An interview with Raúl Necochea López, author of “Dra. Edelmira Will See You Now: Cancer Care and Informal Healing in Early Twentieth-Century Colombia”

Raúl Necochea López is an associate professor in the Department of Social Medicine at the University of North Carolina at Chapel Hill. He is the author of A History of Family Planning in Twentieth-Century Peru (University of North Carolina Press, 2014) and coeditor of Peripheral Nerve: Health and Medicine in Cold War Latin America (Duke University Press, 2020). You can read his article “Dra. Edelmira Will See You Now: Cancer Care and Informal Healing in Early Twentieth-Century Colombia” in HAHR 105.4.

Interview by Rebeca Martínez-Tibbles

1. What inspired you to explore the history of informal healers like Edelmira Salazar de Guzmán and their role in early 20th-century cancer care in Colombia?

I’ve been studying the history of cancer care in Latin America for several years now. Back in 2019 I read Edelmira Salazar de Guzmán’s 1924 book at the Biblioteca Luis Angel Arango in Bogotá, and it impressed me because of how savvy she was at positioning herself as a cancer specialist among surgeons, health authorities, and patients. Fantastic Latin Americanists have created new ways to think about these informal healers, including Pablo Gómez, Diego Armus, Patricia Palma, and Irina Podgorny. Their work helped me see Edelmira Salazar as part of a long line of people who challenge the health care establishment out of self-interest and also out of real concern for what it doesn’t address and whom it leaves behind.

2. How did Edelmira Salazar’s approach to cancer care challenge the medical establishment of her time, and what do you think made her methods resonate with patients?

She challenged the establishment by going after physicians’ dismal record when it came to cancer care. Their go-to approach at the time, surgery, was ghastly, expensive, and offered few guarantees of long-term success. Hers involved no cutting, was inexpensive, and was illustrated using dramatic examples of “success” among her patients. These features of her approach resonated with patients, especially working-class Bogotanos. This is not to say the latter extended her a blank check. Many noted that her treatments were rough on the body, and they came forward to support her only when sufficiently satisfied of the benefits of her interventions.   

3. Can you elaborate on the significance of patient testimonials in shaping public perception of informal healers like Salazar?

The testimonials are tricky sources. On the whole, of course, they highlighted positive experiences and, furthermore, made the case that Salazar deserved authorization from the government to expand her practice. But readers of testimonials, then and now, need to weigh them critically. Salazar influenced the effect of the testimonials by inviting only certain people to speak for her, and by selecting the precise number of testimonials that Colombian authorities required for her to get a permit to practice. On the other hand, Salazar did not completely control the narrative. If no one had had anything positive to say about her care, there would have been no testimonials at all. Furthermore, each testimonial was vetted by a government officer who was not invested in Salazar’s survival as a healer. Finally, some of the testimonials clearly state that Salazar’s treatments were hard to endure: grudging approval makes the approval all the more salient. All this, on balance, enhances the credibility of these testimonials.

4. How did eugenic discourse shape public health policies and attitudes toward diseases like cancer during this period?

During its heyday in the early twentieth century, eugenics encompassed various proposals to spread the “better” inheritable traits of humanity, as defined by eugenics proponents, typically well-educated members of the upper-middle classes in various nation-states, including in Latin America. Salazar’s story is interesting because it shows that eugenic discourse was also appropriated by working classes in Latin America. The latter were less inclined to blame groups of people (the poor, especially) for spreading inheritable illnesses, and more inclined to zero in on insalubrious environments as the root causes of disease, including cancer. They were also keen on well-publicized and state-sanctioned solutions that were affordable for all. One can trace a complicated but still discernable line between this working-class-inflected eugenics and contemporary social medicine in Latin America.

5. What parallels, if any, do you see between the challenges faced by informal healers such as Salazar in the early twentieth century and current debates about alternative medicine and healthcare accessibility?

Although Salazar was not a physician, she understood well that success as a healer did not, at the time, hinge on her credentials as much as on confident theatrics, understanding legal loopholes, appealing to public sentiment against the medical establishment’s shortcomings, and reasonable prices. A century later, and even in a place like the US, I think we can relate to how these skills can undermine trust in experts and health systems. But the way in which this happens is not historically inevitable or permanent.

6. Read anything good recently?

I am reading Song of the Crocodile, a novel by Yuwaalaraay author Nardi Simpson. It’s about three generations of an Aboriginal family in a small town in Australia. I picked that up in Sydney during a short research residence last December. And I just finished reading the 1787 thesis of José Manuel Dávalos, “Sobre algunas enfermedades que circulan en Lima y su tratamiento.” I had been wanting to get to that ever since I read José Jouve Martín’s research on the Black doctors of colonial Lima.