Peripheral Nerve HEALTH AND MEDICINE IN COLD WAR LATIN AMERICA Anne-Emanuelle Birn and Raúl Necochea López, editors AMERICAN ENCOUNTERS/GLOBAL INTERACTIONS A Series edited by Gilbert M. Joseph and Penny Von Eschen The series aims to stimulate critical perspectives and fresh interpretive frameworks for scholarship on the history of the imposing global presence of the United States. Its pri- mary concerns include the deployment and contestation of power, the construction and deconstruction of cultural and po liti cal borders, the fl uid meaning of intercultural encoun- ters, and the complex interplay between the global and the local. American Encounters seeks to strengthen dialogue and collaboration between historian of U.S. international relations and area studies specialists. The series encourages scholarship based on multi- archive historical research. At the same time, it supports a recognition of the repre sen ta tional character of all stories about the past and promotes critical inquiry into issues of subjectivity and narrative. In the pro cess, American En- counters strives to understand the context in which mean- ings related to nations, cultures, and po liti cal economy are continually produced, challenged, and reshaped. Peripheral Nerve HEALTH AND MEDICINE IN COLD WAR LATIN AMER ICA Anne- Emanuelle Birn and Raúl Necochea López DUKE UNIVERSITY PRESS DURHAM AND LONDON 2020 © 2020 Duke University Press All rights reserved Printed in the United States of Amer i ca on acid- free paper ∞ Designed by Drew Sisk Typeset in Portrait Text, Folio, and Rockwell by Westchester Publishing Services Library of Congress Cataloging- in- Publication Data Names: Birn, Anne- Emanuelle, [date]. | Necochea López, Raúl, editor. Title: Peripheral nerve : health and medicine in cold war Latin Amer i ca / Anne- Emanuelle Birn and Raúl Necochea López. Other titles: American encounters/global interactions. Description: Durham : Duke University Press, 2020. | Series: American encounters/global interactions | Includes bibliographical references and index. Identifiers: lccn 2019050692 (print) | lccn 2019050693 (ebook) | isbn 9781478008682 (hardcover) | isbn 9781478009566 (paperback) | isbn 9781478012221 (ebook) Subjects: lcsh: Public health— Political aspects— Latin Amer i ca— History. | Medical policy— Latin Amer i ca— History. | Cold War— Social aspects— Latin Amer i ca. | Latin Amer i ca— Foreign relations— Soviet Union. | Soviet Union— Foreign relations— Latin Amer i ca. | Latin Amer i ca— Foreign relations— United States. | United States— Foreign relations— Latin Amer i ca. Classification: lcc ra395.l3 p47 2020 (print) | lcc ra395.l3 (ebook) | ddc 362.1098— dc23 lc rec ord available at https:// lccn . loc . gov / 2019050692 lc ebook rec ord available at https:// lccn . loc . gov / 2019050693 Cover art: Illustration and design by Drew Sisk. aeb To my beloved father, Richard, and cherished father- in- law, Leonid Pavlovich, who, having spent their lives and careers on “opposite” sides of the Cold War, never met but shared a love of lit er a ture and infused it in their progeny. rnl This book is as old as my lively children, Tomás and Ansel, and half as old as my unfolding story with the amazing Erica Wood. This is for the three of them. CONTENTS FOREWORD ix Part I Gilbert M. Joseph Leftist Affinities and U.S. Suspicions ACKNOWL EDGMENTS xix 1 ­Under Surveillance: Public INTRODUCTION Alternative Destinies Health, the FBI, and Exile and Solidarities for Health in Cold War Mexico 31 and Medicine in Latin Ameri ca Katherine E. Bliss before and during the Cold War 1 2 National Politics and Scientific Anne- Emanuelle Birn Pursuits: Medical Education and the Strategic Value of Science in Postrevolutionary Bolivia 55 Nicole L. Pacino 3 Cold War Mexico in a Time of “Won der Drugs” 86 Gabriela Soto Laveaga Part II Part III Health Experts/Expertise Health Politics and Publics, with and Contested Ideologies and without the Cold War 4 The Puerto Rico Family Life 7 From Cold War Pressures to Study and the Cold War Politics State Policy to People’s Health: of Fertility Surveys 109 Social Medicine and Socialized Raúl Necochea López Medical Care in Chile 187 Jadwiga E. Pieper Mooney 5 Parasitology and Communism: Public Health 8 “Psychotherapy of the and Politics in Samuel Barnsley Oppressed”: Anti- Imperialism Pessoa’s Brazil 132 and Psychoanalysis in Cold War Gilberto Hochman and Buenos Aires 211 Carlos Henrique Assunção Paiva Marco Ramos 6 Revolutionizing Cuban 9 South– South Cooperation Psychiatry: The Freud Wars, as a Cold War Tonic: Cuban 1955–1970 158 Medical Diplomacy to Sandinista Jennifer Lynn Lambe Nicaragua, 1979–1990 241 Cheasty Anderson EPILOGUE A Lingering Cold (War)? Reflections for the Pre sent and an Agenda for Further Research 267 Anne- Emanuelle Birn and Raúl Necochea López BIBLIOGRAPHY 295 CONTRIBUTORS 343 INDEX 347 FOREWORD GILBERT M. JOSEPH Farnam Professor of History and International Studies, Yale University The last twenty years have witnessed nothing less than the remaking of Latin American Cold War history, as the field has burgeoned into a veritable growth industry. For de cades, study of the region’s postwar conflict was dominated by mainstream diplomatic and foreign relations historians who conceived of it largely in bipolar terms and were preoccupied with grand strategy and U.S. policy and sources. Since about 2000, however, scholarship has been signifi- cantly re oriented by Latin Americanists who, without marginalizing interna- tional conflicts and rivalries, have more often approached the Cold War from the inside out— and often “from below.” In the pro cess they have begun to flesh out a distinctive Latin American Cold War, rather than merely studying the dynamics and collateral damage of superpower rivalry in a peripheral region. These scholars speak the region’s languages and read voraciously across dis- ciplines, employing tools and concepts from area studies, politi cal and social history, anthropology, po liti cal science, cultural studies, and studies of tech- nology, health, and medicine. They seek out (and work to declassify) new ar- chival sources as well as pose new questions to older documentary collections. In part owing to more productive conversations with mainstream diplomatic historians and foreign relations scholars, more ambitious transnational and transregional analyses have emerged, steeped in multisited archival and oral history research strategies. Since the early 2000s, bolstered by the creation of new international research clusters, the organization of numerous conferences and symposia, and a series of collective volumes and special journal issues, a new self- identified generation of historians and international relations schol- ars with a penchant for “border crossings” has reshaped Latin American Cold War studies. Anne- Emanuelle Birn’s and Raúl Necochea López’s Peripheral Nerve: Health and Medicine in Cold War Latin Ameri ca constitutes a signal contri- bution to this new watershed of scholarship. As the book’s title cleverly indicates, while Latin American countries ambiguously resided on the periphery and semiperiphery of Cold War– era theoretical imaginings, they invariably exhibited nerve, whether via quiet audacity or full- blown impudence. Such nerve also meant that Latin Ameri - ca’s Cold War was rarely cold. Indeed, few periods in the region’s history were as violent, turbulent, or transformative as the half century that ran roughly from the end of World War II through the early 1990s. One would have to go back to the early nineteenth- century wars of in de pen dence to find the same level of mass mobilization, revolutionary upheaval, and counterrevolutionary repression. Yet the international connections, orga nizational capacities, and technologies of death and surveillance at work in the late twentieth- century Cold War render that earlier cycle of vio lence almost quaint by comparison. Latin Amer i ca’s late great novelist Gabriel García Márquez graphically evoked this “outsized” and “unbridled reality” in his 1982 Nobel accep tance speech. Conjuring up a litany of grisly and apocalyptic events— the dirty wars, disap- pearances, and displacements of the 1970s and early 1980s that had turned Central Amer i ca and South Ameri ca’s Southern Cone into killing fields and barrios—he told his Nobel audience that he had been obliged to develop a new literary genre, “magical realism,” to assimilate the period’s mind- boggling oc- currences and, as he put it, “render our lives believable.” How do we account for such cataclysmic vio lence? To be sure, Latin Amer i ca’s past has always been marked by alternating cycles of social reform and intense conservative reaction, in which the influence, aid, and interven- tion of imperial powers have figured prominently. Even so, the dynamics of the Latin American Cold War were embedded in a particularly ferocious dia- lectic linking reformist and revolutionary projects for social change and na- tional development, with the excessive counterrevolutionary responses they triggered, in the decades after World War II. This dialectic, which several of the contributors to Peripheral Nerve engrossingly document and which played out in intertwined domestic and international arenas of po liti cal, social, and cultural power, shaped Latin American life in the late twentieth century and, as the editors demonstrate in the epilogue, has “lingerings and echoes” in the new millennium. At a macro level, the Cold War was a strug­g le between two postwar “rookie” superpowers— the United States and the USSR— over shifting geopo liti cal stakes and ideological visions of how the world should be or ga nized. But what ultimately gave the Latin American Cold War its “heat” were the politicization and internationalization of everyday life. On a variety of fronts across several de cades, Latin American elites and newly expanded and empowered popular classes participated in local and national po liti cal contests over land, labor, the control of markets, the disposition of scientific, medical, and health resources, and what constituted citizenship x Foreword itself— contests that rarely escaped the power ful undertow of the larger su- perpower conflict.