4 Exporting Francoist Modernity: Health, Social Security, and Hispanidad

If colonial Africa was central to the Franco regime’s international projection during the 1940s and 1950s, then Spain’s former imperial role in Latin America was perhaps even more significant. This book opened with Franco’s speech to an international social security conference in 1951. It was in fact an ‘Ibero-American’ conference, and was an important milestone in the international promotion of Franco’s social state. Among the many Spanish and overseas ministers present was the Falangist minister of labour, José Antonio Girón de Velasco, who addressed the delegates and later published an extended version of his speech. Like Franco, he explained how Spain had been transformed from ‘one of the most backwards countries in the world’ in terms of its socio-political system, to ‘one of the most advanced’. It was this advanced, modern social policy that made Spain once again ‘a nation which deserves to be heard’. But he also wanted to emphasize that a successful modern social policy could only truly be carried out by ‘a Christian state, like the Spanish state, which defines itself as Catholic and social’.¹ According to this argument Francoist social policy was defined by two characteristics: its modernity and its Christianity.

Other Spanish speakers at the conference echoed these themes, as did accounts published in specialist journals and the popular press. One journal claimed that the issue of social security was among the most urgent facing modern society. ‘The man of our time,’ its report argued, ‘surrounded by the marvels of a flourishing civilization, is more helpless and less secure than the man of previous ages. Progress and technology have shrunk him.’² Another described how delegates used their ‘Catholic fervour to create a social strength firm enough to confront and resist the attacks of the materialist world’. All Spanish reports argued that the conference provided an opportunity for countries of the Ibero-American region to learn from each other, discussing how Christian principles could help resolve the social problems which characterized the modern world. But they also emphasized that Spain was at the vanguard of this process, and that the social systems of many Latin American countries had been ‘informed’ by the Spanish model.³

It was no coincidence that this vision of the Francoist social state was promoted most vigorously to Latin American countries. Latin America was seen by the Franco regime and its supporters as a space in which to project itself as a model of conservative Catholic modernity. Social policy and fields such as social security were central to this project, used to promote the idea of the Francoist social state as a spiritual ‘third way’ between the twin materialisms of communism and capitalism. During the Second World War this language was integrated into Falangist projects to promote the idea of a fascist New Order. But after 1945 it could be retooled by both Falangists and more conservative elements of the regime, who used the context of the emerging Cold War to emphasize social policy as a core part of Spain’s modern, anti-communist credentials. Improving social conditions, Francoist experts and officials argued, was vital to counter the appeal of communism among populations increasingly alienated by modern industrial society. But the capitalist welfare model offered by countries such as the US was poorly suited to the countries of Iberia and Latin America because of its ‘materialism’, its narrow focus on material conditions at the expense of the spiritual and moral needs of workers. In contrast, Spain offered a model of Catholic anti-materialist modernity in which social policy was driven by spiritual values better suited to the traditions and cultures of the Christian west.

The idea of a post-imperial ‘Ibero-American’ community built around the ties of history, religion, language, and culture which united the two regions had first emerged during the nineteenth century, and appealed to Spanish elites across the political spectrum.⁴ Originally it had been built around the language of raza, of a shared Hispanic race distinct from Anglo-Saxon or Slavic communities. It had played an important role in visions of Spanish national identity that developed during the turn of the century, particularly within the Spanish regenerationist movement which emerged after 1898 where the concept of hispanidad was used to articulate a new model of national identity for post-imperial Spain.⁵ Forging a new Ibero-American community, Spanish intellectuals and elites hoped, would help both regions to strengthen their political, economic, and cultural position on the global stage, and to facilitate the moral regeneration and structural modernization which would help Spain reclaim its position as a world power.⁶

As the twentieth century progressed, the language of hispanidad was increasingly co-opted by the Spanish right. Conservative thinkers such as Ramiro de Maeztu developed a more nationalist and traditionalist vision of hispanidad based around Catholic values, the historical role of the Spanish empire in expanding global Catholicism (the ‘empire of faith’), and the idea of Ibero-American identity as a counterpoint to liberal and secular forms of modernity.⁷ His ideas helped to inform the foreign policy of the Primo de Rivera dictatorship during the 1920s, under which de Maeztu served as Spanish ambassador to Argentina. Latin America was also a focus for Spanish fascist thinkers prior to the civil war, and it formed an important part of the Falangist imperial imagination during the late 1930s and early 1940s.⁸ These currents of thoughts were carried over into the Francoist era.⁹ They underpinned the rhetorical emphasis on hispanidad in the regime’s formulation and projection of Spanish national identity, and its attempts to establish Spain at the head of a new Ibero-American community of nations.¹⁰

The idea of hispanidad had a much more complicated reception in Latin America. Many in the region had long been supporters of the idea.¹¹ For many Spanish emigrants in the late nineteenth and early twentieth centuries, the idea appealed to their patriotism and loyalty to the ‘mother country’.¹² For sections of the Latin American elite, the idea of a strengthened Ibero-American community offered commercial, political, or personal opportunities. But it was opposed by others who resented the neo-imperialist undertones of Spanish projects. It also ran up against alternative models of transnational community which enjoyed support across the region. Other European countries laid claim to a special relationship with Latin America, whether Britain with its trading relationship in the nineteenth century, France or Italy with their vision of transnational Latin identities, or the Portuguese language of Luso-tropicalism.¹³ These in turn competed with the influence of the US, and the hemispheric vision of Pan-Americanism. As Spanish economic and geopolitical power waned, so did its influence amongst the Latin American republics. And as the Spanish vision of hispanidad became increasingly associated with the political right, so hostility among Latin American liberals and leftists grew.

The Francoist vision of hispanidad was in many ways backwards-looking and reactionary. It harked back to a lost imperial golden age, and emphasized a shared commitment to traditionalist Catholic values and social models. This chapter argues, however, that through its work in Latin America the Franco regime also sought to promote the image of Spain as a technically, economically, and socially advanced state. To do so it had to reconcile its traditionalist vision of hispanidad with elements of social and scientific modernization.¹⁴ It was this which made social experts so important to Francoist cultural diplomacy in Latin America. According to Girón de Velasco they were the ‘shock troops’ of social justice, possessed of technical skills and knowledge which: ‘[when] applied to human misery, becomes no longer cold or mechanical, but instead becomes an extension of our spirit acting in a transcendental way and converting our spectacular and curious intelligence into what it should never cease to be: a blessed tool of the word of God’. Expertise, in this account, could be combined with the ‘spirituality’ of National Catholic Spain to project the values of the Francoist social state beyond its own borders. The religious and cultural identity Spain shared with Latin America meant that it was Latin American experts who would be most receptive to this vision of a modern, spiritually rooted social system.

Despite the significant resources dedicated to this task, the Francoist narrative faced significant opposition in Latin America. Left-wing governments and movements, particularly those which had supported the defeated Republic during the Spanish Civil War, were implacably hostile to any attempts by the Franco regime to promote its influence in the region. The many Spanish Republicans who had gone into exile in Latin America helped to coordinate and bolster anti-Francoist opposition. In particular, the large number of exiled Republican social experts provided a counterpoint to the work of their Francoist rivals in the region. Exile groups offered a more equal and collaborative model of Ibero-American cooperation, highlighting the neo-imperialist language and assumptions which continued to characterize Francoist efforts. Nevertheless, Latin America did provide a route through which Francoist social experts were able to engage with wider forms of international cooperation in certain instances. In areas such as social security and health insurance, cultural and historical ties with the region opened up opportunities to promote a vision of Francoist modernity to the outside world.

This chapter begins by setting out the importance of social experts and expertise within Francoist cultural diplomacy to Latin America, which sought to project Spain as a modern and modernizing power. Unlike the relationship between Spanish social experts and Nazi Germany, or with French and British African colonies during the Second World War, expert involvement with Latin America was directed and promoted by the state as a coordinated aspect of its foreign policy. The second section examines the position of Republican exiles in the Latin American scientific community and their impact on the work of Francoist experts, using the example of international leprosy networks to demonstrate how Latin America provided a gateway through which Francoist experts could engage in wider forms of international activity despite the opposition they encountered. The final section shows how the fields of health insurance and social security were used by both the Franco regime and Spanish experts to promote their influence in the region from the 1950s, adopting the language of development and technical cooperation to position Spain as a model for those Latin American states looking to modernize their social security systems in response to the threat of communism.

At the end of the Second World War the Franco regime launched a new programme to attract Latin American students to study in Spanish universities. In numerical terms the policy was highly successful. By offering scholarships and promoting Spanish universities in the region, the government was able to increase the number of Latin American students arriving annually in Spain from just 25 in 1946 to 3,100 by 1953.¹⁵ The policy reflected the importance of Latin America to the post-war Spanish government. Hispanidad, the idea that Spain stood at the head of a community of Ibero-American nations united by ties of history, culture, religion, and language, was central to the domestic discourse and the foreign policy of the Franco regime. Cultural diplomacy in Latin America was a key element of Francoist foreign policy, particularly during the late 1940s, and the regime hoped that educating the children of Latin American elites in Spain would buttress its influence in the region over the coming decades.

The very first beneficiaries of this new policy, a group of seventeen students and three professors from the University of Chile’s medical faculty, arrived in Spain in February 1946.¹⁶ Over the following five months the group visited some of the most important medical facilities and institutions across Spain, including the Royal Academy of Medicine and the Anti-Tuberculosis Trust in Madrid, and studied with renowned Spanish experts such as Gregorio Marañón and Carlos Jiménez Díaz. Six of the students were awarded additional scholarships to continue their studies in Spain for a further year when their colleagues returned to Chile in May. The importance of the visit was reflected in the size of the scholarships granted at a time of severe financial shortages, and it was followed closely by Spanish diplomats and by the press in both countries. The Spanish ambassador in Chile lauded the significance of the tour in helping to counteract the ‘adverse propaganda’ in the region which painted the Francoist government as ‘nazi-nipo-fascist-Falangists’, particularly within the ‘hostile redoubt’ of the University of Chile.¹⁷ Santiago’s El Diario Illustrado reported in March that the students had been highly impressed by their experiences in Spain and the ‘extraordinary’ efforts of the regime in the social and educational sectors.¹⁸ Pro-Francoist Spanish diaspora groups in Chile described it as a ‘journey of Hispano-American brotherhood’ which would help ‘bring together the Patria and the countries of the New Continent’.¹⁹

Under the surface, however, the tour did not progress as smoothly as its sponsors had hoped. Shortly after the initial group had embarked on their return journey to Chile in May, the Spanish Ministry of Foreign Affairs received information that one of the students was affiliated to the Chilean communist party and had been in contact with ‘extremist elements’ while in Spain.²⁰ Although the purpose and extent of this contact was not clear, they suspected that he had been collecting material intended to begin a ‘campaign of defamation’ against the Franco regime on his return to Chile. The Spanish ambassador in Santiago warned his counterparts in Argentina, Uruguay, and Brazil about the student’s imminent arrival, and with the collusion of Brazilian security services arranged for his belongings to be surreptitiously searched when the boat docked in Rio. No seditious material was found, but the Brazilian security services continued to follow the student around the city and reported that he had deposited a large amount of money in a local bank, before the trail went cold.²¹

Further problems soon emerged. In September, a Spanish resident of Santiago wrote to the Spanish ambassador to denounce Elsa Acuña, another of the students who had received the extended scholarships to stay on in Spain, whom she claimed was engaging in anti-Francoist ‘propaganda’. In numerous letters home to family and friends, the informant alleged, Acuña had:

rudely criticised the current regime…saying that leading figures in the government dedicate themselves to robbery and contraband…that there are no kinds of freedoms, that if anyone complains they are persecuted, and that all Spaniards are silenced and watched, that people are dying of hunger whilst those in the government lack for nothing.²²

The ambassador passed the information on to the Ministry of Foreign Affairs in Madrid, with a request that Acuña’s funding be withdrawn. The Chilean newspaper La Hora, meanwhile, reported that the Federation of Chilean Students had denounced those students who had organized the tour and spoken positively about Franco’s Spain as ‘well-known fascists’ seeking to undermine the solidarity between Chilean students and the Spanish people.²³ The diplomatic and propaganda aims the Franco regime had hoped to achieve through the tour had clearly not been entirely realized.

The tour illustrates the significance of health, science, and social policy to Francoist diplomacy in Latin America, the ambitions which underpinned it, and the factors which limited its success. In the absence of significant political, economic, or military influence in the region, Francoist attempts to enhance Spain’s status in Latin America were focussed on cultural diplomacy. These efforts were led by the Institute of Hispanic Culture (Instituto de Cultura Hispánica; ICH) and its predecessors. The ICH aimed to win the allegiance of national elites and Spanish expatriates across Latin America, primarily by building educational, cultural, and professional ties with universities, businesses, and professional groups.²⁴ Although focussed on cultural activity, its work was not a marginal part of Francoist diplomacy. In 1946 close to 20 per cent of the Ministry of Foreign Affairs’ budget was dedicated to cultural initiatives, the vast majority aimed at Latin America.²⁵

During its peak in the 1940s and early 1950s, science, particularly the medical sciences, was central to Francoist cultural diplomacy in the region. This was partly explained by the fact that exchanges and visits involving experts and students could be promoted on ‘technical’ and scientific grounds, despite the often antagonistic relationships between Latin American republics and the Franco regime. Beyond that, however, lay the goal of using social and scientific experts to promote a modern, technologically advanced image of Franco’s Spain, at a time when the exile of many of the country’s leading scientists following the end of the civil war had severely weakened the regime’s modern and modernizing credentials. In this sense, Francoist cultural diplomacy differed from the model of Cold War-era US cultural diplomacy which was aimed at winning a global ideological and cultural battle against the communist bloc.²⁶ Instead, it much more closely resembled the efforts of interwar states such as Weimar Germany or the USSR, which had been marginalized within the international community, to use their artistic, technical, and scientific pedigree and traditions to build bilateral relations and to bolster their international status.²⁷

The importance of science and medicine to Spanish cultural diplomacy in Latin America had its origins prior to the Spanish Civil War. Since the end of the nineteenth century, Spanish intellectuals had sought to strengthen ties with Latin America through organizations such as the Unión Ibero-Americano, often with the financial support of the Spanish state. In Latin America, political and economic elites, often recent Spanish emigrants, built similar organizations to promote educational and intellectual ties with the madre patria. These efforts were increasingly supported by the Spanish state. The JAE funded a growing number of scientific conferences and visits to Latin America in the 1920s and 1930s, particularly under the Primo de Rivera regime.²⁸

The influence of Falangist leaders over Spanish foreign affairs in the immediate aftermath of the civil war meant that they were at the forefront of the Franco regime’s initial attempts to build ties with Latin America. In November 1940, Serrano Suñer’s Ministry of Foreign Affairs established the Council of Hispanidad (Consejo de Hispanidad) to promote the interests of Spain and the cause of the totalitarian New Order in the region, and to counter the influence of the US and its allies. The council received some support from pro-Axis activists, businesses, and religious and military elites across Latin America. But its overtly imperialist tone meant that it was widely distrusted, and its practical attempts to improve cultural ties were hampered by disruptions to travel and communication caused by the war.²⁹

The end of the Second World War provoked a shift in the Francoist approach to Latin America. Changes were driven by the appointment as foreign minister of the Catholic politician Alberto Martín Artajo, who was well known among the region’s Catholic elites. Latin America remained central to Spanish foreign policy despite the fact that the majority of its states, barring Perón’s Argentina, broke off diplomatic ties in 1946. Most, however, rejected calls for international intervention in Spanish affairs, and ultimately formed the bedrock of support for Spain’s admission to the UN in 1955.³⁰ Martín Artajo’s ministry shifted the language of hispanidad away from the idea of Spanish leadership of a political community to one which promoted the cultural, historical, and spiritual ties between Iberia and Latin America, with Spain presented as the unifying ‘mother country’ or as the ‘bridge’ between the two regions.³¹ Although Spain’s presence in Latin America implied a challenge to the US and to the Pan-American movement, this cultural vision of hispanidad aimed to position Spain as a positive regional partner. Some Francoist proponents of hispanidad presented Spain not as a rival to the US, but as a historical partner in the foundation of an ‘Atlantic civilization’ which united the Iberian and Anglo-Saxon worlds.³²

In 1946, Martín Artajo re-established the Council of Hispanidad as the Institute of Hispanic Culture. The ICH coordinated scientific and medical links with Latin America, with the support of the Spanish National Research Council and the Ministry of Foreign Affairs’ Committee of Cultural Relations.³³ A key strand of their work, particularly after 1946, involved encouraging Latin American students to study in Spanish universities through the provision of scholarships and student support services. The Chilean medical students visiting Spain in 1946 had been amongst the first beneficiaries of this programme, with the number of Latin American students in Spain rising rapidly thereafter.³⁴ The ICH coordinated a network of colleges and residences for Latin American students, providing scholarships, subsidized accommodation, and a range of cultural activities to support their studies. Medicine and medical students were given a prominent place in the organization’s propaganda and publications, which emphasized the opportunities for students to study with internationally renowned experts such as Gregorio Marañón.³⁵ Encouraging student exchanges, the ICH hoped, would improve the contemporary image of Spain across the region through the positive reports of returning students. And it would help to cement Spain’s long-term influence by ensuring that the next generation of Latin American elites gained direct experience of Spanish life.³⁶

The ICH also supported the visits of Spanish scientists and social experts to Latin America. One of the earliest and most prominent examples was the visit of Carlos Jiménez Díaz to Argentina, Chile, and Peru at the end of 1943. The tour involved a series of conferences and lectures across the three countries, during which Jiménez Díaz was awarded various awards and honorary doctorates. It was funded by the Council of Hispanidad, with considerable logistical and political support from the Ministry of Foreign Affairs. Coming at the height of the Second World War when travel between Spain and Latin America was increasingly difficult, it provoked significant interest on both sides of the Atlantic. Jiménez Diaz’s return made the front page of many Spanish newspapers, and led to a personal audience with Franco.³⁷ Accounts of his visit reflected the extent to which Jiménez Diaz was regarded as an ambassador for Francoist Spain through his ability to project a positive impression of the country’s scientific and medical prestige. The newspaper ABC reported that his lectures had provided the Latin American scientific public with lessons about ‘the progress of medical science, to which Spanish talents have always made such a great contribution’, and had reawakened ‘the oldest roots of pride’ in Spanish science.³⁸ The Council of Public Health lauded his work in ‘raising the prestige of Spain amongst the hispano-american nations’.³⁹

The celebration of Jiménez Díaz’s visit reflected a wider belief among the Francoist foreign policy establishment in the importance of science and medicine to Spanish diplomacy in the region. When a leading Spanish ophthalmologist attended an international congress in Uruguay in 1945, the Spanish ambassador called on the Ministry of Foreign Affairs to encourage further visits from Spanish scientists, whom he described as ‘magnificent expressions of the reality of Spain, so often misrepresented and poorly understood’, and whose ‘words and presence are the best and highest propaganda for our country’.⁴⁰ ‘Science,’ argued the foreign minister Martín Artajo in 1950, ‘has strengthened our vigorous international presence, at the same time as it has attracted vast swathes of opinion among the world’s most distinguished figures.’⁴¹ The value of scientists and social experts for Spanish foreign policy lay in their ability to project an image of a positive, modern, and forward-looking Spanish state to Latin American elites. They were also seen as ‘independent’ experts whose views would carry more weight than those of diplomats and officials.

The influence of Spanish scientists and social experts over Latin American elites was challenged, however, by the large number of Spanish exiles who had made their home in the region following the Spanish Civil War. Francoist diplomats encouraging the visits of Spanish experts to Latin America hoped to counter the negative image of the regime promoted by those exiles and their supporters on the left, but were unable to prevent the exile opposition from challenging their efforts. During his 1943 tour of the region, for example, a lecture delivered by Jiménez Díaz in Chile was met by shouts of ‘Fascist! We don’t want Francoists here!’⁴² The problems experienced during the tour of Chilean medical students to Spain three years later highlighted the difficulties Francoist authorities faced in managing and countering these forms of opposition.

Spanish exiles in Latin America promoted an alternative model of Ibero-American cooperation in which Spain stood as an equal and collaborative partner rather than a spiritual and cultural leader. Their example risked throwing into stark relief the hierarchical and imperialistic undertones which endured within the Francoist discourse of hispanidad, even after the more overt neo-imperialism of the Falange had been jettisoned. Nevertheless, the prominent role of Spanish exiles in the Latin American medical community did not prevent Francoist experts from engaging with the region. As the strength of opposition began to die down from the end of the 1940s, they were even able to use Latin America as a springboard to reconstruct ties with international organizations and networks which had been damaged by Spain’s post-war diplomatic isolation, particularly in the field of health.

The estimated half a million Spaniards who fled into exile during and immediately after the Spanish Civil War included a large proportion of the country’s scientific, cultural, and intellectual elites. Most fled in the first instance to France, with many later building new lives in Mexico and, to a lesser degree, Argentina, Venezuela, Cuba, and the US. The field of medicine was particularly well represented among Spanish exiles, including internationally renowned researchers and experts such as Gustavo Pitalluga and Félix Martí Ibáñez, as well as hundreds of doctors and nurses.⁴³ In Mexico alone, 500 Spanish doctors were granted residence between 1939 and 1940, representing 10 per cent of the total number of doctors in the entire country.⁴⁴ Mexico welcomed a broad range of Spanish exiles and provided a base for the Republican government in exile, but was particularly keen to welcome Spanish intellectual immigration to help develop its university system. Spanish doctors, who struggled to gain accreditation in many countries due to a lack of available documentation, were supported in Mexico via a special system of accreditation which allowed them to be examined verbally by a panel of Mexican and Spanish experts.⁴⁵ Spanish experts also played an important role in the development of public health, medical training, and nursing in Venezuela, and went on to establish successful medical careers elsewhere across Latin America.⁴⁶

Spanish scientists in exile set up structures and institutions to help them re-establish their careers and integrate into the scientific communities of their adopted countries. The Union of Spanish University Professors Abroad (Unión de Profesores Universitarios Españoles en el Extranjero) was co-founded by the malariologist and public health expert Gustavo Pittaluga in Paris in 1939, later moving to Cuba and Mexico. The organization lobbied the Allied powers and the UN in favour of the Republican cause, and set up initiatives to support and promote the work of exiled scientists and academics.⁴⁷ Its most successful initiative was the exile-run journal Ciencia which began publication in Mexico in 1940 and continued for thirty-five years, and which reflected the prominent status which many Spanish exiles had attained within Latin American scientific communities.

In addition to the overt efforts of Spanish exiles to campaign against the Franco regime, their presence in the region represented an implied challenge to the Francoist conception of hispanidad, and the role of science and medicine within it. At its annual conference in Havana in September 1942, the Union of Spanish University Professors Abroad set out its view of the relationship between Spanish exiles and Latin America:

The Spanish people, linked by blood, language and beliefs with the Republics which in other times made up the Spanish Empire, take pride in their achievements, harbour no imperial ambitions, and desire a fraternal collaboration to maintain and enrich our common heritage, whilst expressly adhering to the principle of interamerican solidarity and fervently desiring to contribute to the harmonious understanding between the racial and cultural elements which make up the western hemisphere.⁴⁸

Like their Francoist counterparts, Spanish exiles emphasized the historical, linguistic, and cultural ties between Spain and Latin America. But they explicitly denounced the imperialist pretensions which, particularly during the early 1940s, had so clearly influenced the Falangist-inspired vision of hispanidad. Instead of the Spanish-led Ibero-American networks promoted by the ICH, Republican exiles explicitly called for equal and reciprocal forms of collaboration. The references to ‘interamerican solidarity’ and the ‘western hemisphere’ also situated their vision within, rather than against, pre-existing Pan-American networks and relations with the US.

In contrast to the inclusive and collaborative approach of Spanish exiles, many Francoist experts continued to couch scientific ties within imperialist and nationalist rhetoric, even beyond the end of the Second World War. A prime example was the involvement of the Spanish Catholic nursing association, Salus Infirmorum, with Catholic nursing groups in the region.⁴⁹ The leader of Salus Infirmorum, María de Madariaga, was involved in an ongoing battle with her French counterparts to ensure that Spain acted as the primary link between nurses in Latin America and the International Catholic Committee of Nurses and Medico-Social Assistants. Her cause was actively supported and funded by the ICH and the Spanish Ministry of Foreign Affairs. In 1949 the ICH’s director, Joaquín Ruiz Giménez, wrote to the Spanish ambassador in Montevideo lauding Madariaga’s efforts to assert Spain’s ‘rights’ in the region by promoting the ties of hispanidad over French claims based on a broader Latin identity, and setting out the benefits of ensuring that Catholic nursing groups in Latin America were ‘tied to Spain’.⁵⁰

When Madariaga toured the region in 1954, the Salus Infirmorum journal drew enthusiastic parallels with the history of the conquistadors and Spain’s imperial past: ‘[Madariaga] passes her days and nights inventing ways to conquer [conquistar] the whole world for Christ and for Spain. Poring indefatigably over the map she plans out the possible conquests [conquistas], not only within our borders but also outside of them.’⁵¹ Although Madariaga was not aiming to subjugate or dominate Latin American nursing associations, these kinds of references to Spain’s colonial past and the imperialist language which accompanied them clearly contrasted with the more inclusive rhetoric of Spanish exile groups. Thanks to these attitudes, and to the continued role of the Spanish Ministry of Foreign Affairs in promoting cultural ties to Latin America, Spanish experts in the region continued to face suspicions that they were acting as a front for quasi-imperialist Spanish foreign policy ambitions.

Despite the importance of Spanish exiles within the Latin American scientific community, there is little evidence that they actively sought to prevent the engagement of Francoist experts with Latin America, or that they strengthened anti-Francoist sentiment among their Latin American colleagues. In fact, in a number of cases Latin America clearly acted as a springboard for Francoist experts to engage with wider international organizations and networks, sometimes even with the support of Spanish exiles. This was partly thanks to the shared language between the two regions, which meant that the Latin American scientific community provided a forum for the work of Francoist experts to gain exposure outside of Spain. The pharmacologist Benigno Lorenzo-Velázquez, for example, was one of the most internationally active experts in Franco’s Spain during the 1950s, and attributed much of his international standing to the popularity of his work in Latin America. In particular, his invitation to join the WHO expert committee on narcotic drugs in 1952 was the result of a visit by the committee’s chairman to Buenos Aires where he was introduced to Lorenzo-Velázquez’s major work on pharmacology.⁵² The personal, cultural, and linguistic ties between Spanish experts and their Latin American colleagues provided access to the professional networks so crucial to the field of international health, in which appointments and professional opportunities were often based on reputation and personal connections.

In other cases, Latin American experts provided more active support for Francoist medical authorities looking to establish connections with international health organizations and networks. The clearest example of this was the crucial role played by Latin American governments in supporting Spanish membership of the WHO between 1946 and 1951.⁵³ Below this level, Latin American experts supported the involvement of Franco’s Spain in a wide range of international health networks, including specialist bodies such as the International Leprosy Association. The International Leprosy Congress held in Madrid in 1953, for example, was one of the first international medical congresses hosted by Franco’s Spain, and was given an extraordinarily high profile by the regime as evidence of Spain’s reintegration into the international scientific community.⁵⁴ The decision to host the event in Spain had been taken at the previous international conference held in Havana five years earlier. There, the Cuban organizers had agreed to invite a Spanish delegation at a time when Francoist experts were excluded from most other international conferences. Spanish delegates had then actively lobbied for Madrid to host the proceeding conference, and had succeeded in part due to the support of Latin American delegates. A report on the conference in a Spanish journal also alleged that the proposal had received support from unnamed Spanish exiles living in Mexico.⁵⁵

Francoist health authorities saw the field of leprosy as an ideal forum for promoting Francoist health care to the wider world, and particularly to Latin America. The symbolic value of the disease within Catholic culture meant that it could be used to link the idea of Spain as a modern, scientifically advanced power with its historical role as the defender and promoter of Catholic values. Speaking at the 1953 Madrid conference, the interior minister Blas Pérez González presented the care of leprosy sufferers as an integral part of Spanish history, highlighting the humanitarian efforts of historical figures from El Cid to the Reyes Católicos.⁵⁶ This proud history, he argued, was reflected in the expertise of contemporary Spanish leprosy experts and the advanced nature of leprosy treatment in Spain, following its neglect under the Second Republic. José Palanca told delegates that Spain had worked so hard to ensure the international conference came to Madrid because ‘we wanted to show you our medical achievements and our campaign against leprosy which we in Spain carried out alone, without anyone’s help and despite difficult economic conditions’.⁵⁷ The treatment of leprosy, he argued, was unique in combining ‘a strict scientific character’, with the ‘humanitarian, altruistic and disinterested qualities’ which characterized Spanish medicine.⁵⁸ The uniqueness of Spanish medicine, according to this argument, lay in its combination of advanced technical expertise with the social and humanitarian principles which underpinned the Francoist state.

The organizers of the conference, who included leading Spanish leprosy experts, the Interior Ministry, the Department of Health, and the ICH, saw it as an opportunity to promote the scientific and social credentials of the regime to the outside world. They organized extensive tours of medical facilities for the delegates, providing numerous examples of the supposed triumphs of Francoist public health.⁵⁹ Their efforts were targeted primarily at the Latin American experts who made up a majority of the foreign delegates. The historical role of Spanish missionaries in Latin American leprosy colonies and the religious symbolism of the disease were used to promote the idea of a distinctive Ibero-American approach to leprosy care. The success of these efforts was both reflected and reinforced by the newly founded Ibero-American College of Dermatology, which had first been established after the Havana conference and was developed further in Madrid. The work of the organization was supported and part-funded by the ICH, with Spanish leprosy experts holding key leadership positions over the following decade.⁶⁰

The prominent role Spain was able to play in the field of leprosy both internationally and within the Ibero-American region reflected the extent to which, despite the presence of Republican exiles, Latin America acted as a gateway for Francoist experts to gain access to wider forms of international health. Links with Latin America provided Francoist experts with the international exposure, networks, and contacts required to promote their involvement in international organizations, and in a number of cases to establish new Ibero-American patterns and networks of international cooperation.

After 1945 the Francoist approach to hispanidad focussed increasingly on technical development and the idea of a shared Catholic, anti-communist modernity.⁶¹ This was reflected in attempts to establish Spain as a model for the development of social security in Latin America, particularly in the field of health insurance. Inter-American cooperation in the field of social security had been taking place since the 1930s, promoted by the Inter-American Committee of Social Security (Comité Interamericano de Seguridad Social), which in 1942 had published the Santiago de Chile Declaration setting out the fundamental principles of social security for workers on the continent.⁶² But the ICH, in collaboration with the Spanish Ministry of Foreign Affairs, the Ministry of Labour and the INP, actively supported attempts to form an alternative Ibero-American community of social security experts, beginning with the first Ibero-American Social Security Conference held in Madrid in 1951.

Spanish experts and officials used the social security system to promote an image of the Francoist state as both modern and socially advanced. These efforts reflected the post-war western consensus that welfare and technical development were vital to counter the global spread of communism. The US saw technical development as a means to secure the allegiance of Latin American, Asian, and African states to the western cause. But Francoist politicians and experts sought to promote the idea of an Ibero-American ‘third way’ between communism and the capitalist welfare state, based on the model of a Spanish social security system underpinned by a shared set of Catholic values.

Their goal was to promote the Francoist system as a model for the wider region, particularly in the case of health insurance. The centrepiece of early Francoist social legislation was the introduction of the compulsory sickness insurance scheme, the SOE, which was adopted in 1942 and implemented in 1944. Its launch coincided with renewed post-war efforts to promote the social credentials of Franco’s Spain in Latin America. The first successful attempt to formalize Spain’s regional status in the field was the Ibero-American Conference of Social Security held in Madrid in 1951. The conference was attended by delegations from sixteen Latin American states, the Philippines, and Portugal, with many states sending government ministers at the head of delegations of national experts. Observers also attended from Italy, Belgium, the ILO, and the International Association of Social Security, and the conference received statements of support from the Organization of American States (OAS).

The event provided the Franco regime with an international platform on which to promote its ‘social’ credentials. But it also agreed to establish a new Ibero-American Commission of Social Security, based in the ICH headquarters in Madrid, and led entirely by Spanish experts. The commission was intended to act as a clearing house for information about social security in the region, and to organize the provision of scholarships and training for experts in the field.⁶³ It was placed on a more permanent footing following the second conference held in Lima in 1954, when it was transformed into the Ibero-American Organization of Social Security (Organización Ibero-Americana de Seguridad Social, OISS), an organization still in existence today. Its formal role was to promote the coordination and exchange of expertise and the international collaboration of experts, with a focus on developing the distinct ‘spiritual and ethical’ character of social security in the region. Its headquarters remained at the ICH and its secretary general was confirmed as Carlos Martí Bufill, a Spanish lawyer and social security expert at the INP who had been one of the leading promoters of Ibero-American cooperation since the 1940s.⁶⁴

For Martí the field of social security was inherently international, and represented an opportunity for Spain to promote its social credentials to the world in general, and to Latin America in particular. In his major 1947 work, The Present and Future of Social Security, Martí set out his views on the ‘internationality’ of social security, arguing that because the social problems faced by modern nation states had causes and effects which crossed borders, those states needed to cooperate in trying to craft solutions.⁶⁵ This kind of pragmatic international collaboration, he argued, would prove even more effective when carried out among nations united by a ‘brotherhood of the spirit’, as in the case of the Ibero-American states.⁶⁶ In particular, he argued that the Catholic faith shared by Spain and the Latin American states would ensure they avoided the kind of policies adopted elsewhere which ran against Christian values, such as the promotion of birth control or the recognition of civil unions and divorce. Martí presented the Spanish social security system as one of the most modern in the world, inspired by the Franco regime’s ‘desire for social justice’ and providing the perfect opportunity for Spain to promote to the international community both its technical expertise and its social commitment.⁶⁷ ‘The social voice of Spain,’ he argued, ‘can and should be an important factor on the world stage.’ And social security cooperation between the Ibero-American community of nations would represent ‘a lively and eager expression of the most perfect brotherhood’.⁶⁸

Alongside experts such as Martí, much of the impetus and funding for the creation of an Ibero-American social security organization came from the Spanish Ministry of Foreign Affairs and the ICH. The ministry identified social security and welfare as key internal issues for Latin American states in the immediate post-war era.⁶⁹ They attributed this universal interest in welfare to the threat of communism across the continent, and to the realization among Latin American governments that the only way to counter the communist threat was to establish welfare systems which would ensure social peace and harmony. The Francoist rhetoric of social justice and anti-communism, they felt, meant that Latin American governments would naturally regard Spain as a model to copy. Spanish social security, argued the ministry, was particularly attractive to those governments looking to create their own systems financed by workers and employers without direct state funding. Spain represented an impeccably anti-communist model for Latin American governments looking to establish social security systems on the cheap.⁷⁰

The threat of communism was key both to Spanish diplomacy in Latin America and to its approach to Cold War-era international relations more generally. When the OAS issued a denunciation of communism in 1954, the Spanish Ministry of Foreign Affairs argued that it provided an opportunity for Spain to improve its ties with Latin America in general, and with the OAS in particular. According to the ministry’s director of foreign policy:

The radically critical attitude towards the subversive activities of international communism coincides in essence with the historical mission of the current Spanish state…Precisely because of the internationalist character of the political offensive of communism, Spain finds itself in a favourable situation to initiate contacts and gestures of rapprochement towards the American Republics.⁷¹

In the Cold War era the international threat of communism gave Franco’s Spain, which its adherents saw as the original anti-communist power, the opportunity to position itself as a leading player within the western international community. And Latin America was at the heart of this project. The same Foreign Ministry report argued that Latin American states would be keen to cooperate more closely with Spain, the ‘standard-bearer of international anticommunism’, because communist subversion ‘overruns all types of political and geographical borders’.⁷²

But Francoist authorities also saw social security as a field in which Spain could counter US influence in the region. The US, according to the Ministry of Foreign Affairs, would be reluctant to enter into any kind of formal agreement with its Latin American neighbours in the field of social security for fear of inviting outside interference in its internal policies. In the absence of US influence, Spain could present its social security model as a Catholic-inspired ‘third way’ between communist and capitalist welfare systems.

This idea particularly appealed to the Falangists who continued to dominate much of the Spanish social security system in the 1950s, and who were keen to promote their vision of welfare as an alternative to the ineffective liberal capitalist states of western Europe and the US. But they were also looking for ways to maintain their influence over Ibero-American relations which distanced themselves from their previous advocacy for the fascist New Order in Latin America. In his address to the first Ibero-American Conference of Social Security in 1951, Girón de Velasco contrasted Francoist social legislation to welfare systems elsewhere in the liberal capitalist west, which he alleged were built on ‘petulant formulas’ inspired by Adam Smith on a naïve ‘patriarchal’ approach which entrusted social justice to the good will of businessmen.⁷³ Spanish conceptions of social justice, he argued, were defined by the Catholic principles which underpinned them, a form of Francoist ‘humanism’. Rather than promoting material well-being as an end in itself, as the capitalist countries did, the Francoist state saw man as the ‘carrier of eternal values’, to be supported in his relation to God, to eternal glory, and to his patria.⁷⁴ While Inter-American cooperation would expose Latin American states to the materialistic influences of US capitalism, Ibero-American cooperation would allow them to develop a more holistic form of social security based on these shared Catholic values.⁷⁵

The idea of Ibero-American cooperation in the field of social security was not just rhetorical, and Spain enjoyed limited success in promoting its social model among certain Latin American states. The importance of the OISS to Spanish cultural diplomacy was reflected in the decision to house the organization’s secretariat in the ICH.⁷⁶ Spanish experts, led by Martí, dominated its leadership positions until the 1960s. Latin American delegations to the regular OISS conferences were generally headed by labour or social security ministers, providing Spain with the opportunity to promote its social model to influential Latin American audiences. The ICH, for example, ensured that every Ibero-American social security conference during the 1950s included an exhibition featuring scale models of the SOE’s new hospitals and health clinics, despite the difficulties and expense involved in shipping them to Latin America.⁷⁷

The OISS also organized training courses in Madrid for Latin American experts to study the Spanish social security system, drawing attendees from across the continent.⁷⁸ Although countries such as Chile and Uruguay had established successful social security systems well before the Second World War and had little to learn from the Spanish model, other Latin American states with relatively underdeveloped systems seemed more open to Spanish support. The clearest cases of Spanish influence were Bolivia, Ecuador, and El Salvador, which all received ‘technical assistance’ from the OISS during the 1950s. This assistance consisted of teams of Spanish experts providing support in drafting legislation and designing systems and processes to inform national social security reforms.⁷⁹ Through the OISS, Spain was also able to develop ties with other international organizations such as the OAS and the ILO, which both sent observers to OISS conferences and dispatched delegations to Spain during the 1950s.⁸⁰

The success of these efforts should not be exaggerated. The Franco regime’s overtly politicized use of the OISS to promote its interests and image in Latin America limited its effectiveness as a genuine forum for the multidirectional exchange of expertise and ideas. Although certain Latin American states and experts were willing to engage with Spanish social security as a model, the reverse was not the case. There is little evidence of Spanish experts adopting ideas or practices from their Latin American counterparts, or of the OISS in its early history acting as the primary forum of exchange between those Latin American states which had already had well-developed social security systems. Inter-American exchange could more easily be carried out on a bilateral basis or through organizations such as the OAS or the ILO. Although Spain was successful in promoting the OISS as one among a number of overlapping regional social security bodies, it did not succeed in establishing it as the primary form of cross-border cooperation in the region.

Its efforts were also hampered by the fact that the reality of Spanish social security fell a long way short of the regime’s rhetoric. The Francoist social security system was piecemeal, fragmented, underfunded, and largely ineffective. Despite the grand propaganda claims attached to the SOE, in reality it amounted to a modest scheme which provided limited coverage to approximately 8 million urban Spanish workers and their families, but which offered no support for the rural labourers who made up over half of the workforce. It was entirely funded by mandatory contributions from workers and employers, with no funding from general taxation. Its administration was divided between an array of mutuals, insurance providers, and political bodies (syndicates and organizations linked to the Movimiento), and its rushed implementation meant that from the start it faced widespread financial and logistical difficulties.⁸¹ Unlike other welfare schemes being introduced in post-war Europe, the Francoist health and social security system was neither universal nor redistributive.

The ‘Ibero-American’ existed alongside the ‘Inter-American’ and the ‘international’ as a nexus for cooperation and exchange. If social security and health insurance represented one of the most successful concrete manifestations of Francoist hispanidad, that success consisted in establishing Spain as part of the overlapping web of international networks with which Latin American experts were able to engage. In the context of Spain’s post-war isolation, this represented a significant diplomatic achievement. It did not, however, come close to matching the grandiose ambitions or expansive rhetoric which characterized the Francoist vision of a historically, culturally, linguistically, and religiously united community.

The idea of hispanidad encompassed a range of diverse and competing visions of Spain’s relationship with Latin America. For the traditional Spanish right it was a resolutely conservative concept, resting on the historical ties of Spain’s imperial ‘Golden Age’ and a shared Catholic identity. In the 1930s and early 1940s, Falangists saw Spain as the link between Latin American and the totalitarian states of the ‘New Europe’, the vanguard of a new global force extending its influence to the region, shaping and translating fascism for a Latin American audience. Republican exiles challenged both of these visions, promoting in their place a relationship of equals based on genuine collaboration, and open to the influence of the US.

The role of social experts, however, points towards a different side to the Francoist vision of hispanidad, one which was present throughout the early years of the regime but which came to the fore after 1945. Their involvement with the region was part of the regime’s attempt to promote Spain as a model of post-war modernity, more closely aligned with the history and culture of Latin America than those offered by the liberal capitalism of the US on the one hand, or by global communism on the other. In the 1940s, scientific and social experts were used to project the Franco regime as a technologically and socially advanced power. The emphasis on social security from the 1950s exploited the language of technical development to portray the Francoist ‘social state’ as an advanced and comprehensive model for emerging Latin American social services, but one which was underpinned by shared Catholic values.

For Spanish experts, involvement in these Ibero-American organizations and networks was politically, professionally, and personally rewarding. Taking part in the cultural diplomacy driven by the ICH and the Ministry of Foreign Affairs helped to cement the status of experts within the Francoist system. Carlos Jiménez Díaz, for example, had been regarded with suspicion by many within the Franco regime in the aftermath of the Spanish Civil War on account of his perceived liberal sympathies. But his feted tour of Latin America in 1943 and his subsequent audience with Franco helped to secure his standing and reputation, paving the way for his rise to prominence as one of the most high-profile and well-supported medical researchers working in Spain over the coming decades. Others, such as Martí Bufill, genuinely saw the shared culture, history, and religion of the Ibero-American region as the basis for a distinct approach to his field of social security. Even for those who placed less store by such shared values, the fact that Spain was tied to Latin America through a common language made it a natural focus for overseas exchange and collaboration. Ibero-American expert networks thus combined the shared scientific beliefs and values of epistemic communities with the goals of Francoist diplomacy, the self-interest of individual experts, and the shared ties of culture and language between the two regions.

Despite its relatively limited success, the Francoist vision of hispanidad was not completely out of step with wider post-war developments. The attempt to establish modern international networks on the foundations of past imperial glories echoed British and French efforts to maintain their international influence through the Commonwealth and French Union, both of which leant heavily on the language of development and technical assistance in the 1940s and 1950s. The aim of integrating Spain within a distinct Ibero-American region reflected the importance of regional bodies and regional cooperation within the post-war international order, in which Spain’s estrangement from its western European neighbours left it without the regional forms of economic or political support enjoyed by other states. The idea of uniting states around the vision of a ‘third way’ between the increasingly polarized capitalist and communist blocs was one that was widely shared during the early decades of the Cold War, from European social democrats to the governments involved in the Bandung Conference and the non-aligned movement during the 1950s and 1960s.

The post-war international system, to a greater degree than its interwar predecessor, was made up of numerous interlocking and overlapping regional, linguistic, religious, political, and cultural units, with individual states positioning themselves at the intersection of a range of different international groups and networks. The post-war promotion of hispanidad represented part of the Franco regime’s attempt to achieve the same goal by constructing a new Ibero-American community through which its influence could be projected beyond Spanish borders.