Appropriating Foreign Assistance for Political Gains: Public Health in the Dominican Republic, 1945–55

Starting in 1945, with the purported goal of improving the Dominican health system, the Institute of Inter American Affairs, the Rockefeller Foundation, the Pan American Sanitary Bureau (among other international organizations) launched eradication campaigns, equipped laboratories and dispensaries, trained cadres of new health technicians, and implemented sanitary engineering projects. The newly emerging international health cooperation was designed to promote the Cold War agenda through “the development of modernization schemes directed at preventing the emergence of social movements and communism,” in the words of historian Marcos Cueto. 

The Trujillo dictatorship eagerly dedicated financial and human resources to complement these foreign interventions into local health matters. An incentive for the regime to devote so much attention to the health sector was a pressing – albeit cosmetic – need to meet new international standards. But also –  through expansion of health and social assistance systems – President Trujillo consolidated his patronage networks and increased popular support. Trujillo’s priorities for control over the population and permanence as supreme head of the state superseded all other considerations at the national level – a situation created and reinforced by the untrammeled approval he received from Washington for his role in the U.S.’s global Cold War strategy.

President Trujillo’s use of assistance from highly visible organizations to legitimize his power transformed aid into a means to stymie local demands for reform. “Modern” and highly technical solutions to endemic health problems translated into a strengthening of the state apparatus and an expansion of its capacities to reach even the most isolated regions of the country. The incomplete and perfunctory implementation of the health projects effectively subverted key international humanitarian objectives, displacing social priorities in favor of superficial modernization and political propaganda for the Trujillo regime.