First Steps: The Rockefeller Foundation in Early Czechoslovakia(1)

Article excerpt

According to Rockefeller sources, Czechoslovakia was the first country in Europe where the Rockefeller Foundation (RF) undertook a program. Until then (June, 1919) its fields of activity had been in the West Indies, Central America, Brazil, Egypt, China, Sri Lanka, the Pacific, and various medical schools and Southern and Western states in the US. In addition, it had devoted the bulk of its resources, during the First World War, to relief efforts in Europe, including a Commission for the Prevention of TB in France, but this was always considered a temporary, albeit urgently needed undertaking.(2) In fact archival documents indicate that Europe was not even considered as a possible field--other than in terms of collaboration with offices located there charged with the administration of the overseas "possessions" of European empires--until late in 1919, a shift in which Czechoslovakia played a role. Over the next two decades, the RF was to collaborate in programs of various extent throughout Europe, including the creation of major medical centers in London, Brussels, and Rome, and assistance to others elsewhere in the UK, France, Germany, and Yugoslavia, collaboration in the building of institutes or schools of public health, nursing, or social work in both East and West Europe, and a fellowship program that enabled some 680 people from 23 European countries to study public health, nursing, and related subjects in the US--all of this in addition to the work the RF was also doing elsewhere in the world.(3)

The RF was founded in 1913, with the self-proclaimed mission of promoting the well-being of mankind throughout the world. Prior Rockefeller-funded agencies--the first two of which remained independent of the RF--had been created to work in the US, in biomedical research (the Rockefeller Institute for Medical Research--RIMR, 1901), and, in several Southern states, in educational and agricultural development (the General Education Board--GEB, 1904) and a campaign against hookworm, "the germ of laziness" (the Rockefeller Sanitary Commission--RSC, 1909); starting in 1913 the GEB had also undertaken an additional project, that of enticing elite medical schools to place their faculties on a full-time basis, as a condition of further Rockefeller assistance to buildings or endowments. The trustees of the new foundation explicitly decided not to publish specific policies, so as to retain maximum flexibility.(4)

Although the RF's early years were a period of groping for direction,(5) its trustees did establish two organizations of more lasting contribution: in 1913 the International Health Board (initially "Commission," later "Division"; here IHB) to carry the RSC's hookworm campaign to what had been determined to be a global "belt" of affected countries, and, shortly afterwards, the China Medical Board (also initially "Commission"; here CMB), to develop in China "scientific" medicine and medical education, along the lines then being pursued by the GEB and other reform efforts in the US.(6) In addition to hookworm, the IHB, using research produced by the RIMR, also initiated international campaigns against yellow fever and malaria. More importantly, all of its campaigns, wherever undertaken, were explicitly designed to serve as "entering wedges" in the development of public health and its administration as fields, and of tax-supported public responsibility for full-time, professional public health work.(7) Out of this, the IHB together with the GEB created at Johns Hopkins University the world's first School of Hygiene and Public Health; a partner was developed at Harvard, after the war.(8)

It does not seem, from archival evidence, that the early RF intended to work in Europe itself, other than collaboration with the colonial office or international organizations located there, and the temporary war relief aid. The end of the war made it possible to begin thinking globally again: Wicliffe Rose, the former philosophy professor who directed and largely shaped first the RSC and then the IHB, envisaged, in April of 1919, "a series of schools of hygiene at strategic places all over the world, with relations of interchange, and including the building up of public health organization, statistics and public health laboratory services, and demonstrations in the control of [certain key diseases]," but gave no geographic specifics. …

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