Going Local

In March 1930, Dr. Francisco de P. Miranda, the DSP's director of the Office of International Exchange, published a speech he had recently given to the visiting “Committee of Cultural Relations between the U.S. and Latin America.” Commending the “pioneering American spirit” that had led the group to “learn the truth about Mexico,” he noted that Mexico—in the midst of reconstruction— had much to learn from the public health field in the U.S. But this address, appearing on the front page of the Boletín de la Oficina Sanitaria Panamericana ( Bulletin of the Pan American Sanitary Bureau ), was no sycophantic display: Miranda aimed to teach his North American visitors “nothing new except the manner in which we are seeking to resolve our special problems.” After tracing the roots of Mexico's involvement in public health to the late nineteenth century, Miranda deftly showcased the DSP's recent burst of activities—from vaccine distribution to food inspection to child health measures— that renewed this commitment. He mentioned the friendly relations that had been established with the RF through the yellow fever campaign, when Mexican and American doctors had worked “arm in arm” and cited continued cooperation in the control of hookworm as well as other activities. As he looked to the future, however, Miranda focused on the areas of tuberculosis, occupational health, malaria, and clean water, none of which involved the RF. Indeed, both the Committee of Cultural Relations—and the Boletín 's readership—were likely left with the impression that the RF's efforts were on the margins of a “vast program, hopefully to be realized.” A quick nod of thanks was decidedly not what the RF was seeking in its Mexican venture. As the IHB-DSP hookworm agreement was nearing its expiry date in the late 1920s, the RF found itself at a crossroads in Mexico. In some countries, its presence was purposely short-lived, especially once public health activities had gained a solid footing. In Mexico it was precisely because of public health's institutional takeoff that the RF was not ready to leave. Parlaying IHB cooperation into a deeper contribution to Mexican public health, however, required more than another standard disease control campaign.

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