Two days full of political developments, although they have not involved me much personally. The events: Árbenz stepped down under pressure from a US military mission threatening massive bombing attacks, and a declaration of war from Honduras and Nicaragua, which would have led to the United States becoming involved. Árbenz probably could not have foreseen what would come next. The first day, colonels Sánchez and Elfego Monsón, avowedly anticommunist, pledged their support for Díaz, and their first decree was to outlaw the PGT. The persecution began immediately and the embassies filled with asylum seekers; but the worst came early the next day when Díaz and Sánchez stepped aside, leaving Monsón at the head of the government with the two lieutenant-colonels as his subordinates. Word on the street is that they totally capitulated to Castillo Armas,6 and martial law was declared as a measure against anyone who might be found bearing any weapons of a prohibited caliber. My personal situation is more or less that I’ll be expelled from the little hospital where I am now, probably tomorrow, because I have been renamed “Chebol”7 and the repression is coming.
Ventura and Amador are seeking asylum, H. stays in his house, Hilda has changed her address, Núñez is at home. The top people in the Guatemalan party are seeking asylum. Word is that Castillo will enter the city tomorrow; I received a beautiful letter that I’ll keep safe for my grandchildren.
Several days have passed now without that earlier feverish rhythm. Castillo Armas’s victory was total. The junta is made up of Elfego Monzón as president, with Castillo Armas, Cruz, Dubois, and Colonel Mendoza. Within a fortnight they will hold an election within the junta to see who comes out on top — Castillo Armas, of course. There is neither a congress nor a constitution. They shot the judge from Salamás, Rómulo Reyes Flores,8 after he killed a guard who was trying to trick him. Poor Edelberto Torres is behind bars, accused of being a communist; who knows what the poor old man’s fate will be.
Today, July 3, the “liberator” Castillo Armas entered the city to thunderous applause. I am living in the house of two Salvadoran women who are seeking asylum—one in Chile, the other in Brazil—with a little old woman who is always telling stories about her husband’s misdeeds and other interesting matters. The hospital sent me packing and now I’m installed here. [...]
The asylum-seekers’ situation has not changed. The novelty has worn off and everything is calm. Helenita left today by plane. The look in the German’s eyes gets worse each time I see him. I won’t visit him again except to pick up some things and my books.
Some fairly serious things have happened, although not in the political arena, where the only change is that illiterates have been disqualified from voting. This is a country where 65 percent of the adult population is illiterate, reducing the number who can vote to 35 percent. Of this 35, perhaps 15 support the regime. The level of fraud, therefore, does not have to be so extreme for the likely “people’s candidate,” Carlos Castillo Armas, to be elected. Unfortunately, I had to leave the house I had been living in, now that Yolanda, the other sister of the two women hoping for asylum, is here and is planning to move to San Salvador. I’ll see if I can go to Helenita’s aunt’s house.
Now I’m settled in the new house. I keep going to the Argentine embassy, although today it was closed. Nevertheless, because today was July 9 [Argentina’s national day], I managed to get in this evening. There is a new ambassador, Torres Gispena, a stocky little pedant from Córdoba. I wolfed down a few things, but there wasn’t much to eat. What a guy has to put up with! I met some interesting people at the embassy. One of them, Aguiluz, has written a book on land reform; another, Dr. Díaz, is a Salvadoran pediatrician and a friend of Romero’s from Costa Rica.
Asthma is fucking with me after what I ate at the embassy. Otherwise nothing much has changed. I got a letter and a photo from my old lady, and a letter from Celia and Tita Infante [...].
Cheché [José Manuel Vega] must have been granted asylum in the last few hours. We agreed he would present himself at the embassy at 6:30 p.m. My plans are very fluid, but it’s most likely I’ll go to Mexico—although it’s within the realm of possibility that I might try my luck in Belize. [...]
Mexico
The following day (or rather, that same evening) we set off for Veracruz aboard the Ana Graciela, a little, 150-ton motor boat. The first day went well, but on the next a big northerly blew up and had us flying all over the place. We rested a day in Veracruz and then set off for Mexico City via Córdova, stopping there for an hour to look around. It’s no big deal, but still a very pleasant town, more than 800 meters above sea level, with a breeze that is refreshing in the tropical climate, and coffee fields in abundance. The nearby town of Orizaba is much more like the Andes: grim and cold. The Blanco River lies just beyond town, as if it were an extension of the town. It was the site of a historic massacre of workers protesting against their exploitation by a Yankee company. I don’t remember the year.
Only two important events. One shows that I am getting old: a girl whose thesis I helped edit included me in the list of those who had helped her (it’s customary here to dedicate your thesis to half the world) and I felt pretty happy. The other was a beautiful experience. I went to Iztacihualt, Mexico’s third largest volcano; it was quite a long way, and the journey’s novelty value was in the fact that some were traveling on horseback. At first I managed to keep up with the best, but at one point I stopped for five minutes to treat a blister and when I got going again I had to race to catch up with the rest of the column. I did so, but was really feeling it, and in the end I began to tire. Then I had the luck to meet a girl who could go no further, and on the pretext of helping her (she was on horseback), I went along dangling from the stirrup. We eventually reached the tents where we were to spend the night; I got totally frozen and couldn’t sleep. When we had arrived the ground was dry, but when we got up the next day there were 30 or 40 centimeters of snow and it was still snowing. We decided to keep going anyway, but we never even made it to the shoulder of the volcano and by 11:00 a.m. we were on our way back.
The road that had been dusty and rocky on the way up was now covered with snow. Suffering poor circulation in my feet, I was wearing five pairs of socks, and was barely able to walk. A muleteer with a loaded mule passed by me with bare feet, which really gave me a complex. When we reached the woods the scenery was so beautiful, for the snow in the pine trees was quite a magnificent sight and the falling snow further enhanced the beauty. I arrived home exhausted.
Once again to Iztacihualt, after a number of failures. This time it happened thus: At dawn, nine of us arrived at the foot of the slope and began to climb along the edge of La Gubia towards the Ago shelter, crazy to straighten our knees. When we hit the snow, two turned back. I remained in the last group and as we tackled the glacier and saw it was pure ice, the guy accompanying me turned back. I was therefore by myself when I fell, ending up in the ice clutching a shoulder. The fall made me more cautious and I continued very slowly. The guide tried to encourage me by showing me how to climb, but then he fell down. He flew past me like a ball, desperately trying to drive his axe into the ice, and after some 80 meters he did finally come to a stop, close to a precipice from which there was a great leap into the shit. After the guide’s thumping crash, we descended very carefully, discovering that it takes longer to go down than up. The guide was exhausted and kept wandering away from the downward path, so it was 6:00 p.m. by the time we reached the foot of the slope.
A long time has passed and there have been many events not yet recounted. I’ll just note the most important one. Since February 15, 1956, I’m a father: Hilda Beatriz Guevara is my firstborn.
I belong to the Roca del CE group of Mexico.
Five jobs I was offered all fell through, so I signed up as a cameraman in a small company and my progress in cinematography has been rapid. My plans for the future are unclear but I hope to finish a couple of research projects. This could be an important year for my future. I’ve already given up hospitals
. I’ll write soon with more details.9
1. Carlos Ferrer was a childhood friend from Córdoba, Argentina.
2. Isaías Nougués was an exiled Argentine opponent of Perón.
3. After the 1952 revolution in Bolivia, President Victor Paz Estenssoro instituted many progressive reforms, including the nationalization of the largest tin mines and land reform.
4. The article titled, “Experimento extraordinario es el que se realiza en Bolivia,” was published in El Diario de Costa Rica on December 11, 1953.
5. Carlos Prío Socarras was president of Cuba and Pepe Figueres was president of Costa Rica.
6. After the coup against Árbenz, Castillo Armas began a fierce wave of repression that continued until 1957 when he was assassinated.
7. A play on the words “Bolshie” (Bolshevik) and “Che.”
8. This turned out to be false information.
9. This is the last entry in Che Guevara’s diary as he left Mexico on November 25, 1956, on board the Granma, along with Fidel Castro and the other Cuban revolutionaries, to initiate the struggle to overthrow the Batista dictatorship.
Doctors and Their Environment
This unpublished text is a rough draft of an unfinished manuscript, The Role of the Doctor in Latin America, of which only a few paragraphs were written between 1954 and 1956. Che began work on this book in Guatemala (see his letter dated February 12, 1954), and continued sporadically during his time in Mexico. Despite being a rough draft, this document has great value, presenting Che’s views on social medicine, and shows how advanced his positions were. The bibliography he consulted is also important because of its breadth and heterogeneity.
The Role of the Doctor in Latin America
When initiating the struggle for the people’s health, as a first step doctors should investigate what possibilities already exist in their complex surroundings. Earlier analyses have shown that facilities vary in different regions, countries, social classes and ethnic groups, and doctors must respond accordingly.
The struggle should always be expressed within a general framework that guarantees success and that leads doctors to win first the confidence and then the affection of those for whom they are medically responsible. Even though the problem can only be outlined in general terms, it should be noted that a doctor’s first weapon is flexibility. Flexibility—without any very obvious probing—will allow a doctor to gain the respect of the population generally. Naturally, the conditions of struggle will vary greatly, but doctors should always take this first step along the path of consolidation.
One of the first pitfalls to be avoided is offered by colleagues and others in related professions—in small towns, a rival doctor or the pharmacist; in larger towns, a variety of colleagues and specialists. In any case, the first skirmish will always be waged on the monetary front. After a doctor has demonstrated that he is absolutely impregnable to bribes, he will be subjected to harsher attacks. Good use should be made of this period between armed neutrality and open warfare. Later, war should be waged not only against the commercial disgraces of the profession but also against deficiencies of other kinds.
The struggle to obtain better working conditions for workers and adequate medical attention will easily lead doctors to clash with the established authorities in the sector, who are always lickspittles responding to the orders of those who hold the purse strings in the area, and with whom the authorities are sometimes confused. All activities should be carried out taking into account local public opinion supporting the popular cause that is being defended; this is where doctors should use their abilities as psychologists to the utmost—above all, in those places where the struggle must be waged directly against capital, without the help of any labor laws. Strikes are very hard to organize, unless the pretext is of such seriousness that it is understood even by those with a low level of consciousness, which is the case among the masses of workers in our continent. In general, one must be very careful not to be labeled a strike doctor, because that can finish off a professional’s reputation in some places.
If it is not possible to remain entirely on the sidelines, the doctor’s general role will be to provide an ideological orientation, without indicating any apparent interest in the popular movement itself. Small towns contain elements that cannot be underestimated. Public opinion is much more important in such places than in the cities, and doctors should always have anecdotes to draw on to highlight the poor working and living conditions of the people they defend.
To draw up a general outline of how to conduct oneself, one must enter the battlefield armed with a good basic knowledge [of the locality]. This includes the birth rate; the infant, prenatal and general mortality rates... and, assisted by other data, the general morbidity. In cases in which there are no death or other records—which means most places in Latin America—it is a good idea to visit the local people’s homes so as to gradually learn about their domestic situation.
The general picture of diseases will give you an idea of the main problems to be solved. Later, I’ll go into the need for the doctor to get the inhabitants to take an active part in health care, but it can always be said that epidemic diseases—and especially endemic ones—can be combated by making correct use of the general public health system, helped by a precise understanding of the problem, explained by the doctor.
One of the doctor’s most successful—though always dangerous— methods is to create health cooperatives. They are always a double-edged sword, and are usually promptly taken over by the “ladies” of the town and by other people who, in general, tend to stifle the normal development of health care. However, in those places where cooperatives must be created, this is easy to do if there is nothing else, as they will always be a step forward. Right now, to avoid being smeared as “red”—a charge which would be immediately extended to the doctor—it is not necessary to insist on having workers and peasants represented in the charitable societies, but it is important that, using a lot of common sense, the doctor start raising consciousness among the needy classes, making them aware of what an important role health care plays in problems of daily life.
Medically, it is essential to stress how important nutrition is in all the most common endemic diseases. Correct nutritional treatment and its corresponding success will draw attention to its importance. Doctors should remember that, in the present conditions, economic worries are primary, followed (as a complement to the former) by health care and then education.
Someone who eats well will be immediately concerned about their health care, and when that is improved—which will be a real achievement in unhealthy, marginalized communities—will then worry about the next problem: their education and that of their families.
With regard to this last aspect, while doctors should play an important counseling role, it is not a good idea for them to be in the foreground— especially in studies the nature of which will inevitably lead them to clash with the ideology of the ruling classes.
In places with deeply rooted religious traditions, one must also be careful there—at least until those who are best placed to offer systematic opposition to doctors have been neutralized.
In terms of public health, it should always be remembered that children should receive the best possible treatment. Always try to achieve success through collective action by the community rather than from the individual effort of the doctor.
The problems of individual health care are not so much the concern of the revolutionary doctor as collective health care. In terms of preventative health care, in addition to the measures that should be taken in each individual case, in accord with the established rules and regulations, doctors can set up systems for seeking and isolating diseases in the areas where they are found. When attempting to do this in an important community, Dr. Germinal Rodríguez’s book Higiene y Profilaxis [Health and Prophylaxis] offers a good model.
It makes for a quite pretentious office, but the doctor needs a secretary, a lab assistant, two social worker
s and some volunteers in order to do this effectively. In addition to the invaluable health service it offers, a clinic of this kind also has the virtue of winning over the inhabitants to the idea of exercising their rights as citizens—which, when they get used to it, will lead many “lone wolves” to rejoin the community.
One of the points to which doctors should pay close attention is that of ensuring the government’s neutrality, if nothing else. There is an apparently wide range of systems of government in Latin America, but nearly all of them share the common denominator of colonialism. This encapsulates the tragedy of the human communities now living in Latin America and has certain general features:
•control by large landowners,
•powerful authorities who oppose the people,
•control by the clergy,
•an absence of effective social laws and
•the predominance of foreign monopoly corporations.
In this panorama, with the authorities as the direct representatives of the upper social classes, doctors have to take things very slowly in order to keep the government neutral or win it over. Therefore, they should fulfill their obligations to the higher health authorities, while at the same time demanding that those authorities provide as many resources as possible. They must wage virtually a personal struggle against the exploiters, separate from the central bureaucracy, while ensuring that their medical-social activities are not seen as part of the political struggle.
It seems hardly necessary to emphasize that the doctors’ work should be carried out with complete dedication, for this is what will make their ideas triumph over the inconsistent, mercenary activities of their individualistic colleagues, who view their role only as a means toward their desired goals— whether this is power (the relative power wielded by the doctor in a village), fame or money. Revolutionary doctors should always remember that it is their duty to attack whatever problems adversely affect the people, who are the only ones they should serve.
The Awakening of Latin America Page 11
