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Rockefeller Sanitary Commission (RSC)

The Rockefeller Sanitary Commission for the Eradication of Hookworm Disease (RSC) was a separate organization created to eradicate hookworm disease in the American South. The work of the RSC was the first major attempt at disease eradication, and it provided a model for future work of the Rockefeller Foundation (RF) and its associated organizations, like the International Health Division (IHD)

Educating the people by demonstration and lecture at dispensary, Cocke County Tennessee

Educating the people by demonstration and lecture at dispensary, Cocke
County Tennessee

The Origins

The RSC was formed in 1909 with a donation from John D. Rockefeller, Sr., of $1 million over five years. The stated object of the commission, according to its by-laws, was “ … to bring about a co-operative movement of the medical profession, public health officials, boards of trade, churches, schools, the press and other agencies for the cure and prevention of hookworm disease.”[1]  However, eradication of hookworm was not the RSC’s only goal. This rampant yet easily curable disease provided what was described as a “favorable wedge,” allowing the RSC to promote the creation of an organized and well-funded public health network across the southern United States, a region where health programs had long been neglected. A 1939 RF report tracing the development of rural health services noted that when the RSC began its work, one of the most serious obstacles was the lack of organized public health services in rural districts. In 1909 only three states in the South had a state department of health, and only a few cities had full time health officers.[2]

Leadership

Wickliffe Rose, a humanities professor and advocate of southern educational reform, was appointed the first head of the RSC. The appointment reinforced the general belief among RSC members that education would be the most important factor in both curing hookworm and creating a new way of thinking about the responsibilities of public health.

Strategy

Through health surveys, travelling dispensaries for treatment and lectures and demonstrations on disease prevention and sanitation, the RSC hoped to create a model that would convince southern states that public health issues were vitally important.

Hookworm treatment dispensary, Robertson County, Tennessee 1914

Hookworm treatment dispensary, Robertson County, Tennessee 1914

To help accomplish this goal, the RSC tied its funding to partnerships with county health departments willing to contribute funding and assistance. Where county health departments did not exist, the RSC helped to create them. According to Frederick T. Gates, RSC member and Rockefeller’s most trusted advisor, “We do not go into a county, on principle, unless the county officers will pay something from the public funds on the work.”[3]

A Quick End

The RSC was disbanded on December 31, 1914. Congratulating the commission on its work, Rockefeller wrote to its members that “[t]he work thus far accomplished would seem to have brought about in all of the southern states a very general knowledge on the part of physicians, health authorities and the public regarding the prevalence of hookworm disease and the methods of treating and preventing it.  The chief purpose of the commission may thus be deemed to have been accomplished.”[4] 

Letter from John D. Rockefeller Sr. to the Rockefeller Sanitary Commission, 1914 August 12

Letter from John D. Rockefeller Sr. to the Rockefeller Sanitary
Commission, 1914 August 12

For many in the RSC, its end came as a surprise. While only a five-year commitment had been made, many staff, including Rose and Charles W. Stiles, a parasitologist and key organizer of the hookworm campaigns, had expected the work of the RSC to continue until the disease was completely eradicated. The RSC had achieved a great measure of success. Medical staff examined more than 1 million persons and treated 441,408 of them in just five years. However, hookworm still existed in portions of the South. The decision to shutter the RSC was due largely to Gates, who wished to move the newly formed RF towards new global public health goals.  While the decision to close the RSC was criticized publicly by Stiles, Rose accepted the decision and remained to helm the newly formed IHD. 

The Next Phase

Examining Specimens, Cartersville, Cumberland County, Virginia

Examining Specimens, Cartersville, Cumberland County, Virginia

The IHD remained in the southern United States carrying out the last of the region’s hookworm campaigns. Yet as the organization continued work on this regional campaign, its scope broadened to transform public health and eradicate major diseases worldwide.

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