Conjuring the State is a breathtaking, unforgettable study of the invention of public health in early twentieth-century Ecuador. By focusing on the pragmatics of public health work—what is to be done and how?—at a time when few models existed for it, Clark demonstrates how state systems actually get built, slowly and contentiously, over time. Through meticulous, painstaking work with uncataloged archives, Clark tells a story that is at once deeply sensitive to the nuances of the Ecuadorian case and revelatory of the links between public health and state formation more broadly, with implications up to the present.
The Ecuadorian Public Health Service was founded in 1908 in response to the arrival of bubonic plague to the country. A. Kim Clark uses this as a point of departure to explore questions of social history and public health by tracing how the service extended the reach of its broader programs across the national landscape and into domestic spaces. Delving into health conditions in the country—especially in the highlands—and efforts to combat disease, she shows how citizens’ encounters with public health officials helped make abstract ideas of state government tangible. By using public health as a window to understand social relations in a country deeply divided by region, class, and ethnicity, Conjuring the State examines the cultural, social, and political effects of the everyday practices of public health officials.
This meticulously researched monograph by a foremost expert in Ecuadorian history reframes our understanding of the birth of social medicine in early twentieth-century Latin America while also tracking how Pablo Arturo Suárez, a physician from this small Andean country, helped develop Ecuador’s Servicio de Sanidad while solving the centuries-old mystery of the spread of bubonic plague.
A. Kim Clark is professor of anthropology at the University of Western Ontario, Canada. She is the author of The Redemptive Work: Railway and Nation in Ecuador, 1895–1930 and Gender, State and Medicine in Highland Ecuador: Modernizing Women, Modernizing the State and coeditor, with Marc Becker, of Highland Indians and the State in Modern Ecuador.