In this excerpted report published in the Quarterly Bulletin of the League of Nations Health Organisation (LNHO) in 1932, the Medical Director of the LNHO provided a vivid account of disastrous recent floods in China and their massive social and health consequences. The Medical Director was Ludwik Rajchman, who had been head of LNHO since late 1921 when the Health Section had been accorded “permanent” status by the League of Nations. Rajchman, a Polish physician from a distinguished family, had received postdoctoral training in bacteriology in France and England before becoming Director of Poland’s Central Institute of Epidemiology in Warsaw in 1919.1 In 1920, he was appointed to the League of Nations’ Epidemic Commission, which had been created to deal with a terrifying typhus epidemic then ravaging Russia and Eastern Europe.2 In 1921, the Commission was transformed into the Health Section of the League, with Rajchman as Director.
As Rajchman consolidated his leadership of the Health Section, he maintained a careful balance between biomedical and socio-medical health initiatives.3 He promoted the development of vaccines and the international standardization of pharmaceuticals. But with support from the Rockefeller Foundation, he also strove to achieve an international “esprit de corps” among public health professionals of various nations by arranging extensive study trips (“interchanges”) to exemplary public health projects and training sites. Rajchman also gradually increased LNHO’s emphasis on social medicine. He appointed well-known Italian proponents of social medicine to the Health Section’s malaria commission, created special commissions on maternal welfare and child hygiene, and worked with the International Labor Office on industrial diseases, workmen’s compensation, and other socio-medical issues.
One of Rajchman’s priorities was to extend the reach of LNHO beyond Europe to Africa, Latin America, and the Far East. He was particularly concerned with the Far East and pushed for the creation in 1925 of an “Eastern Bureau” in Singapore as an epidemiological transmission station.4 By 1926, Peking, China, began transmitting data to LNHO headquarters in Geneva, Switzerland. By 1928, China’s Ministry of Health formed an international advisory council of three with Rajchman as an invited member.5 Soon afterward, the LNHO was asked to prepare a survey of maritime quarantine in Shanghai and other Chinese port cities and of cholera in Shanghai. The Chinese government accepted the LNHO’s offers of an anticholera vaccination campaign in Shanghai and plans for a central “field station” in Nanking as the hub of a new national public health system. In return, it requested training fellowships for Chinese medical and public health officers; by 1933, 25 fellows had been funded by the LNHO. With the 1931 flood, LNHO’s presence increased further, with several LNHO health officials being temporarily posted to China, including the Secretary of the Malaria Commission. Rajchman himself was deeply involved, and in 1933 his passion for China was so intense that he agreed to go on leave as Director of the LNHO so that he could serve as “technical agent” to coordinate all League of Nations assistance to China while being paid by the Chinese government.
Japanese protests over the League’s assistance to China forced Rajchman back to his position as head of LNHO. But he remained outspoken about Japanese military aggression in China and also spoke out against Italy’s annexation of Ethiopia in 1936 and fascist and Nazi support for Franco’s forces in the Spanish Civil War.6 He was increasingly labeled “Communist,” “pro-Soviet,” and “Jewish-Masonic . . . of the Second and Third Internationals” and in early 1939 was compelled to resign as head of the LNHO. After World War II, because of Cold War politics, Rajchman was excluded from planning for the new World Health Organization (WHO), but he had a central role in the creation and leadership of UNICEF, which in some ways became WHO’s rival. China was excluded from the WHO because of Cold War politics, but was finally allowed to join in the 1970s when WHO, under the leadership of Director General Halfdan Mahler, belatedly returned to the international health priorities Rajchman had emphasized 40 years before.7
Endnotes
- 1. M.A. Balinska, For the Good of Humanity: Ludwik Rajchman Medical Statesman, English edition (Budapest, Hungary: Central European University Press, 1998).
- 2. M.A. Balinska, “Assistance and Not Mere Relief: the Epidemic Commission of the League of Nations, 1920-1923,” in International Health Organizations and Movements, 1918-1939, ed. P. Weindling (Cambridge, UK: Cambridge University Press, 1995), 81–108.
- 3. I. Borowy, Coming to Terms with World Health: The League of Nations Health Organisation 1921-1946 (Frankfurt am Main, Germany: Peter Lang, 2009).
- 4. L. Manderson, “Wireless Wars in the Eastern Arena: Epidemiological Surveillance, Disease Prevention, and the Work of the Eastern Bureau of the League of Nations Organisation, 1925-1942,” in International Health Organizations and Movements, 109–133.
- 5. I. Borowy, “Thinking Big—League of Nations’ Efforts towards a Reformed National Health System in China,” in Uneasy Encounters: The Politics of Medicine and Health in China 1900-1937 (Franfurt am Main, Germany: Peter Lang, 2009), 205–228.
- 6. Balinska, For the Good of Humanity.
- 7. M. Cueto, “The Origins of Primary Health Care and Selective Primary Health Care,” American Journal of Public Health 94 (2004): 1864–1874; S. Litsios, “The Long and Difficult Road to Alma-Ata: A Personal Reflection,” International Journal of Health Services 32(2002): 709–732. [DOI] [PubMed]