In much of Latin America, Indigenous and Afro-descendant medicine operated, if not thrived, alongside scientific medicine. In most places, authorities and medical professionals disparaged and discounted Indigenous and other traditional medicines and their practitioners. Yet in Mexico, healers, scientists, officials, and patients have sought to establish a generative relationship between biomedicine and Indigenous healing. Joshua Mentanko carefully demonstrates how intercultural medicine—dubbed as such by Mexican medical elites—shaped by national and international economic and political forces. Mexico’s ruling party, the Partido Revolucionario Institucional (PRI), for example, used intercultural medicine to enhance their political support. Remarkably, much of that collaboration was fomented without much infrastructure to support it.
Framing exchanges between diverse health care epistemologies and practices as hybrid healing or medical pluralism can obscure the power relations in those dynamics. In some places, like Guatemala, state agents and medical professionals persecuted Indigenous healers even as elites sometimes consulted them. In other places, like Bolivia, Indigenous healing and medical science often enjoyed parallel trajectories without much tension between them. With his analysis of intercultural medicine in Mexico, Mentanko centers power. He argues that Indigenous curers were formidable adversaries because they were recognized as having the power to heal and harm. The medical professionals and politicians who approached them had to account for that sway. Of course, the state and scientific medicine too had the power to harm and heal. Rural Indigenous and other peoples knew those powers and medicines well. With careful attention to detail, Mentanko traces how intercultural medicine changed over time in response to political, social, and economic trends and the influence of those who implemented it. As was true in other Latin American nations with large Indigenous populations, Indigenous and scientific medicine were inextricably intertwined long before intercultural medicine outreach began.
A tireless leader and facilitator of institutionalizing the Mexican revolution, President Lázaro Cárdenas (1934–40) has been studied extensively by historians. Mentanko provides a fresh perspective on his administration by demonstrating how Cardenismo and indigenismo, which Mentanko defines as a “contradictory brew of romantic and disparaging views of indigenous peoples” (13), coalesced around the shared goals of improved health care and economic development. During Cárdenas’s administration, intercultural medicine sought to expand access to health care for rural Indigenous populations and reduce poverty.
Eschewing reductive portrayals of Indigenous people as traditional and wary of modernization, Mentanko explains that they do not so much critique scientific medicine, but rather lament their lack of access to it. They also recognize the power of narrating the past. The Nahua writer Natalio Hernández envisioned “an education that would really allow us to interpret our history, to become conscious and understand the historical process taking place” (127). As Mentanko and other ethnohistorians have revealed, many Latin American indígenas (Indigenous people) have been doing just that to better understand their past, strategize for their present, and forge their future.
At the same time intercultural medicine advocates brought Indigenous and rural health care providers and patients into the national fold, the government deployed hospitals to expand its power and influence. Mexico City housed the most (and often the best) hospitals. When intercultural medicine failed to cure patients, they were compelled to embark on what historian Sara Hidalgo, in a 2024 article in Mexican Studies/Estudios Mexicanos, calls “medical journeys.” Hidalgo documents how hospital use increased throughout the early and mid-twentieth century, which roughly coincides with the state’s effort to roll out intercultural medicine. Did that expansion in rural Indigenous communities compel more patients to move beyond local health clinics when they needed to consult medical professionals in the capital?
At times Mentanko’s narrative focuses on a few “great” men (particularly the doctor and anthropologist Gonzalo Aguirre Beltrán) to the detriment of learning more about the Indigenous healers, doctors, and organizers so crucial to advancing intercultural medicine. In part, that may be because COVID-19 curtailed the author’s plan to conduct oral history research in Mexico. Despite that limitation, he conducted some dozen oral history interviews with traditional doctors, midwives, and educators. Unfortunately, he does not elaborate on the whether the interviews were conducted in Spanish or Indigenous language(s). That is a surprising oversight when set against his otherwise fine-grained analysis of ethnicity and medical cultures. More broadly, Mentanko conducted excellent archival research and adeptly employs contemporary ethnographic studies to enrich his description of Indigenous people, customs, and healing.
The book boasts evocative images, but Mentanko seldom incorporates analysis of them into the text. At times, when he describes an image (e.g., on p. 59), it appears far from its location in the text (p. 83). Broad assertions such as his claim that “the visual archive of the indigenista public health materials testifies to this intercultural character” (59) leave the reader wanting thick descriptions in the captions, as modeled by disability scholars, and analysis of the images in the text. But these are minor quibbles for a book that advances our understanding of how multiple parties enjoyed the power to facilitate pluralistic therapies and multiple pathways toward healing in Mexico. The Power to Harm and Heal provides an excellent model for scholars and students studying health care in nations with significant Indigenous populations.
