Costa Rican Cholera

The Costa Rican state was singularly successful in preparing for the epidemic that swept Latin America in the 1990s after the disease, absent from the continent for over a century, appeared unexpectedly in Peru early in 1991. The small Central American republic was under great pressure due to the armed civil conflicts that had destabilized its neighbours to the north, the dismantling of state institutions in the wake of the debt crisis, and a huge wave of illegal migration from Nicaragua where cholera had hit hard.

         The state’s medical officers drew on a century-old investment in public health infrastructure and a highly literate civic culture of hygiene to respond to the threat. While its neighbours saw cholera cases in the thousands, and deaths in the hundreds, Costa Rica easily treated and contained a little over one hundred cases, and escaped the continental epidemic without a single death. This collection brings together a range of educational materials developed by the Ministry of Public Health to mobilize the public to prevent the spread of cholera, from popular pamphlets and radio ads to posters used by health promoters. It also presents interviews with microbiologists who were in the front lines of cholera response in the Hospital of Upala on the frontier with Nicaragua.

Special thanks to Daniel Pérez for research assistance, and to the librarians and archivists of the Costa Rican Ministry of Health.