History of Latin American Dermatology

ELBIO FLORES-CEVALLOS, LUIS FLORES-CEVALLOS, ZUÑO BURSTEINand control of STDs for their members; thus, in April, 1923, the pertinent rulings weredecreed for the Republic’s Police and the Gendarmerie, and, in November, 1928, for theNational Army.In September, 1926, by supreme decree, the National Anti-STD League was createdas a health and welfare institution, dedicated to anti-STD activities and propaganda. Thiscreation took place in fulfillment of the recommendations of the First National Anti-STDConference, held in Lima on August 30 through September 5, 1926, which also, amongother things, recommended starting sexual education at high school level, unifying healingmethods or procedures, stimulating the development of the specialized field ofvenereology, and introducing the prenuptial medical certificate. It declared that, as longas existing social conditions continued, the regulation of prostitution would be necessary.It recommended a series of protection measures for under-age offspring, and for abandonedyoung women, suggesting the establishment of 18 years as the minimum age forthe practice of prostitution, and also agreed to legally demand the mandatory numericdeclaration of STDs.On May 6, 1927, the Bylaws of the National Anti-STD League were approved bySupreme Resolution, which pursued the goal of collecting and channeling the guidelinesoutlined by the First National Anti-STD Conference; but, in its constitution, such a complexmembership was set up — from the President of the Republic, ministers of State,presidents of the Supreme Court and of the Legislative Chambers to representatives ofcountless institutions — that it never began to operate.The Government stepped in once again in January, 1941, creating by supreme decreethe National Anti-STD Service, which answered to the General Health Office; it was entrustedwith the execution of preventive, social and medical assistance activities relatedto STDs, and was the institution for guidance and the technical study of problems inherentto these diseases, with the obligation of centralizing general STD statistics and enforcingthe supervision and technical control of existing venereology services carried outby other entities. That same year, and also by Supreme Decree, the medical treatment ofany person suffering from any of the following diseases in the period of contagion, is renderedmandatory: syphilis, gonorrhea, soft chancre and venereal lymphogranuloma. Itestablished severe sanctions for violations, including police intervention, if necessary,and the free sale of drugs, specifics and general medicine destined to the treatment ofSTDs, was prohibited. Furthermore, related medical obligations were established.The current control of the practice of prostitution in Peru is stipulated in the Regulationson Special Police Licenses, approved by Supreme Decree in December, 1946, whererequirements for the operation of houses of tolerance, brothels and pandering houseswere laid down, as well as the obligation for women who practice prostitution to carrythe certificate of good health issued by the Anti-STD Service, and the personal license issuedmonthly by the Tax Office. The managers of these houses are compelled to havethem examined weekly by the National Anti-STD Service. The police monitor its fulfillmentand send women who suffer a contagious disease for treatment. Violations of theserules incur fines that are provided for in these Regulations.Due to a ministerial reorganization, the National Anti-STD Service was dissolved andsubstituted by the Venereology Department, which, by mandate under Supreme Resolutionof May 19, 1952, adapted its operations to the purpose of modernizing the methodsfor the struggle against STDs in the country, and, in accordance with the principle of administrativedecentralization of the peripheral executive sanitary services, was put incharge, mainly, of planning the anti-STD campaign. Consequently, it drafted a GeneralWorking Plan, with the following functions: outlining the national anti-STD fight plan, issuingtechnical guidelines for the execution of anti-STD campaigns the local health serviceswould have to carry out, supervising or monitoring the fulfillment of localprograms, setting up the advisory organization for all local programs, setting up the352