MARTHA MAY ELIOT: SOCIAL
PEDIATRICIAN, CHILDREN'S BUREAU CHIEF
1891-1978
by William M. Schmidt
Address at the Harvard
University Memorial Church, 1977
I
met Dr. Martha Eliot first in 1941, thirty-six years ago, not
long after she had had her fiftieth birthday. I had just come
to join the Children's Bureau to work on regulations relating
to health hazards for young workers, a field that was new to
me.
Dr. Eliot soon made a new member of the staff feel like an
established co-worker. Since then there has never been a time
when we were not in touch, sometimes working together, sometimes
just by a phone call or a letter or card. I have had great respect
and admiration for her, and affection. I know that there are
many who share these feelings--some who were her close associates
for many years, and others who knew her mainly because of what
she had accomplished. I want to speak about what she did, and
about the kind of person she was.
For more than fifty years Martha May Eliot took a leading part
in the development of health services for mothers and children.
She was concerned for children of all countries of the world,
and worked for them in the great international organizations:
the League of Nations, United Nations Relief and Rehabilitation
Administration (UNRRA), the United Nations Children's Fund,
and the World Health Organization. At home, here in the United
States, her own country, she used her vision and vigor in the
United States Children's Bureau, at Yale Medical School, Harvard
School of Public Health, and the Massachusetts Committee for
Children and Youth, as well as in many governmental and non-governmental
agencies and committees.
Her entire career was a fulfillment of a decision and commitment
made early in her life. At Radcliffe she had a great interest
in the classics, and her deep appreciation of her cultural heritage
enriched her work and her life. While still a Radcliffe student
she determined to study medicine. She has related that having
learned that Professor Sedgwick was working to create a school
of public health, she went to seek his advice. When he suggested
that she should aim to become a laboratory technician, she asked
him what advice he would give her if she were a man. "Study
medicine," he said. "It was what I wanted to hear," she said.
 |
|
Dr.
Eliot among Robert Bradford, Margaret Sanger, and others
at the 1949 Smith College Commencement
|
While in the second year of medical school at Johns Hopkins
in 1915 (she was 24 years old) she wrote to her family that
she had a strong feeling that she should take every opportunity
to take part in social work. "You see," she wrote, "even if
I am studying here, and if I should practice, I want to keep
attached to the social end of it; in other words, to be some
kind of a social doctorthough what kind I don't know."
The kind of social doctor she was to become hardly existed then;
she created the model as she went along.
Her first step in social pediatrics was to be a demonstration
study in New Haven, but before that she had to finish medical
school at Johns Hopkins, with honors, and have further training
in internal medicine and pediatrics at the Peter Bent Brigham
Hospital in Boston and at the St. Louis Children's Hospital.
She opened an office for private practice on Marlborough Street,
sending out notices that it was a practice in the "prevention
and treatment of diseases of children." It was not the usual
wording but even then she was not the usual doctor. She liked
the patients, she liked the work, but she did not like asking
for a fee. She abandoned her practice happily some ten months
later when Dr. Edwards A. Park invited her to become his first
resident pediatrician in the new department of pediatrics he
was establishing at Yale. It was there that Dr. Eliot moved
into social pediatrics with her study of rickets.
Rickets was then one of the most common diseases of children,
an affliction which impaired child development and contributed
to severe complications of childbirth. It was known that rickets
was a deficiency disease which could be prevented by adding
vitamin D to the diet, and by sunlight. Dr. Eliot was well acquainted
with the research on rickets of Dr. Edwards A. Park (while he
was at Hopkins) and Dr. E. V. McCollum. Vitamin D was then available
as cod liver oil, which had to be given to infants daily.
The question Dr. Eliot undertook to study was whether a program
could be designed and carried out which would afford protection
to every child on a community-wide basis. It was one
thing to know that a child in an enlightened family, under excellent
health care, could be protected from rickets. She wanted to
know if all the children, even in a poor neighborhood, could
be equally protected. She proved that they could. This was an
important step in the history of the disappearance of rickets.
Her three-year demonstration in New Haven was also a model of
a community health center approach to meeting child health needs.
While continuing at Yale, Dr. Eliot became a member of the
Children's Bureau staff, commuting frequently to Washington
until 1935, developing the Division of Child Hygiene, and keeping
in touch with what was being done under the Sheppard-Towner
Act, which was the first Maternity and Infancy Act. She collaborated
in the drafting of the children's sections of the Social Security
Act.
I
don't know whether it was she who wrote the section on the purpose
of the Act, which states that the grants are to enable the states
to "extend and improve" services for mothers and children and
for handicapped children. She liked the language, I do know,
and often referred to it. She used it in testimony in Congress
defending one of the most important efforts of her Children's
Bureau years. It was provision of maternity and infant care
for wives and babies of men in the armed forces during World
War II, a program known as Emergency Maternity and Infant Care,
or EMIC for short. The program began modestly enough in 1941
with a small grant to meet the needs at Fort Lewis, Washington.
Before it was over, it had become the largest public medical
care program up to that time. At its peak the birth of one baby
of every six was provided for by that program.
It was not simply a bill-paying program. Good standards of
care were encouraged and minimum requirements were established.
There was no specific legislative authorization for all
this. Dr. Eliot saw the need and moved firmly ahead, basing
her action on the general authorization of the Social
Security Act to establish special projects to extend and
improve health care of mothers and children. She won the
approval of the appropriations committee and the appreciation
of all who were concerned with the welfare and morale of men
in the armed forces and their families.
As an administrator she wanted first-hand knowledge of the
programs she was responsible for. While she was Associate Chief,
and later Chief of the Children's Bureau, she managed to visit
every regional office of the Bureau, from time to time, and
she observed programs in every one of the states. She kept her
finger on everything, and held the reins of authority lightly
but firmly.
Dr. Eliot believed that administrative procedures should serve
the program well, and when they did not she undertook to change
them. Thus, she decided that grant-in-aid formulas were too
rigid, and did not give the state agencies the flexibility they
needed to try new approaches. So she produced the idea of reserving
a portion of the available funds to enable the States to try
out new ideas in special projects. This was the model for special
project grants beginning in 1963 to make possible many new child
health and family planning programs.
This was no mere technical maneuver, but a way of releasing
the energy and stimulating the initiative of people all over
the country. She was, as Katharine Lenroot, her predecessor
as Chief of the Children's Bureau, writes, a "wonderful colleague."
 |
|
Governor
Herter and Dr. Eliot conferring in Boston in 1958
|
Later on, in her administrative responsibilities for WHO she
worked with the same flexible style. She explained:
"...just as in the Children's Bureau our
approach on the job we had to do was different from the approach
of some of the other agencies of the federal government, so
my approach in the World Health Organization was different from
the way in which some other people in the administrative field
would have done things...
"I didn't follow clear-cut lines of how you
do this or that. When I found that there was something that
I thought could be done for the benefit of a government's program,
and if I thought that it should be done not according to Hoyle
but in a new way, I would proceed with it in the new way."
Dr. Eliot's work for children through international organizations
began in 1935 when she was an alternate delegate for Grace Abbott
to a conference of the League of Nations, in Geneva, on child
welfare. The next year she took part in a conference on infant
and child nutrition of the Health Organization of the League.
After that conference she seized the opportunity to visit seven
European countries and to study their ways of providing health
and welfare care for mothers and children. During the Second
World War when England was under air attack, she went to London
with a delegation from the United States to see how the British
were handling civil defense, and especially caring for children's
needs. With this background it is not surprising that she was
called upon to serve with the U.S. delegation to the International
Health Conference in 1945, where she and Dr. Brock Chisholm
won the support needed to have the constitution of the World
Health Organization include child health as one of its major
responsibilities. She was the only woman to sign the constitution
of the World Health Organization. She has been referred to by
its present Director General as one of the brilliant pioneers
of international health. Her work for UNICEF, the United Nations
Children's Fund, at the invitation of Maurice Pate, surveying
the situation of children in some thirteen European countries
in 1937, and working on agreements between the governments and
UNICEF, was a great achievement, as Mr. Charnow, representing
UNICEF, who knew and worked with Dr. Eliot, has told us.
Dr. Eliot's last contribution to the international effort for
children came in 1960, when she made two strenuous trips through
Asian and African countries on a mission relating to the training
of Maternal and Child Health personnel, a mission sponsored
jointly by the World Health Organization and UNICEF. She was
not one to allow herself to be upset by the discomforts of travel.
She wrote home from Cairo during her 1960 trip (she was 69)
that there was a prolonged plane delay, but that she stretched
out on a bench at the airport, used her flight bag as a pillow,
and slept for an hour and a half - - "on and off."
I
happened to be in Sofia, Bulgaria a week or so after her 1947
trip there for UNICEF and met the doctor who had acted as her
interpreter. He described the formal welcome ceremony for her
at the railroad station, followed by the suggestion that she
would be taken to her hotel to rest from her journey. "Rest?,"
he told me she replied, "there's no time for that. I must leave
tomorrow evening for Bucharest, and by then we must complete
our work here." The poor interpreter was made to stay up all
night putting the text of the draft agreement into Bulgarian
and English, but it was done, and signed by the Prime Minister
the next day. The interpreter was deeply impressed, and I would
guess that the Prime Minister was too.
When she returned from this swing through the Eastern European
countries someone asked Dr. Eliot what the people behind the
"Iron Curtain" were like. "Much like people on this side," she
said.
In her three years at Harvard as Professor of Fraternal and
Child Health, her students came to know her and appreciate her
in conversations in her office as much as in the lecture hall
or seminar room. She formed lasting friendships with many students,
from many countries, and continued to hear from them and to
have visits from then whenever there was opportunity.
She was much attached to Harvard. On her appointment to the
World Health Organization, as an international civil servant,
she resigned appointments she held in the United States, all
except her appointment as a member of the Committee to Visit
the School of Public Health. That she did not wish to give up,
and she received Dr. Chisholm's approval to continue to hold
it. She followed with interest and admiration the development
of the School with its new buildings, and its new and strengthened
programs.
Dr.
Eliot's approach to the establishment of the Massachusetts Committee
for Children and Youth in 1959 shows her sure hand in creating
an organization to meet what she liked to call the "public responsibility."
The beginning was the Governor's request to her to head the
Commonwealth's delegation to the White House Conference on Children
and Youth of 1960. This was the sixth in the series of conferences
which had begun in 1909. Dr. Eliot knew well the history of
these conferences. She understood what they had accomplished
and what they had not, and she knew the risk that fair words
and bold resolutions might too easily be forgotten if there
were no continuing organization to see to promoting suitable
action.
She therefore accepted
the Chairmanship of the delegation, on the condition that the
Governor would designate the Massachusetts Committee for Children
and Youth (MCCY) as an ongoing organization to conduct studies,
and to advise the Executive and members of the legislature,
and the public generally on matters affecting the children of
Massachusetts and their families. She organized a strong Board
of Directors, drew into the Committee an able executive director
and a talented staff. She led the organization thereafter in
studies which resulted in strengthening and modernizing welfare
and youth services, and other local and state actions for children.
The Massachusetts Committee (MCCY) continues the work she started
so well. She took great satisfaction after she retired from
it to receive reports showing that the plans she and a few leaders
in health and welfare laid down nineteen years ago resulted
in a continuing organization, a continuing commitment, and new
contributions to the new problems affecting children.
She seemed to have unbounded energy. She made her staff work
hard, she sometimes prodded them, but she did not spare herself.
For years she was at work at the Children's Bureau at six or
seven in the morning, and when she left in the evening a bulging
briefcase often went home with her. In the morning she had notes
ready to send to staff members, asking them to follow up on
plans, or to consider planning something new. According to one
colleague, the notes that flew out after a three-day weekend
were "murder". But then very often she would drop into one's
office, or send a note along saying that she might be asking
too much, pressing too hard. She knew that she was not always
an easy person to work with, and she made up for this with continuing
encouragement, and above all, with her ability to make one feel
that he was in a partnership with her in a cause which could
not be laid aside.
During the shameful period of McCarthyism, Dr. Eliot, as Chief
of the Children's Bureau, had the courage of her moral convictions.
She did not hesitate to intervene in the defense of members
of her staff who were being wrongfully harassed.
She recognized her need for rest and recreation from time to
time. Since she was in medical school a drive or walk in the
country was what she wanted for a Sunday afternoon. Her holidays,
whenever she could take them, were spent at the family camp
in Magog, Quebec, which her parents had made theirs many years
before, with tents set up in the forest, bordering beautiful
Lake Memphremagog and facing a magnificent mountain. Over the
years the camp came to be a group of cabins and to have some
amenities including, finally, a telephone. With or without amenities,
Martha loved the family camp.
We shall remember Martha Eliot as one of the great pioneers
of maternal and child health; as one of the early advocates
of a national health program; as one who worked for the welfare
of children, believing that child health and child welfare were
inseparable. She had the highest honors from her peers in her
professional associations, and from many universities and other
organizations. We shall remember her as a good person, and we
shall remember that she did indeed become, as she had hoped
and planned when she was still a medical student, a "kind of
social doctor" a great social doctor.
Courtesy
of the Schlesinger Library, Radcliffe Institute, Harvard University
Current
Biography 1948 (article, pp. 184-186). Christian
Register (article, January/February 1957, p.22).
|