Empire and the Politics of Health in Early 20th-Century Cuba

This paper examines the postcolonial politics of health in early twentieth-century Cuba. Between 1899 and 1902, the U.S. military government in Cuba instituted what historians have characterized as a colonial public health project on the island. But Cuban health officials and medical workers took advantage of American health concerns to assert their own priorities, in the process redefining the colonial public health agenda into nationalist medical project that would reverberate in the coming decades, as Cuba became the first country in the world to establish a Ministry of Health, and as physicians and patients joined forces to call for the socialization of the medical system as a way to meet the medical needs of the Cuban people and the labor needs of Cuban doctors. Unlike most histories of medicine, which tend to focus solely on elite medical discourses and practices, this paper examines how new ideas about medicine infused republican statecraft, facilitated the development of new healthcare institutions, and—most importantly—shaped the lives of Havana’s residents. In Cuba new conceptions of a social right to health emerged in the period of transition from colony to republic, as physicians, patients, and reformers demanded robust government investment in quality medical care for all Cubans. By examining a broad array of social actors, the paper highlights how new social rights are contested and developed at all levels of society before they are officially articulated in elite political discourse or in constitutional law. And by putting Cuba at the heart of emerging global discussions of social rights, it helps decenter Europe and North America as leading exponents of citizenship rights, and adds to a nascent body of scholarship that looks at how Latin America was a center for the articulation of new social rights in the twentieth century.