Fifty years ago, Shriver wanted 500 doctors for universal health education! What happened?

Vietnam. In a remarkable speech to the Albert Einstein School of Medicine on November 15, 1964, Sargent Shriver called for universal medical education, manned, in part by Peace Corps Volunteer doctors. Read the entire impassioned  speech at Peace Corps’ greatly expanded digital library:

http://collection.peacecorps.gov/cdm/singleitem/collection/p9009coll13/id/12/rec/3

Shriver said:

“We need a new idea and a new program…The answer lies in universal health education, with effective medical programs, medical centers and medical personnel serving as the central source for this public education.  Just as the Peace Corps has sent thousands of teachers overseas to help developing nations achieve universal school education, so now we must help them make universal health education a reality.”

If this program sounds familiar, it is exactly what is now being developed, fifty years later. by a contract between Global Health Volunteers and Peace Corps Response. There are striking similarities between the proposals, separated by fifty years.

Shriver explained to his audience that he understood that physicians have special considerations when it came to volunteering. He noted the high cost of a medical education resulting in debt that needed to be retired; the many years medical training required during which time, medical students might marry and begin a family; and the fact that physicians selective service obligation extended beyond the age of 26, in those days. Shriver looked at what might be done to allow more doctors to volunteer and presented this plan:

1) Volunteer doctors needed to have help in paying off their medical training debt.  Shriver said that the Peace Corps National Advisory Council would meet in January of 1965 and take up a plan to establish a private Foundation to help Volunteer doctors with debt incurred during their long medical training. Today, raising private funds to help PC Response doctors with medical school debt is at the heart of the proposal by Global Health Volunteers.

The PCResponse/Global Health proposal is different in one respect. PCR/GHV are to be placed directly in medical schools to instruct medical and nursing students. Shriver proposed expanding the kind of programs that were then in effect in Thailand, Ethiopia and Malawi.There, Peace Corps doctors were supervising teams of PCVs, many of whom were liberal arts graduates, in health programs. Shriver anticipated a “multiplier effect.” One Peace Corps Volunteer doctor could supervise teams of PCVS and HCN to enhance efforts in  health education and disease prevention.

2) Shriver looked at the resources he already had and saw a way to get this “multiplier effect.” The original Peace Corps Act of 1961 had established a provision for Peace Corps Volunteer Leaders, or PCVLs.Peace Corps was authorized to provide funding to allow such PCVLs to bring their families with them. Shriver proposed that doctors could serve as PCVLs in the field and Peace Corps would provide living allowances, transportation costs and health care for their wives and children.

3) Finally, Shriver proposed that doctors who were Public Health Service Commissioned officers could fulfill their two-year military service obligation by serving as Peace Corps Volunteer Leaders.  Such a provision would require approval of the Selective Service Commission and perhaps Congress.

In 1963, Peace Corps had 100 physicians serving as either Volunteers or staff.  Shriver wanted to double that number immediately, with an ultimate goal of 500 physicians serving two years. Peace Corps Response/Global Health goal is for 36 medical education instructors serving for one year.

So what happened to Shriver’s plan? I don’t know. I don’t even know what happened to the Peace Corps National Advisory Council. The digital library does not have records of what happened nor have I ever seen any follow up in the public records I have been able to see. I will speculate, however, that  what happened was Vietnam.

Shriver gave his speech a few months after the Gulf of Tonkin Incident. At the time, he was already serving part-time as Director of the “War on Poverty” and part-time as Director of the Peace Corps. He may have learned that winter that President Johnson might be preparing for war. In June of 1965, major legislation was passed establishing the unique Peace Corps personnel system with its “In, Up, and Out” principle. But, there was no mention of special provisions for Peace Corps Volunteer Doctors. Later that summer, President Johnson issued an order to call up 500,000 men to serve in Vietnam. Doctors were needed for war, not peace.