Dir: Luis Buñuel/
Sc: Luis Buñuel/ Ph: Eli Lotar/ Spain/ 1933/
English narration: 27 min.
Surrealism, with its often anarchic
call to revolt, has also provided a powerful inspiration for
exploring the web of unconscious links between eating, sexuality
and social order. Across the career of just one surrealist
film-maker, Luis Bunuel, it is possible to trace a continuing
assault on totem and taboo, much of it expressed through bizarre
images of food and eating.
Bunuel's first film in his
native Spain was a documentary on the barren region of
Las Hurdes. An extraordinarily powerful documentary on
the impoverished people living in this region, Bunuel's
vision is so strong that the film becomes unsettling,
turning the real into the surreal.
Las Hurdes: The Realism and Surrealism
of Iodine Affliction
Las Hurdes is a mountainous enclave in west
central Spain, in northern Cáceres, close to Portugal. Because of
its "monsters" and "backwardness," it has long been subject to
travelogues and medical studies. It was also the subject of a
"surrealist" film by the famous Spanish filmmaker, Luis Buñuel. It
is therefore emblematic, for myth and polemics surrounding the
Hurdenos' plight unite into a highly charged whole. For many, Las
Hurdes stands for isolation, affliction, neglect, subhuman living
conditions, and subhuman beings. For some medical investigators, Las
Hurdes has represented the natural field experiment. For other
social and medical investigators, Las Hurdes has stood as an
unconscionable expression of disorganisation and misdirection in
Spanish medicine and public health. For church spokesmen, Las Hurdes
has represented the investment of church and state in compassionate
and even visionary efforts. For the purpose of gaining an overview
of iodine prophylaxis and the obstacles to it in Spain, one can
hardly do better than examine a chronology of missions to, and
representations of, Las Hurdes.
Conspicuous efforts on behalf of Las Hurdes began
in 1922 when the most famous Spanish physician-statesman of the
twentieth century, Gregorio Marañón, who had come to recognize this
remote area as a dramatic instance of endocrine disorder, urged the
king to accompany him there on a visit. This visit triggered royally
sponsored development programs and the creation of the Goiter
Commission, headed by Marañón himself.
As a result of this royal attention, Hurdeno
children became, though only briefly, the first experimental
subjects of dietary iodine supplementation in Spain. Pregnant
Hurdena women were also offered prophylaxis "as a wedding present,
to avoid the emergence of the goiter normally expected during
pregnancy" (Vidal Jordana 1924, Marañón 1927). Before the end of the
1920s, however, both programs were dropped in favour of more general
measures aimed at modernization.
Roads were gradually built into the area, followed
by welfare and education programs brought in under the auspices of a
charitable foundation (Patronato de las Hurdes) headed by Marañón
during the few years of the Spanish Republic. It was in this period
that Buñuel filmed Tierra sin Pan (1933, Earth without Bread, often
seen abroad as the last of Buñuel's surrealist art films. It was
made, according to Buñuel (1982), to draw attention to the plight of
the Hurdenos and to prompt long-promised reforms.
The film depicts Hurdenos in
a state of perpetual hunger, forever foraging in scrub and forest
for whatever the land may offer. Their faces are haggard
and their feet bare in a rough and thorny landscape.
Normal-appearing Hurdeno men are shown only in labour migration,
walking off in single file to the central plateau to mow grain for
absentee landlords. Goitrous women, dwarfs, and cretins are filmed
from low camera angles that emphasize monstrous deformations. Even
the fosterage of abandoned city children, official wards of nearby
cities and one of the few sources of local income, was turned
against the Hurdenos. For these children were assumed to be
syphilitic, having been born to unwed mothers presumed to be
prostitutes.
Earth without Bread, surrealist or naturalist,
appeared so excessively alarming that Marañón's foundation refused
to subsidize a sound track for the film (Buñuel 1982), and officials
prohibited its showing. The Franco regime also withheld it from
public view.
Indeed, Spanish audiences did not see the film
until the winter of 1982–83, soon after the Socialists were voted
into office. Since then, it has been shown several times on the
national channel.
Nevertheless, toward the end of the 1940s, even
without such cinematic promotion, the Franco regime in close
alliance with the church began to vigorously promote human and
economic development in the area. The aim was to turn Las Hurdes
into a symbol of governmental benevolence and national "redemption"
(de la Vega 1964). The Ministerio de Gobernación (Ministry of
Internal Affairs) sponsored and ultimately oversaw most of these
"redemptive" activities, which gradually eliminated malaria and
hunger and according to de la Vega, also eradicated goiter (1964).
Indeed, converging forces had the effect of making
goiter in Las Hurdes seem to disappear. State-sponsored
labour-intensive reforestation after mid-century gradually replaced
the forest products, the chestnuts and acorns of the subsistence
economy, with a rapid growth timber economy and with previously
scarce cash. Such changes replaced the goitrogenous staples of the
traditional diet with cultivated and commercial foods. In the course
of this dietary transformation, the elderly bearers of gross goiters
gradually passed on, while others, less grossly afflicted than their
elders, gradually came into maturity.
Popular mythology regarding the people of Las
Hurdes held that they were "crossed with wolves," "degenerate
vestiges of a primitive race," "descendants of escaped convicts,
Moors, or Jews," or simply "representatives of the New World in
Spain" or "our own interior Guinea." The traditionally high
incidence of disfiguring goiters and dwarfism surely contributed to
these myths of different racial origin, or racial degeneration.
There was also an identity dynamic at work. As
Spain in the nineteenth century was forced to withdraw from its
colonial and missionary enterprise, the foreign "other" was
discovered closer to home. Hurdenos conveniently came to represent
that other against which normal fitness and level of civilization
could be measured. As in Strabo's time, descriptions of these
humanoids were disseminated among "civilised peoples" both Spanish
and foreign. For instance, the French Guide Michelin in the 1970s
still assigned two stars to Las Hurdes, in part because of the
picturesque nature of the people, a "picturesqueness" the Hurdenos
occasionally exploited and, as far as we know, came to resent and
resist only recently (R. L. Fernandez 1986:423–427).
Whatever the dynamics of identity among marginated
peoples of the peninsula (see chap. 3), Spaniards after
mid-twentieth century had the impression that the prevalence of
gross deformity was declining in places like Las Hurdes. This
impression was correct insofar as the "irreversible cases, God's
preferred children" (de la Vega 1964:88), gradually lost their
visibility and diminished in number as the severity of deficiency
declined. The precipitousness of the drop was more reassuring than
real, however, because many of the afflicted, having become
institutionalized, ceased to be on view.
But to one group of medical
workers—long focused on Las Hurdes and located at the Instituto
Marañón, Spain's national center for experimental thyroidology, a
branch of Consejo Superior de Investigaciones Científicas (CSIC),
which, by 1989, had become the Centro de Estudios de Endocrinología
Experimental—this decline in overt pathology still left a great deal
of room for improvement. For years, a team headed by Dr. Francisco
Escobar del Rey had been monitoring the dietary and endocrine state
of Hurdeno children in feeding programs, finding the rate of urinary
iodine excretion (chap. 2) generally low and endocrine disorders
alarmingly high, especially among those not included in the feeding
programs. Escobar used these findings to demonstrate that
consanguinity plays a minor role, if any, in the high incidence of
goiter and other endocrine disorders found among these children and
thus ruled out consanguinity as the primary cause of IDD in Las
Hurdes. He argued, both in foreign and in national journals (Escobar
del Rey et al. 1981a , 1981b , 1984; Escobar del Rey 1983, 1985),
and most recently in a special issue of Endocrinología (1987), that
only generalized iodine prophylaxis would lower the incidence of
endocrine disorder in all the children. In 1983 and 1984, he
circulated a letter, under the letterhead of the Subcommittee for
the Study of Endemic Goiter and Iodine Deficiency of the European
Thyroid Association, later published in Lancet, drawing attention of
colleagues both at home and abroad to the continued un availability
of iodized salt in Spain. This circulating letter is considered
instrumental in "embarrassing the Ministry of Health" and animating
it to correct the situation.
Escobar's findings and
recommendations were hardly contrary to expectations or new to
thyroidology, but their publication in Spanish professional journals
and in Lancet makes them noteworthy. Coming from a thyroidologist
esteemed both by his national colleagues and by the international
members of the WHO goiter eradication team, the carefully presented
findings suggest that Escobar set aside his experimental work (at
the leading edge of thyroidology) to convince his colleagues in both
medicine and public health to set aside their hereditary thinking.
Where the health of marginalised people is concerned, such thinking
may often be a key obstacle to prophylaxis.