Geography is key in this spirited book, where the Mexico-United States borderlands lie abuzz with the transit of disease, public health officers, soldiers, local and federal authorities of two countries, as well as Mexican, African-American, and white American citizens. The earnestness of the public heath interventions implemented highlight three important matters for Latin Americanists: the ubiquity of human mobility in this region, the variety of interventions deployed by the US Public Health Service and the US Marine Hospital Service, and the options available to populations singled out for health surveillance by local medico-political forces.
By the 1840s, the borderlands in McKiernan-González's story had been a part of Mexico far longer than they had been a part of the United States. Mexico's territorial losses in the aftermath of the war in 1848 did little to diminish the influence of Mexicans and people of Mexican descent to the economies of the areas the United States acquired. A new fact of life for Mexican populations in the borderlands, control by US authorities included public health measures cast as ‘privileges of citizenship’ (p. 17) that evinced levels of intrusiveness and antagonism absent from health authorities' dealings with white Americans living in the same places. Public health officers in Brownsville, Rio Grande City, Laredo, Eagle Pass, and El Paso, key cities in Fevered Measures, derived much of their power from their ability to control the mobility of residents and migrant workers alike, with an eye to the danger their potential and actual illnesses might harbour for residents beyond the border.
Smallpox, typhus, and yellow fever are recurrent entities over the near century the book covers. Readers will note the rising authority of US public health officers over this period, thanks to their increased efficacy treating diseases and translating their concerns into medical policies for the provision of vaccines, the fumigation of households, worker quarantines, and the disinfection of individual migrants walking across the border. The choices these experts did not make are as telling as those they made, such as when they opted to tear down the Chihuahuita neighbourhood of El Paso in 1916, upon suspicion of its harbouring typhus, instead of targeting the pathogen-carrying rats in this poor part of town. Their choices are also tied to the changing political environment, which, for example, quashed the idea of a boundary health commission in 1938, yet permitted the emergence, after some 15 years of debates, of the United States–Mexico Border Health Commission in 2000.
The rationales for the organisation and selection of cases for the book are not as apparent as the evidence for the seven chapters is rich. Without such clear signposting the level of detail becomes unwieldy at times. The distinctiveness and significance of chapters 1, 5 and 7, in particular, did not become clear to me until I was several pages into each, and even then I strained to relate the substance of those chapters to their long titles: ‘From the US-Mexican War to the Mexican-Texas Epidemic: Fevers, Race, and the Making of a Medical Border’; ‘Domestic Tensions at an American Crossroads: Bordering on Gender, Labor, and Typhus Control, 1910–1920’; and ‘Between Border Quarantine and the Texas-Mexico Border: Race, Citizenship, and National Identity, 1920–1942.’
On the other hand, McKiernan-González's depictions of lay people dealing with smallpox prevention policies are so thorough and elegant as to deserve second readings. The story of the African-American colonists from Alabama swindled by the Tlahualilo Agricultural Co. out of a promised living not only compels indignation long after 1895, but also expands our understanding of who were the migrants at the border, and explains the lengths the US government would go to opportunistically organise a field experiment for a smallpox treatment on a quarantined population of its own citizens, while offering little actual care. McKiernan-González's skills weaving complex motivations into lively narrative are again on display in his analysis of the misadventures of border crossers who defied US Public Health Service officers' attempts to enforce a smallpox vaccination policy in the 1910s. With the Mexican Revolution unfolding, the public health officers fell back on the position that ‘an unpredictable nation fostered unreliable bodies’ (p. 205) to justify their mistrust for the vaccine scars exhibited by Mexicans travelling to the United States. The latter, in turn, objected to re-vaccination and responded with insolence and disobedience, some of it abetted by Mexican consular officers at the border, who stood to gain legitimacy by supporting the outrage of the ‘gente decente’.
Fevered Measures succeeds in documenting the long, fraught, and uneven dialogue about the meaning of good health between people in two countries that share a porous border. It is important reading at a time when Mexican officialdom has changed its tune regarding Mexicans in the United States. Consular officers, who long deemed these migrants as traitors and worthy of scorn and contempt, now hail them and their descendants as resilient heroes. The changes that began with the Comunidades programme in the 1990s and continued with the Instituto de los Mexicanos en el Exterior since 2003, have encompassed a clear mandate to offer additional options to care for the health of Mexican citizens in North America. What interventions will become politically feasible? Who will have access to them? How will US public health authorities take to this invigorated public health activism by its neighbour? As before, human geographic mobility, available public health interventions and public reactions to such interventions will be essential to our understanding of the two nations' decisions about what and who might pass through those borders.
