Nationalizing Transnational Health Initiatives: Hybrid Health Care in 20th-Century Guatemala

The influence of its European and U.S. progenitors notwithstanding, transnational humanitarianism often reflected the national race, gender, and class relations where it was implemented. Interpreted through the lens of their ideas about science and distinct approaches to public health in their countries, Guatemalan medical professionals’ approaches to health care offer a window into the ways Latin Americans applied transnational humanitarian overtures. During the first half of the twentieth century, Guatemalan authorities’ strategies ranged from improving hygiene (particularly among the poor and indigenous people) and compelling midwives to undergo formal training to deploying eugenics and instituting measures to reduce syphilis, tuberculosis, and malaria. Revealing the ambiguity that marked many transnational influences, as much as elites and officials deployed and distorted biomedicine to support national goals, at times local indigenous approaches to health care shaped the thinking of medical professions and biomedical health care in the nation more broadly.

Because transnational humanitarian approaches to public health generally ignored or discounted indigenous health care practices and knowledge, such programs often resulted in increased persecution of traditional healers. By first redefining curanderismo and brujeria (charlatanism and witchcraft respectively) and then criminalizing their practitioners for putting patients at risk by not adhering to biomedicine, authorities marginalized the broad range of services provided by empirical health care practitioners, effectively reducing health care options for large swaths of the population. Intended to protect people from illness, hygiene and sanitation campaigns too often did quite the opposite. Suggesting transnational humanitarian efforts often did little to address the underlying structural conditions such as poverty, racism, and sexism that undermined many Guatemalans’ well being, improved public health in some areas contrasted starkly with anemic responses in others that exacerbated the vulnerability of already disenfranchised populations.