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The article presents views from above and below of the Rockefeller Foundation's International Health Commission's (IHC's) hookworm control program in Nicaragua from 1914 to 1928. It looks at the meaning, impact, and unique configuration of the Nicaraguan mission, while taking into account the larger global institutional project of this important international health actor. Although the IHC program in Nicaragua complemented some of the social policy goals of the US intervention in Nicaragua, which was a de facto protectorate during this period, the institution cannot be considered a direct expression or agent of US foreign policy. Ultimately the shape and limits of the IHC mission to Nicaragua were determined by the institutional project of the international public health agency itself, and by local considerations ranging from the characteristics of the staff to the response of rural communities to the anti-hookworm campaigns.
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