i n t r o d u c t i o n
Throughout the first half of the twentieth century, Bolivia pre-
sented formidable public health problems: tropical and even tem-
perate zones were plagued by malaria and yellow fever; yaws and
hookworm were endemic in low-altitude zones, while whooping
cough, typhus, and typhoid were especially common in high alti-
tudes; and people in all parts of the country suffered from tb, small-
pox, venereal disease, and illnesses generally associated with lack of
pure drinking water and with malnutrition. Silicosis was accepted
as an occupational cost for workers who mined tin, the country’s
most important export. Everywhere infant morality was very high.
In 1900 Bolivia had a population of 1,633,610 people, and by 1950
it had grown to almost 3,000,000. Yet its health statistics and most
common illnesses remained substantially the same throughout the
half century, and, despite concerted campaigns against specific dis-
eases in the 1930s and ’40s, some health problems became worse. By
the early 1950s, although control measures had reduced malaria in
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