title: Public health policy and the building up of a Brazilian medical identity.
abstract: Since George Herbert Mead studied "the social self" and the interactionists went further in distinguishing "images of self", a lecture on the building up of a Brazilian medical identity should try to focus on the patterns of self-images, presented images, and aspired-to images among the Brazilian medical elites during the First Republic (1889-1930). In no other period of Brazilian history were those "images" of professional identity so close--in contrast, later periods of Brazilian history witnessed an almost permanent "collision" or the clashing of such images among public health specialists. Oswaldo Cruz, Carlos Chagas, Artur Neiva and Belisário Pena are perhaps the best examples of successful careers as "sanitarians" (to recall John Duffy's historical work on luminaries before and after the "New Public Health" in the United States), and as important political actors during Brazil's First Republic. In light of the prominent political, policy-oriented, and scientific roles public health professionals played in Brazil, it is interesting to suggest that in large part such prominence resulted from the symbolic impact of the ideologies of sanitary reform on the political agenda of that period of Brazilian history. Where many studies look for personal rivalries and disputes around Chagas and Neiva as public figures, we may also see the importance of finding identity-building processes among public health specialists as an integrated group (e.g., trying to appear as "significant others" for the new generations of medical graduates in the country), regardless of existing rivalries. Cruz and Chagas, especially, were names with great impact in the Brazilian press (pro and con), a circumstance made possible largely by their easy and direct access to the Brazilian presidents Rodrigues Alves and Epitácio Pessoa, and, most clearly, by public health being one of Brazil's political priorities to find a place among the "civilized nations" of the world. A task that further concerns us is the drawing of a few tentative and very crude comparisons between identity-building among the medical and sanitary professionals in Brazil and France.
authors.affiliation: Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Brazil. lacs@compuland.com.br
authors.forename: L A
authors.initials: LA
authors.lastname: de Castro-Santos
mesh_terms: D000047:Academies and Institutes / Q000266:history; D001938:Brazil; D006076:Government / Q000266:history; D006291:Health Policy / Q000266:history; D049672:History, 19th Century; D049673:History, 20th Century; D007391:International Cooperation / Q000266:history; D010820:Physicians / Q000266:history / Q000523:psychology; D011634:Public Health / Q000266:history*; D012936:Social Medicine / Q000266:history*; D014330:Tropical Medicine / Q000266:history*