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Comrades in Health

Comrades in Health: U.S. Health Internationalists, Abroad and at Home

Anne-Emanuelle Birn
Theodore M. Brown
Copyright Date: 2013
Published by: Rutgers University Press
Pages: 350
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  • Book Info
    Comrades in Health
    Book Description:

    Since the early twentieth century, politically engaged and socially committed U.S. health professionals have worked in solidarity with progressive movements around the world. Often with roots in social medicine, political activism, and international socialism, these doctors, nurses, and other health workers became comrades who joined forces with people struggling for social justice, equity, and the right to health.Anne-Emanuelle Birn and Theodore M. Brown bring together a group of professionals and activists whose lives have been dedicated to health internationalism. By presenting a combination of historical accounts and first-hand reflections, this collection of essays aims to draw attention to the longstanding international activities of the American health left and the lessons they brought home. The involvement of these progressive U.S. health professionals is presented against the background of foreign and domestic policy, social movements, and global politics.

    eISBN: 978-0-8135-6122-6
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. List of Figures
    (pp. ix-x)
  4. Foreword
    (pp. xi-xiv)
    Vicente Navarro

    The promotion of corporate interests by the U.S. government takes place in many different forms. Quite frequently it occurs as a military intervention. Indeed, many people in the United States learn geography by looking up the place where the latest U.S. troop intervention has taken place: Iraq, Afghanistan, Yemen, possibly tomorrow Iran, and so on. While military interventions are known for their costs and ineffectiveness, not to mention brutality, their frequency is likely to continue. Further, the “stick” is usually accompanied by the “carrot,” called “humanitarian” aid. And within that aid, health care and medical care take a prominent place....

  5. Acknowledgments
    (pp. xv-xvi)
  6. Part I Health Comrades in Context

    • Chapter 1 Introduction: Health Comrades, Abroad and at Home
      (pp. 3-14)
      Anne-Emanuelle Birn and Theodore M. Brown

      In January 1937 Lini De Vries, a widowed nurse and former factory worker from New Jersey, volunteered to be part of the American Medical Bureau’s (AMB) mission to Spain. For months she struggled to save the lives of brave young men who had been mortally wounded while fighting the enemies of Spanish democracy: General Francisco Franco’s army and his fascist allies. As she later recalled:

      Men coming out of anesthesia cowered … [o]thers shuddered when they heard planes overhead. Spain, a recognized, legally elected government with representation in the League of Nations, was being brutally attacked … I hated what...

    • Chapter 2 The Making of Health Internationalists
      (pp. 15-42)
      Theodore M. Brown and Anne-Emanuelle Birn

      How did health and left-wing internationalist politics come together in the early twentieth century? We approach this question by tracing the provenance of health internationalism, and how it emerged in the United States, against the odds, from two nineteenth-century sources that later converged. The first source was social medicine, which originated in the middle of the nineteenth century and was based on the premise that health is embedded in the political and social order. The second source was proletarian internationalism, taking shape around the same time and expressed in movements for social justice that transcended national boundaries and identities in...

  7. Part II Generation Born in the 1870s–1910s

    • [Part II Introduction]
      (pp. 43-44)

      The chapters in this section reflect the experiences of U.S. health internationalists who were born around the turn of the twentieth century, when the world was transformed by the intensification of global capitalism, the imperialist scramble for raw materials, colonies, and markets in Asia, Africa, Latin America, and the Caribbean, and a new glorification of science and confidence in secular solutions for social problems. At the same time, the mobilization of the industrial working class, both nationally and internationally, involved contentious struggles for political power and demands for state protection in the context of a surging international socialist movement. The...

    • Chapter 3 The Perils of Unconstrained Enthusiasm: John Kingsbury, Soviet Public Health, and 1930s America
      (pp. 45-64)
      Susan Gross Solomon

      In 1933, against the background of intense discussions of the costs, the availability, and the delivery of medical care in the United States¹ and the release of the final report of the Committee on the Costs of Medical Care,² Doubleday Doran—the largest publishing house in the English-speaking world—brought out a three-hundred-page book written by Sir Arthur Newsholme and John A. Kingsbury provocatively entitledRed Medicine: Socialized Health in Soviet Russia.³ The book was based on a month-long, nine-thousand-mile fact-finding trip to Russia taken by the authors in 1932 at the behest of the Milbank Memorial Fund⁴ to see...

    • Chapter 4 American Medical Support for Spanish Democracy, 1936–1938
      (pp. 65-81)
      Walter J. Lear

      The Spanish Civil War was a seminal moment for U.S. health-Left internationalism. From 1936 to 1938, the Fascist-supported assault on the democratically elected Republican government of Spain intensely engaged the U.S. Left, as it did progressive forces around the world. Approximately 2,800 individuals from the United States joined the Spanish Republican forces in this first major, transnational military action against fascism, which included some 40,000 women and men from over fifty countries.¹ Roughly 800 of the American volunteers lost their lives in Spain, and many more were seriously injured or severely traumatized. This extraordinary enterprise was the American Left’s first...

    • Chapter 5 Medical McCarthyism and the Punishment of Internationalist Physicians in the United States
      (pp. 82-100)
      Jane Pacht Brickman

      Studies of the impact of McCarthyism often overlook its effects on medicine. As noted by Manhattan obstetrician and activist Benjamin Segal in the mid-1950s, the “legion of men and women … [who were] exiles in their homeland … [and faced] economic and social reprisals … [by] being labeled subversive” included many physicians.¹ “Medical McCarthyism,”² as cardiologist and medical reformer Ernst P. Boas dubbed it, punished physicians who had “internationalist” inclinations with prison sentences, license suspensions, lost income, years of testimony before government review boards, deprivation of hospital privileges, military demotions, tarnished reputations, and psychic wounds. Indeed, the most enduring aspect...

  8. Part III Generation Born in the 1920s–1930s

    • [Part III Introduction]
      (pp. 101-102)

      The chapters in this section reflect the experiences of a generation born in the 1920s and early 1930s (as immigrants or the children of immigrants) who grew up during the Depression and reached adulthood during World War II, the brief postwar interlude of internationalist optimism, and the Cold War. The pall of McCarthyism led indubitably to caution about overt political expression, especially readily identifiable left-wing perspectives. Members of this generation gravitated, perhaps unconsciously but not by accident, to political causes that could be framed in the less ideologically threatening terms of human rights, international learning and exchange (even with supposed...

    • Chapter 6 Contesting Racism and Innovating Community Health Centers: Approaches on Two Continents
      (pp. 103-118)
      H. Jack Geiger

      This is the story of a pioneering health care innovation—the community health center (CHC)—merging primary medical care with population-targeted public health interventions. It is also the story of another merger—the use of health care as an instrument of social justice and empowerment for those oppressed by racism and poverty. Finally, it is the story of how my early experience with community health centers enabled me to accomplish that merger, that fusion of interests, in my own life and work.

      The story begins in the late 1930s and early 1940s, when a group of activist medical students at...

    • Chapter 7 Barefoot in China, the Bronx, and Beyond
      (pp. 119-133)
      Victor W. Sidel and Ruth Sidel

      The “barefoot doctor” has come to symbolize the attempts in China, under the leadership of Mao Zedong (Mao Tse-tung)¹ and the Communist Party of China, to improve the provision of medical care for China’s vast rural population. The improvements began during the 1930s and 1940s with the work of the People’s Liberation Army (the “Red Army”) in the “liberated areas” during the Japanese occupation and the revolution. These changes became national policy after what is known in China as “Liberation.” On October 1, 1949, Mao announced the establishment of the People’s Republic of China (PRC) by declaring in Tiananmen Square...

    • Chapter 8 Medical Internationalism and the “Last Epidemic”
      (pp. 134-150)
      Bernard Lown

      I was already middle-aged when I began an emotional and intellectual journey through rugged and uncharted terrain. I risked credibility and even retribution when I joined forces with a perceived enemy to contain the unparalleled terror of nuclear war. The enemy became a friend, and together we launched a global movement.

      This is both my story and the story of an organization founded to engage millions of people worldwide in a struggle for human survival. To a large extent my own identity and that of the organization became one. Building the organization became a preoccupation, even an obsession. Although I...

  9. Part IV Generation Born in the 1940s–1960s

    • [Part IV Introduction]
      (pp. 151-152)

      The chapters in this section are written by members of the baby boom generation (born in the postwar decades) who came of age in the 1960s and 1970s amid the struggles of many new and resurgent political movements and groups—the civil rights movement and the more militant Black Panther Party and Young Lords, the anti–Vietnam War movement, the women’s movement, the New Left, the United Farm Workers, the solidarity movements supporting urban welfare rights groups, the reproductive rights movement, the Gray Panthers, and the gay rights (later lesbian, gay, bisexual, and transgender) movement. The baby boomers’ focus also...

    • Chapter 9 Social Medicine, at Home and Abroad
      (pp. 153-167)
      Howard Waitzkin

      Norman Bethune, a Canadian surgeon, provided an early inspiration for my efforts in social medicine, both internationally and in the United States. In his work with poor and marginalized patients in Detroit, Bethune became infected with tuberculosis, as I myself did while taking care of a family at La Clínica de la Raza, a community health center in Oakland, California. Bethune saw clearly, as do most people who dedicate their work to social medicine, that social conditions often lie behind medical disorders. Without addressing these illness-generating social conditions, health professionals frequently find that the impact of their work remains limited,...

    • Chapter 10 Find the Best People and Support Them
      (pp. 168-183)
      Paula Braveman

      “Identify the best people and do everything you can to support them.” That was the advice of Milton Roemer, for decades a professor of public health at the University of California, Los Angeles and an internationally renowned expert on medical care systems. By “best” he meant the most capable, dedicated to the public good and committed to social justice. Responding to a question from me about the role of an international consultant, his words had a characteristic clarity, depth, and deceptive simplicity. Milton (or Muni, as he was affectionately called by family and friends) had an enormous influence on me,...

    • Chapter 11 Cooperantes, Solidarity, and the Fight for Health in Mozambique
      (pp. 184-199)
      Stephen Gloyd, James Pfeiffer and Wendy Johnson

      Health Alliance International (HAI) was founded, and continues to be sustained, by individuals strongly motivated by social justice concerns. But those of us participating in international health cooperation through HAI have sometimes found it challenging to maintain our initial idealism and enthusiasm. We have faced not only the overtly threatening opposition of reactionary political and military forces but the more corrosive, subtle, and sometimes principle-testing anxieties of a world increasingly dominated by neoliberal economics, nongovernmental organization competitiveness, and self-promotional entrepreneurialism. How can a solidarity-minded organization like HAI participate in international health cooperation while simultaneously challenging the structures of the larger...

    • Chapter 12 From Harlem to Harare: Lessons in How Social Movements and Social Policy Change Health
      (pp. 200-218)
      Mary Travis Bassett

      As far back as I can remember, we children were carted along to marches and meetings. I grew up in the multiracial, largely working-class community of Upper Manhattan. My parents are life-long activists, involved in the civil rights movement, the peace movement, and in more local issues, including schools and health care. It was only years later that I realized our family was embedded in a community of leftists, many with ties to the U.S. Communist Party (CP-USA). My great-uncle, Theodore Bassett, was a CP-USA functionary and at one time its Harlem organizer. In our family circle were others who,...

  10. Part V Generation Born in the 1960s–1970s

    • [Part V Introduction]
      (pp. 219-220)

      The chapters in this section are written by a fourth generation of health internationalists born in the 1960s and 1970s. They reached adulthood two decades later during the rapid and insidious spread of neoliberalism, the assault on unions and the Left generally, intensified technology–, finance sector– , and corporate-driven economic globalization, and the imposition of free trade agreements that privilege transnational corporations and patent holders over people’s lives. The end of the Cold War initially promised a peace dividend, but lingering legacies of the demonization of socialism and persistent U.S. support for antidemocratic regimes friendly to U.S. economic interests,...

    • Chapter 13 Brigadistas and Revolutionaries: Health and Social Justice in El Salvador
      (pp. 221-237)
      Michael Terry and Laura Turiano

      In 1981, while I was working in an ice cream shop and getting my GED after being kicked out of high school, the countries of Central America were enduring the worst of their civil wars. People there, especially young men and women my own age, were choosing, or being forced to choose, which side they were on and what they were willing to do for it.

      Meanwhile, my government was spending billions of dollars to support the sides it had chosen.¹ In El Salvador and Guatemala, it sided with the governments against armed rebel groups that had coalesced into the...

    • Chapter 14 Health and Human Rights in Latin America, and Beyond: A Lawyer’s Experience with Public Health Internationalism
      (pp. 238-253)
      Alicia Ely Yamin

      I was in Baborigame to document military atrocities, but the helicopter going to the military base was full that morning. So I stayed behind with the nuns, who were the only source of health care for the impoverished Tepehuac Indians in this remote area of northern Mexico. By the time his mother brought him in, the infant was so dehydrated and weak that he couldn’t even cry. Given the nuns’ meager supplies, there was nothing to be done but watch as he faded from his tiny little body. His mother held his body and cried softly. The old canard that...

    • Chapter 15 History, Theory, and Praxis in Pacific Islands Health
      (pp. 254-267)
      Seiji Yamada

      My father is from Hiroshima. Members of his immediate family were scattered far enough from the epicenter on August 6, 1945, to escape the bomb’s immediate physical effects. As a thirteen-year-old, together with his brother, he had been evacuated across the mountains. My father admits that witnessing the atomic bomb impressed him with the power of physics, which encouraged him to pursue its study, obtaining his PhD in Japan, then working as a postdoctoral fellow in Europe and the United States. At Cornell, he worked under Robert Rathbun Wilson, a Quaker who during the Manhattan Project (the U.S.-led secret effort...

    • Chapter 16 Doctors for Global Health: Applying Liberation Medicine and Accompanying Communities in Their Struggles for Health and Social Justice
      (pp. 268-285)
      Lanny (Clyde Lanford) Smith, Jennifer Kasper and Timothy H. Holtz

      Doctors for Global Health (DGH) began in 1995 in rural El Salvador during the years that the country began to rebuild after a devastating twelve-year civil war.¹ Founding members of DGH had been invited three years prior by local community leaders to engage with them in transforming the fundamental causes of ill health plaguing their communities and to create together a new and stable environment for the war-torn region. Since 1995, DGH has grown from a small, informal group working in one area of El Salvador to a more formal international nongovernmental organization whose member-volunteers work with communities in their...

    • Chapter 17 Doctors Across Blockades: American Medical Students in Cuba
      (pp. 286-300)
      Razel Remen and Brea Bondi-Boyd

      Imagine a young generation of U.S. health progressives traveling to an “enemy state” to be trained in something that has eluded U.S. activists and policymakers for a century: social justice in health. TheEscuela Latinoamericana de Medicina(ELAM), the Latin American School of Medicine, was founded in 1999 as an inspired outreach program by then Cuban president Fidel Castro. Its mission is to use Cuban models and Cuban expertise to train primary care physicians for work in underserved communities outside of Cuba by offering full scholarships to low-income students from thirty different countries in the Caribbean, Latin America, Africa, and...

  11. Part VI Conclusion

    • Chapter 18 Across the Generations: Lessons from Health Internationalism
      (pp. 303-318)
      Anne-Emanuelle Birn and Theodore M. Brown

      For almost a century, U.S. health leftists have looked overseas for what they hoped to accomplish at home. They found sites of political struggle where they could join forces with those fighting for social medicine and social justice abroad and, as can be attested to by the narratives in this volume, they also used their international solidarity experiences as guides, exemplars, and inspiration in their attempts to transform conditions in the United States. In this chapter, we identify cross-cutting themes, patterns, and perspectives that emerge through the varied experiences of the mix of physicians, nurses, physician assistants, anthropologists, teachers, social...

  12. Notes on Contributors
    (pp. 319-324)
  13. Index
    (pp. 325-350)
  14. Back Matter
    (pp. 351-352)