Disease and Democracy: The Nineteenth-Century Cholera Epidemics of Tucumán and the Formation of the Argentine National Health Care System

Disease and Democracy: The Nineteenth-Century Cholera Epidemics of Tucumán and the Formation of the Argentine National Health Care System.

This paper uses the cholera epidemic of the nineteenth century as a prism through which to analyze the interaction between provincial and national governments and the institutionalization of information as a means of integrating regions. Argentine scholarship has rarely dealt with the cholera epidemics of the nineteenth-century and most medical histories focus on Buenos Aires as the site of Argentina’s historical development. I break off from this tradition and focus on the actions of provincial governments during the epidemics and their interactions with the national government entities. In Tucumán, a northwestern province of Argentina, health commissions were founded as early as the 1860s and functioned almost independently from the National Department of Hygiene (NDH) based in Buenos Aires. A study of the health commissions of Tucumán presents what essentially was a federalized national health system before the concept even existed. Although the health commissions interacted with the NDH, the provincial governments practiced public health initiatives in response to immediate local needs. An analysis of governmental, administrative, and hospital records demonstrates that regional integration was not a unilateral process initiated out of Buenos Aires, and instead presents a vibrant bilateral relationship between province and central government. This paper argues that this political interaction and the information and responsibility patterns it established created a system/structure that would eventually lead to the foundation of the Ministry of Public Health in 1949. The role of disease and public health offers a new avenue in which to engage broader issues of the exercise of governance, political consolidation and health policy.