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approaches, the social and economic development of a commu-
nity can be achieved more efficiently and effectively.
Recognizing that the USPHS did not have enough personnel
“to do it alone”,Willard Thorp, Assistant Secretary of State for
EconomicAffairs, called upon US public health workers to “vol-
unteer to go out and take their places in this unique enterprise
in building a healthier world” [30: 1483]. Hyde soon added his
voice to this call, specifically aiming it at America’s public health
engineering staff. Since “health is one of the roots of social and
economic progress, it is incumbent on us”, said Hyde, “to press
forward its development throughout the world as rapidly and ef-
fectively as possible.”The “problem is in the first instance one of
sanitation.The key to it is held, in almost unique fashion, by the
sanitary engineers ofAmerica” [31: 1].
When Dr Daubenton took over as Regional Director of the
newly establishedAfrican Regional Office in the early 1950s, he
expressed the opinion that “it was impossible to consider health
and disease inAfrica as isolated factors; the environment, sanitary
engineering problems, and social and anthropological conditions
had also to be taken into account” [32: 7]. Dorolle went further;
he wrote of the “absolute necessity to associate ethnological stud-
ies with all health actions” [33: 315]. Dorolle managed to engage
Jean-Paul Lebeuf, a very eminent French ethnologist, to work
for WHO’s African regional office for several years. Dorolle
was one of the very few individuals still engaged in international
health work who had participated in the 1937 Bandoeng Confer-
ence.
Public health problems in rural areas
was the subject for the technical
discussions at the SeventhWorld Health Assembly held in May
1954, under the chairmanship ofAndrija Stampar.A list of refer-
ences on rural hygiene was compiled by theWHO Secretariat to
assist participants in their discussions. Some 309 references were
cited, including five LNHO publications, Hydrick’s book, six of
Roemer’s papers, 4 on SouthAfrica and 2 on China.Again rural
sanitation was recognized as being of vital importance; “in less
developed countries it is of first importance” [34: 5].
America’s politics undermines
global rural hygiene initiatives
This brief section is confined to examples related to the initiatives
described above.
UNRAA was essentially an American funded and run organiza-
tion. Republican members in the US Congress viewed UNRAA
primarily as a solution to the problem of large agricultural sur-
pluses; they opposed any efforts at institution building since it did
nothing to advance food exports. Lacking congressional support,
UNRRA was closed down just asWHO was being created.
Matters seriously deteriorated following Eisenhower taking over
the presidency in January 1953.The ECA was replaced in 1951
by the Mutual Security Agency (MSA), which was replaced in
1953 by the Foreign Operations Administration. These shifts
“hampered US development assistance in significant ways and
tied it ever more strongly to often uncoordinated economic,
political, and social objectives and programs, while an increas-
ing amount of aid went to military purposes” [35: 31]. Harold
Stassen, who was made Director of the MSA, was “convinced
that not all that had gone beforehand was acceptable to the new
administration”. He “and Company” were suspicious of “far left
organizations” and of anyone that had any association with such
organizations [36: 39].What had been favored earlier was now
objected to, as Andrews remarked concerning the program in
Ethiopia – he got “hell for it” because he was “putting some of our
materials and some of our money in a United Nations deal and
also our technicians” [15: 65]. It was Andrews who judged the
Ethiopian program to be the best inAfrica, as noted above.
Grant witnessed the collapse of promising initiatives due to the
retreat of American support to broad integrated development
projects whose development he was pursuing. None of the pro-
jects that he proposed were initiated.
Efforts to encourage American public health workers to get
involved in international health were undermined by the right-
wing elements inAmerica, led by J Edgar Hoover, targeting pro-
gressive Americans.When Du Bois applied for a position at the
WHO, “J Edgar Hoover ordered theWashington [FBI] to con-
duct a full time investigation on her” [37: 297].On leavingWHO
she joined the ranks of academia, where she continued to be har-
assed by the FBI. She was but one among manyAmerican anthro-
pologists that were greatly affected by the political atmosphere
in America; as noted by Margaret Mead: “the Joseph McCarthy
era and the KoreanWar, when everybody inside the government
who could have used material or insights that anthropologists
could have produced, went home or got fired” [38: 258]. As
well, hundreds of university professors were dismissed; medi-
cal schools “divested themselves of left-leaning faculty members”
[39: 434].
A major loss was Milton Roemer being forced to resign from
WHO in 1953, after the State Department revoked his passport
for refusing to sign a loyalty oath, which the US required of all
Americans working for the UN.The State Department went so
far as to threaten any organization that employed‘suspect’Amer-
icans.
The pullback of American funding and the retreat of American
expertise to assist in the development of rural hygiene programs
effectively cut short all of the promising initiatives identified
above and many more.
Concluding comments
None of the above impacted negatively onWHO’s malaria con-
trol/eradication program. If anything,America’s ColdWar poli-
tics greatly augmented the importance of malaria control, as it
was believed that malaria control would contribute to agricul-
tural productivity and that the rapid progress achieved would
contribute to winning the “hearts and minds” of rural popula-
tions threatened by communism [40: 283]. On the other hand,