Commentary: Salvador Allende and the birth of Latin American social medicine

Very little remains of Allende’s Chile. Almost all of his policies were reversed following the military coup and the capitalist oriented counter-revolution that followed. General Pinochet’s regime returned most of the industries nationalized by Allende to their prior owners, slashed public spending, and repressed the trade union movement. However, a small number of Allende’s most popular policies remain to this day, such as the half litre of milk provided daily to Chilean school children and the state’s ownership of most of the copper industry. One lasting achievement was the elimination of the latifundios in the countryside, although ironically Allende’s socialist reforms in this sector, in removing the large land owners, paved the way for the capitalist mode of agricultural production established by the military after 1973. In a broader political sense, the memory of the Allende period and the dictatorship that followed continue to divide Chileans to this day. For some, the 3 years of Allende’s government represent the only time in Chilean history when the working class and the poor gained a genuine stake in running the country and the economy. For others, it was a period of political and economic instability that drove the country to the brink of chaos and even civil war. Both the way Chileans vote and the nature of the political alliances that govern the nation continue to be structured by this Left/Right divide, even if the politics of consensus predominates. Even for the Chilean Left, Allende’s legacy is a matter of some contention. The Socialists stress the social democrat in Allende who was committed to achieving greater social justice within the bounds of the existing democratic system. The main lesson they draw from the UP’s defeat is that any attempt to bring about social change needs to be based on a broad national consensus and an alliance between the Left and the Centre of the political spectrum. By contrast, the Communists blame the US and the Right for the coup and stress the continued relevance of the UP’s Marxist programme. They accuse the Socialists of abandoning Allende’s cause in their pursuit of consensus politics and gradual reform. Salvador Allende was a product of his time. A distinguished parliamentarian from a bourgeois background, he remained steadfastly committed to the constitutional system of republican Chile. He was also a Marxist inspired by the Cuban Revolution and the political movements shifting the global agenda to the Left during the 1960s. His tragedy was that in his attempt to combine both his democratic principles and his belief in radical social change, he demonstrated the limits of the consensus underlying Chile’s much vaunted democratic system. MEDICAL AND SOCIAL REALITY IN CHILE 739