Lost in colonialism: Spanish public health in Cuba before and after the Ten Years’ War

Abstract

The specific features of Spanish domination over Cuba during the 19th century are usually “lost” when translated into a conventional historiographic language of colonialism. For the particular case of public health and epidemics, this paper proposes by contrast an analysis of that domination as a somewhat balanced relation between a “peninsular Spain” and an “overseas Spain” which differed from French colonialism in Algeria or British colonialism in India. The juxtaposition between the Spanish and Cuban health administrations, the leading role of Cuban public health and epidemiology within the Spanish Empire and the significant participation of Creole physicians were main aspects of a singular relation which prevailed until the Ten Years’ War (1868-1878). After this conflict, Cuban public health and epidemiology moved even further away from colonialism because of tensions between an incipient Cuban medical nationalism and Spain’s desperate attempt at integrating the island within its public health system.