In March 1944, the U.S. Institute of Inter-American Affairs (IIAA) celebrated the second anniversary of its "cooperative health and sanitation program" in Latin America.(1) George C. Dunham, the director of the IIAA's health and sanitation division, evaluated the program's accomplishments and goals. Although Dunham took most of his examples from Brazil, the IIAA's program was not restricted to that country. The institute had signed agreements with all but two Latin American republics: Cuba and Argentina.(2) In March 1944, the IIAA had 181 North American technicians working in eighteen Latin American countries. Most were physicians, nurses, sanitary engineers, construction engineers, architects, entomologists, and business managers.(3) By January 1944, another 13,000 nationals of the other republics were employed by the program, of whom some 600 were qualified technicians, working on a range of projects such as malaria control, environmental sanitation, hospital organization, dispensaries and health centers, professional training, and health education.(4) Of the original 821 planned projects, 451 had been concluded by July 1945.(5)
Roots of Cooperative Action
The IIAA's health and sanitation program was a product of the Good Neighbor Policy instituted during Franklin D. Roosevelt's administration, as a direct answer to Nazi economic and political expansion and its effects on the Americas. Although the program began to operate in 1942, its roots went back to the 1930s. U.S. Assistant Secretary of State A. A. Berle Jr. indicated to the Buenos Aires Conference of Foreign Ministers of the American republics in 1936 the beginning of economic cooperation in the hemisphere. He outlined the diverse aspects of the Nazi policy that was threatening the interests of the United States in Latin America.(6)
The main economic issue highlighted by Berle was related to the trade between Latin America and Europe, particularly with Germany. During the 1930s, Latin American countries had been the chief suppliers of raw materials for rebuilding the German war machine. Germany had introduced the so-called barter agreements to Latin America to tie its trade to its economy. Through this implementation, commodities imported from Latin America were paid in blocked currency, which means it could only be spent in Germany.(7) So the new economic hemisphere policy, referred to by Berle, was to shift Latin American trade to the United States.
The United States was concerned with this commerce that "offered a fertile field in which the Axis power could carry on propaganda activities."(8) The political dilemma became more evident in 1937, when "Nazi and Fascist propaganda" began to be "exported in large scale."(9) Significantly dangerous in the political discourse of that time were the would-be fifth columns: Germans, Italians, Japanese, and their descendants living in the American republics. An American governmental publication alerted that some 1,400,000 "Axis aliens" and approximately 4,450,000 citizens of German and Italian descent lived in Brazil, "most of whom lived in the South and Southeast."(10)
Feelings of insecurity increased within the United States after the fall of France in 1940, and the U.S. government, for the first time, felt that the German military threat could possibly reach the Americas. After the Nazi expansion in North Africa, Berle believed that "it was perfectly possible that aggressive powers might commence to operate in the Atlantic."(11) The War Department realized that northeastern Brazil could be reached by the power of German aircraft from western Africa. Concerned with U.S. security, Under Secretary of State Sumner Welles suggested to the American ambassador to Brazil to have a "personal and confidential" talk with the Brazilian minister Oswaldo Aranha over the importance of the Fernando de Noronha and Natal areas, "both within ferrying range of European bombers operating from West African bases, and both of which could be used to facilitate the transfer of planes, men and munitions to the Western Hemisphere."(12) If the Nazis conquered the Brazilian hump, they could reach the Caribbean and the Panama Canal. Under this threat, by the second half of 1940, the focus of U.S. foreign policy shifted to hemispheric defense and cooperation.(13)
American business leaders were also discussing the need for economic cooperation with Latin American countries. One of these businessmen was Nelson Rockefeller, who in a memorandum submitted to Roosevelt on June 14, 1940, pointed out that U.S. economic position and security should be instituted "in the frame of hemisphere economic cooperation and dependence." He proposed a specific policy toward Latin America and suggested that the United States consume the region's agricultural and mineral products, increase investments there, and establish a program of cultural relations.(14) This proposal brought Rockefeller to a key position in the debate of how to deal with Latin America, leading to the creation of a specific governmental agency responsible for inter-American affairs.
In August 1940, the Roosevelt administration created the Office for Coordination of Commercial and Cultural Relations between the American Republics. A year later, the agency's name was changed to the Office of the Coordinator of Inter-American Affairs (CIAA), and from March 1945, until its termination in May 1946, it was called the Office of Inter-American Affairs. The official function of the CIAA was "to provide for the development of commercial and cultural relations between the American republics and thereby increasing the solidarity of this hemisphere and furthering the spirit of cooperation between the Americas in the interests of hemisphere defense." Nelson Rockefeller was nominated as coordinator of the new agency, answering directly to the president, with the formulation of the office's policies done in agreement with the State Department.(15)
The interest of the CIAA in the field of health and sanitation began in 1941, when the coordinator became aware of negotiations to establish U.S. military bases in Latin America. Rockefeller relied on advice from the staff of the Rockefeller Foundation, which had been working on public health in Latin America, therefore realizing that some of the areas proposed for these bases had unhealthy conditions. The coordinator suggested to the War Department that his office organize a "public works improvements" program around the planned military bases. The original blueprint intended to build water systems and hospitals and provide sanitary improvements, but the plan was made smaller, focusing on sanitation around the proposed bases. After the Japanese seized important production areas in Asia, the issue of securing the supply of raw materials for the war effort became as important as the fight on the battlefield itself. The health and sanitation plan was then extended to target-producing areas in Latin America that could compensate for the loss of supplies now in the Japanese domain.(16)
Adhesion of Brazil to the Allies' cause became imperative for the United States. In Brazil, both the military and economic interests of the United States fit into the CIAA's health and sanitation project. The military interests focused on the northeast coastline, where the Joint Military Commission for the Preparation of Defense in Northeast Brazil planned to muster a large number of armed forces.(17) Economic pressure for establishing the health and sanitation plan in Brazil focused on the need for rubber. This economic pressure was, however, subordinated to military interests. After the Japanese seized the rubber production areas in Asia, the short supply of this commodity became a serious threat to the Allies' war effort. Roosevelt had appointed the Baruch Committee to study the rubber problem, and the committee concluded that the war effort would collapse if an alternative for rubber was not found.(18) Because it was recognized that organizing plantations of new trees would take too long, the wild rubber trees of the Amazon became an alternative source for the supply of the Allies' armies as well as for civilian needs. To extract rubber from the Amazon jungles, however, would require an effort to overcome the deadly diseases of the region, mainly malaria. Consequently, the earliest health and sanitation project of the CIAA focused its attention on...