Public health in times of bureaucratization: the case of the physician Noel Nutels

Abstract

This case study of the trajectory of sanitarian Noel Nutels argues that starting in the 1930s and particularly during the long Vargas period, the history of Brazilian public health became characterized by a process of bureaucratization. Although the chief consequence was an increase in problem in implementing public policies, these difficulties do not appear to have prompted any immediate ideological demobilization within the sanitation movement, as occurred under the Old Republic, having instead engendered conflicts between those directly responsible for designing and implementing public policies, on the one hand, and the growing State bureaucracy, on the other. The historical period initiated in 1930 thus marked a broad divergence between the conduct of 'men of science' and 'men of State'. If the period preceding the revolution was characterized by a certain harmony between these two social sectors, won in the late nineteenth century, the process of bureaucratization altered this balance, dislodging public health agents and authorities from the special roles they had enjoyed within the Brazilian State machinery.