GUEST EDITOR'S NOTE
The year of 2009 marks the centennial of one of the great achievements in Brazilian science: the discovery, by Carlos Chagas (1878-1934), a young researcher at the Oswaldo Cruz Institute, of the disease that bears his name.
American trypanosomiasis currently afflicts around twelve million people in Latin America and is one of the so-called neglected tropical diseases, intimately bound up with this continent's poverty. Despite noteworthy advances in the scientific understanding of the disease and how to combat it, much remains to be done, as we have been warned by specialists, the governments of affected countries, and international agencies.
As at other commemorative moments, we turn to history to reconstruct the facts and better celebrate this historical event. But historical research goes well beyond commemorations, seeking answers to fundamental questions: How did this singular achievement in Brazilian medicine come about? What were the circumstances that made it possible? What was its impact in Brazil and abroad? Why is it that after all these years the disease is still a major public health problem? Historians, armed with documents from those days and with their field's specific approaches and methodologies, have devoted themselves to the theme, exchanging ideas with researchers from the biomedical and health fields as well.
The anniversary of this discovery leads us to reflect on the long path taken by Brazilian science - more specifically, by early twentieth-century medical science, driven forward by the victories of microbiology and tropical medicine - in the process of establishing itself as a legitimate social activity, gaining its own institutional spaces, and winning society's recognition of its role in identifying and solving the problems of the much coveted 'Brazilian civilization in the tropics'.
Given the opportunity to bring together in this commemorative issue reflections on Carlos Chagas' discovery as an emblem of science at the service of health and modernization, we opted to place the event within the broader historical and social context that framed it as a historical fact and national symbol. Central to this backdrop was the debate on the 'woes' of Brazil, which - despite the era's confidence in progress, manifested in the Belle Époque capital of Rio de Janeiro - was a country whose unknown hinterlands made it an "enormous hospital." This famous phrase by Miguel Pereira, first pronounced in October 1916, synthesized a discussion that had been prevalent in Brazilian medicine since the discovery, in the Minas Gerais backlands, in the settlement of Lassance, of the 'scourges' then assailing the interior of Brazil. This discussion would echo for years, with the repercussions of the rural sanitation campaign.
The sanitary movement of the First Republic was a landmark in Brazil's nation-building process. The historiographic production that took up this object of study contributed greatly to the institutionalization of the Casa de Oswaldo Cruz and of the research field in the history of science and health in Brazil. This production continues today, with new analytical outlooks on the relations between science, health, and society at different moments in history.
We have gathered in this issue articles that address the discovery of Chagas disease and the ensuing research in Brazil and abroad. Some of these were presented at the round table organized by Casa de Oswaldo Cruz, through the steering committee made up of Simone Kropf, Nara Azevedo, Nísia Trindade Lima, and Magali Romero Sá, as part of the International Symposium on the Centennial of the Discovery of Chagas Disease (http://www.chagas2009.com.br), sponsored by the Oswaldo Cruz Foundation. The collection also includes papers on the more general debate about ideas and proposals for sanitizing Brazil. We would like to point out that 2009 also marks the 90th anniversary of a major reform of Brazil's federal public health apparatus. Creation of the National Department of Public Health was approved in December 1919, with Chagas' appointment as its first director evincing the intersection of science, health, and politics. The metaphor 'enormous hospital' engendered - and continues to engender - not just images of Brazil but also initiatives, policies, and institutions.
In addition to articles by historians, the issue offers texts by eminent doctors who have researched Chagas disease: one, by Joffre Rezende, is found in the Articles department; the other is Francisco Laranja's 1986 testimony, sourced from the Casa de Oswaldo Cruz oral history collection. Enriched by an analysis of iconographic sources related to the themes of the discovery of Chagas disease and of sanitation, these pages also contain the key document responsible for creating the image of Brazil as an "enormous hospital": the speech by Miguel Pereira. Often cited but hard for readers to access, this text is reproduced here in its entirety, along with an analysis of its various meanings.
We invite you, our readers, to join us as we follow the paths of this history, partaking of the opportunity to get to know the past and likewise to ponder the new challenges and many things left to be done in the fields of science and health.
Simone Petraglia Kropf
Dominichi Miranda de Sá
Publication Dates
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Publication in this collection
07 July 2009 -
Date of issue
July 2009
