For the Good of Humanity: Ludwik Rajchman, Medical Statesman (review)

Marta A. Bali´nska. For the Good of Humanity: Ludwik Rajchman, Medical Statesman. Translated by Rebecca Howell. Originally published as Une vie pour l'humanitaire (La Découverte, 1995). Budapest: Central European University Press, 1998. xvii + 293 pp. $35.00.

Ludwik Rajchman (1881-1965) pursued a career of service to humanity that should have made his name famous. Instead, he is largely unknown. How could a figure who occupied highly visible international positions for decades have become so invisible? According to Marta Bali´nska, Rajchman's great-granddaughter, politics, both corporate and general, played the major role. Arguably, Ludwik Rajchman may have been the most political of physicians. His professional life was spent trying to improve the quality of life of a large part of the world's population. Yet there seem to be no Rajchman Awards or Prizes or Lectureships. He played a major role in the activities of the Health Section of the League of Nations. He was essentially the founder and was the first president of the United Nations International Childrens Emergency Fund, UNICEF.

Born in a Poland ruled from Russia, and into an intellectual and influential family, Rajchman inevitably became heavily involved in anti-Russian scheming at the turn of the century. In 1906, as a young physician, his involvement culminated in his arrest at a clandestine meeting in Warsaw. He spent four months in prison and then was released only because his family bribed the government, who insisted as a condition that he leave Poland. He did so and, despite heavy involvement in Poland's scientific and philanthropic communities throughout his lifetime, he lived in Poland again only in 1910 and from 1918 to 1921. A consequence of significance arising from his exile was the decision to further his medical education at the Pasteur Institute in Paris. There, he studied under two other exiles, Élie Metchnikoff and Constantin Levaditi; it was just a year later that Metchnikoff received the Nobel Prize. Rajchman was much influenced by the great Russian scientist.

After Paris, Rajchman spent the war years in London, but returned to Poland in the giddy atmosphere of independence in 1918. There, he took charge of public health in the Ministry of Health. He was needed badly. The postwar situation in eastern Europe was catastrophic. Typhus became endemic, affecting perhaps thirty million patients in Poland and Russia. Diphtheria was epidemic, as were typhoid and the venereal diseases. Rajchman set up an Institute of Hygiene, patterned to some degree on the Pasteur Institute. He also announced the creation of an Epidemiological Review. Vaccines were produced, paramedical cadres educated, and funds raised, particularly from the Rockefeller Foundation. His work there ended, however, when he left to join the League of Nations.

One almost incredible facet of the political aura within which Rajchman functioned was the ongoing antipathy of the French for the Health Section of the League of Nations. The explanation seems purely nationalistic: centered in Paris was the Office Internationale d'Hygiène Publique--which had haughtily spurned membership in the League. As far as the French were concerned, international health matters were to be funneled through Paris, not Geneva. This unedifying and selfish attitude existed throughout the life of the League. But political machinations by Rajchman and others prevailed, and in 1922, for

the first time in history, health matters had been brought to the forefront of the international stage, thus setting a significant precedent. The principles [that Rajchman] had managed to have grudgingly accepted on the governmental level (and not through humanitarian organizations) were going to transform completely sanitary and medical cooperation and offer possibilities that had been up to then unimaginable. (p. 61; italics in original)

What must be recalled is that prior to World War I, international public health was essentially an exercise in controlling contagious diseases in the interests of commercial trade. Then, in the 1920s and 1930s, Rajchman "succeeded in...