MORBIDITY, MORTALITY, AND HEALTH STRATEGIES IN THE PARAGUAYAN WAR: A HISTORICAL ANALYSIS (1864–1870)

Abstract

This article aimed to examine the Paraguayan War (1864–1870), identifying the primary causes of its high morbidity and mortality rates, as well as the health strategies employed, which shaped the outcome of the conflict and highlighted the importance of healthcare even within a predominantly military context. An integrative literature review was conducted, including articles published in Portuguese, English and Spanish and indexed in the CAPES, JSTOR, LILACS, MEDLINE, PubMed, SciELO, and SCOPUS databases between 1864 and 2024. Articles available only as abstracts and duplicate records were excluded. The descriptors used were: “war”, “Paraguay”, “medicine”, “South America”, “Brazil”, “morbidity”, “mortality”, “war-related injuries”, “wounds and injuries”, “diseases”, “medical records”, and “smallpox”, combined using the Boolean operators AND and OR. Twenty-nine articles were selected for in-depth analysis. Infectious diseases, particularly cholera, smallpox, and malaria, were the predominant causes of death, surpassing combat-related injuries, largely driven by poor sanitation and logistical failures. It is concluded that the high mortality from disease reveals a critical failure in strategic war planning, in addition to the limitations of 19th-century medical knowledge and predominantly reactive health strategies. The conflict serves as a stark lesson on the strategic importance of public health in armed military operations.