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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.
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 doctor—though 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.”
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.