Nurses, Indigenous Authorities, and Rural Health in Oaxaca, Mexico, 1934-1970 Restricted; Files Only
Nichols, Marissa L. (Summer 2023)
Abstract
In the mid-1950s, the Instituto Nacional Indigenista (INI, National Indigenist Institute) trained and employed Indigenous promotores de salud (health promoters) as nursing assistants in Oaxaca, Mexico. Bilingual in Spanish and Indigenous languages, health promoters facilitated the expansion of rural healthcare, a primary goal that emerged from the Mexican Revolution of 1910. In 1954, this large federal development agency recognized the need to hire bilingual Indigenous men who could act as translators, cultural intermediaries, and political brokers in rural Indigenous communities. This dissertation argues that the federal government shifted its hiring practices in response to years’ worth of petitions sent from Indigenous communities and suggestions made by doctors and nurses who worked across rural Oaxaca in the 1930s and 1940s. In those decades, visiting nurses from urban or district centers traveled across the state and entered Indigenous communities largely unequipped to navigate local norms and municipal governance.
As an ethnohistory of rural nursing, this dissertation examines visiting nurses’ correspondence and complaints alongside the petitions and requests sent from Indigenous municipal authorities in Mixtec, Mazatec, and Zapotec communities, three of the largest Indigenous groups in Oaxaca. These communities adapted to the incursion of the state’s rural health projects by building on long traditions of negotiating with the government to access health-based resources tied to post-revolutionary citizenship. They selectively supported and engaged with the state’s rural health projects while making claims to health-based rights which continued to expand following the military phase of the revolution. Simultaneously, federal officials sought to modernize and eliminate Indigenous modes of practicing health, but Indigenous health promoters adapted to new health directives by blending practices from multiple healing cultures and selectively implementing the state’s development initiatives in response to community requests. This dissertation traces the influence of local actors in shaping federal health policy from 1934, when the federal government prioritized the expansion of rural health, through 1970, a year in which President Luis Echeverría ushered in a new period of development policy in Mexico.
Table of Contents
Introduction 1
Chapter 1: Local Healers and State Practitioners: An Overview of the Expansion 25
of Rural Healthcare in the 1930s and 1940s
Chapter 2: Navigating Cross- Cultural Norms: Visiting Nurses in Rural Oaxaca 56
during the 1940s
Chapter 3: Labor, Legitimacy, and Resources: Nursing and Community-State Relations 88
in Mid-Century Oaxaca
Chapter 4: Promoters of Development? Indigenous Nurses in Mixtec and Mazatec 116
Communities
Chapter 5: “Si la información traduce:” Health Translation and the Summer Institute 149
of Linguistics
Conclusion 186
Glossary 196
Appendix 200
Bibliography 202
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