The Politics of Health in the Lusophone Libertarian Movement: Portugal and Mozambique, 1910–1935

Abstract

Significant advances in the study of the historic labor movement have entailed new work on the intersection between political parties, trade unions and subjects such as ‘race’, colonialism, sexuality, masculinity, and the reception of scientific ideas. The intersections between the labor movement and the politics of health, however, have been neglected to date both in labor studies and in social studies of health care and provision. This article builds on my on-going research into the dynamics of the Lusophone (Portuguese-speaking) labor movement in the form of anarchism and syndicalism and explores, specifically, the reception of ideas on health and the attainment of healthy working conditions and lifestyles as a central aim of these working-class movements. This study examines, among other aspects, the reception of ideas on nutrition, medical care, the provision of hospitals, the responsibility of medical professionals, sexual health, the consumption of alcohol and the provision of quality housing for workers within a framework that critiqued capitalism and the state and the relations they fostered.

A further dimension is incorporated into this study. This is the colonial dynamic at play between Portugal and its colonies, in this case Mozambique. What were the relations between the Portuguese syndicalist movement and the emerging trade union movement in Mozambique? To what degree did concerns in Portugal over issues of health find resonance in this African colony's labor movement? To what degree was the largely white labor movement in Mozambique attuned to local knowledge on health and racial issues surrounding health? What specific aspects of health and medicine were broached in the colony and how did these interact with an anticolonial critique and discourses and practices of ‘tropical medicine’?

This study, through a detailed analysis of a range of libertarian periodicals in Portugal and Mozambique during the movement’s period of maximum influence provides responses to these questions and makes a contribution to transnational research on labour movements through the interconnecting linguistic and class dynamics of the Lusophone world.

Introduction

This article aims to make a distinct contribution to two fields that have hitherto remained largely separate: the history of labor movements and the politics of health. It focuses on two countries, Portugal and Mozambique, divided by geography but connected by colonialism, language, and the existence of powerful trade union movements inspired in the early twentieth century, to varying degrees, by anarchism. Discussions on issues pertinent to health, from demands for adequate nutrition to greater workplace and domestic hygiene, from the prevention of disease to the provision of medical facilities, were incorporated into workers’ struggles in both countries, not as peripheral subjects but as core concerns.¹

A consideration of anarchist discourse on health-related issues such as those mentioned above not only expands our knowledge on the engagement of leftist movements with issues that go beyond traditional economic demands. A discussion on shared discourses and priorities around health also employs a largely untested lens through which to evaluate whether these avowedly internationalist movements were able to break with the constraints imposed by the inherently inegalitarian workings of “race” and colonialism. In addition, such an inquiry assesses how far alternatives to conventional and state-oriented western medical interventions were posited by workers’ movements in Europe and colonized countries in Africa.

In tune with recent historiographical trends, there has been an on-going re-evaluation of anarchism as “the world's first and most widespread transnational movement organized from below.”² Accompanying this broadening vista is a focus on movements outside of Europe and the Americas and on the reception by anarchism of wider phenomena such as nationalism, gender, and “community” struggles following the insights of global and transnational histories.³ A small number of studies have gone further still by attempting to decolonize anarchist history, thereby allowing for a critique of the relationship between “centre” and “periphery,” the metropole and colony, and for an examination of how questions of “race” informed anarchist practice.⁴

Despite the ways in which “anarchist thought can creatively contribute, even provide solutions” to current debates on health by providing alternative visions of what “good health” within a salutary environment could be,⁵ there has been little discussion of anarchist health-related undertakings either historically or in relation to present-day medical bioethics.⁶ Existing work on anarchism and health-related issues centers principally on the revolutionary experiences of 1930s Spain.⁷ Publications on anarchist psychiatric reform in Catalonia and on the transformation of sanitary provision in Valencia provide significant developments in the field, showing how for libertarians a radical transformation in health and, therefore, society was impossible without the destruction of capitalism and the complete overhaul of medical provision; indeed, capitalism and hierarchical relationships were deemed causes of ill health rather than the latter's remedy.⁸

Just as the geographical spread of research on anarchist movements has expanded, in the last twenty-five years the historical interconnections between health and colonialism have also constituted a site of interest from a variety of perspectives. The role of medicine as a seat of power within colonialism has been revealed,⁹ and, it has been acknowledged that medical interventions “played a pivotal role in shaping the contours of European colonization of Africa.”¹⁰ The fundamentally unequal power relationship between colonizers and colonized has also meant that Western biomedicine played a major role “in creating and reproducing racial and gendered discourses of difference.”¹¹

Class and the power dynamics that surround it in relation to medicine and colonialism, however, continue to be understudied aspects;¹² this is certainly the case in Lusophone contexts. Although there is an increasing body of work on early twentieth-century Portuguese colonial and tropical medicine,¹³ on medical practices in Brazil, Portuguese-speaking Africa and the East,¹⁴ and, on the interface between European and local medical knowledges in Mozambique and Angola,¹⁵ work on medicine in the colonies is under-developed.¹⁶ There has been almost no work on the history of medicine and health in relation to Portuguese-speaking labor organizations.¹⁷

The Labor Movement in Mozambique and Portugal

More than twenty years ago, the authors of African Anarchism: The History of a Movement observed that “Anarchism as a social philosophy, theory of social organization, and social movement is remote to Africa – indeed, almost unknown.”¹⁸ Despite this, certain initiatives, such as the syndicalist Industrial Workers of the World (IWW) in South Africa, operating in the 1910s, enrolled large numbers of African workers as well as Europeans,¹⁹ and the mostly Black syndicalist Industrial Workers of Africa, although small, had some influence.²⁰ In Mozambique, in addition to their stronghold in primarily European émigré industries such as the railways,²¹ some unions also recruited local workers who moved across national borders in search of employment in the gold mines of the Rand.²² Labor movement dynamics in Mozambique, however, were heavily constrained by the oppressive apparatus of colonial rule and by racial prejudice.²³ Even though Lucien Van der Walt has argued that the close links maintained by unions in Mozambique with Portuguese anarcho-syndicalist and socialist movements impeded the development of so-called “White Labourism” in Lourenço Marques (now Maputo),²⁴ the reality is that the division of the population into “indigenous” and “whites” upheld the racial, economic, political, and health hierarchies at colonialism's foundation.²⁵ Trade unions, political movements, and strikes led by Europeans often excluded Africans or brokered deals that improved the situation of whites only, thereby reinforcing a climate of mistrust and hostility.²⁶ Colonial health policies added to these divisions, as the 1912 Lourenço Marques Health Council's recommendation to keep indigenous habitation away from European settlements in the city center shows.²⁷

Integral to the white-led workers’ movement in Mozambique was the lack of clear demarcation between socialist and libertarian or anarchist movements, an example of the “uniquely hybrid manifestation” of global anarchism in the African context.²⁸ While this poses a challenge for interpretation, the search for strict “coherence” impedes an understanding of the permeability of leftist movements in the colony and their shifting alliances in the search for the most effective modus operandi on the ground.²⁹ Such ideological heterogeneity permitted the creation of cooperatives and trade unions, support for candidates for elections to local and state bodies together with more “classical” libertarian forms of organization. As Capela has pointed out in his history of the Mozambican labour movement, even the anarchist-leaning periodical Os Simples (1911–1915) shared this rather ecumenical nature by declaring that it had no defined political ideology.³⁰ There were, nevertheless, some small-scale initiatives in the 1910s that were much closer to European-style anarchism in Lourenço Marques such as the Francisco Ferrer Circle and the anarchist group “Resurgir.”³¹

Despite this ideological fluidity, Capela notes that anarcho-syndicalism, brought by metropolitan workers, was the dominant trade union influence in Lourenço Marques in the 1910s and 1920s.³² The Lisbon daily A Batalha, the mouthpiece of the predominantly anarcho-syndicalist Confederação Geral do Trabalho or General Confederation of Labour (CGT), was widely read in Lourenço Marques,³³ being available for sale at the city's Livraria Roque Ferreira bookstore.³⁴ The CGT was initially evaluated positively by the weekly socialist paper O Emancipador (1919–1937), a publication that acted as an organizational hub for the ideologically diverse labor movement in the capital.³⁵ O Emancipador itself had libertarian roots, having grown out of the more explicitly anarchist O Germinal (1914–1918) on whose press it was printed, and followed the Socialist Party in Lisbon until 1921, when it declared its independence as a result of disagreements over the tactics employed by the metropolitan party.³⁶

The Lourenço Marques General Union, a new union of all trades that was sponsored by O Emancipador, affirmed its opposition to involvement in parliamentary politics and acted, it stated, primarily in the defense of workers’ economic interests.³⁷ The General Union's secretariat on November 14, 1921, decided accordingly to recommend affiliation to the Portuguese CGT,³⁸ while also maintaining the right not to adopt explicit anarchist tactics in its struggles.³⁹ By mid-January 1922, the CGT's logo featured on the paper's masthead.⁴⁰ Co-existing for some years with O Emancipador was another ideologically heterogeneous publication, the militant weekly O Incondicional (1910–1920).⁴¹ Print runs of these periodicals were small (and their appearance somewhat erratic as a result of repression); in March 1932, O Emancipador recorded its production at 1,500 copies.⁴²

The CGT-influenced railway workers union in Lourenço Marques, nevertheless, achieved a certain degree of leverage. Lourenço Marques's railways provided a high proportion of the province's income; in 1903–1908 this was 25 percent; in the ten years after WWI, it accounted for 15 percent.⁴³ The 1917 strike by white railway, tram, and port workers led to a state of siege being declared. The subsequent strike of 1925–1926 was prolonged and constituted the last major confrontation before military rule was established in Portugal in 1926.⁴⁴ Although unsuccessful and despite the considerable power of the railway unions, the complexities of this last strike illustrate how relatively weak the Mozambican trade union movement was and how it continued to be fragmented along racial and sectorial lines. Mainly single male workers from the metropole took up qualified roles, whereby African workers were placed mainly in unskilled work, despite the progressive professionalization of Africans across most sectors between 1912 and 1927 (apart from health).⁴⁵ Those sectors that enjoyed better organization were where the reserve army of European workers was smallest. In the 1925 strike, individuals from Macau and Mauritius took up strikers’ posts and the stoppage almost entirely failed to halt the circulation of trains by non-Europeans.⁴⁶

As the above discussion shows, these publications and unions in Mozambique were clearly not “anarchist” in any straightforward manner. In Portugal, there was a much larger range of libertarian publications and organizations with closer ideological affiliation. Of the most influential and long-standing organizations was the CGT, which boasted a membership of between eighty-five and ninety thousand between 1920 and 1922.⁴⁷ According to individuals involved centrally in the paper's editorship, between 1921 and 1923 some forty thousand copies of A Batalha were printed.⁴⁸ The paper also published a cultural supplement under the title A Batalha. Suplemento literário e Ilustrado (1923–1927), and both publications paid increasing attention to issues of colonialism and the need to oppose it.⁴⁹

Nutrition, Class, and Health

Josep Barona has argued that in the twentieth century “nutrition became a major concern for most European governments, for civil society and for social and charitable organisations.”⁵⁰ Portugal, however, lagged far behind. The “public health system was rudimentary,” state involvement was minimal, and provision relied on the “centuries-old tradition of charity (beneficência).”⁵¹ Attention to health matters including nutrition, however, was evident in the broader press,⁵² and anarcho-syndicalist publications emphasized the impact of economic penury on hunger, turning access to adequate supplies of quality food into a central working-class demand. There were good reasons for this: the poor quality of food supplies, the inability to purchase adequate quantities, and the fact that food costs consumed most workers’ entire wages.⁵³ Following the November 1918 general strike called by the forerunner of the CGT, the União Operária Nacional (National Workers’ Union) to protest against the high cost of living,⁵⁴ the CGT agreed at its founding congress in September 1919 that A Batalha should adopt a “modern look,” meaning that it was to carry articles on science, art, sociology, hygiene, and literature.⁵⁵ As part of this remit, it regularly protested about the increasing cost of basic foodstuffs, including bread, fish, vegetables, and beans, as well as coal for heating.⁵⁶ The tried and tested syndicalist methods of wage demands and the strike were advocated to attenuate price rises. In addition to striking for higher pay, CGT unions advocated the organization of collective canteens. Striking railway workers were supported by such an initiative, described as “communist kitchens,” in the summer of 1919.⁵⁷ The fact remained, a 1919 article asserted, that the Portuguese population suffered the most deficient nutritional intake in Europe.⁵⁸

Inadequate levels of nutrition, anarchists argued, resulted from broader patterns of deprivation affecting the working class. In A Batalha's literary and cultural supplement, one author, Roque Simões, argued that in Lisbon poor food, “promiscuity” (understood mainly as overcrowding), syphilis, and alcoholism resulted in a high mortality rate especially among workers.⁵⁹ If proper measures to combat these conditions were introduced, Simões argued, they would result not only in better general health but also in the “reinvigoration and perfection of the [human] Race.”⁶⁰

As well as highlighting the causal linkages between poor health, nutrition, and poverty, Portuguese anarcho-syndicalists focused on the practicalities of disease prevention. This was not from an oppositional politics of “anti-medicalization”—anarchists were not generally concerned with “over-medicalization” but instead with the absence of medical provision. Anarchists attempted to steer individuals toward improvements in their health through the application of scientific knowledge in the transformation of diet and the environment. Such a strategy included raising awareness about disease. The progressive feminist doctor Adelaide Cabette published insights in A Batalha on different aspects of hygiene in short didactic articles. She brought the dangers of children touching dogs to readers’ attention and discussed the workings of microbes in an accessible questions-and-answers format.⁶¹ Other authors addressed the lack of hygienic conditions in tailors’ workshops, a situation that was described as meriting “the greatest attention by our class.”⁶²

In a country with low levels of state development, rates of illiteracy of over 60 percent,⁶³ and a largely traditional economy, anarchists also addressed the relationship between poor hygiene and poverty: “poverty,” one piece read, “is the enemy of cleanliness,” affecting one's mental health.⁶⁴ It was more than just a question of washing one's face in the morning or changing one's shirt collar; poverty, Machado argued in 1919, entered the psychological state of the individual. While the rich could renovate their properties, workers endured inadequate housing. The few institutions provided by capitalism—namely schools, hospitals, and prisons—left the “mark of poverty, the branding of degradation that accompanies the people's lives.”⁶⁵

The question of adequate nutrition was also addressed from a class perspective by O Germinal (1914–1917) in Lourenço Marques in the same decade. Reflecting the local culture of ideological non-alignment, in 1915 it came out in favor of the candidature of Alfredo de Magalhães for deputado of Mozambique.⁶⁶ Such a position did not prevent it, however, from reporting on the creation of a new libertarian group in the capital. This group, O Germinal announced, would work toward the observance of laws on accidents at work, would act for press freedom, and would also protest against the cost of living.⁶⁷ Alongside debates on hygiene in the city markets and the privations experienced by the indigenous population, as highlighted by the local papers O Africano and O Brado Africano,⁶⁸ the question of food supplies was raised constantly by O Germinal in 1916 and 1917. In October 1916, the paper signaled the difficulties caused by the war, resulting in insufficient food “for the formation of healthy and robust bodies.”⁶⁹ The upcoming May Day commemorations would be used to protest against the cost of living and the proliferation of hunger and diseases such as tuberculosis.⁷⁰ The inequalities fostered by colonial economic relations were denounced explicitly in May 1917 when it was declared that there was a lack of fish, otherwise abundant in the locality, and a shortage of bananas despite the trains exporting to the Transvaal being full.⁷¹

The paladin of the working classes in Lourenço Marques, O Emancipador, also took up the issue of poor-quality food and deficient nutrition. In an on-going section, “Complaints and demands,” in March 1920, it highlighted the high price of bread and meat.⁷² A long series of articles in May 1920 focused on rising food costs.⁷³ Such denunciations, including a report on the famine in Cape Verde,⁷⁴ were interspersed with pro-CGT sentiment and calls to the workers of Mozambique for solidarity with no distinction of race, color, or creed.⁷⁵

Alcoholism and Tuberculosis

Both the Portuguese and Mozambican movements addressed the twin scourges of alcoholism and tuberculosis (TB) as part of their attention to issues affecting the health of workers. In the case of Portugal, tuberculosis was the chief cause of death in the early twentieth century, accounting for up to twenty thousand fatalities per year.⁷⁶ The causes of TB, according to a writer in the November 1919 issue of A Batalha, who focused on a “bourgeois and ineffectual” initiative in Paris against TB,⁷⁷ arose from the combined forces of over-crowding (referred to as “surménage”), impoverishment, and poor nutrition.⁷⁸ It was no use doctors telling workers to eat better, to take the mountain airs of the Serra da Estrela in the north of the country, or to inhale the sea breezes of Madeira. Tuberculosis would only be beaten by means of a social transformation, something impeded by the bourgeoisie. The disease, the author continued, was in fact a kind of social illness, arising from the conditions in which people lived; it would not be defeated by recourse to the same structures that had allowed it to flourish in the first place. The inauguration of an anti-TB initiative, this time in Lisbon, was in turn dismissed as a “bourgeois farce” in 1931, in the Mozambican O Emancipador, a paper that had already taken up the campaign against the disease and its effects in both Portugal and Mozambique.⁷⁹ In this 1931 account, probably written by a Portuguese expatriate, the origins of the problem were placed in the “terrible and deficient nutrition among the working classes in the country.”⁸⁰

In addition to concerns about transmissible diseases and nutrition, the consumption of alcohol became an important concern for anarchist and socialist movements not only in Portugal and Mozambique but elsewhere too.⁸¹ Partly a “moral” concern, partly a health issue, leftist movements viewed alcohol and its excessive consumption as an impediment to workers’ health and a brake on collective solidarity, leading them to advocate alternative forms of sociability beyond the nightly tavern. A Batalha tried to attract workers to public conferences on the subject, as the publicity provided for the talk given by Luciano da Silva at the Lisbon Socialist Centre in August 1919 suggests.⁸² It also attacked the production and sale of alcohol for consumption in the colonies. An article in 1919 noted that the British government had prohibited the importation of alcohol to the country's colonies; lamentably, Portugal had not followed suit.⁸³

Although the precise uptake of teetotalism among workers is hard to pinpoint, the links between organized anarchism and anti-alcohol campaigns are readily discerned by the convening of a public meeting held by the Workers’ Anti-Alcohol Association in March 1922. This meeting was to take place at the same address, the Calçada do Combro, 38-A, 2°, Lisbon, as the headquarters of the CGT and a cluster of libertarian organizations and publications, including the Syndicalist Youth and the review Renovação.⁸⁴ It was hoped, the text of invitation read, that the proletariat would appear in large numbers to hear the address by the association on the “physical as well as moral damage” that this “terrible enemy” wrought on workers, serving only to “brutalize and enslave” them.⁸⁵ Such concerns were reinforced in A Batalha's weekly cultural supplement where female workers in particular were advised not to consume alcohol.⁸⁶

In Mozambique, the problem took a different form. The state labor force was comprised of convicts who had no money to spend on alcohol and who were restricted to barracks.⁸⁷ It was only those employers who depended on a paid labor force that had to worry about drunkenness.⁸⁸ On the one hand, there were powerful Portuguese wine lobbies that operated in Mozambique, and which constituted a significant “pillar of colonial trade”;⁸⁹ on the other, alcoholism fueled a moral panic for the colonial powers for its connections to prostitution, which was technically illegal. Such panic led Protestant missionaries to create a Mozambique Anti-Alcoholic League in 1919 to combat “this social scourge.”⁹⁰ One writer in late 1922 in O Emancipador criticized the abundance of bars in Lourenço Marques in contrast to the lack of libraries.⁹¹

For workers’ organizations, the connections between alcoholism and prostitution became an opportunity to address the issue of women's emancipation.⁹² Both O Incondicional and O Emancipador combatted prostitution as a “vice” and viewed it as a product of the colonial regime and of excessive alcohol consumption. In the first of these publications, during its more explicitly anarchist phase, one author declared that vice, prostitution, and poverty all came from the same source: an “evil” society that required “regeneration.”⁹³ At the peak of the violent class struggle in the capital during the mid-1920s, O Emancipador combined a race-inflected critique of the “trade” of prostitution of Black women with a rejection of the law that entailed the imprisonment of illegal prostitutes.⁹⁴

While the question of alcohol use did not feature prominently in O Germinal, the important health consequences of TB certainly did. A four-part reflection in the autumn of 1914 highlighted what was understood as the authorities’ lack of coordinated response and the paucity of facilities to treat the disease. In the first part of the series, the author noted that the combative local periodicals, The Lourenço Marques Guardian and O Africano, had discussed the dire situation relating to TB in the city. It was reported that eleven persons had died in August, of whom three were white and eight Black. What precisely were the authorities waiting for? The racial divide in the provision of health care, the paper argued, needed to be addressed through the establishment of a sanatorium for both whites and Blacks “because both races make up Humanity.”⁹⁵ A subsequent article argued that the necessary financial resources were available for such a project. In tune with common libertarian understandings of health issues, it was also argued that prevention was the key and that there was a need for prophylaxis to fight the disease. In particular, the article pointed to the high levels of TB among indigenous workers in the Rand mines and demanded improved working conditions. In 1913, according to O Germinal, 576 miners had succumbed to the disease as well as suffering from silicosis. Furthermore, in 1913 some 1,366 Black workers had died in the Rand from pneumonia.⁹⁶ Finally, the author proclaimed that the sub-director of the Hospital Miguel Bombarda, the main hospital in the capital, Dr. Antonio Pedro Saraiva, had confirmed in the Boletim Sanitario that very same year the analysis foregrounded by O Germinal on the prevalence of TB.⁹⁷ As other sources show, while malaria was under control, higher rates of TB prevailed.⁹⁸

The discourse on TB in O Germinal evidences the interconnections forged between the politics of health, a critique of capitalist relations, and a potent class- and race-oriented analysis. It indicates how O Germinal went beyond what Partha Chatterjee has identified as a merely “derivative discourse” founded in Western thought where references to the nation's “dignity” or “sovereignty” provided the principal arguments in the colonized world.⁹⁹ The denunciation of colonial rule together with a racially-inflected analysis was not necessarily typical of socialist and anarchist movements of the period, but the specific circumstances in Lourenço Marques and the ideological nature of O Germinal permitted an acute analysis of these issues. The attention paid to these issues also shows how integrated the periodical was within the fabric of Lourenço Marques society by its reference to conditions in the local hospital, data provided by official documentation, and articles in the combative local press.

Hospitals and Medical Provision

Public health services were incipient in nineteenth-century Portugal and basic at best within the colonies.¹⁰⁰ The Portuguese state, realizing the devastating effects of tropical diseases on the “civilizing” settler population and the native population as a labor resource, undertook to improve medical facilities in the colonies at the end of the nineteenth century in the context of rival imperial interests.¹⁰¹ There were three distinct periods in this medicalization process: the end of the monarchy (up to 1910), the democratic republican period (1910–1926), and the era of dictatorial rule under the military and the New State from 1933.¹⁰² Facilities were provided primarily for Europeans.¹⁰³ In the case of treatment for leprosy in Mozambique, for example, the indigenous were sent to a colony in Lourenço Marques bay. The few existing white lepers, in this “society deeply scarred by racial hierarchy” where racial “mixing was inconceivable,” were sent for treatment in the Transvaal.¹⁰⁴

Although there was a certain reorganization of medical facilities in Mozambique in the first part of the democratic republican period between 1917 and 1919,¹⁰⁵ it was only in the 1920s that a concerted drive to provide health systems in the Portuguese African colonies was attempted. Such a development arose partly in response to the highly negative report by the US sociologist Edward Ross in 1925 on labor and social and health conditions, which denounced the “near slavery” conditions of some workers in the colonies.¹⁰⁶ The same year saw a medical mission sent to Mozambique to study sleeping disease (trypanosomiasis),¹⁰⁷ developments that coincided with increasing demands in the labor press in the same decade for better health care.

Evidence from the preceding years shows how fragmented and inadequate health facilities were in Mozambique. In 1914, under the directorship of J. Baptista Cid, there was a total of five doctors in the capital's Hospital Miguel Bombarda, although by 1916 this had increased to seven.¹⁰⁸ Other hospitals, such as that of the “Missão Suiça,” under Dr. Henri Garin,¹⁰⁹ and the “Casa de Saude inglesa,” a private nursing home founded in May 1918 and sustained by British traders on payment of a £10 per annum subscription by merchants with a £2 additional sub by workers, largely completed the picture.¹¹⁰ Infection rates for various diseases were recorded in the Anuário de Lourenço Marques as well as in the national Relatórios dos Serviços de Saúde, reports published by the Directorship of Health and Hygiene Services.¹¹¹

The inadequacies of medical facilities engendered sustained criticism within the workers’ press. As in A Batalha, class featured prominently in discussions on the quality and quantity of health services. In addition, and in contrast to A Batalha, the racial dimensions of the inadequacies of health provision in the colony were addressed explicitly. O Incondicional called for a range of improvements in medical provision for the indigenous population,¹¹² as well as the introduction of Swedish-style gymnastics to schools¹¹³ and instruction for new mothers on infant nutrition, hygiene, and weighing.¹¹⁴ O Emancipador, particularly in the 1920s, produced the most detailed critique of medical services in the capital, but largely from a European perspective. It stated that while the Hospital Miguel Bombarda was well resourced and achieved high standards of cleanliness, the state was refusing to pay staff properly. It complained that doctors were only paid fifty libras to come from Portugal to practice in the colony. Issues of resource availability could be resolved, the paper went on, if those in power set up a proper Health and Hygiene Council where matters such as the prevention of different types of fever could be addressed. The problem, the anonymous author argued, was that doctors arrived, set up their consultancies in pharmacies, and were absent from where they should be—that is, on the frontline treating patients.¹¹⁵ Interleaved with positive evaluations of the revolutionary work of the anarcho-syndicalist International Working Men's Association (IWMA)¹¹⁶ were regular revelations of unequal conditions between Blacks and whites in the health sector, including the fact that at the new nursing school in the hospital, Black trainees were paid half that received by whites.¹¹⁷

This cluster of articles from the late 1910s and early 1920s apparently had some impact on the authorities, moving the government spokesperson, José Flores, to promise a reorganization of facilities in the city.¹¹⁸ The critique—both of doctors’ availability and of the lack of facilities—was renewed in June 1929 when the deficient out-of-hours service was highlighted. On Sundays, O Emancipador lamented, there was no service as doctors did not come into the city. This affected poor districts in particular.¹¹⁹ Such words provoked a response from doctors as unfair and a letter was published by a Dr. Palma Calado in their defense, showing evidence of the influence of the paper and its bearing in the city with respect to social and, in this case, medical matters.¹²⁰ As part of this debate, O Emancipador did recognize that some doctors were exceptional and placed service to patients above personal financial gain.¹²¹ Improvements, in the meantime, continued. According to official figures, by 1934 there were eleven hospitals and some forty-four health posts in rural areas in the country, in addition to those facilities established by Christian missions and the plantations.¹²²

Alternative Health Practices, Sexual Relations, and Venereal Disease

While calling on the state, as some writers in O Emancipador did, may have created tensions for more doctrinal anarchists, that this newspaper acted in this way confirms the ideological heterogeneity of the working-class press in Mozambique at the time. More attuned to libertarian positions was the faith anarchists in both Portugal and Mozambique placed on alternative theories of health and the treatment of illness. João Freire, in the case of Portugal, has noted that a “natural” approach to health and wellbeing enjoyed great sympathy among libertarians.¹²³ There were three main outlets for this alternative approach: discussions on the importance of food and nutrition, seen above; analyses of health itself, including questions related to reproduction and sexual health; and, the advocacy of physical exercise and gymnastics to achieve greater bodily and mental equilibrium. Anarchist support for natural remedies for illnesses, however, sometimes sat uncomfortably with demands for increased medical facilities, which may have included conventional medicine.

Sometimes, however, this conundrum was addressed head on, for example, in A Batalha's illustrated supplement. In addition to a discussion of sex education,¹²⁴ and the abolition or regulation of prostitution,¹²⁵ the supplement discussed the relative worth of conventional and natural medicine. Written as a two-part open letter to a doctor friend who attended to the poor in his clinic, “without even having the time to take meals,”¹²⁶ Hélios, a “simple worker,” praised the medic for his tireless labor and his ability to listen to those such as himself without formal qualifications. The doctor in question, the writer continued, was somewhat sympathetic to libertarian ideas, being an assiduous reader of the Suplemento. Conventional medicine, Hélios remarked, was laboring under a serious misconception as to its ability to identify the cause of illnesses, which he put down to people's alienation from nature.¹²⁷ Illness itself was a reaction to extraneous and harmful elements that had been introduced into the body as a result of poor nutrition. Official medicine sought to provide remedies that were not drawn from nature but from toxic concoctions. The result, Hélios claimed, was that instead of extinguishing disease, medicine conserved it. The second part of this article discussed allopathic and homeopathic medicine. Rather than advocate homeopathy, as we might have expected, Hélios criticized both, although he reserved his most vehement critique for allopathic medicine. Most physicians, he argued, considered just one organ of the body or a set of symptoms without taking a holistic approach.¹²⁸ But more important for Hélios was the nutritional regime that people should follow as a way of curing and preventing disease. This would be achieved by a natural, raw food diet.

The daily A Batalha, like its Suplemento, also discussed natural remedies favorably. On July 11, 1920, the newspaper praised a Portuguese Naturist Society picnic in Algés, where members of both sexes “happily intermingled.”¹²⁹ At this gathering, the naturist supporter Eliezer Kamenetzky (1888–1957) provided a gymnastic demonstration. Kamenetzky, well known in the Lisbon and Porto vegetarian movement, was praised as an “apostle” of naturism. In a piece a few days later, “M.D.” noted in their summary of Kamenetzky's ideas that naturism was a movement dedicated to human perfection.¹³⁰ It provided, in a word, a route toward moral regeneration: “Man” [sic] must be a friend of the animals and must abolish “the consumption of flesh”. For M.D., cities and alcohol brought degeneration and prostitution; part of the solution was to provide hygienic housing.

As we have seen, in Lourenço Marques, O Incondicional broached the health issues that affected Europeans and indigenous alike. In doing so, it appeared to favor both allopathic and alternative health measures. The Lisbon School of Tropical Medicine bacteriologist José Firmino Sant'Anna, in a series of articles on health in 1910 and 1911 in O Incondicional, called for greater measures against cholera and for preventive methods and vigilance against sleeping disease and plague in zones inhabited by indigenous populations.¹³¹ Elsewhere in O Incondicional the advantages of a vegetarian diet were extolled: vegetarianism was at the center of “hygiene, health, the economy and moral balance.”¹³² Readers were urged to consult Carlos Marques's Diccionario de medecina vegetal to combat the “panaceas” that the pharmacological industry advocated.¹³³ Further regular advice on medical questions was provided in O Incondicional's “Boletim sanitario.” O Emancipador was also attentive to alternatives such as naturism and vegetarianism, combining anti-alcoholism with exposure of the body to the sun as a healthy practice.¹³⁴ Such an approach may well have conditioned its rejection of Neo-Malthusianism as a form of birth control and eugenics.¹³⁵

The threat posed by venereal diseases attracted the attention of anarchists in Portugal but received less emphasis in Mozambique. A Batalha discussed alternatives to mercury-based treatments for syphilis.¹³⁶ Despite less coverage in Lourenço Marques, evidence shows that venereal disease was also an important issue. While in the year up to September 30, 1914, there had been 112 cases of tuberculosis (affecting 64 white people and 98 Black people), there had been some 99 cases of genital or urinary infection (39 for whites and 60 for Blacks).¹³⁷ Many of these would have arisen from sexual contact and, no doubt, the number of actual cases would have been greater than those reported or treated. Three years after this official report, O Germinal, recognizing the importance of the issue, noted that venereal disease treatment was provided free of charge at the Hospital Miguel Bombarda in the clinic operated by Dr. Antonio Aurelio Cordeiro Casqueiro.¹³⁸

Conclusion

While the two movements discussed here were separated by distance and by different degrees of observance of anarchist politics, the interconnections—both linguistic and ideological—between each allowed for the facilitation of shared experiences and the construction of political commonalities in a number of spheres including health. Although the influence of anarchism was more diffuse and its uptake more pragmatic in Mozambique than in Portugal, questions of health in both countries were informed by anarchist understandings of the class-based nature of society and the impossibility, in libertarians’ eyes, of attaining enduring health under capitalism. Discussions in both countries’ labor movements attest to the breadth of issues raised in their publications and daily struggles, taking them beyond wage demands into the realm of community- and health-related issues. From questions of nutrition to the scourge of TB, these labor movements demonstrated their successful integration into local political cultures by their interaction with other newspapers such as O Africano and the Brado Africano and through their demands placed on the local sanitary authorities. There were fault-lines, however, where national and especially racial divides proved hard to overcome.

In Mozambique in particular, it was in those publications where anarchist adherence was strongest, especially in O Germinal and O Emancipador, that the inequalities engendered at the intersection of class, “race,” and colonialism were most sharply interrogated through the lens of health. In focusing on this interrelation, anarchist-infused and labor movement periodicals helped to undermine the discursive myths that Laura Ann Stoler later identified as integral to the project of colonial authority.¹³⁹ One of these was the notion that “Europeans in the colonies made up an easily identifiable and discrete biological and social entity; a ‘natural’ community of common class interests, racial attributes, political affinities and superior culture.”¹⁴⁰ Workers’ periodicals in Lourenço Marques rejected such class harmony and often—although not always—actively opposed the racial divide created by colonialism through the demand for better health for all humanity. Their attempt to ensure improvements to medical facilities and access to decent food for non-Europeans helped to undercut prevailing racial and gendered differences in the colonial sphere.¹⁴¹ As Capela, Penvenne, and others have illustrated, however, such an approach was not always consistently adopted when it came to trade union practice. The exclusion of Black workers from the unions derived partly from colonial labor hiring policies but also from enduring prejudice on the part of European workers.¹⁴²

The demand by Mozambican and Portuguese periodicals for a material and moral transformation of health provision also involved an attempt to move away from medicine as a hierarchical pursuit, by seeking to democratize it and to make real improvements to workers’ lives in respect of housing, nutrition, workplace sanitation, and disease prevention. Despite this, while O Germinal denounced food inequality and malnutrition among the Black population and O Emancipador attended to improvements in sanitary provision for both Europeans and the indigenous, neither advocated local health remedies and practices as a response to the failings or absences of colonial medicine.¹⁴³

The labor movement, as well as the rest of the free press, in both countries, however, was to face ever greater restrictions as the 1920s wore on. Even though O Emancipador continued to be published up to 1937, the anarcho-syndicalist A Batalha had been forced underground ten years earlier and the CGT illegalized. By 1933, under the New State led by Dr. António de Oliveira Salazar, the differences between Europeans, the “assimilated” and the “indigenous” were reinscribed and labor organization was subject to increasingly severe bouts of repression. The transnational flow of ideas and organizational possibilities between labor movements in Portugal and Mozambique were thereby interrupted with activists from both countries suffering imprisonment and deportation to African colonies governed by the Portuguese state. Public health under the New State would remain as an issue low on the political agenda until after the end of the Second World War.¹⁴⁴