"Repeated Disappointment": The Rockefeller Foundation and the Reform of the Greek Public Health System, 1929-1940

During the interwar period the Rockefeller Foundation (hereafter RF) became the most conspicuous private American philanthropic organization with an international mission. It channeled its expertise and funds to an international public health campaign aimed at building public health systems in developing countries and improving international health. This essay on the RF’s involvement in Greece in the years 1929–40 fits into a historical literature that seeks to understand the international health efforts of such private voluntary organizations. Operating out of developed countries and relying on skilled experts and considerable resources, modern private voluntary organizations sought to demonstrate to the governments and public health agencies of developing or war-torn countries ways to help themselves via material reconstruction and the improvement of public health.

A good part of the RF’s interwar efforts were focused on Europe, particularly Eastern European and Mediterranean countries. During the 1920s and 1930s the Foundation provided governments with technical, scientific, and limited financial assistance to combat widespread epidemics, upgrade or establish medical health facilities, train corps of public health administrators and personnel, and create public, especially rural, health programs. ¹ RF experts viewed the application of modern hygiene and preventive medicine and the building of innovative health and welfare systems as means of reinforcing economic growth and political stability in postwar Europe.

Yet the effort to apply a model of modern and efficient public health in Greece did not bear the intended results. Although it began with high expectations and produced a few successful projects, the collaboration between the RF and the Greek state was not fruitful. The clash between the RF’s specific set of values and Greek practices contributed to the lack of success. The onus for this unfulfilled effort, however, falls on the unsettled state of Greece’s politics and economy, and, in the end, the outbreak of World War II.

The Circumstances of the RF’s Involvement in Greece

The RF’s assistance in rebuilding public health in postwar Europe was a cultural and scientific commitment with an underlying political consideration—namely, to enhance the American presence in Europe through peaceful intervention. Private American philanthropy and a growing commerce developed into expedient tools of American foreign policy in Europe at a time of self-dictated U.S. diplomatic isolationism.

The RF’s engagement in the reorganization of the Greek public health system bears particular significance in the context of American cultural expansion in the Eastern Mediterranean. It served as the closing stage of a long tradition of private American philanthropy in Greece and the Eastern Mediterranean that dates back to the early nineteenth century. As early as the 1820s American Protestant philanthropists were engaged in missionary, educational, and philanthropic work among Armenian and Greek Christians in the area, in an effort to assert a strong Protestant presence in the Holy Land and the Eastern Mediterranean. By the end of World War I these efforts had created among Near Eastern peoples a perception of the United States as a benevolent power in the world in sharp contrast to the dominant diplomatic and economic role of the European powers.

The American philanthropic involvement in Greece reached its high point in the aftermath of World War I. Following the expansionist Greek war in Asia Minor in 1920-22 and the disastrous defeat of the Greek forces by Mustafa Kemal’s nationalist armies in August 1922, hundreds of thousands of Ottoman Greeks and thirty-five thousand Armenians were forced out of Turkey into Greece proper in the fall of 1922 and early 1923. Unable to handle such an enormous refugee influx, the Greek government appealed for foreign assistance. It was American philanthropic organizations, namely the American Red Cross and the Near East Relief, that offered the most extensive foreign aid. Operating under the auspices of the U.S. government, they conducted a nine-month emergency relief campaign among scores of refugees fleeing into Greece in late 1922 and 1923.

During the refugee crisis Greece appealed to the RF as well—not, however, for emergency aid, but for scientific and technical...