December 2003, Vol 93, No. 12 | American Journal of Public Health 2011
© 2003 American Public Health Association
Public Health in Central America
Elizabeth Fee,
Marcos Cueto and
Roxanne Beatty
Elizabeth Fee and Roxanne Beatty are with the History of Medicine Division, National Library of Medicine, National Institutes of Health, Bethesda, Md. Marcos Cueto is with the Universidad Peruana Cayetano Heredia, Lima, Peru.
Correspondence: Requests for reprints should be sent to Elizabeth Fee, PhD, Building 38, Room 1E21, 8600 Rockville Pike, Bethesda, MD 20894 (e-mail: elizabeth_fee{at}nlm.nih.gov).
IN LATIN AMERICA, THERE HAS long been a running debate over the relative effectiveness of "vertical" rather than "horizontal" programs in public health. In the 1950s, when this photograph was taken, the Pan American Sanitary Bureau (forerunner of the Pan American Health Organization, or PAHO) was engaged in vertical malaria, yaws, and smallpox eradication campaigns under the direction of Fred L. Soper, a former Rockefeller Foundation officer, who directed the Bureau from 1947 to 1959.1
| |
Courtesy of National Library of Medicine, Bethesda, Md.
Source. Fred L. Soper Papers, History of Medicine Division, National Library of Medicine.
|
|
This image from the Soper archives provides evidence that, despite the predominant emphasis on technical interventions that characterized the disease eradication campaigns, there was also another approach to public health. Here, a visiting nurse from the Institute of Nutrition in Magdalena, Guatemala, is examining a child suffering from a scalp infection. In the 1950s, visiting nurses working in shantytowns and rural areas were a new development in Central American public health. The institute organized some of the first community-based health programs that would later become a central aspect of horizontal primary health care programs in the 1970s and 1980s.
The Pan American Sanitary Bureau and the ministers of health of Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, and Panama first decided to create the Institute of Nutrition in 1946 and then formally inaugurated it in September 1949. The institute conducted pioneering clinical and epidemiological studies and interventions aimed at identifying and correcting dietary deficiencies in Central America, and it developed some of the first studies on the chemical composition of foods used by the population.
Early on, the institute viewed undernutrition as a major health problem—closely associated with poverty—that was responsible for retarding the growth of children and making them vulnerable to infectious diseases. The institute emphasized the value of vitamin supplements in correcting some of these problems. Today, the institute is known as the Instituto de Nutritión de Centro América y Panamá (INCAP) and serves as a PAHO/World Health Organization (WHO) Regional Center, with field offices in all the Central American countries, including Belize.2
 |
References
|
|---|
1. The Fred L. Soper Papers. Available at: http://profiles.nlm.nih.gov/VV. Accessed May 16, 2003.
2. Instituto de Nutritión de Centro América y Panamá. Available at: http://www.incap.org.gt. Accessed May 16, 2003.
Copyright © 2003 by the American Public Health Association
TOP
References
