Table Of ContentComing to Terms with World Health
Iris Borowy
Coming to Terms
with World Health
The League of Nations Health Organisation 1921-1946
PETERL ANG
Frankfurt am Main • Berlin • Bern • Bruxelles • New York • Oxford • Wien
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ISBN 978-3-631-58687-7 (Print)
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DOII 1S0B.3N7 2967/89-738--633-16-5538-608571-473-8
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Table of Contents
Acknowledgments 7
List of Abbreviations 9
Technical Remarks 10
Introduction 11
I. The Rise
1 Beginning — The Formation of the LNHO 41
2 The Early Years: The Provisional Health Committee 1921-1922 77
3 Towards Permanence: The Provisional Health Committee 1922-1923 95
Interchanges, 100; Causes of Death Classification, 105; Africa, 109;
Diseases: Malaria - Cancer, 111; Standardization, 114; Opium, 116;
Towards a Permanent Health Committee, 120
II. The Basis
1 The 1920s — the first Decade 129
2 The Backbone of LNHO Work: the Permanent Programs 143
Epidemiological Intelligence, 143 ; Standardization , 143;
Opium, 160 ; Conclusions, 165
3 The Basis for Deciding on Health Work: Assessing World Health 167
Cause of Death and Disease Classification, 167; International Health
Yearbooks, 177; Infant Welfare, 184; Conclusions, 190
4 The Basis for Conducting Health Work: Contact and Communication 191
Interchanges, 191; Public Health Education, 205; Latin America,
212; Africa, 225; Conclusions, 235
5 The Traditional View on Health: Diseases 237
Malaria, 239; Sleeping Sickness, 255; Cancer, 261; Tuberculosis, 268;
Conclusions, 275
6 Shifting Development: Decline and Growth between the 1920s and 277
1930s
6
III. The Social Determinants of Health
1 The Innovative Approach to Health Work: Establishing Health Systems 301
Greece, 301; Bolivia, 304; China, 305; Conclusions, 323
2 Rural Hygiene 325
Rural Hygiene in Europe, 325; Rural Housing, 344; Rural Hygiene in
Asia, 347; Rural Hygiene in America, 357; European Conference on
Rural Life, 258; Conclusions, 360
3 The Effect of World Depression — Nutrition 361
Economic Depression, 361; limited Results; :The Psychological Effects of
the Depression / “Coloniîçation”, 346; Suitable Statistical Methods to Study
the Effects of the Depression on Public Health, 366; Ways to Safeguard Health
by Coordinating the Work of Public and Private Health Institutions, 369;
Nutrition, 379; Conclusions, 393
4 Housing 395
Phase one: Environmental Conditions of Housing — Heating
and Cooling — Noise 403; Phase two: Natural and Artificial
Lighting, 408; Phase three: Population Density — Smoke and Dust
— Water Supply and Purification — Waste Disposal, 414;
Conclusions, 419
IV. The Fall
1 War 421
Conclusions 445
Annex 464
Photographs, 464, Budget, 468; Health Committees, 470;
Interchanges, 472
Bibliography 477
Index 497
7
Acknowledgments
As all authors know, the process of writing a book piles up ample debts,
institutional, financial, intellectual and personal. Professor Wolf Gruner, who was
already my supervisor during my Ph.D. thesis, continued to support me and helped
find funding and a workplace at the Historical Institute at the University of
Rostock, without which this study would not have been possible. The Deutsche
Forschungsgemeinschaft (DFG) has generously financed the long period of research
during the project. The archivists of several archives I visited in the course of the
project provided competent and encouraging help. Above all, Ms. Bernardine
Pejovic at the League of Nations Archive in Geneva became a constant companion
of my searches.
.In different forms and shapes, elements of texts in this book have already
been published. Thus, parts of chapter III.3 have appeared as “Crisis as
opportunity: International health work during the economic depression,” Dynamis
28 (2008), 29-51. Descriptions of the LNHO standardization program have been
collected into “Serological and Biological Standardisation at the League of Nations
Health Organisation, 1921 — 1939/’ in: Harmonising 20th Century drugs: Standards in
pharmaceutical history, edited by Christian Bonah, Christophe Masutti and Anne
Rasmussen, (Paris: Glyphe, 2009). Similarly, I portrayed the LNHO classification
program in “Counting Death and Disease - Classification of Death and Disease in
the Interwar Years, 1919 - 1939,” Continuity and Change, 18, 3 (2003) 457 - 481. In
condensed form, elements of the LNHO efforts in social medicine have been
discussed in “International Social Medicine between the War. Positioning a Volatile
Concept,” Hygiea Internationalism 6, 2 (2007), 13—35, and I have included accounts of
LNHO initiatives in China and of the International Health Yearbooks into volumes
I (co-)edited: “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, edited by Iris Borowy, (Berlin: Peter Lang Verlag,
2009), 205-228; and “World Health in a Book - The League of Nations
International Health Yearbooks 1925-30,” in Facing Illness in Troubled Times. Health in
Europe in the Interwar Years, 1918-1939, edited by Iris Borowy and Wolf D. Gruner,
(Berlin: Peter Lang Verlag, 2005), 85-128. Finally, a similar version of chapter IV. 1
has appeared as “Manoeuvering for space. International health work of the League
of Nations during the Second World War,” in “On Shifting Ground:” Health and Space
in the Twentieth Century, edited by. Susan Gross Solomon, Patrick Zylberman and
Lion Murard, (Rochester: Rochester University Press, 2008), 71-89. I am thankful
for being allowed to re-assemble these accounts in ways that reveal their meanings
within the life and times of the League of Nations Health Organisation, among the
numerous remaining stories as yet untold.
Through such publication projects, at conferences and otherwise, many
colleagues have helped, inspired and supported me with their comments and
friendship. Esteban Rodriguez-Ocana, Patrick Zylberman, Bernard Harris, Annick
Guenel, Socrates Litsios, Shifra Shvarts and Anne Hardy are just a few of a long list
of people who, in one way or another, have in discussions contributed to ideas that
have found their way into this book. Many more are members of the interwar-
health list, which I have been privileged to edit for some years. Paul Weindling has
read the entire manuscript. I am deeply indebted to him as well as to Ted Brown
and to an anonymous reviewer of Rochester University Press whose critical
comments proved invaluable and have helped turn the text into a much better
book. For any remaining weaknesses I have noone but myself to blame
My warmest gratitude, obviously, goes to my family. To my sons, Markus
and Ralf, for whom work on this book spanned time between Lego toys and iPods
while they came to consider sitting in a corner and staring into a laptop computer
normal motherly behaviour. And to Norbert, for discussions over Sunday morning
rolls and many other things that do not belong here. Together, they have allowed
me to be part of their lives, which has enabled me to keep my sanity in between
interwar epidemics and social hygiene.
This book is dedicated to my father, who died while I was working on the
first draft. He would have disagreed with most of its conclusions, but would have
boosted sales numbers anyway. The book will have to do without him now.
9
Abbreviations
AA Auswärtiges Amt
AISI Archive of the International Statistical Institute
AMAE Archives du Ministère des Affaires Etrangères
APHA American Public Health Association
ARC American Red Cross
BArch Bundesarchiv
BNI Archive of the Bernhard Nocht Institute
HC Health Committee
ICRC International Committee of the Red Cross
IHB International Health Board
IHD International Health Division
IIA International Institute of Agriculture
ILO International Labour Organization
IRC International Red Cross
ISI International Statistical Institute
HC Health Committee
LNHO League of Nations Health Organisation
LONA League of Nations Archive
LRCS League of Red Cross Societies
MRC Medical Research Council
OIHP Office International d’Hygiène Publique
PAAA Politisches Archiv des Auswärtigen Amtes
PASB Pan-American Sanitary Bureau
PRO Public Record Office
RF Rockefeller Foundation
