“Volunteer and Former Volunteer Future Health Care Issues”

 

by Bill Josephson (PC/Washington 1961-66)

The adequacy of health care for Peace Corps volunteers and former Peace Corps volunteers who have service connected health issues seems to be a recurrent and unresolved problem.  The following thoughts are based on memories from 1961 to 1966, and I’ve made no effort to fact check those memories.

Bill Josephson

The early Peace Corps was fortunate in respect of its healthcare staff because Selective Service still existed, and as the Vietnam War began in 1965, Selective Service became an even more important source of physicians.

A plan that I recall as the “Berry Plan” enabled physicians to meet their Selective Service obligations through public health and similar medical assignments in the public interest.

This meant that the early Peace Corps was virtually assured of the availability of high-quality medical staff both overseas and in Washington.

Moreover, the first Peace Corps medical director, whom I recall as Lee J. (Leo) Gehrig, was an especially talented and dedicated physician.  In 1966, Lee became Deputy Surgeon General of the Commissioned Corps of the United States Public Health Service (Corps).

John Coyne in an email to me confirms that when he was a Peace Corps volunteer in Ethiopia in the early 60s and when he was on staff later, the Peace Corps had four Public Health Service physicians.  It also had access to the physicians at the American Army base in Asmara.  His any my recollections are that volunteers with major medical problems would be flown to a military hospital in Germany at or near the Air Force base in Wiesbaden.

Service as a Peace Corps physician overseas could still offer opportunities for physicians who are interested in tropical medicine and in infectious or other diseases that might be prevalent in countries to which Peace Corps volunteers are assigned.

Could the Peace Corps establish relationships with the Center for Disease Control and medical schools that have specialties in tropical medicine, infectious diseases and other diseases that might be prevalent in countries to which volunteers are assigned?  Certainly, the 2021 Peace Corps should make a serious effort to do so.

If established, such relationships could insure the availability to the Peace Corps of highly qualified physicians interested in temporary duty overseas with Peace Corps volunteers and high quality supervision and medical evacuation services in Peace Corps Washington.  The close relationships the early Peace Corps had with the medical and medical evacuation resources of the Defense Department could and should be re-established.

William Josephson is a retired partner of Fried, Frank, Harris, Shriver & Jacobson LLP. He is the senior advisor for the Sargent Shriver Peace Institute and a long-time partner, friend, and colleague of Sargent Shriver. In late 1960, with a State Department colleague, Warren W. Wiggins, Mr. Josephson co-authored The Towering Task. Josephson worked at the Peace Corps until 1966, holding positions as Special Assistant to the Director and then the General Counsel.

 

4 Comments

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  • Thank you for the excellent article, Bill. My experience with PC Medical staff in Ethiopia from 1964-1966 could not have been better. We had four top-flight young MDs taking care of PCVs and staff and their families. I’m not sure I ever had better and more attentive health care anywhere else during my long life. All of our PC/Ethiopia docs (Clark, Torrey, Mayer, Bickell) went on to distinguished careers in their post-PC days. Let’s recapture that magic if we can.

  • Good points! There are many untapped synergies here.

    I was a PCV TB worker in South Korea, 1980-1981. When I had my first physical in the Foreign Service, I had a positive skin test. I was prescribed a year on INH, and thankfully, that was the end of the issue. I believe State directed my treatment and paid for the medication, which was very inexpensive.

    In the Foreign Service, I had several occasions to meet PCVs with medical credentials. In each case, neither the host country nor PC Washington would allow them to practice, due to certification and liability. One PCV in Togo was an MD, and one night he described his heartbreak at how horrible and misguided, from an MD’s perspective, “healthcare” was at the rural clinic where he worked.

    When I was in Ethiopia as PC country director, the minister of health, Tedros(now head of WHO), expressed his frustration that, over the many years he had observed PC health programs and PCVs, the medical needs of the country were not being served. He wanted trained American health professionals to train med students and their Ethiopian counterparts in positions where certification and liability were not issues. The now discontinued program PC was developing with a US NGO seemed to be headed in this direction, but ran aground in the three countries where the program had its trial run.

  • Bill and John are correct, as usual.
    (A) Dr. David G. Miller in 1961 joined the Peace Corps staff from the US Public Health Service’s Epidemic Intelligence Service. Based in Dacca, then East Pakistan now Bangladesh, he first arranged medical care for my team (Pakistan 1). Second, as Regional Medical Director for South Asia, he travelled to West Pakistan, India, Sri Lanka, and Afghanistan to make medical surveys of areas requesting new Peace Corps Volunteers. Third, as groups of new PCVs arrived in Pakistan and India, he briefed them about maintaining their health and using medical facilities.
    (B) When one of my teammates sustained head injuries in a traffic accident, Dr. Miller and I and Deputy PC Rep Paul Slawson were luckily on hand in Dacca. The next day, Dr. Miller escorted the Volunteer to the U.S. Army Hospital near Frankfurt, Germany. After recovering, the PCV returned to duty to complete his service in East Pakistan.
    After his USPHS/Peace Corps service, Dr. Miller dedicated his career to starting and leading one of America’s first Community Health Centers, the Hough-Norwood Family Health Care Center, caring for hitherto-underserved poor citizens of Cleveland, Ohio.

  • My mother’s oldest brother was Dr. Leo J. Gehrig (1918-2010), a thoracic surgeon and first medical director of the Peace Corps as Mr. Josephson said. A commissioned USPHS officer from 1945 to 1970, he was later Deputy Surgeon General under William Stewart from 1965 to 1970. After that he was Washington director of the AHA until 1980 when he retired. Uncle Lee lived in DC from ’57 until about 2009 when he and his wife, Marilyn moved back to his native Minnesota. I lived in DC from ’64 to ’74 and often saw “Uncle Lee”, who was also a lifelong student, master tinkerer and ham radio operator. If you have newspapers.com or such, there are some interesting articles about his service with the Peace Corps and USPHS (and some wonderful interview statements by him), starting with his service in the Alaska Territory in 1946 fighting TB there. Per his obituary in the Minneapolis newspaper, “In a 1990 interview for the Lyndon B. Johnson Library’s oral history archives, Gehrig fondly recalled the Peace Corps, and the young volunteers who shared his idealism and drive to make the world a better, healthier place.

    “I had a period of my life, of two years, that I have looked back upon as some of the most rewarding time that I’ve spent,” he said. “And one of the times in life where it seemed that everything you touched had enthusiasm, and the quality of the people, and the volunteers, were absolutely fabulous.”

    I would be happy to hear from anyone who has any reminiscences of my uncle or photo scans they are willing to share.

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