Promoting Health: Rural Nurses and Indigenous Authorities in 20th-Century Oaxaca, Mexico

In the 1940s, visiting nurses traveled across rural Oaxaca to provide health services for those that lived far from the state’s capital. They staffed rural clinics, completed hygiene inspections in the markets, and traveled from town to town to vaccinate children in their own homes. Scholars have examined how medical auxiliaries like visiting nurses supported the expansion of rural health initiatives in the mid-twentieth century. However, these studies often portray auxiliaries as extensions of colonial or federal power and key collectors of public health surveillance. This paper complicates those portrayals by examining how visiting nurses negotiated with indigenous residents, municipal authorities, and higher-up health officials to adapt methods and practices to local circumstances.

As they completed their work, visiting nurses relied on topiles (town constables) and municipal presidents to legitimize their presence and guide their movement within villages. Depending on the situation, nurses employed varying strategies to assert their authority when their age, gender, single and outsider status would normally preclude them from doing so. To examine these strategies and daily negotiations, I use individual case studies from the Mixteca Alta to center the work of nurses and local guides. The main sources for this paper include nurse’s correspondence as the encargadas (heads) of rural clinics, papers from municipal presidents, complaints against nurses sent from local residents, and receipts for travel reimbursement from municipal and state archives.