Chisholm, WHO and the pursuit of the public’s health

S. William A. Gunn

doi:10.1503/cmaj.090892

Brock Chisholm, the World Health Organization, and the Cold War

John Farley

UBC Press; 2008. 254 pp $85.00

Whether by coincidence or by design, 4 remarkable books that express the ideal of peace through health, the goal of the World Health Organization, were published in 2008, coinciding with WHO’s 60th anniversary. And to this Canadian reviewer the fact that all their authors and editors happen to be Canadian is an expression not of chauvinism, but of legitimate pride.

Crimes Against Humanity, by Adam Jones of the University of British Columbia Okanagan; this reviewer’s book, Concepts and Practice of Humanitarian Medicine; Peace through Health (page 1234), by Neil Arya and Joanna Santa Barbara of McMaster University; and John Farley’s book embody in their own ways what another Canadian, Dr. George Brock Chisholm (1896–1971), envisioned and practised as the first director-general of WHO.

Based on an extensive search through the archives of WHO and related records, Brock Chisholm is an attempt by Farley, a Dalhousie University medical historian, to clarify the often entangled relationships between an idealistic leader, a fledgling organization for a new world order and a pitiless Cold War confrontation. Being by design limited in time and scope, the book is an insightful account of that first decade, without pretending to be a biography of Chisholm or the history of WHO. Nonetheless, much transpires on the personality of the leader, the politics of the organization, and the postwar competition of ideologies that soon turned into bitter animosity, considerably detracting from the objectives, performance and efficacy of the organization.

Image courtesy of UBC Press

This book will be of interest to medical historians, health planners and social scientists and is a vast depository of documentation for Canadian politologues, students of health policy and international administrators.

The author begins with an account of Chisholm’s life, from a young, decorated Ontario soldier to physician, psychiatrist, major-general, deputy minister of health at the federal level, representative to the United Nations and thence to WHO. In light of this exceptional professional climb, one wonders why Farley reports that “Chisholm had been a surprising choice” as the first director-general of WHO when no document or statement alludes to any surprise. Indeed, being initially sent from Health Canada to the UN might seem surprising, but once in the international milieu Chisholm persistently climbed by the votes of his peers, all experts and potential competitors. Norman Howard-Jones, the historian of WHO and no soft-spoken judge, is categorical about this: “He was the natural choice.”

The author’s ambiguity also translates in other ways; indeed whether through indecisiveness or concern for impartiality Farley lets some doubts persist that lead to vague interpretations and sometimes give the impression of a dreamy, impractical man with wooly ideas on such issues as poverty, family planning, peace, social services and medical coverage. That opponents during the Cold War might have thought this and used it against him may be understandable, but that another Canadian author should even today think that Chisholm was “a bit of a second rater” and that there was “mieux ” (his italics) is untenable. 1 Yes, like most people, Chisholm had his weaknesses and idiosyncrasies and he did not hold a masters in public health, but he knew how to surround himself with the best experts of the time and had confidence in youth. His directors of finance and publications were both aged 38 when appointed, and I recall when he officiated at our medical graduation, his passionate message was: “safeguard your youthful vision and work health into social justice.” And as his objective was the public’s health rather than traditional public health, his being from outside the club should be seen as an advantage, as indeed it proved to be.

A postscript to the book would also have shown how much his visionary ideas have turned out to be not that illusory after all; to take just 1 example, the relationship between poverty and health, for which he was “crucified” by some at the time.

As an international organization, WHO, even in the earliest years suffered from its members’ nationalistic interests and lack of political will, exacerbated by the Cold War. The hot tensions were not particular to Chisholm’s period — 4 of his successors faced similar problems — but it was he who first confronted them and, given the maddening complexities, it is to the credit of his capacity for damage control that the ship maintained its course and has safely sailed through its 60th year.