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História, Ciências, Saúde-Manguinhos

Print version ISSN 0104-5970On-line version ISSN 1678-4758

Hist. cienc. saude-Manguinhos vol.27 no.4 Rio de Janeiro Oct./Dec. 2020  Epub Dec 18, 2020

http://dx.doi.org/10.1590/s0104-59702020000500001 

EDITOR’S NOTE

Historians and epidemics in Latin America

iScience editor, Researcher, Casa de Oswaldo Cruz/Fiocruz. Rio de Janeiro – RJ – Brazil


Over the past few decades, historians of medicine working on Latin America have studied rich and complex epidemic events ( Cook, 1981 ). These investigations have transitioned from a focus on the demographic impacts of epidemics, especially during the European conquest, to research on social, political, cultural and public health themes ( Cooper, 1980 ). Most historical investigations of the nineteenth and twentieth centuries deemphasized demography, with some remarkable exceptions, such as studies on the notorious influenza epidemic of 1918 that caused large numbers of deaths all over the world (Porras, Davis, 2014). Epidemics have provided a lens to learn about social disparities and what physicians, indigenous healers, nurses, quacks, and activists think about the body, health, and disease (Cueto, Palmer, 2015; Cueto, 2020 ). In recent years, research on epidemics has shed light on changes and continuity in the collection of epidemiological data, the emergence of master narratives on health and development, and responses to social anxieties and moral panic. Historians of epidemics have also examined how public health and medicine relate to changing meanings of civil liberties, like defending the healthy by isolating the sick in quarantines and lazarettos and protecting those who live with disease. The recurrence of epidemics has also demonstrated the low priority placed on prevention by governments that have resigned themselves to living with imminent disaster. Beyond Latin America, analyses of epidemics have inspired theoretical models on how historians should study disease (Rosenberg, Golden, 1992) and also generated new models. The complex intertwining of society and nature is magnified in times of distress, a notion dear to the promising field of planetary health that interconnects environmental and health historians (Dunk, Anderson, 2020).

More recently, professional historians have responded to frequent requests for comment on the covid-19 epidemic from newspapers, webcasts, blogs, and special events (Campos, Perdiguero-Gil, Bueno, 2020). In doing so, they have established a rich dialog with new audiences, avoiding hasty comparisons while providing nuanced interpretations. Professional historians have put events into context, applied archival evidence that has been collected for years, referred to previous historical studies, and cautioned against predictions involving apocalyptic or paradisaical futures in the post-pandemic world. Historians have another advantage: they can speak truth to power, unlike government medical officers who have to navigate between their loyalty to knowledge and their obligations to the authorities.

Some issues discussed by historians reappear with the emergence of covid-19: social inequalities, stigma, neoliberalism, and magic bullets. The coronavirus clearly reveals the poverty of health systems under attack by neoliberalism, as well as the vulnerability of the poor. Latin Americans living in crowded shantytowns could never implement European recommendations for social distancing, for example, but nearly all the governments in the region dismissed this vulnerability and made insufficient contributions to their own health systems, which themselves were undermined by years of structural adjustment programs dictated by the International Monetary Fund.

Still, historians can signal that sabotage of health systems and indifference to social disparities are not the only factors aggravating the epidemic. The coronavirus pandemic also highlights the insufficiency of social programs to reduce poverty, which were launched at the turn of the twenty-first century by center and center-left governments in Latin America who believed that these programs could coexist with neoliberal economic policies. Neoliberalism advanced more rapidly, and together with science denialists and conservative evangelicals multiplied poverty, blame, and disease. The alliance between neoliberals and evangelicals in many Latin American countries is behind a key explanation for disease-related disasters: an obsession with blaming the victims. First, neoliberalism blames the poor for their misery and sickness in order to validate the social order where only a few enjoy the world’s wealth; similarly, evangelicals blame sinners (usually their followers in shantytowns) for their dissolute lifestyles and disregard for traditional family values. According to this rationale, the poor are responsible for their misery, the sick for their illness, and sinners for crime. The unjust social order carries no guilt in these explanations, which are instrumental to a potential full return of neoliberalism spearheaded by fragmented competition for vaccines. This competition evokes another topic which has been examined by Latin American historians: magic bullets. Quick technological fixes like today’s chloroquine and vaccines have been tried in the past to contain epidemics without changing the living conditions of the poor.

The articles in this issue of História, Ciências, Saúde – Manguinhos remind us of how valuable historical research is to understand the past and the present. One I would like to highlight is the study by Soraya Lodola and Cristina de Campos, on the reorganization of São Paulo’s Health Service in the early twentieth century to control trachoma. This remarkable study deals with themes analyzed by historians of epidemics, such as diseases among the poor, the centralization of health responses, and efforts to fight diseases in both urban and rural areas.

I also would like to inform readers of an ongoing development at História, Ciências, Saúde – Manguinhos: new, clear instructions for authors, which will be published during the first half of 2021. Some of the new topics of these instructions are related to open science and include the acceptance of “preprint” manuscripts, namely final complete drafts that have appeared on respected platforms like SciELO Preprints.

I truly hope that this issue, and the conviction that history is a fundamental tool for understanding society, will inspire some hope in these difficult times.

REFERÊNCIAS

CAMPOS, Ricardo; PERDIGUERO-GIL; Enrique, BUENO, Eduardo (Ed.). Cuarenta historias para una cuarentena: reflexiones históricas sobre epidemias y salud global. Madrid: Sociedad Española de Historia de la Medicina. 2020. [ Links ]

COOK, Noble David. Demographic collapse: Indian Peru, 1520-1620. New York: Cambridge University Press. 1981. [ Links ]

COOPER, Donald. Las epidemias en la ciudad de México, 1761-1813. Ciudad de México: Instituto Mexicano del Seguro Social. 1980. [ Links ]

CUETO, Marcos. El regreso de las epidemias: salud y sociedad en el Perú del siglo XX. [EPub]. Lima: Instituto de Estudios Peruanos. 2020. [ Links ]

CUETO, Marcos; PALMER, Steven. Medicine and public health in Latin America. New York: Cambridge University Press. 2015. [ Links ]

DUNK, James; ANDERSON, Warwick. Assembling planetary health: histories of the future. In: Myers, Samuel; Frumkin, Howard (Ed.). Planetary health: protecting nature to protect ourselves. Washington: Island Press. p.17-35. 2020. [ Links ]

PORRAS, María Isabel; DAVIS, Ryan (Ed.). The Spanish influenza pandemic of 1918-1919: perspectives from the Iberian Peninsula and the Americas. Rochester: University of Rochester Press. 2014. [ Links ]

ROSENBERG, Charles; GOLDEN, Janet L. (Ed.). Framing disease: studies in cultural history. New Brunswick: Rutgers University Press. 1992. [ Links ]

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