Water and the death of ambition in global health, c. 1970-1990 / A água e o fim da ambição na saúde global, c. 1970-1990

Abstract Economic development and good health depended on access to clean water and sanitation. Therefore, because economic development and good health depended on access to clean water and sanitation, beginning in the early 1970s the World Bank, the World Health Organization (WHO), and others began a period of sustained interest in developing both for the billions without either. During the 1980s, two massive and wildly ambitious projects showed what was possible. The International Drinking Water Supply and Sanitation Decade and the Blue Nile Health Project aimed for nothing less than the total overhaul of the way water was developed. This was, according to the WHO, "development in the spirit of social justice."

Resumo Crescimento econômico e boa saúde dependem de acesso a saneamento e água limpa. Assim, o Banco Mundial, a Organização Mundial da Saúde (OMS) e outros órgãos, a partir do início da década de 1970, inauguraram um período de contínuo interesse no desenvolvimento de ambos para bilhões de pessoas desprovidas de tais necessidades. Durante a década de 1980, dois projetos monumentais e extremamente ambiciosos demonstraram o que era viável fazer. A International Drinking Water Supply and Sanitation Decade e o Blue Nile Health Project visavam à total reestruturação do modelo de desenvolvimento da água. Tratava-se, segundo a OMS, do "desenvolvimento do espírito de justiça social".

Global health in the making: health demonstration areas in Europe, 1950s and 1960s / Construcción de la salud global: zonas de demostración sanitaria en Europa, décadas de 1950 y 1960

Abstract Global health is a multifaceted concept that entails the standardization of procedures in healthcare domains in accordance with a doctrine agreed upon by experts. This essay focus on the creation of health demonstration areas by the World Health Organisation (WHO) to establish core nodes for integrated state-of-the-art health services. It explores the origins, theoretical basis and aims of this technique and reviews several European experiences during the first 20 years of the WHO. Particular attention is paid to the historical importance of technical cooperative activities carried out by the WHO in regard to the implementation of health services, a long-term strategic move that contributed to the thematic upsurge of primary health care in the late 1970s.

Resumen Salud global es un concepto complejo que implica la normalización de los procedimientos de actuación sanitaria siguiendo una doctrina acordada por expertos. Este trabajo se ocupa del establecimiento de zonas de demostración sanitaria por la Organización Mundial de la Salud (OMS) a modo de núcleos de modernos servicios sanitarios integrados. Revisa el origen, las bases téoricas y los objetivos de esta técnica y examina diversas experiencias europeas durante los primeros veinte años de la OMS. Pone de manifiesto la importancia histórica de las actividades de cooperación técnica de la OMS en la puesta en marcha de servicios sanitarios, una estrategia de largo plazo que ayuda a entender la aparición de la atención primaria de salud a finales de la década de 1970.

The anti-cancer League and public outreach for cancer control in Peru / A liga Anticancerosa e a sensibilização pública ao controle do câncer na sociedade peruana

Abstract Peru's first cancer control public outreach scheme started in the 1910s, but ground to a standstill as it attained official governmental recognition in 1926 as the Liga Anti-Cancerosa (LAC). This paper explains the developments leading to that earliest effort to enlist a coalition of State health agencies, physicians, and lay people in a campaign to publicize early signs of this disease, as well as the medical and political reasons for and implications of its decline. Besides highlighting the importance of professional initiatives shaping cancer activism, contextualizing the rise and fall of the LAC calls attention to the effects that hospitalization of cancer treatment had on aspects of cancer care that were not directly treatment-related, such as public outreach.

Resumo O primeiro programa peruano de sensibilização pública para controle do câncer iniciou na década de 1910, mas arrefeceu quando reconhecido pelo governo como Liga Anticancerosa (LAC), em 1926. Este artigo aborda os avanços que conduziram aos pioneiros esforços de recrutamento de agências governamentais de saúde, médicos e leigos na divulgação sobre os primeiros sinais da doença, assim como as motivações políticas e médicas e as implicações de seu declínio. Além de assinalar a importância de iniciativas profissionais no ativismo na temática do câncer, a contextualização da ascensão e declínio da LAC chama a atenção para os reflexos da hospitalização no tratamento do câncer sobre aspectos indiretamente relacionados ao tratamento, como os esforços de sensibilização pública.

The role of the World Health Organization country programs in the development of virology in Spain, 1951-1975 / El papel desempeñado por los programas país de la Organización Mundial de la Salud en el desarrollo de la virología en España, 1951-1975

Abstract Within the framework of recent historiography about the role of the World Health Organization (WHO) in modernizing public health and the multifaceted concept of global health, this study addresses the impact of the WHO's "country programs" in Spain from the time it was admitted to this organization in 1951 to 1975. This research adopts a transnational historical perspective and emphasizes attention to the circulation of health knowledge, practices, and people, and focuses on the Spain-0001 and Spain-0025programs, their role in the development of virology in Spain, and the transformation of public health. Sources include historical archives (WHO, the Spanish National Health School), various WHO publications, the contemporary medical press, and a selection of the Spanish general press.

Resumen En el marco de la reciente historiografía sobre el papel de la Organización Mundial de la Salud (OMS) en la modernización de la salud pública y el concepto multifacético de salud global, se estudia el papel de los llamados "programas país" de la OMS en España desde su admisión en 1951 hasta 1975. Adoptando perspectiva histórica transnacional y enfatizando el estudio de la circulación de personas, conocimientos y prácticas científico-sanitarias, nuestro análisis se centra en los programas España-0001 y España-0025, en evaluar su papel en el desarrollo de la virología en España y en la transformación de la salud pública. Nuestras fuentes vienen de archivos históricos (OMS, Escuela Nacional de Sanidad), publicaciones de la OMS, revistas médicas contemporáneas, y una selección de prensa general española.

Debordering public health: the changing patterns of health border in modern Europe / Tirando as fronteiras da saúde pública: mudanças nos padrões de fronteira sanitária na Europa moderna

Abstract According to David Fidler, the governance of infectious diseases evolved from the mid-nineteenth to the twenty-first century as a series of institutional arrangements: the International Sanitary Regulations (non-interference and disease control at borders), the World Health Organization vertical programs (malaria and smallpox eradication campaigns), and a post-Westphalian regime standing beyond state-centrism and national interest. But can international public health be reduced to such a Westphalian image? We scrutinize three strategies that brought health borders into prominence: pre-empting weak states (eastern Mediterranean in the nineteenth century); preventing the spread of disease through nation-building (Macedonian public health system in the 1920s); and debordering the fight against epidemics (1920-1921 Russian-Polish war and the Warsaw 1922 Sanitary Conference).

Resumo Segundo David Fidler, a gestão de doenças infecciosas entre meados do século XIX e e o XXI guiou-se por uma série de acordos institucionais: Regulamento Sanitário Internacional (não interferência e controle de doenças em fronteiras), programas verticais da OMS (campanhas de erradicação da malária e varíola), e posicionamento pós-vestefaliano além do estado-centrismo e interesse nacional. Mas pode a saúde pública internacional ser reduzida à tal imagem vestefaliana? Examinamos três estratégias que destacaram as fronteiras sanitárias: prevenção em estados vulneráveis (Mediterrâneo oriental, século XIX); prevenção à disseminação de doenças via construção nacional (sistema público de saúde macedônico, anos 1920); remoção de fronteiras no combate às epidemias (guerra polaco-soviética, 1920-1921 e Conferência Sanitária de Varsóvia, 1922).

Historical epidemiology and global health history / Epidemiologia histórica e história global da saúde

Abstract The subdiscipline of historical epidemiology holds the promise of creating a more robust and more nuanced foundation for global public health decision-making by deepening the empirical record from which we draw lessons about past interventions. This essay draws upon historical epidemiological research on three global public health campaigns to illustrate this promise: the Rockefeller Foundation's efforts to control hookworm disease (1909-c.1930), the World Health Organization's pilot projects for malaria eradication in tropical Africa (1950s-1960s), and the international efforts to shut down the transmission of Ebola virus disease during outbreaks in tropical Africa (1974-2019).

Resumo A subdisciplina epidemiologia histórica se propõe a criar um alicerce robusto e refinado para o processo de tomada de decisões em saúde pública global, aprofundando registros empíricos que nos ensinam sobre intervenções passadas. Este artigo se baseia na pesquisa epidemiológica histórica de três campanhas globais de saúde pública para ilustrar essa proposta: os esforços da Fundação Rockefeller para controle da ancilostomose (1909-c.1930), os projetos-piloto da Organização Mundial da Saúde para erradicação da malária na África tropical (décadas de 1950-1960), e os esforços internacionais de interrupção da transmissão do vírus Ebola durante surtos na África tropical (1974-2019).

Como manter saudáveis nossos imigrantes: preceitos higienistas na constituição da Hospedaria de Imigrantes da Ilha das Flores / Keeping our immigrants healthy: hygienist doctrine in the Hospedaria de Imigrantes da Ilha das Flores

Resumo A criação da Hospedaria de Imigrantes da Ilha das Flores, em 1883, esteve de acordo com os preceitos higienistas vigentes na época. O isolamento de imigrantes na costa leste da baía de Guanabara ocorreu em virtude das epidemias de febre amarela que retornavam à capital do Império todo verão, desde 1849-1850. Higienistas atribuíam a doença à precária condição sanitária da cidade do Rio de Janeiro, que propiciava a multiplicação do germe e infeccionava a atmosfera. Na medida em que os médicos reinterpretavam a doença à luz da teoria pasteuriana, foram sendo adotados novos procedimentos para a recepção de imigrantes, alterando a estrutura e o funcionamento da Hospedaria da Ilha das Flores.

Abstract The Hospedaria de Imigrantes (Immigrant Lodgings) da Ilha das Flores was established in 1883 in accordance with the hygienist thinking of the time. Immigrants were isolated on the east coast of Guanabara Bay because of the epidemics of yellow fever which returned to the Imperial capital every summer since 1849-1850. Hygienists attributed the disease to the precarious health conditions in the city of Rio de Janeiro, which enabled germs to multiply and infect the atmosphere. As physicians reinterpreted the disease in light of Pasteurian theory, new procedures were adopted to receive immigrants, changing the structure and function of the facility on Ilha das Flores.

Os mosquitos e o Estado no relatório do chefe do Serviço de Saneamento e Profilaxia Rural da Bahia, 1922 / Mosquitos and the State in the report by the head of the Rural Sanitation and Prophylaxis Service of Bahia, 1922

Resumo Em 1923, o doutor Sebastião Barroso, chefe do Serviço de Saneamento e Profilaxia Rural da Bahia, apresenta um relatório das atividades desenvolvidas no ano anterior. O documento reúne informações sobre as iniciativas coordenadas pela autoridade no tocante às epidemias e à profilaxia rural, acompanhadas de uma compilação dos relatórios dos profissionais responsáveis pelos postos de profilaxia rural e de tabelas contendo dados sobre os trabalhos nas diferentes regiões do estado, as notificações recebidas e as despesas realizadas. O trecho desse documento aqui apresentado permite uma aproximação das discussões em relação ao papel do Estado no enfrentamento dos problemas de saúde pública, num contexto marcado pela recorrente eclosão de surtos epidêmicos, dentre os quais se destacam os surtos de febre amarela.

Abstract In 1923, Doctor Sebastião Barroso, head of the Rural Sanitation and Prophylaxis Service of Bahia, submitted a report on the previous year's activities. The document contains information on initiatives coordinated by the entity on rural epidemics and prophylaxis, accompanied by a compilation of the reports by the professionals responsible for the rural prophylaxis units and tables containing data on the different regions in the state, notifications received, and expenses. The section of this document presented here enables us to investigate the state's role in addressing public health issues in a context marked by recurring outbreaks of epidemics, especially yellow fever.

Saúde Pública e Colonização da Natureza / Public Health and Colonization of Nature

Este trabalho apresenta algumas questões sobre as quais o campo da Saúde Pública/Coletiva no Brasil precisa se reposicionar. Tomando por referência a concepção de biológico e social que se consolidou no campo a partir da década de 1970, discute-se a concepção de natureza e cultura que subsidiou o debate. Mostra como esse debate foi circunstanciado historicamente, por isso mesmo merecendo uma revisão, tendo em vista o contexto das sociedades modernas contemporâneas. As práticas biotecnológicas são objeto da análise na medida em que, além do seu uso intensivo pela saúde, carregam consigo as características de articular o biológico e o social num mesmo objeto, de transformar e criar seres vivos e de atuar na diversidade biológica. Este cenário coloca, à Saúde Pública/Coletiva, a imperiosa necessidade de rever seus marcos teórico-epistemológicos.

This paper presents some issues on which the field of Public/Collective Health in Brazil needs to reposition. Based on the design of biological and social consolidated in the field from the 1970s, it discusses the concept of nature and culture that has supported the debate. It shows how this debate has been historically positioned, so it deserves to be reviewed, given the context of contemporary modern societies. Biotechnology practices are the subject of analysis in that, in addition to their intensive use by health, hold the characteristics of joining biological and social factors in the same object, transforming and creating living beings and working in the biodiversity. This scenario requires from the Public/Collective Health the urgent need to review their theoretical and epistemological marks.

Chang Sei Kim's Activities on Public Health in Colonial Korea / 의사학

After graduating from Severance Medical College in 1916, Chang Sei Kim went to Shanghai to work as a missionary in a adventist hospital. The establishment of the Korean Provisional Government led him to participate in the independence movement. Educating nurses to assist the forthcoming war for independence, he seemed to realize the fact that the health of Koreans would be a key factor for achieving independence. He left for the U.S. to conduct comprehensive research on medicine. Chang Sei Kim was the first Korean to receive a Ph. D. degree of Public Health, graduating from the Johns Hopkins School of Hygiene and Public Health in 1925. He then gained an opportunity to work for Korea as a professor at Severance Medical College. His objective was the 'Reconstruction of the Korean People In Terms of Physical Constitution.' He pointed out that Koreans' weak state of health was a major reason for Korea's colonization. To gain independence, he emphasized that the Korean people should receive education on public health in order to improve the primitive conditions of sanitation. There is little doubt that Chang Sei Kim's ideas developed Heungsadan's views on medicine in terms of its stress on cultivation of ability, especially considering the fact that he was a member of the organization. As a member of the colonized who could not participate in the developing official policy, Chang Sei Kim was not able to implement his ideas fully, because an individual or a private organization could not carry out policy on public health as large a scale as the government did. Never giving up his hopes for Korean independence, he rejected requests to assume official posts in the Government-General. That was why he was particularly interested in the Self-Governing Movement in 1920s Korea. If the movement had attained its goal, he might have worked for the enhancement of sanitary environment as a director of Sanitary Department. His application for funding to establish a hygiene laboratory in Korea was rejected by Rockefeller Foundation, as the policy of foundation was to finance only government institutes, not private ones. Resigning his position at Severance Medical College in 1927, Chang Sei Kim went to Shanghai to work as a Field Director in the Council on Health Education. The council was affiliated with the Rockefeller Foundation and was founded to ameliorate the hygienic situation in China. He was well fitted to the job, because China, like Korea, shared the aim to achieve independence by promoting better health for its people and because he could be appointed as a public officer which could not happen in colonial Korea. To solve the ever-serious problems with tuberculosis in China, he went again to the U. S. to conduct research and raise money for the establishment of a sanitarium. Chang Sei Kim passed away there in 1934 at the age of 42.

Abortion in Korea Since 1945 / 의사학

Since prehistorical era, the human has desired to control reproduction artificially. However, abortion, one of the productive methods has been prohibited to a certain degree by law in some countries, but the operation of abortion has been done in practice. Also, controversial arguments on legitimacy of abortion have been raised. In Korea, physicians operates abortions more than 2 million times each year. In spite of serious social problems, arguments on abortion have not been common yet. The efforts to find a good solution for abortion have not been very sufficient. Therefore, this study is to investigate the concerns for the conditions of abortion since 1945 (this year is the independent one from Japan's government) through a historical perspective and to suggest the efficient direction in policy. Since 1945, many women have had no choice but abortion for their basic life. The Korean government of legislated the Crimes of Abortion in Criminal Law in 1953. However, the number of women who underwent abortion increased since 1962 due to the governmental Family Planning Policy. In addition, the Mother and Fatherless Child Health Act was enacted in 1973 that tolerated abortion to some extent. The disparate treatment of abortion between Criminal Law and the governmental policy fueled the confusion to potentially pregnant women. The first reason why Korean women choose abortion is wrongful pregnancy. Compared to other countries, in Korea, abortion were operated for sex selection. To conclude, it is important to be implement positive sex education, proper contraception education by government and social publicization of arguments on abortion.

Saber médico e populações nas práticas de saúde pública no Paraná, nas décadas de 1930 e 1940 / Medical knowledge andf populations in public health practices in Paraná, during the 30`s and 40`s

Demonstra a constituição da saúde pública no Estado do Paraná nas décadas de 30 e 40. Por constituição, entende a própria história da medicina que circulou entre as práticas de ciências da história natural, definindo rumos para o pensamento brasileiro, como os da higiene, e aparecendo como base científica que fundamentou as práticas de assistência médica, de ensino, de pesquisas e enfim, de toda a experiência médico-acadêmica.