ARTíCULO 177 - redalyc.org · El IMT, constituyó una ... Mario Testa. Many of them were filmed...

Salud Colectiva

ISSN: 1669-2381

[email protected]

Universidad Nacional de Lanús

Argentina

Martin, Ana Laura; Spinelli, Hugo

Para que el hombre vuelva a cantar mientras trabaja. El Instituto de Medicina del Trabajo (IMT) y la

salud de los trabajadores

Salud Colectiva, vol. 7, núm. 2, mayo-agosto, 2011, pp. 177-197

Universidad Nacional de Lanús

Buenos Aires, Argentina

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Universidad Nacional de Lanús | Salud Colectiva | English Edition ISSN 2250-5334

177arTIcle / ARTíCULO

absTracT This text is the product of an investigation initiated in 2006 with the objectiveof recuperating the memories and experiences of those involved in the creation of theInstituto de Medicina del Trabajo (IMT) (Institute of Occupational Medicine) between1973 and 1974 in the Faculty of Medicine of the Universidad de Buenos Aires. Thirteeninterviews with referential figures of the Institute were conducted, using their oral histories asa resource, and a survey of documents from personal archives of members of the IMT andfrom public records was carried out. The IMT constituted an innovate experience in thefield of occupational health, questioning the categories and practices in hygiene,safety, and occupational medicine prevalent at that time. The primary results demonstratethe novel character of the experience and the way in which the IMT was able to createits own autonomous and alternative discourse that prompted the development of criticalthought in relation to health and work. This capacity transcended the limits of the countryand still today influences the discourse of research and educational centers from manydifferent countries. The sources collected as part of this investigation now form part of theCentro de Documentación Pensar en Salud (Thinking about Health Documentation Center)of the Instituto de Salud Colectiva.key words History of Medicine; Occupational Medicine; Occupational Health;Occupational Risks; Argentina.

resuMen Este texto es producto de una investigación iniciada en el año 2006, que tuvopor objetivo recuperar la memoria y la experiencia de los actores involucrados en la creacióny desarrollo del Instituto de Medicina del Trabajo (IMT) entre los años 1973 y 1974 en laFacultad de Medicina de la Universidad de Buenos Aires. Para ello, utilizando el recurso dela historia oral, se realizaron trece entrevistas a los principales referentes del Instituto, seefectuó un relevamiento documental en archivos personales de los miembros del IMT y enarchivos públicos. El IMT, constituyó una experiencia innovadora en el campo de la saludlaboral que cuestionó las categorías y prácticas en higiene, seguridad y medicina del trabajodominantes en la época. Los principales resultados demuestran el carácter innovador de laexperiencia y cómo el IMT logró formar un discurso propio, alternativo y autónomo que seconvirtió en referente para la construcción de un pensamiento crítico en la relación salud ytrabajo que trascendió las fronteras del país y que hoy forma parte del discurso de numerososcentros de docencia e investigación de diferentes países. Las fuentes recuperadas en el cursode esta investigación forman parte del Centro de Documentación Pensar en Salud delInstituto de Salud Colectiva.palabras clave Historia de la Medicina; Medicina del Trabajo; Salud Laboral; RiesgosLaborales; Argentina.

So that man might once again sing while

he works. The Instituto de Medicina del

Trabajo (IMT) and worker health

Para que el hombre vuelva a cantar mientras trabaja. El Instituto de Medicina del Trabajo (IMT) y la salud de los trabajadores

Martin, Ana Laura1; Spinelli, Hugo2

1Masters in History.Researcher of the CollectiveHealth Institute, UniversidadNacional de Lanús (UNLa),[email protected]

2Doctor in Public Health.Director of the CollectiveHealth Institute; Secretary ofScience and Technology,Universidad Nacional deLanús (UNLa), [email protected]

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11MarTIn al, spInellI H.


InTroducTIon

In July 1973, a few months after a majorpolitical overhaul in the Universidad de BuenosAires (UBA), the Institute of OccupationalMedicine (IMT, from the Spanish Instituto de

Medicina del Trabajo) was created within theFaculty of Medicine of that university. It wasconceptualized as part of a political project in thehealth field, organized and elaborated withrenewed ideas about the relationship betweenhealth and work.

The distinctive feature of the IMT wasits focus on the active participation of workersand their organizations in occupational health,hygiene and safety. To this end, academicactivities were carried out in association withtrade unions in order to provide worker training,a series of collaborative research agreementswere developed to understand the workingconditions in certain industries, and the activeparticipation of the workers was encouragedthrough “hygiene commissions” formed in eachfactory or company.

This interest in the centrality of workersin occupational hygiene and safety control was inconstant tension with the established role ofdoctors and of the health sciences in general. Byexamining the place afforded to workers in thecontrol of their health, it was possible to questionthe existing paradigm of occupational medicineas well as the role of medical professionals, of theuniversity and of the health sciences as a whole.The process that led to the creation of the IMTwas, at the same time, a critical exploration of theconditions to which Argentine workers weresubject in terms of salary and general livingconditions, as well as of the scant interest thathealth issues had generated among the unions.Therefore, this initiative of the Faculty ofMedicine, although short-lived, was able to raisethe issue of occupational safety and health in away that that transcended, questioned and soughtto significantly modify the medical discipline.

Two critical situations influenced andmade possible the development of the IMT. Onthe one hand, the particular political momentexperienced in Argentina, which had reached theuniversity classrooms in addition to other

territories of knowledge production; on the other,the conditions that many sectors of the labormovement were undergoing and the degree ofmobilization they were experiencing. The IMTacted as a link between these two frequentlydistant worlds, seeking to modify the relationshipbetween technical-scientific processes andworker demands.

The purpose of this study was to recoverthe experiences of the IMT through the testimoniesof those who participated in this process ofconstructing a critical consciousness regarding therelationship between health and labor.

abouT THe sTudy

The field of social medicine as way ofthinking about health has been explored verylittle in Argentina and there is no systematicrecord preserving the memory of those who haveformed part of this school of thought.Furthermore, at the start of this study we wereunable to find material available documentingthe work IMT. Fortunately, in 1973, the Actas de

las Jornadas Nacionales de Medicina del Trabajo

(Minutes of the National Conference ofOccupational Medicine) (1) organized by thisinstitution were published, which allowed us tohave access to the primary sources of this eventand to the first expressions of such a rareexperience as is the joint formulation betweenhealth professionals and workers of a publichealth agenda in the workplace.

The analysis presented is the result of aproject entitled “The Institute of OccupationalMedicine and the development of critical thinkingin public health during the 1960s and 1970s inArgentina,” a research study carried out over fiveyears (2006-2011) with the objective of recoveringand analyzing the contributions of the IMT (a)regarding the relation between work and health.

A documentary survey of primarysources was carried out and using this initialinformation, guideline questionnaires for each ofthe interviews were designed. Thirteeninterviews were conducted with referentialfigures of the Institute: Felipe Aguerre, LuisBenencio, Silvia Chejter, Ruben Efron, Gilou

THe InsTITuTo de MedIcIna del TrabaJo (IMT) and worker HealTHSA

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Garcia Reioso, Omar Glezer, Estela Giménez,Horacio Kujnisky, Eduardo Menéndez, CarlosRodríguez, Osvaldo Saidón, Ricardo Saiegh andMario Testa. Many of them were filmed andserved as a base for elaborating oral documents.The collected and elaborated material was thenprocessed, edited and catalogued and thecontents written out and edited. The testimonyand narration of the experience of thoseinterviewed were used in order to comprehendthe more concrete and everyday dimensions ofthe process, which were not included in theofficial documents.

In order to preserve the vast and richdocumentary material resulting from this invest-igation, the Thinking about Health DocumentationCenter (CEDOPS, from the Spanish Centro de

Documentación “Pensar en Salud”) was createdwithin the Institute of Collective Health at theUniversidad de Lanús. This Documentation Center(2) stores the interviews and the documentarymaterial used as primary sources in this analysis soas to make them available to and to allow for futureresearch studies.

THe FaculTy oF MedIcIne, THe IMT,

and “occupaTIonal MedIcIne aT

THe servIce oF workers”

A starting point for those whoelaborated the guiding principles of the IMT wasthe necessity of linking knowledge produced inscientific and university environments with socialneeds, in particular the needs of workers. Therupture between science and scientism and thepositive relationship between knowledge andpolitics – pronounced by the most radicalizedstudent sectors since the 1960s – were in this wayrecovered. The IMT assigned itself a fundamentalrole in connecting knowledge developed withinthe university to the world of work.

One of the first measures taken by thegovernment of Hector Cámpora, who took officeon May 25, 1973, was the overhaul of thenational universities. This political act allowed forthe creation of policies such as those developed inthe Faculty of Medicine of the Universidad deBuenos Aires, which at that time was renamed the

Universidad Nacional y Popular de Buenos Aires(National and Popular University of BuenosAires). During the administration of RodolfoPuiggrós and that of his successors Ernestovillanueva and Raul Laguzzi as rectors of theUBA, other similar innovations took place, suchas the Mother and Child Institute in the Faculty ofMedicine and some time later, the RegionalPathology Institute with headquarters in theMuñiz Hospital. In the Faculty of Pharmacology,the Drug Institute located in the Ramon Carrillopharmaceutical production plant dedicated itselfto domestic drug production. The Social MedicineDepartment was created in 1973 with the idea ofcoordinating the activities and functions of thesenew institutes, although it was never able to carryout this task. In different faculties of the UBA,chairs, courses and departments were developedaccording to the discourse of the “university at theservice of national reconstruction,” with the goalof bringing science as a whole closer to problemsconsidered socially relevant (b). In accordancewith the executive order that mandated theoverhaul of the Universidad de Buenos Aires, thechanges were directed at “definitively putting theuniversities at the service of the people,” as theuniversities were experiencing a severe crisisreflected “in the cultural realm and in theeconomic and political dependency thatArgentina was suffering” (6 p.202).

A number of the new universityadministrators were connected to theMontoneros [an armed group of the Peronist left],or at least had the support of that organization. In1973, in the distribution of positions of influencewithin the State, the university would be held bythe Peronist left. During that year, the PeronistUniversity Youth (JUP, Juventud UniversitariaPeronista) won almost all of the student unionelections – nine of the thirteen student unionsexisting at the time – thus consolidating itsinfluence in the university government (c).

In the Faculty of Medicine, after thebrief term of Tomas Mascitti, Mario Testa becamethe new dean of the overhaul. He had the supportof an important sector of the JUP, and was inagreement with the fundamental principles of thepublic health policies proposed by that sector ofPeronism for this new phase, the primaryobjective of which was the creation of a Unified

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National Health Program (d) (8,9). Since the endof 1972, with the possibility of elections puttingan end to the de facto government close at hand,various groups of professionals had cometogether within Peronism with the goal ofinfluencing the political content of the nextgovernment’s program. Within that context,Mario Testa had returned to the country a shorttime before and was collaborating, inconjunction with some members of the PeronistYouth, in the development of the core contents ofa health program (9). The project Mario Testaannounced for the Faculty of Medicine focusedon admissions (unrestricted until just a short timebefore), on a progressive course of study in whichstudents would gain skills of increasingimportance, on the integration of universitystudies with work as well as with research, on thedecentralization of teaching, and on thecoordination of university curricula andknowledge with the health program of thenational government (8 p.77).

This new phase allowed the directorsand some of the members of the IMT to reenterthe university in decision-making roles, whichwas experienced as a continuity between priorstudent activism and university administration.These were young graduates who, in many cases,did not have any formal training in occupationalmedicine but whose political activism andparticipation in left-wing organizations since the1960s had put them in contact with grassrootsunions and helped them to understand theworking conditions in different sectors ofproduction. The relationship the IMT wished toestablish with the most combative sectors of thelabor movement and its conceptualization of thekey role of these sectors in the productionprocess would be very important to the IMT andits capacity to integrate young professionals fromdifferent political and ideological backgroundswithin the same project (10). In a short time,physicians, psychologists, psychiatrists, socialscience professionals, engineers and technicianswith a broad range of ideological stances, insome cases connected with politicalorganizations that did not support thegovernment, also joined the IMT.

The heterogeneous membership of theIMT was united by a common interest in

establishing an organic relationship withunionized workers, by the belief that thepoliticization of these sectors regarding theirexploitation was necessary, and by a sharedconcern regarding the effects of workingconditions upon workers’ health. For the IMT’sleadership, working conditions formed anorganic and material whole directly affecting thelife of workers and their families beyond theworkplace. An important part of this thinking hadbeen developed in the 1960s, in particular duringthe strikes that took place in the industries in theprovince of Cordoba during those years.According to Ricardo Saiegh, the first director ofthe Institute, the creation of the IMT was theresult of experience and reflection:

…as part of our activism in relation to the worker

struggles during the Cordobazo [massive worker

and student protest that took place on May 29,

1969], we started analyzing one aspect of that

political struggle more deeply, in this case the

effect that labor had on workers […] In 1973,

when the popular government took office, we

had the idea of creating a tool to channel these

concerns, which became the Institute of

Occupational Medicine (11).

At that moment, after the electoralvictory of the Peronist Justicialist Front forNational Liberation (FREJULI, Frente Justicialista

de Liberación Nacional), a series of conflicts thattook place mainly in the factories situated in theGreater Buenos Aires area expressed demandsregarding the control of working conditionswhich were added to other non-salary baseddemands, such as the reclassification of labortasks, the reincorporation of dismissed workers,and the conflicts within the plants over theappointment of new and genuine unionleadership (12). On the one hand, it was aboutputting in motion a series of “overdue” workerdemands given validity by the new politicalsituation, and on the other hand, the“intensification of the class struggle as a result ofthe consensus politics established by thegovernment in the Social Pact between companyowners and the CGT [government-sponsoredunion]” (13 p.333) (e). Frequently, especiallybetween mid-1973 and the beginning of 1974, a


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number of strikes and factory occupationsemphasized issues of occupational hygiene andsafety. In general, these protests were a strategyused by labor groups that challenged the“bureaucratized” union leadership andencouraged more grassroots participation.

The relationship between IMT directorsand combative unions encouraged the partici-pation of these labor leaders and fostered contactwith workplaces where conflicts had arisen.After the project was implemented, workersenrolled in opposition union organizationscould be seen in the university. One of the firstorganizations that joined the IMT belonged toAstarsa Shipyards. The contact came throughtwo of its leaders: Juan Sosa, who had a previousconnection with directors of the Institute andLuis Benencio, an active member of theopposition in the shipyard. It is worthmentioning the participation of the IMT at thebeginning of 1974 during the strike of SouthAmerican Company of Industry and Trade(INSUD, Compañia Sudamericana de Industria y

Comercio), whose main demand was related tothe health damages produced by the workers’exposure to lead.

The development of the political eventsduring the 1960s put into focus a decade later anissue that was not new for left-wing intellectualsand political sectors: the identification of theworking class with Peronism. This relationship, atmoments difficult for the left to comprehend,seemed to cement itself in the particular politicalscenario resulting from Hector J. Campora’s riseto power. Once the choice the working class hadmade to support Peron in 1945 was accepted aspositive, then in the present the only possiblealternative of political construction was throughPeronism (16). This coincided with the prog-ressive incorporation of sectors traditionally atodds with Peronism, such as university studentsand professional middle classes (17, 18). RubenEfron, part of the leadership of the IMT, states thatthe members of the Institute:

…were interested in Gramsci, in the concept of

hegemony, and we always dreamed of the

possibility of building hegemony and the role of

professionals and intellectuals within factories.

An important part of our political practice was

focused on that. […] The basis of our idea was to

build politics that established relationships

among professionals, technicians and the

possibility of articulating with the conditions of

worker control over industrial hygiene and

safety. (19)

The presence of workers in the controlover health issues was, according to the IMT, theonly possible way to guarantee that workers couldtransform their own working conditions. There-fore, a series of ideas and institutions, which werecreated to benefit workers but which actuallyworked as “agents of the repressive system,” beganto be questioned (20 p.6). The fundamentalcriticism of the way occupational medicine waspracticed at that time was that the mechanisms ofhealth control in operation exclusively favored theidea of health as a commodity (21 p.17). Theuniversity held a key role in socializing theessential knowledge needed to carry out a realcontrol of hygiene and health within the factoriesand therefore had the obligation to traintechnicians and professionals capable of dealingwith labor problems from a new perspective,which could be paraphrased as “occupationalhealth at the service of workers” (20 p.1).

The image of the “factory doctor” wasuseful in order to describe the process thatoccupational medicine was experiencing. Doctorswere increasingly associated with control ofabsenteeism, their role changing from“practitioners” towards a function of “medicalpolicing” and as a consequence distrust wasfostered between them and workers (20p.19).Therefore, over the preceding 18 years a kind of“reverse medicine” had emerged, which was moreoriented toward demonstrating that workers werenot sick than to making correct diagnoses andproviding proper treatment (21 p.6). This criterionwas translated into economic compensation foroccupational accidents and permanent injuries,and the purpose of any medical care received waslimited to assuring that sick workers resumed theirwork quickly (20 p.19). According to the newdiscourse, the kind of occupational health that wasnecessary was one that:

…focused on the preservation of the physical

and psychological conditions of the working

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population instead of, as generally happens, on

absenteeism indexes or the increase of

production costs that occupational illnesses or

accidents could cause. (20 p.39).

These arguments were not limited to anisolated observation of the work process. On thecontrary, this line of argument affirmed that thetwo decades after Peron’s overthrow in 1955 hadbeen decisive for the development of dependentcapitalism and for the subsequent intensificationof labor exploitation (20). This situation hadspread and could be seen in factory medicaloffices, in industrial safety conditions, in the so-called labor or absenteeism control clinics, inuniversity hygiene and occupational medicinecourses, in government agencies of occupationalhygiene and safety control and in the collusion ofmany bureaucratized union leaders whosupported the dictatorship (22 p.5-6).

The notion of “occupational health atthe service of workers” also achieved a historicaldimension; it was described as the continuationof the bright past the working class had hadduring Juan Domingo Peron’s government, incontrast to the rights progressively lost over thelast decades and the process of dependence intowhich Argentine capitalism had sunk. It was inthe contemporary historical process that the IMTfound its legitimacy and defined its meaning, inopposition to the recent past and within a criticalpolitical situation that made transformationpossible. The Institute’s discourse placed it inalignment with the Peronist project and thusenabled the Institute to more effectivelycommunicate with the working class.

researching working conditions, the

interaction between workers and

professionals, and the concepts of harmful

work environment and worker control

The rapid development and shortexistence of the IMT made it difficult tosystematize the work done and to expand andreflect upon each project undertaken. However,by examining the practice of the IMT, some of thecore ideas that guided IMT staff and the way inwhich those ideas were implemented can be

recovered. With its existence of a little over ayear, the Institute initiated two major courses ofaction: one directed at professional and workertraining and the other at research regarding theworking conditions in different industries. Both ofthem implied a close relationship with workers.

In August 1973, a postgraduate coursewas taught that included topics typically absentfrom standard medical training, such as“industrial toxicology,” “psychopathology in theworkplace” and “a critical history of occupationalmedicine.” Professionals specialized in eachsubject were invited to participate. Some werepracticing medicine at the Hospital de Clínicas,where the Institute had its headquarters, andalthough they did not have prior knowledge ofthe project, they quickly accepted the proposal(g). This program was an introduction tooccupational medicine and was especiallytargeted at factory doctors. The Dean’s Office ofthe School of Medicine had planned, if thecurriculum could be modified, to incorporatethese subjects into the Social Medicine coursethat would be among the first required by theHealth Sciences (formerly Medicine) degreeprogram. It would ultimately be offered only oneyear, in 1974.

The worker training courses (Figure 1)were offered at different times and includedwithin the curriculum concepts regarding thework environment and factors harmful to health:industrial toxicology, occupational fatigue,accidentology, workplace safety, organization ofindustrial hygiene and safety, and laborlegislation (21 p.30). The training coursesmultiplied and, according to data from theInstitute, were attended by 1,300 workers from anumber of different unions (23 p.28). Thesecourses were taught within the Faculty ofMedicine and were accredited by the university;the workers were symbolically granted a diplomaduring the Faculty’s graduation ceremonies.

In order to reinforce the connectionwith unionized workers, the National Conferenceof Occupational Medicine was held fromNovember 1-3, 1973. Mining, telecommu-nication and shipyard union leaders participated,as well as worker commissions from differentsectors that presented the problems and needs intheir unions regarding health and working


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conditions. Almost all the members of theInstitute took part in discussion panels whicharound 1,000 people attended, according to theconference organizers (1).

The conference promoted a moredynamic relationship between the IMT and theunions, particularly with those opposed to thebureaucratized union representation and with

those belonging to the second and third lines ofleadership in their unions (24). It was also a wayto make the political orientation of the Instituteexplicit within the University and the Faculty ofMedicine where it had its headquarters, as wellas within the heterogeneous universe that madeup the political support for the government inoffice since March 1973 and within which deep

Health issues in industries

Course in the Argentine Mine

Workers Association

(Asociación Obrera Minera

Argentina)

Course at the Labor

Federation of Argentine

Ceramicists (Federación

Obrera Ceramistas de la

Republica Argentina)

Course for workers of the

Metallurgical and Automotive

Industry

Course for the Milk Industry

Workers Union (Sindicato de

Trabajadores de la Industria

Lechera)

Work environment: noise, heat, dust.

Industrial toxicology

Fatigue

Occupational safety and accidents

Organization of industrial hygiene and safety

Labor legislation

Health and labor

Work environment: noise, heat, dust

Mining activities and pneumoconiosis

Medical problems related to heat


Chemical risks

Physical risks

Psychological risks

Medical problems

Legal aspects

General risks faced by automotive and metallurgical industry workers

Welding risks and diseases of welders

Polishing risks and diseases of polishers

Lever operation risks and diseases of lever operators

Lathe operation risks and diseases of lathe operators

Risks in thermal treatments and electrotyping

Assembly line risks and associated pathologies


Chemical risks

Physical risks

Psychological risks

Medical problems

Legal aspects

Topics coveredCourse Title

Table 1. Course titles and topics covered in worker training courses taught at the Institute of

Occupational Medicine between 1973 and 1974. Faculty of Medicine, Universidad de Buenos

Aires, Argentina.

Source: Own elaboration based on the Boletín del Instituto de Medicina de Buenos Aires (21) and Un año de realizaciones (23).

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political and ideological differences wereincreasingly openly debated (h). In this sense, theconference sessions can be considered as a wayto ratify, in a reduced arena but nevertheless withcertain visibility and great symbolic power, theinitiative and organizational capacity of theyoungest sectors that had approached Peronismand found in it the closest possibility of a pathtowards socialism at a national level, but that hadalso discovered its main contradiction to be thecentrality of traditional trade unionism.

Despite the relationship that the IMTdeveloped with grassroots working class sectors,the project was not immune to the conflictinginterests within Peronism, and it was not alwayseasy for young university students to limit theworking relationship to these favored sectors. Inreference to this situation, Mario Testaremembers:

We couldn’t… privately, we talked about trade

union bureaucracy, but when they came, it was

all: comrade, yes comrade, take a seat, comrade,

come in, comrade. (24)

Apart from these this resistance andthese limitations, the IMT was able to make apriority the project of an occupational medicineable to reach all workers and at the same timeinnovative in its perspective and approach. Inpractice, the Institute was able to draft analysis(analytic) criteria that avoided reducing theanalytical scope to the workplace and isolatingthe work environment, proposing instead a viewfrom which it was possible to connect theworker, the worker’s health, and the place inwhich that work was carried out. The questionsmotivating each study were of an epi-demiological nature and considered the workenvironment as the one that “generates,

perpetuates or concentrates certain risk factors

that should be focused on” when evaluating thediseases and illnesses of those affected (25). Thisepidemiological focus and the way it wasapproached – with the incorporation ofdisciplines in addition to the biomedical and theinclusion of workers within the process – werecohesive elements that made it possible to attractprofessionals of different political affiliations andfor them to coexist.

The consensus among IMT membersregarding the objective of the Institute and thefluid relationship with worker organizationsallowed common projects to be implementedquickly. The Dean of the Faculty of Medicine andthe Institute directors signed a number ofresearch agreements with different unions tocarry out studies on problems considered priorityby the parties involved (i). In a short time,between August and November 1973, a series ofworking groups sustained by a large group ofprofessionals (j) were in operation, withparticipation from many different disciplines.Several Chilean and Uruguayan doctors andnurses, recently exiled and with more experiencethan local doctors, were also incorporated (k).

Among the research projects carried out,the most important was on the Pirquitas mine inthe province of Jujuy (l). At that time, the provincehad one of the highest levels of child morbi-mortality and one of the shortest life expectanciesin Argentina. In the National Conference ofOccupational Medicine, the health conditions ofworkers in Jujuy had been discussed based on anotice submitted by authorities of the province,which then led to the signing of an agreementbetween the Faculty of Medicine and the HealthUndersecretariat in Jujuy. At the end of Novembera large multidisciplinary group of IMT memberssettled in the vicinity of the mine for several days.These members of the Institute went to Pirquitaswith a hypothesis: that there was no regularregistration of retired miners because miners diedbefore reaching retirement age (10,29). Theinformation was attributed to the Argentine MineWorkers Association (AOMA, Asociación MineraArgentina), a mining trade union with which theyhad been directly connected in the last few monthsthrough its general secretary Carlos R. Cabrera.

The field research in Pirquitas allowedfor the identification of different dimensions thataffect the health of miners. Doctors andtoxicologists worked for a number of dayscollecting clinical data that showed the presenceof pneumoconiosis and the need for immediatetreatment of the condition. Engineers specializedin industrial safety assessed the quantities of dust,humidity, noise and vibrations, among anotherfactors, in the work environment. The activeparticipation of the mental health team allowed


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for the development one of the most importantareas of study in the Institute: the psychologicaldimension of occupational risk factors, whichhad been little considered within occupationalmedicine and had enormous significance in thisexperience. Using individual interviews,predesigned surveys and group meetings, specificaspects regarding the psychological effects ofmining work for both miners and the familygroups to which they belonged were explored.The team noted a recurring dream among theworkers related to a black dog that sat upon theirchests and provoked in them a distressingsensation of asphyxia that woke them up. Theinterpretation was that this black dog, considereda mythical animal by the inhabitants of theregion, appeared in their dreams as a symbol oftheir frequent lung diseases (m). The mentalhealth team became interested in issues that werepresent in the daily life of the community settledin the mine, such as phobias and fears ofaccidents, diseases and death, as well as theeffect that this kind of activity in the mine shaftshad on workers outside of the sphere ofproduction (10).

The idea that mining work was tryingwas not new; some time before, the AOMA hadpromoted a project to draft a statute for workers inthe sector with the objective of solving problemsspecific to this type of work – frequent diseases,accidents, living conditions in the campsites – andwith the intention of modifying the retirement age(10). Pirquitas was a key experience for IMTmembers, as it was there that they developed aseries of multidisciplinary strategies that could belater observed in other investigations. Not onlydid these strategies seek to reveal the mostpoignant risks that the work produced, but theyalso offered an opportunity to question the effectsof work in a more complex way.

In association with the Buenos Aireschapter of the Federation of Argentine TelephoneWorkers and Employees (FOETRA, Federacion

de Obreros y Empleados Telefónicos de la

Republica Argentina), the union that representedthe phone workers of the NationalTelecommunications Company (ENTEL, Empresa

Nacional de Telecomunicaciones), the IMTcarried out an interdisciplinary research study ofthe health of phone operators. As had happened

in the case of the miners, the hypothesis wasformulated based on inquiries that the union hadpreviously made regarding the health of itsaffiliates. A series of psychological, auditory andorthopedic effects were found, produced by awork pace that demanded many tasks beperformed simultaneously (11).

In both cases, multidisciplinary andinterdisciplinary work was not simply afunctional operational method for the IMT teams,but rather responded to a conceptualization ofhow occupational risks in industries andworkplaces operated. Labor organizations wereconsidered a product of social relationships andhad to be analyzed as such. Therefore, the issuesprovoked in individuals could be understood notonly “as individual but also as a manifestation ofthe conditions silently shared by all [workers]” (1p.128). In this way, isolated analyses wereavoided in order to understand as a whole thefactors harmful to health and their interaction andpermanence, in opposition to diagnostic criteriaand medical proceedings that considered onlythe individually affected worker (1 p.77).Interrelating such dimensions as the psy-chological with risk factors like the exposure tonoise, heath and dust, proposing a more criticalanalysis of the effects of the work pace, andassessing its consequences in the person at work,together constituted a way of thinking about therole of health professionals and technicianswithin the industries.

The studies carried out in the mine inJujuy and with telephone operators evidenced aparticular aspect of the conceptual position thatthe IMT was developing regarding work andoccupational diseases. The form of questioningand the interest in health disorders not usuallytaken into account had as a base an originalformulation which the IMT defined ad the “dailymicro-trauma of work” (1 p.42). This categoryaimed to displace the idea of “professionalillnesses,” which were usually individualized inthe legislation and were common in the medicaldiscourse, as they did not reflect the deeperproblems implied in the relationship between theworker and his work (1 p.41). The concepts ofunhappiness, alienation and dissatisfaction wereused to explain the problematic relationshipbetween work and the person who performs it; this

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was in turn closely related to the social conditionin which that relationship developed each day.

The slogan chosen by the IMT toillustrate its objectives summarizes these ideaswell: so that man might once again sing while he

works. With this clear reference to the capitalistexploitation of the labor force, the sloganevidenced a core problem in worker health: thevery thing that makes self-fulfillment possible, inthis case the worker’s labor, is also the factorresponsible for his alienation (1 p.125) and that“state of unhappiness that originates in theworker for not having a free relationship with hislabor” (1 p.42).

Other research studies made it possibleto reexamine the diagnostic criteria thatoccupational medicine applied. One of thesestudies was developed to look into the effects oflead exposure in the Caseros branch of theautomotive company FIAT, as well as anothermetallurgical company by the name of Prattivazquez e Iglesias S.A. in the locality ofAvellaneda. Some of the members of the IMTclinical team had previous knowledge basedupon experiences providing medical care in thegraphics union that caused them to doubt labanalyses as a basis for diagnosis and to questionthe legally established lead exposure levels. TheIMT team combined the biochemical analysesused to measure lead absorption with otherelectrophysiological analyses. The resultsdemonstrated that almost every person tested hadsome level of poisoning and that the biochemicaltests by themselves did not make it possible todifferentiate between clinically demonstrable andlatent cases (n). Moreover, the correlationbetween exposure intensity, calculated in theamount of hours worked, and disease wasestablished (28, 31 p. 87-88).

The knowledge produced by theInstitute regarding lead poisoning was then usedby workers of the INSUD. A strike began duringthe first months of 1974 in the lead processingplant of that company in the locality of LaMatanza, in Greater Buenos Aires, reaching itspoint of highest tension in the month of Marchwhen the manager Enrique Mendelsohn waskidnapped. The IMT supported the communitysoup kitchen that the workers organized near thepremises, participated in the workers’ meetings,

and wrote a technical report about leadpoisoning in the plant that could be used tosubstantiate the demands being made (33).

The demands directed at the companyfocused on the inadequate working conditions inthe processing of lead and on the collusion offactory doctors who did not acknowledgeillnesses such as saturnism in workers. On theother hand, the Commission of Delegates of theINSUD accused the Metallurgical Trade Union(Union Obrera Metalurgica) of acting incollusion with the company because althoughtheir doctors had diagnosed poisoning they didnot support the strike.

The Institute provided a key element tosupport the demands and made it possible toexplore the real health conditions of workers inthat company. In the interaction with affectedworkers, the IMT was able to confirm that thesymptoms of poisoning often presentedthemselves long before consulting a doctor butthat those symptoms were not mentioned for fearof economic consequences or of being fireddirectly from their jobs, or because of theintimate nature of their symptoms. The workerswere all men, and lead poisoning produced,among other consequences, sexual dysfunction,a condition they were not always willing to admitto their peers or doctors. However, these types ofconsequences resulting from working with leadand in an inadequate work environment wereexpressed by INSUD workers in some of thegeneral meetings carried out during the conflictin 1974 that the IMT also attended. To thesurprise of IMT members, the workers as well astheir families spoke publicly about the issue andclearly established the relation between theproblems expressed and the work carried out inthe plant of the company in question (o).

These kinds of exercises were especiallyvalued by IMT researchers because they reinfor-ced the idea that workers were the most pertinentguardians of occupational health; they alsohighlighted the ability of workers to detect themost frequent health problems produced by theirwork and the clarity with which they related suchdamages to working conditions. Furthermore,most of the Institute members were youngprofessionals and not all of them were trained inthe occupational health field. In the interaction


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with workers and in this concrete field ofpractice, they found it possible to experience arole as professionals which, among other things,allowed them to explore less evident aspects ofillness as a process that goes beyond individualand biological disease.

The urgency of the political events in1973 and the speed at which the actions of theIMT were implemented did not leave much roomto systematize what was being done. In somecases, research projects and experiences such asthose at INSUD and Pirquitas were related toconcepts and definitions developed later on andthat influenced the professional careers of thepeople involved, as in the case of EduardoMenéndez and his elaboration of the HegemonicMedical Model, which he published just after thecreation of the Institute (p).

The legislation at the time regardingoccupational hygiene was also reexamined. Theresearch into noise within the plants directlyquestioned the levels authorized by theregulations. The IMT team of engineers analyzedthe relevant legislation and verified that it washighly lax and that it was biased in assessing theeffects produced by noise. Horacio Kujnisky (q),a member of the team, summarizes:

…within the law, the criterion applied to hearing

loss considered that at the end of your

productive work life, when you retired, it was

enough if you ended up hearing at least common

speech. It didn’t matter if you lost the rest of your

hearing capacity. We were fighting against that

(36).

The legislation was questioned becauseit was permissive and scarcely protected peoplefrom disability, in addition to the isolated criteriait imposed. Luis Benencio, from the companyAstarsa, confirmed that the compliance with theregulations was usually not enough to guaranteethe wellbeing of the workers (r):

You know what happens? If you were going to

take the measurements according to the

regulations, some of them would not be enough

to declare a public health issue. It’s very

curious… It wasn’t that in some places

employers were screwing us over, no, no, it was

that the results of measurements just were not

enough. The problem was that in some places,

there was welding going on and the same time

there were gusts of wind blowing everything

around you, so, what were you going to

measure? You couldn’t. You couldn’t measure

dust, smoke, or anything… So there were places

that could not be declared unhealthy according

to law (15 p.119).

In this regard the issue of worker controlover the working conditions was becoming morecentral for the project of the Institute. “We’re the

ones who feel what goes on,” said Juan Sosaduring one of the meetings of the IMT at theFaculty of Medicine (1 p.75). Each workerpossessed a fundamental element with which tomeasure and assess the conditions of his dailywork because the main instrument was his body,which was the best index for measuring theinfluence of risk factors present in the workplace.

Sosa’s comment becomes even moreintelligible within the concept of worker control,which was an ultimate goal of the IMT. Tools suchas the medical manual for workers – Manual de

Medicina para los Trabajadores (22) – as well asworker trainings did not intend just to educateworkers and provide a guide for dealing withrisks. The IMT aimed to visualize the incidence ofcertain work conditions within occupationalhealth and safety and proposed worker control asa concrete strategy to modify the situation in theindustries and in the production system.

In order to communicate in clearlanguage the concept of work environment andfactors harmful to health, establish criticalarguments for assessing legislation, and proposetools for worker control, a long and detailed three-part document was produced. The first partnamed and described workplace risks; the secondanalyzed the current legislation at the time; andthe third, more proposal-oriented, developed theidea of worker control over working conditionsand proposed mechanisms to make that controlpossible. It may be that the IMT attempted amassive circulation of the text in order to expandupon and overcome the limits of the workertraining courses, but unfortunately it has not beenpossible to confirm the destination of the materialnor whether it was finally published. The

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11


MarTIn al, spInellI H.

distribution was likely limited to the contacts theInstitute had with different unions.

With simple illustrations, the Manual

described the “work environment” and thefactors harmful to health that circulate within it(Figures 1 and 2). Four groups of risk elementswere described: the first group dealt with the“workplace microclimate” and included theeffects of light, noise, heat, temperature andhumidity; the second described pollutants inthe work environment and defined theirmaximum acceptable levels according to law;the third covered aspects connected to“physical effort and awkward postures”; and thefourth corresponded to the psychological

effects that the pace and conditions of work hadon workers.

The concepts of work environment andrisk factors was analyzed in constant reference tothe exposure levels that the regulationsconsidered acceptable for the health of workers.For this purpose, the Manual (22) defined theindexes of reference for measuring noise, light,humidity, etc.; the maximum and minimumlevels admissible for each type of activityaccording to law; and the health risks present inthe work environment when these conditionswere not respected. The way in which thecontents were presented is interesting in that theyallowed for the comparison of the admitted and

Figure 1. Description of the occupational microclimate.

Source: Instituto de Medicina del Trabajo (22).


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recommended values and their impact onoccupational accidents and health deterioration.In order to clarify the importance of reassessingthe established values, the report includedexamples of research studies and their resultswhen the safety measures were higher (Figure 3).

The proposal-oriented section of theManual (22) defined instruments to makepossible worker control of the workingconditions by means of Internal Hygiene

Commissions and a Book of Risks and Damages.The latter would have a personal version madeespecially for each worker and a collectiveversion for the group of workers at eachcompany. Consequently, each worker couldmaintain control over his condition and have

knowledge of the diagnoses made by the medicalstaff of the company; this evaluation would bepart of the general record controlled by theInternal Hygiene Commission in each plant. TheIMT affirmed that in this way, the effect of workercontrol “is twofold: not only is health once againthe patrimony of those who put it at risk in theirwork, but also everyone participates in thecontrol over working conditions and finally incontrol over the production” (22 p.59).

Some promising experiences beingdeveloped at that time were taken as precedentsfor the concepts of worker control and workenvironments. In its last pages, the Manual (22)makes reference to the experience in Astarsa – asituation with which the directors of the Institute

Figure 2. Description of the work environment.

source: Instituto de Medicina del Trabajo (22).

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were well acquainted, and where worker hygienecommissions had already been implemented –and to the Italian Worker Model (MOI, Modelo

Obrero Italiano) promoted by the ConfederazioneGenerale Italiana del Lavoro, that had beencirculating since the 1960s in that country (s).

In Italy, in the context of worker protestsagainst the capitalist organization of work, a modelof action and exploration regarding the harmfuleffects of industrial work was developed, with akey characteristic being the role the workersoccupied in it (39). During the 1970s, a con-siderable number of workers became researchers

of their own labor conditions. The distinctiveslogan of this movement was “health is not forsale” and “no delegation” of worker control overthe conditions in their workplace (40 p.63).

Cristina Laurell analyzed the Italiancase as a conceptualization of the working classthat was able to develop a view of health differentfrom the one in existence until that moment. TheMOI explained health as a vital part of theworkers and not as a good with a price; thismeant rebelling against the idea of theimmutability of the capitalist organization ofwork as it raised the possibility of modifying

Figure 3. Lighting, eye strain, harmful effects in the industry.

Source: Instituto de Medicina del Trabajo (22).

Note: The table above summarizes the results of an experience carried out in the mechanical industry, in which the legal minimum

lighting levels were increased. A 25% decrease in occupational accidents was observed.


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production conditions to remove their harmfuleffects (40). It also meant a qualitative advance inworker demands and such a degree of workermobilization that it was able to influence theGeneral Reform of the Italian National PublicHealth System in 1978.

The Argentine and Italian experienceshad some elements in common. The ideasregarding the “demercantilization” of health,“dealienation” and worker control were sharedby both and were widely expressed under theslogan of “occupational medicine at the serviceof workers.” In practice, that idea was integratedinto a single discourse which included thequestioning of occupational medicine as it waspracticed at the time, the concept and approachto health and sickness and the role of workerswithin that process. However, there was onemajor difference between the Argentine andItalian experiences: in Argentina, the criticalideation came from very different social actors. Itwas led by university professionals, most of thembelonging to the health sciences field, who in aparticular political juncture were able toformulate a proposal for worker control overworking conditions and who, above all, wantedto create a new focus for the medical criteria andpractices in the field of occupational medicine. Itwas in this sense a repudiation coming fromwithin the field, which was able to extendbeyond the limits of that field and show itself asan alternative and as a proposal for a jointpolitical between workers and healthprofessionals (t). Thus, the IMT team became asort of workers’ ally whose function was to makeavailable necessary knowledge and to “create theneed among workers” to make health an issueworth fighting for (26). Health in the workplaceand work as a component of health were a twoparts of an equation that could have positiveresults if the exploitation processes implicit independent capitalism could be unraveled and ifeach worker assumed control over his own laborcapacity. In this way, the IMT sought toovercome initiatives focused on “cleaning up”the work environment and proposed that everydoctor become an “occupational epidemiolo-gist.” Finally, the IMT proposed a reversal ofterms: rather than taking care of the workers’health and anticipating the harmful effects

produced in the work environment, they aspiredto modify the production conditions (in Englishwe would take this to me the conditions in theplace where things are produced?)– in everysense – so that they would no longer be a risk toworkers’ health.

epIloGue

The activities within the IMT werecarried out for a little over than a year. By the endof 1974 most activity had ceased, although someof the research projects continued for a few moremonths. The conservative and authoritarian turnthe government had taken became particularlyevident in July of that year with the death of JuanD. Peron and with his widow Maria EstelaMartinez sworn-in as the new president. AlbertoOttalagano, who came from the extreme rightwing of Peronism, began to intervene in theUniversidad de Buenos Aires, with OscarIvanissevich at the head of the Ministry ofEducation. Within the university, starting in late1973, tensions among the different sectorssupporting the government had mounted and theuniversity leadership, coming from RevolutionaryPeronism, began to find limitations within anenvironment they thought was theirs but that wasbecoming increasingly constrained. Conse-quently, many projects in operation slowed andeventually stopped their activity. In addition, theway in which conflicts were solved – many timesby using political weapons particular to theuniversity – dispelled the camaraderie that theuniversity’s renewal had at first generated. In ashort time, the university would become animportant site of political violence.

The Faculty of Medicine was not at thesidelines of these conflicts; in May 1974, DeanMario Testa resigned his position. A few daysbefore, the tension between Juan DomingoPeron and groups of young people from the left-wing of Peronism had heightened until finallyexploding with the expulsion of the Montonerosfrom Plaza de Mayo [during a government-sponsored political act for InternationalWorker’s Day]. However, the leadership in theFaculty of Medicine preserved the same

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political character. The position of dean wastaken over by Ricardo Saiegh, who was at thetime director of the IMT, and Ruben Efronoccupied his position at the Institute.

At least until September of that year, theInstitute kept up its activity and was able to begintraining courses for workers, but the violence andpersecution perpetuated by the paramilitarygroups of the Argentine Anticommunist Alliance(Triple A) finally dispersed its members. Onlythen was it possible to perceive the quickeningpace of political events and the haste toimplement changes and obtain results in the shortterm. The weak organic and institutionalinsertion that renewal projects such as the IMThad acquired left them powerless before theimmensity of the repressive apparatus set inmotion and with no political reserve to sustainitself. The daily work of the Institute had beenprolific but was not enough to establish a turningpoint within the paradigm of occupationalmedicine. The fight was dual and implied twodifferent timeframes: on one hand, related to thespeed of the political events to which the IMTwas tied since its foundation; and on the other,connected to the rigidity of the academicstructures and their dynamic regarding therenewal of ideas and paradigms.

The continuity and projection of theexperience of the IMT can be traced in theintellectual and professional biographies of someof its leaders. Ricardo Saiegh, during his firstyears of exile in Madrid, worked with issues ofoccupational health, serving as consultant to theTrade Union Confederation of Workers’Commissions (CCOO, Confederacion Sindical de

Comisiones Obreras) and later, to the GeneralWorkers Union (UGT, Union General de

Trabajadores), with the aim of encouraging citycouncils to take on functions related to the healthof workers. He later became involved in the

public health system after taking office as directorof Mental Health in the community of Madrid(42). Carlos Rodriguez, after studying at theClinica del Lavoro Luigi Devoto in Italy,collaborated with the CCOO in the developmentof occupational health. He also managed the firsttwo occupational health centers (Barcelona,Cornellá del Llobregat) that offered training,technical assistance and research in occupationalhealth to workers and their unions, especially tomembers of the CCOO. He was professor ofOccupational Medicine at the UniversidadAutónoma de Barcelona, and later returned towork in Argentina in different agencies andpositions related to occupational health, forexample: the Office of Occupational Hygieneand Safety (1984-1989); the National Office ofOccupational Health and Safety (1995-1996);General Manager of the Occupational RisksSuperintendency (2003-2005) and Minister ofLabor and Social Security in the province of SantaFe (from 2007 to date). Roberto Donalisiocomplemented the experience of the IMT in Italyin close connection with MOI advocates. Later,in Spain, during the democratic transition, heserved as consultant to the Confederacion

Sindical Comisiones Obreras (Trade UnionConfederation of Workers’ Commissions) onoccupational health and safety matters and laterbecame Director of Occupational Health of theNavarra administration.

Despite the abrupt and dramaticinterruption of the activities in the IMT, some ofits members could later develop theirprofessional careers on the basis of the sameconcerns that had brought them to the Institute.They were able to expand upon and continue thisline of inquiry, however, the forced or preventiveexile and estrangement they experienced meantthey had to do so outside of their home country.


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acknowledGeMenTs

This article is part of the project entitled “El Instituto de Medicina del Trabajo y la formación delpensamiento crítico sanitario durante las décadas de 1960 y 1970 en Argentina” located at theUniversidad Nacional de Lanús and financed by the Agencia Nacional de Promocion Cientifica yTecnológica, Project PICTO Nº36734.

We would like to thank the following people for their collaboration in this article: Felipe Aguerre, LuisBenencio, Silvia Chejter, Rubén Efron, Gilou García Reinoso, Omar Glezer, Estela Giménez, HoracioKujnisky, Eduardo Menéndez, Carlos Rodríguez, Osvaldo Saidón, Ricardo Saiegh and Mario Testa.

end noTes

a. It is difficult to create a definitive list of all thepeople who participated in the different stages ofthe IMT. The following names – includingmembers of work teams, participants of specificactivities, collaborators and teachers – weredrawn from the primary sources uncovered andthe testimonies collected: Alicia Aboy, FelipeAguerre, Dalila Becker, Luís Benencio, SilviaBerman, Guillermo Bigliani, Carlos Caccioli,Rubén Cano, Silvia Chejter, Alberto Cohen,Raquel Colombo, Alejandro Cordero, ÁngelesCotello, José Luis D´alessio, Rubén Díaz,Roberto Donalisio, Armando Dragún, RubénEfron, Gastón Feldstein, Gilou García Reinoso,Noemí Ghirardi, Estela Giménez, Omar Gleizer,Susana Greco, Omar Guagnini, victoria Korín,Silvia Kosac, Horacio Kujnisky, María CristinaLennie, Marta Mastrogiacomo, EduardoMenéndez, Silvia Mesterman, Jacobo Muhafra,Eduardo Ortiz, Liliana Pérez, Eduardo Perugini,Mary Pizzurno, Carlos Pommerenck, CarlosRachid, Pedro Reggi, Néstor RodríguezBrunengo, Osvaldo Saidón, Ricardo Saiegh,Hernando Sala, Remigio Sánchez, SilvioSchneck, María del Carmen Scorziello, RobertoSica, Carlos Silva, Ana Singerman, Estela Testa,Mario Testa, Norma vallejos, Ana ventura,Ramón villar.

b. In almost all the faculties of the UBA, researchprojects were started, new courses and chairswere created, and programs were carried out thataimed at renewing the profile of the university.For example, the Institute of Applied Economicswas created in the Faculty of Economic Sciencesand the First Conference of Popular HousingExperiences was held in the Faculty ofArchitecture and Urbanism. In most cases, theprojects were difficult to develop and had weaklevels of institutional implementation. For a moreminute account of the Universidad de BuenosAires during the different Peronist administrationssee Aritz Recalde and Iciar Recalde (3). Also seethe account solicited of Ricardo Saiegh and

published in many morning newspapers withnational circulation (4). For more on the reformscarried out during Rodolfo Puiggros’administration, see Rodolfo Puiggros (5).

c. The presence of Montoneros in theUniversidad de Buenos Aires governmentcontrasts with its limited presence in other areasof power. In the Argentine National Congressthere were only eight representatives connectedto the Montoneros of the 145 belonging to thePeronist Justicialist Front for National Liberation(FREJULI, Frente Justicialista de LiberaciónNacional), the coalition that had won theelections and taken office in 1973. In theexecutive branch, the influence of left-wingPeronism was even more limited and brief, withthe short-lived administration of Jorge Taiana asMinister of Education and the longer service ofEsteban Righi as Minister of the Interior. Theprovinces of Salta, Santa Cruz, Mendoza,Formosa y Buenos Aires experienced deepconflicts which ended up in a political overhaulof the majority of these provinces as the Peronistgovernment advanced, for it was considered thattheir governors supported the left wing of thePeronist movement. For an analysis of therelation between the Peronist government andthese provinces, see Alicia Servetto (7p. 73-76).

d. In one of his first speeches, Mario Testa, asdean of the overhaul in the Faculty of Medicine,makes explicit his agreement with and support ofthe Unified National Health Program.

e. For a detailed description of the conflicts in theGreater Buenos Aires area, see Ruth Werner andFacundo Aguirre (13). The Social Pact, signed inJune 1973 between Cámpora’s government andthe Argentine General Confederation of Labor(CGT, Confederación General del Trabajo), theGeneral Economic Confederation (CGE,Confederación General Economica) and otherbusiness sectors, sought to control theinflationary spiral and suspended rights tocollective negotiation regarding salaries in orderto delegate them exclusively to the CGT. In this

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way the Pact acknowledged the politicalimportance of worker organization while at thesame time tying that organization to a consensusprocess with businessmen.

f. Juan “Chango” Sosa was a musician whobecame part of the proletariat and later became atrade union leader of Astarsa Shipyards. Heheaded the group that occupied the plant in thelocality of Tigre in 1973. The conflict wasresolved in favor of the workers during the firstdays of Cámpora’s government, and one of thedemands met was the formation of a HygieneCommission made up of plant workers, in whichLuis Benencio took part. Sosa was a member ofLos Obreros, an armed independent group, andhe joined the Peronist Working Youth (JuventudTrabajadora Peronista). Luis Benencio kept up therelationship between the IMT and AstarsaShipyards during 1973 and 1974 (15).

g. The Introductory Seminar on OccupationalMedicine was delivered between August andOctober 1973. Estela Gimenez and AnaSingerman, toxicologists and professors at theUniversity of Buenos Aires, and AlejandroCordero, dermatologist, were invited to deliverthe seminar. Engineers from the National Officeof Industrial Hygiene and Safety and lawyersspecialized in labor legislation were also invitedto participate (20 p.28-29).

h. At the end of 1973, Peronism was alreadyexpressing deep conflicts between the youngestleft-wing sectors of the movement and the right-wing sectors of the party, which became moreevident after the events that took place in Ezeiza,Cámpora’s resignation and the assassination ofIgnacio Rucci, the General Secretary of the CGT.The Universidad de Buenos Aires was not outsidethe reach of these conflicts. In October 1973,Rodolfo Puiggrós was forced to resign hisposition as rector and after the brief and resistedadministration of Alberto Banfi that led to theoccupation of several faculties, Ernestovillanueva was appointed to fill the vacantposition. The new rector was a young sociologistwho had been, until that moment, the AcademicSecretary of the UBA and militant in the PeronistArmed Forces (FAP, Fuerzas Armadas Peronistas)and Montoneros (3 p.296-297).

i. Research agreements were signed with theWorkers Union of Fiat Caseros (SITRAFIC), theFederation of Argentine Telephone Workers andEmployees (FOETRA, Federacion de Obreros yEmpleados Telefónicos de la Republica Argentinafrom Buenos Aires), the Argentine Association ofTelegraphists (Asociación Argentina deTelegrafistas) , the Argentine Mine Workers

Association (Asociación Obrera MineraArgentina), the Electroacoustics Laboratory of theFaculty of Engineering and with theUndersecretariat of Public Health of the provinceof Jujuy.

j. According to IMT members, there wereapproximately 40 people working at the IMT,some of whom received a salary and hadteaching positions within the Faculty of Medicine(26, 27).

k. Their condition as political exiles facilitated theintegration of these professionals into the IMT.Some professors voluntarily shared with them thesalary paid them by the university (28).

l. The Pirquitas Mining Company is located inRinconada, a department in the northeast of theprovince of Jujuy at an altitude over 4000 meters.It employed more than 500 workers in miningactivity but concentrated more than 2500 peopleincluding the workers’ families and the staffworking in administrative and other tasks relatedto the mine.

m. Private communication with Osvaldo Saidónin Buenos Aires, in October 2010 and May 2011.

n. A previous version of this research waspresented at the International Conference ofOccupational Medicine held in Buenos Aires in1972 and provoked a series of discussions thatled to the repudiation on the part of a group ofdoctors, including Ricardo Saiegh, of what washappening there. They claimed that the eventavoided responding to workers’ real healthproblems in underdeveloped countries andignored the conditions of exploitation they wereundergoing. This group of dissidentprofessionals, formed in opposition to theorganizers of the Conference, attributed thecharacter of the conference to company interestsand to doctors with ties to these companies whowere present at the event. (30).

o. Eduardo Menéndez, Rubén Efrón and RobertoDonalisio all spoke of the experience butexpressed different versions of the meeting inwhich the sexual disorders were brought to light.According to Roberto Donalisio (32), it was aworker’s wife who mentioned the situation butaccording to Eduardo Menéndez (27) and RubenEfron (19), it was mentioned by one of theaffected workers.

p. Eduardo Menéndez affirmed that heincorporated IMT experiences with metallurgicalworkers, the miners from Pirquitas and busdrivers (a project initiated by the Institute but


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developed outside of it because of the universityoverhaul in 1974 that interrupted its activities) toelaborate the notion of the Hegemonic MedicalModel. He first published this concept as prefaceto the book La salud en la fabrica by F. Basaglia(34); the revised and updated version was laterpublished by Salud Colectiva (35). Othermembers of the IMT finished their occupationalhealth training abroad in years to follow, forexample Roberto Donalisio in Italy and CarlosRodriguez in Spain. For more on RobertoDonalisio’s work after the experience of the IMT,the interview conducted with him in 2011 can beconsulted (32).

q. Kujnisky is an engineer and was member of theIMT engineering team. He participated inresearch on noise in industry work and inagreements made between the faculties ofMedicine and Engineering of the University ofBuenos Aires.

r. Comment made by “Jaimito” (Luis Benencio) inthe Navales working group with former Astarsaworkers (May 1988) held in the Center of

Occupational Studies, as cited by FedericoLorenz (15 p.119). See also the interview withLuis Benencio in 2010 (37).

s. One of the first descriptions of workenvironment was published in 1965 in RessegnaSindicale (38). It centered on the organization ofthe labor and the pressure and overexploitation itmeant for workers. Four characteristic groupswere described: the first included temperature,humidity, noise, lighting, pressure, etc.; thesecond included the levels of concentration ofdust, gas, steam; the third made reference tophysical fatigue; and the fourth dealt with thepsychological effects or disruptions to thebiological rhythm such as posture and pace ofwork (38 p.19).

t. We stress this particularity, because during theyears prior to the experience described herein,there were projects developed that focused onworker control and participation in companiesbut did not include control over hygiene andsafety issues within the industries.

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Content is licensed under a Creative CommonsAttribution — You must attribute the work in the manner specified by the author or licensor (butnot in any way that suggests that they endorse you or your use of the work). Noncommercial — You may not use this work for commercial purposes.

This article was translated as a part of an interdepartmental collaboration between the Bachelor's Program inSworn Translation of English Language and the Institute of Collective Health within the Universidad Nacional deLanús. The article was translated by Patricia velázquez, reviewed by María victoria Illas, and modified forpublication by vanessa Di Cecco.

Received: 10 April 2011 | Final version presented: 17 June 2011 | Accepted: 15 July 2010

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