Smallpox vaccination, the establishment of vaccination boards, and state formation in Venezuela and Cuba in the nineteenth century

The Balmis expedition, sent to America by the Spanish monarch Charles IV in 1803, was a watershed in the history of Medicine as it made smallpox vaccination available for the first time, effectively prevented the disease from spreading, and saved thousands of lives. Immunization required complex administrative measures and political decisions including the creation of Vaccination Boards, all of which involved different sectors of Spanish American society. This dissertation argues that at the beginning of the nineteenth century the Spanish American colonial state had reached some level of maturity and cohesion that made it capable of executing this complex project in public health. The significance of this mobilization and the every-day experience in implementing this new public health measure is the center of this work. It is situated geographically in Venezuela and Cuba, entities which took different evolutionary paths in the nineteenth century. The organization and functioning of Vaccination Boards in these two areas are used to illustrate the state formation process, and sharp political differences in this critical period.

Forging professional public health nursing in a southern state: Florida's public health nurses, 1889-1934

From 1889 to 1934, Florida's nurses belonging to a new group of professional women ushered in a pioneering phase of public health nursing in Florida. During this era, the nurses' ability to confront health and professional issues varied a great deal but in quiet and forceful ways they tackled cultural and environmental problems to assist people who were ill or help prevent people from becoming ill. This dissertation places the development of professional public health nursing in its social context by uncovering the relationships public health nurses formed with clubwomen, the medical profession, city leaders, midwives, and others. In 1888, there were few graduate nurses in the state, no state board of health and no organized nursing service to respond to Jacksonville's great yellow fever epidemic. By 1934, national and state leaders of public health nursing had built up the profession to become an essential part of the State Board of Health's service to the community. Between these milestones, in the era of white supremacy and Jim Crow, public health nurses combined their professional training with a pioneer spirit of innovation and risk-taking. In the predominately rural state, the public health nurses' resolve to overcome environmental hazards and cultural obstacles stands out as they attempted to reach those who were unserved or underserved by modern medicine.