Gilberto Hochman

Pouca saúde, muita saúva, os males do Brasil säo... Discurso médico-sanitário e interpretaçäo do país

O objetivo deste artigo e, primeiro, apontar o papel central e prolongado dos registros e textos medico-higienistas e do movimento pelo saneamento do Brasil, das tres primeiras decadas do seculo XX, na reconstrucao da identidade nacional a partir da identificacao da doenca como elemento distintivo da condicao de ser brasileiro e, segundo, sublinhar sua forte presenca em textos fundamentais da chamada fase de institucionalizacao das ciencias sociais no Brasil, marcada pela criacao dos cursos universitarios de sociologia e antropologia.

O Brasil não é só doença: o programa de saúde pública de Juscelino Kubitschek

Analyzes the public health program that Juscelino Kubitschek presented while running for president and its dialogue with interpretations that identified Brazil as an ailing country that should be recovered through public medicine. The proposals and goals contained in Kubitscheks healthcare program, as released during his 1955 campaign, serve as the main sources for this analysis. They also were key to establishing this dialogue, which was both prompted and shaped by a national and international context characterized by the post-war idea of development and public health optimism. Within the context of his development project, the article looks at how Kubitschek elaborated the themes of the centrality of rural endemic disease and the abandonment of the rural worker, both dear to the sanitary movement in the 1910s. It also underscores how Kubitschek the candidate endeavored to link health and development within this arena of government policy.

Priority, Invisibility and Eradication: The History of Smallpox and the Brazilian Public Health Agenda

This article describes three periods in Brazils modern history when governmental action was (or was not) taken against smallpox: first, when smallpox control became a priority in the Brazilian sanitary agenda from the nineteenth century to the beginning of the twentieth century; second, when it was rendered politically invisible during decades when greater attention was given to yellow fever and malaria control; third, when it reappeared at the centre of Brazilian health policy in the 1960s until its eventual eradication in 1973. Smallpox control in the latter two periods is suffused with paradox. For example, evidence suggests that the nearly fifty-year absence or lack of policies and agencies to deal with smallpox actually favoured the mobilization of local, national and international resources once the eradication programme was launched in 1966; these new approaches were accelerated from 1969 until the completion of eradication in 1973. Equally paradoxical, it was during the specific context of the military regime after 1964 that the Brazilian health system developed the capacity to mobilize existing but dispersed resources and flexibly to innovate, incorporate, and adapt new policies. Another important element in this period was institutional learning based on other vertical programmes such as the malaria eradication campaign. Although the Brazilian smallpox eradication programme was constrained by international agencies and by bilateral co-operation with the United States, the period after 1964 offered opportunities for the realization of a new and wide-ranging national health capacity including the creation of a national system of epidemiological surveillance and a national childhood immunization programme. It also saw the empowerment of young physicians who would later come to occupy key positions in Brazilian public health and in international health organizations.

Innovative old-age security models for developing nations: Chile and Brazil

Abstract Despite the similar origins of their public pension programs, by the 1980s Chile and Brazil emerged with very different old-age security schemes. This paper presents a comparative analysis of these two models with a focus on developments during the past twenty-five years. Brazil has emerged as a model of how in a developing nation old-age security programs can be extended to include most of the rural population and many urban workers in the informal sector. Chile has emerged as a model of a fully capitalized pension scheme with substantial private sector control over pension assets. The Brazilian scheme has done more than the Chilean system to reduce income inequality, but the Chilean system has done a better job than the Brazilian system for some categories of workers, particularly more affluent workers. It also has had a more positive impact on the economy.

O sal como solução? políticas de saúde e endemias rurais no Brasil (1940-1960)

O objetivo deste artigo e analisar e comparar as politicas acerca do uso do sal no tratamento de duas doencas graves que assolaram a Amazonia e as areas rurais do Brasil durante o periodo desenvolvimentista: o bocio endemico e a malaria. Apesar de serem doencas muito diferentes – a primeira e uma doenca carencial, e a segunda uma doenca parasitaria – a luta dos medicos e nutricionistaspara tornar obrigatoria a iodacao do sal de cozinha consumido no pais inspirou a ideia de um sal misturado com cloroquina, a ser distribuido livremente em zonas de malaria, onde o uso de DDT (Dicloro-Difenil-Tricloroetano) nao seria eficaz. O que seria um metodo simples – e, portanto, eficaz – para controlar e ate mesmo eliminar tais doencas, o uso do sal de cozinha como veiculo para fornecer iodo e uma droga antimalarica para a populacao, esbarra em fatores cognitivos, economicos, sociais e culturais. Algumas variaveis contribuem para a analise historica desses programas de saude: o consenso quanto a etiologia da doenca, o grau de institucionalizacao da comunidade de especialistas e a sua organizacao, a importância da doenca na agenda das organizacoes internacionais de saude, o locus de decisao politica, a existencia de uma lideranca cientifica envolvida na formulacao e gestao das politicas de saude, e os padroes de consumo das populacoes-alvo.

Um método chamado Pinotti: sal medicamentoso, malária e saúde internacional (1952-1960)

The article analyzes the creation, acceptance, and abandonment of a means of fighting malaria known as the Pinotti method: kitchen salt mixed with chloroquine. The early 1950s brainchild of Brazilian malariologist Mario Pinotti, this method was intended to both prevent and treat malaria. Chloroquine-medicated salt was tested during the first half of that decade and used in Brazil from 1959 through 1961 as part of a malaria eradication campaign coordinated by the World Health Organization. The method won recognition on the world health stage, drew criticism, and underwent testing in other countries until the mid-1960s. We argue that Brazils abandonment of the method was primarily due to the political decline of its creator, which began in 1960.

Smallpox eradication, laboratory visits, and a touch of tourism: travel notes of a Canadian scientist in Brazil

The paper presents and discusses the travel notes diary of Canadian scientist Robert J. Wilson when he visited Brazil in April 1967 during the Smallpox Eradication Programme run by the World Health Organisation. Wilsons report makes it possible to reflect on the smallpox eradication campaign in Brazil; on the Canada-Brazil cooperation to improve the quality of the smallpox vaccine; on his assessment by of scientists and Brazilian laboratories; on the effects of intersections between scientific activity and social and cultural activities; on the role played by specialist communities of experts role in international scientific cooperation projects; and on a Canadian travellers concepts and prejudices about Brazil at the end of the 1960s.

O princípio do fim: o "torna-viagem", a imigração e a saúde pública no Porto do Rio de Janeiro em tempos de cólera

This article examines the relationship among public health, immigration, and epidemics, focusing on the immigrant ships affected by cholera, which arrived at the port of Rio de Janeiro in the late nineteenth and early twentieth centuries. The analysis is based on four immigrant ships, which should have remained in quarantine, but were forced to return trip to the ports of origin, because they had cholera on board. The article analyzes the efforts of health services to prevent ingress of diseases in the country and, at the same time, ensure the flow of goods and immigrant labor.

Smallpox eradication and Brazil: an interview with Donald A. Henderson

Interview with Donald A. Henderson, the U.S. physician and epidemiologist who headed the World Health Organizations Smallpox Eradication Program from 1966 to 1977. The interviewer talks about the endemic nature of smallpox in Brazil; relations between WHO, the Pan American Health Organization, and the Brazilian government; the role of Connaught Laboratories in the quality of the Brazilian smallpox vaccine; the process that brought certification of smallpox eradication in Brazil; international cooperation in eradicating smallpox and the various strategies applied; the role played by Brazilians in eradicating smallpox in India, Bangladesh, and Africa; and the future of the notion of disease eradication

Samuel Barnsley Pessoa e os determinantes sociais das endemias rurais

O artigo analisa os principais aspectos da trajetoria, das ideias e da atuacao academica e politica de Samuel Barnsley Pessoa (1898-1976). Indica que a atuacao de Samuel Pessoa deve ser compreendida tambem a partir da sua militância comunista e ressalta que uma das contribuicoes originais de seus trabalhos foi o estabelecimento da relacao entre estrutura agraria e endemias rurais, entre latifundio e doenca e a adesao a um projeto de transformacao da sociedade brasileira.