This dissertation analyzes public health programs and the reform narratives doctors and state officials produced from 1930 to 1940, along with residents' petitions sent to Cali's municipal council during the same period. Some of the central questions it strives to answer are: what were Liberal reformers striving to do when they set out to implement social programs in public health and sanitation at this time? How did these programs and the public narratives they produced help alter state-society relations in Colombia? And finally, how did local communities use these programs to negotiate with state officials and gain access to the benefits of full social citizenship? In answering these questions, I argue that Liberal reformers used public health, hygiene, and the organization of space as tools to modernize the nation, redefine the state's responsibility to its citizens, and modify or regulate people's everyday habits, customs, and private lives. Teaching workers and peasants how to create habits that promoted their physical wellbeing and allowed them to contribute to national prosperity through their labor and their productive capacities. Liberal reformers argued that the expansion of public health services and implementation of hygiene campaigns were ideal mechanisms to help the state lead the masses in this transformation.

As the Liberal party, in power from 1930 to 1946, set out to implement public health programs designed to modernize the nation, foster economic prosperity, and improve the health of its citizens, government officials and the groups these reform efforts targeted sought to define what citizenship, modernity, health, and progress meant for them. Reform narratives provide just one angle to this story. While reformers portrayed workers and peasants at best as passive victims of more than four decades of state neglect at the hands of Conservative regimes, or at worst as stubborn, backward, ignorant, and unruly subjects---the ways local communities responded to state reform efforts complicates this seemingly simple dichotomy. While reformers promoted a brand of modernity that relied on science, education, and state intervention to diagnose, treat, and cure their society, the petitions local residents sent to their council and other municipal officer show that these actors both adopted and challenged the state's official rhetoric. Municipal records show that communities drew from public narratives and reform language to claim their rights, and gain access to the benefits of inclusion into the social body. While some petitioners used current understandings of hygiene, sanitation, modernity, progress, party loyalty, or citizenship to claim their rights and hold local authorities' accountable for solving their grievances, others proposed alternative definitions of these notions.

At a time, when the Liberal party continuously emphasized its commitment to extending state power and responsibility in guaranteeing its citizens access to health, sanitation, education, and other social benefits, petitioners' use of a language that resonated with and challenged these public narratives, shows that negotiation is an essential part of state-society relations, and the limits of reform efforts once they are implemented on-the-ground. In their petitions, local residents turned blame away from themselves, and turned it towards the local state, which they argued was ultimately responsible for failing them. This act showed both the state's inability to extend social guarantees to all its citizens, and contradictions in the state's democratizing efforts.