The wider project from which this research stems examines the intersections of race, gender and national identity in Ecuador in the early-to-mid twentieth century, using the state and the process of state formation as the key locus of analysis. The expansion of public health and sanitation was central to this process of modernization in Ecuador. During the period under review, the tropical coastal and Amazonian regions were being spatially integrated into the nation for the first time through infrastructure projects such as the Quito-Guayaquil Railroad and the creation of a highway from the highlands to the Amazon, while the exploitation of the raw materials (including oil, gold, ivory-nut and rubber) that lay in these regions was imperative to elite goals of economic modernization and full national integration into the world economy. Yet these zones were plagued by diseases like yellow fever and malaria which discouraged both the migration of labor and the penetration of foreign capital.
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