Hospitals
Authors: Vrana Heather 
Published: April 2021

Contemporary readers likely have a narrow view of hospitals. But prior to the 19th century, hospitals were used for many purposes: to provide charity for the needy, shelter wounded soldiers, house homeless community members, inoculate against disease, learn and teach anatomy, and heal the sick and wounded. Hospitals were nearly indistinguishable from hospices, where citizens who could prove their need could receive shelter and food. These hospitals were charged with dealing with epidemics, demographic collapse, war wounds, birth (and sometimes baptism), death, and all of the other bodily expressions of colonization, occupation, and expansion. Of course, buildings or other spaces for healing preceded European colonizers. While a few of the books discussed below provide a glimpse of pre-Columbian hospitals, this is an ample area for exploration. Early colonial hospitals were built alongside churches, buildings of state, trade houses, and houses for the wealthy. The boundary between medical and religious knowledge was blurred. Practitioners were diverse: the very indigenous and African healers who were censured by the Inquisition were also relied upon. Universities, like Guatemala’s Universidad de San Carlos (founded in 1676), offered medicine as a course of study. The Enlightenment “arrived” unevenly in Latin America. Generally, the number of hospitals grew, as did the number of the regulations concerning them. Owing to imperial anxieties, as well as epidemics and medical innovation, medicine (and hospitals) became more a part of colonial life. Enlightenment hospitals were teaching and research institutions, too. With independence, medical science became a tool of liberal state building, as it had previously been of colonial administration. Liberal governments wrested responsibility for care of the sick and the needy from religious orders. Positivism and eugenics became the drivers of much hospital work. Clinics for the degenerate and other threats to the nation promised rehabilitation. Diagnoses and specializations proliferated. Then, a number of welfare states emerged throughout the region, sometimes in response to popular demand. Some hospitals sat in uneasy balance between positivism and the welfare state. Hospitals were also laden sites in the Cold War. Mid-20th-century revolutions were fought with health care among guerrillas’ demands. Some revolutionary states managed to fulfill their promises of accessible community health care. Around the 1980s, state welfare gave way to privatization. While this has continued, proponents of community and preventive health care have won crucial victories in many places. Hospital historiography sits at the intersection of many fields. Historians of science, technology, medicine, public health, charity, nationalism, social movements, and political repression all have a stake in hospital history. Many of these fields have produced extensive bodies of knowledge, even conferences and journals dedicated to their study. But this is not the case for hospitals. Of course, the boom in scholarship on history of medicine and Science and Technology Studies (STS) has provided still more texts featuring hospitals in nuanced ways. In fact, many different types of historians consult hospital records in the course of their research. So, on the one hand, hospital history is everywhere; on the other, it is obscure.