuality, immigration, and political disorder.

This course has five major intellectual goals that are inspired by this new and dynamic body of literature. First, students will develop an historical awareness of the political and social dimensions of disease and health in Latin America. Second, students will gain insight into how the disease and health reflect broader political and economic developments in Latin America. Third, we will examine how interactions between medical practitioners and their clients have shaped public health policy in Latin America, perceptions of what constitutes “ill-health,” and notions of race, class and gender. Fourth, we will consider the ways in which women and men have shaped health and welfare policy. Finally, students will develop a global perspective not just on issues of health and disease, but also economic, racial, and social inequality (at the local, national and international levels).

The broader goals of this course are: 1) ability to integrate history with other disciplines, including biology, epidemiology, public health, and sociology

 2) improvement in written and oral communication 3) ability to conceptualize research questions and to find the relevant source materials 4) willingness to take ownership in how the class is taught and what we learn.

To the extent that students take ownership of the class and the learning process, I will gladly modify assignments. In this respect, you should think of this class as one that has the potential to take on the characteristics of an anarchist collective where responsibilities and rights are evenly distributed. See Murray Bookchin’s essay on Francisco Ferrer

A final warning: This is a history class and the workload includes a great deal of reading, writing, and research.  

Required Books

Jonathan Ablard, Madness in Buenos Aires: Patients, Psychiatrists, and the Argentine State, 1880-1983 (Ohio)

Tracy Kidder, Mountains beyond Mountains (Random House)  

Jeffrey Pilcher, Que Vivan los tamales! (UNM Press)

Cristina Rivera-Garza, No One Will See Me Cry (Curbstone)

 Shawn Smallman, The AIDS Pandemic in Latin America (North Carolina)  

Shawn William Miller, Environmental History of Latin America (Cambridge)

Films of Interest:

Motorcycle Diaries (life of Che Guevara, social medicine, health conditions)

Carandiru (AIDS, sexuality, prison populations, social medicine)

Man Facing Southeast (psychiatry, mental illness, political context of health care)

Pixote (child welfare, crime, social conditions)

Websites of Interest

American Journal of Public Health

Harvard World Health News

Johns Hopkins School of Public Health

Pan-American Health Organization

Centers for Disease Control and Prevention

Ithaca Health Alliance

Department of Human Ecology, Cornell U.

Johns Hopkins University School of Public Health

Columbia University School of Public Health

Steve Volk, Oberlin College, Latin American History Website

History of Science in Latin America and the Caribbean


Tracy Kidder’s Mountains Beyond Mountains (10%)  (3 pages)

According to Kidder’s account of the life and work of Dr. Paul Farmer what are the principle causes, consequences, and possible solutions to global health inequalities? This essay should be concise and devoid of unnecessary retelling of Farmer’s story. Write as if you are providing essential notes to a future international public health worker. Three pages.

In-class Essay on Colonial Era (10%)

Rivera-Garza, No One Will See Me Cry  (20%) (4 pages)

Your essay on this book will ask you to consider how Rivera-Garza addresses the major themes covered in the course to date. I will distribute the question no later than the beginning of Week Six. This essay serves as the course mid-term examination.

Cold War and Health Essay (2 pages) (10%)

In what ways did the ideological ferment and conflicts of the Cold War era shape public health? Did these ideological conflicts have a deeper impact on health care than earlier political and social positions? Why?

Research Project (30%) (Parts A. and B. below)    

The capstone assignment of the course is a research project. The project is divided into two parts, a group project and individual research papers (10 pages). The class will be divided into research teams that will investigate topics assigned by the instructor. As a team, you will conduct a preliminary research of the topic and then divide the topic into discrete research projects.

  1. Group Presentation (5%)

Grade for the assignment will be based on the quality of the group presentation. Students who do not work well with the group may be removed from the group and asked to do an individual project. For the presentation, all students must be active participants.

The following is the list of possible topics. If your group is assigned a topic but you wish to pursue another issue, you may petition me to change it.

1.         How does immigration to the United States effect the health of Mexicans residing in both the United States and Mexico?

2.         What factors have contributed to the rising rates of obesity in parts of Latin America? What explains the different rates of increase in the past 20 years?

3.         In what ways are drug consumption and drug trafficking public health concerns for Latin America? How, why, and when did the region transition from being a supplier of illegal drugs to a consumer region?

4.         As Shawn Miller demonstrates, awareness of environmental problems has developed over the past two decades in Latin America. What are some of the major environmental challenges facing the region? How do they relate to issues of health and disease? How have civic organizations and states grappled with these problems?


B. Individual Research (25%)

I will base your grade upon the strength of your thesis, the clarity of your writing and the depth and breadth of the sources that you use. (Effort, time expended, and frequent meetings with me will not have any impact on your grade). As a general rule, the only acceptable internet sources are those that are accessed via Ithaca College Library’s website. These include such sites as The New York Times, J-Stor, Project MUSE, Current History, etc. There are also useful internet sources that are connected with major research libraries. Two most important of these are the Handbook on Latin American Studies which is housed at the Library of Congress and the Hispanic American Periodical Index.I absolutely forbid students in this class to use Wikipedia or any other encyclopedia or web-based resource (including blogs, personal web-pages, etc.) which is not connected to a certifiable university or government agency (including the governments of Latin America, the United States, etc.). If you are not clear about an electronic source (and I would err on the side of caution), speak with me first. Failure to follow these guidelines will result in a failing grade on the final paper.

The final product must include the following:

Title, author, date at top of the 1st page (No title pages or covers)

Paper Abstract: one paragraph synopsis of your argument.

Footnotes (Chicago or Turabian)

Bibliography (Chicago or Turabian)

Numbered pages (8-10 pages)

Six scholarly secondary sources

Students will submit a proposal and bibliography on March 23rd. This document should frame the scope and direction of your project. Failure to hand this in, and to receive my comments on your project, will make it difficult to receive a passing grade on the final project.

In addition to writing the paper, each student will provide a brief presentation of their individual research project. Dates and details of the presentation will be provided later in the semester.

FINAL ESSAY (Take Home) (10%)

The final essay will ask you to assess the historical changes that have occurred in terms of health and disease during the course of the twentieth century. The following is an example of the kind of question you can expect:

Participation (10%): For full credit, students must demonstrate a consistent and substantial understanding of course material during class discussions. Participation will only count if it is informed by course materials.


  1. Students who miss more than two weeks of class will be dropped from the roll unless you have a valid excuse in writing from a doctors, judge, or academic adviser.
  2. Papers must be handed in during class on the date indicated.
  3. This course follows the Ithaca College policy on Academic Honesty. Students found to be in violation of this policy will be expelled from the class, will receive a failing grade and will have their name reported to the appropriate college authorities. The policy reads as follows: “Academic honesty is a cornerstone of the mission of the College. Unless it is otherwise stipulated, students may submit for evaluation only that work that is their own and that is submitted originally for a specific course. According to traditions of higher education, forms of conduct that will be considered evidence of academic misconduct include but are not limited to the following: conversations between students during an examination; reviewing, without authorization, material during an examination (e.g., personal notes, another student's exam); unauthorized collaboration; submission of a paper also submitted for credit in another course; reference to written material related to the course brought into an examination room during a closed-book, written examination; and submission without proper acknowledgment of work that is based partially or entirely on the ideas or writings of others. Only when a faculty member gives prior approval for such actions can they be acceptable.”

-Article 7.1.4. Ithaca College Policy Manual

4. Students and faculty will treat each with respect and collegiality in the classroom. Cell phones and any other electronic devices must be put away before coming to class. Do not bring food to class unless you have enough for everyone. I reserve the right to confiscate and redistribute any foodstuffs that come into my classroom.


Week One

            1/26     Course Introduction

            How and why historians study disease and health? (Lecture)

Contemporary Health Issues in Latin America (Lecture)

Recommended: Gert H. Brieger, “Bodies and Borders: a new cultural history,” Perspectives in Biology and Medicine 47:3 (Summer 2004): 402-21. (Project MUSE) and Planting a Seed: Autonomous health in Chiapas (film)

1/28     Tracey Kidder, Mountain over Mountain, Parts 1-3

Week Two

            2/2       Tracey Kidder, Mountain over Mountain, Parts 4-5

                        Kidder Essay Due in Class

            2/4       Pre-Columbian Health

                        Miller, Ch. 1; Pilcher, 1

Week Three: Colonial Latin America

            2/9       Conquests and Pandemics  

                        Miller, Ch. 2; Pilcher, 2

            2/11     Health and welfare in the Colonial Era

Miller, Ch. 3 & Louis Perez, To Die in Cuba: Suicide and Society (In reader)

Recommended: Carlos Viesca Treviño, “Curandismo in Mexico and Guatemala: Its Historical Evolution from the Sixteenth to the Nineteenth Century” in Mesoamerican Healers; Silvia Marina Arrom, Containing the Poor: The Mexico City Poorhouse; Sherry Fields, Pestilence and Head Colds: Encountering Illness in Colonial Mexico @ and William Taylor “Drinking” in Homicide and Rebellion in Colonial Mexican Villages (In reader);Karol Kovalovich Weaver, “The Enslaved Healers of Eighteenth-Century Saint Domingue,” Bulletin of the History of Medicine (2002) (Project MUSE)

Week Four :Independence and the Early Republics

2/ 16    Take Home Essay on Colonial Era due by 4pm (Class does not meet)

2/18     Joao Jose Reis, “Death to the Cemetery: Funerary Reform and Rebellion in Salvador, Brazil, 1836,” in Arrom and Ortoll, Riots in the Cities: Popular Politics and the Urban Poor in Latin America, 1765-1910 (SR Books, 1996) (In reader) & Sidney Chalhoub, “The Politics of Disease Control: Yellow Fever and Race in Nineteenth Century Rio de Janeiro,” JLAS (1993). (JSTOR)

Recommended: Martina Will, Death and Dying in New Mexico (University of New Mexico Press) Sandra Lauderdale Graham, “Contagion and Control,” in House and Street: The Domestic World of Servants and Masters in Nineteenth Century Rio de Janiero (Texas)  ; Greg Grandin, “A Pestilent Nationalism: The 1837 Cholera Epidemic Reconsidered” in The Blood of Guatemala (Duke, 2000); Donald B. Cooper, “The New ‘Black Death’: Cholera in Brazil, 1855-1856,” Social Science History 10:4 (Winter 1986): 467-88. (J-Stor)

Week Five:  

             2/23    The Idea and the Reality of Sickness and Health

Miller, Ch. 4; Pilcher, Chapter 3

 2/25    Ablard, Chapters 1-2  

Week Six:

            3/2       Ablard, Chapters 3-5

Recommended: Dain Borges, “’Puffy, Ugly, Slothful and Inert’: Degeneration in Brazilian Social Thought, 1880-1940,” JLAS (1993) (JSTOR) and Eduardo Zimmermann, “Racial Ideas and Social Reform: Argentina, 1890-1916,” Hispanic American Historical Review 72:1 (1992): 23-46 (JSTOR) Ana Maria G. Raimundo Oda, Claudio Eduardo M. Banzato, and Paulo Dalgalorrondo, “Some origins of cross-cultural psychiatry,” History of Psychiatry 16:2 (2005): 155-69; Ann Zulawski, “Mental Illness and Democracy in Bolivia: The Manicomio Pacheco, 1935-1950,” in Diego Armus, editor Disease in the History of Latin America ; Porter and Wright, The Confinement of the Insane (Cambridge) See also:Case Histories from the History of Psychiatry

            3/4       Prostitution, Syphilis, and Public Health

David McCreery, “’This life of misery and shame:’ female prostitution in Guatemala City, 1880-1920,” JLAS (November 1986) (JSTOR)

Recommended: Katherine Bliss, “The Science of Redemption: Syphilis, Sexual Promiscuity, and Reformism in Revolutionary Mexico City,” Hispanic American Historical Review 79:1 (February 1999) (JSTOR);; Donna Guy, “White Slavery, Public Health, and the Socialist Position on Legalized Prostitution in Argentina, 1913-1936,” Latin American Research Review 23:3 (1988): 60-80. (JSTOR); Jorge Salessi, “The Argentine Dissemination of Homosexuality, 1890-1914,” Journal of the History of Sexuality (1994) (JSTOR); Donna Guy, “Medical Imperialism Gone Awry: The Campaign Against Legalized Prostitution in Latin America,” in Meade and Walker, editors. Science, Medicine and Cultural Imperialism (St. Martin’s Press); League of Nation: Report of the Special Body of Experts on Traffic in Women and Children 

Week Seven:  Degeneration

            3/9       Rivera-Garza, No One Will See Me Cry

            3/11     Rivera-Garza, No One Will See Me Cry

Rivera-Garza Essay Due in Class

* Note: this is your mid-term essay

Week Eight

3/16-18            SPRING BREAK

Week Nine:  International Health

            3/23     Pan-American Sanitary Bureau and the Rockefeller Foundation

Alexandra Minna Stern, “Buildings, Boundaries, and Blood: Medicalization and Nation-Building on the U.S.-Mexico Border, 1910-1930,” Hispanic American Historical Review 79:1 (February 1999). (JSTOR)

Paper Proposal and Bibliography is Due

            Recommended: Ann Zulawski, Unequal Cures: Public Health and Political Change in Bolivia, 1900-1950 (Duke); Marcos Cueto, The Return of Epidemics: Health and Society in Peru during the Twentieth Century (Ashgate); Glen David Kuecher, “Public Health, Yellow Fever, and the Making of Modern Tampico,” Urban History Review 36:2 (Spring 2008).

3/25     Nationalism, Health, and Nutrition

                        Pilcher, Chapters 4             

Week Ten:

3/30     Children, Health and Medicine

            Robert M. Levine, "Pixote: Fiction and Reality in Brazilian Life," in Based on a True Story: Latin American History at the Movies.


Anne-Emanuelle Birn, “Child health in Latin America: historiographic perspectives and challenges,” História, Ciencias, Saúde-Manguinhos 14:3 (July-September 2007): 677-708. (On-line)

                    Pixote (film)

            4/1       Motorcycle Diaries (film) & Carandiru

Week Eleven:  Social Medicine

            4/6       Marcos Cueto, “Social Medicine and ‘Leprosy’ in the Peruvian Amazon,” The Americas 61:1 (July 2004): 55-80. (Project MUSE) & Salvador Allende, “Chile’s Medical-Social Reality” (1939) (In Reader)

            4/8       Cold War: Reform and/or Revolution?

                        Latin America, 1945-89

Week Twelve:

            4/13     James McGuire and Laura B. Frankel, “Mortality Decline in Cuba, 1900-1959: Patterns, Comparisons, and Causes,” Latin American Research Review (2005) (Project MUSE)

            4/15     Howard Waitzkin, “Health Policy and Social Change: A Comparative History of Chile and Cuba,” Social Problems 31:2 (December 1983) (JStor) &   

Recommended: Candace Johnson, “Health as Culture and Nationalism in Cuba,” Canadian Journal of Latin American and Caribbean Studies 31:61 (2006): 91-113

Week Thirteen: Cold War: Reaction

             *         Students should watch Carandiru during this week. On reserve at Library.

             4/20    Vicente Navarro, “What Does Chile Mean: An Analysis of Events in the Health Sector Before, During, and After Allende’s Administration,” Millbank Memorial Fund 52:2 (1974): 93-130. (J-Stor) & Ablard, Ch. 6, 7

                        Cold War and Health Essay Due

            4/22     Student Presentations

Week Fourteen

4/27     Student Presentations

            4/29     Smallman, The AIDS Pandemic in Latin America, Chapters 1-2

Recommended: Carandiru (film)

Week Fifteen

5/4                   Smallman, The AIDS Pandemic in Latin America, Chapters 3  

Recommended: Marcos Cueto, “Stigma and Blame during an Epidemic: Cholera in Peru, 1991” in From Malaria to AIDS & Charles Briggs and Clara Mantini-Briggs, Stories in the Time of Cholera: Racial Profiling during a Medical Nightmare (University of California Press, 2003); Paul Farmer, The Uses of Haiti (Common Courage)

 5/6      Miller, Chapters 6-7

Research Paper & Final Essay Due on May 11th BEFORE 7pm