Progress through  CooperationThe Rockefeller Foundation and International Health          Soma Hewa           © 2004
History Through the Camera LensThe following slide show presents two contrasting stories                in the history of ...
A Group of Workers in India        Waiting to Leave for Sri LankaWhen the British established the plantation economy in Sr...
Sri LankaAn Island Nation, South of India                         Workers came by                         boats to the    ...
Migrant Workers on a Tea Estate          in Sri LankaEntire families worked on the plantations, and childrenstarted workin...
Typical Living Quarters (Lines) of theMigrant Workers on the Tea Plantations The workers lived in barrack-like “lines,” an...
A Bird’s Eye View of a LineThere were no windows in the rooms and the verandahswere boarded up to keep out the drenching m...
A Tea FactoryA tea factory built with solid materials with large windowson the hill side of central Sri Lanka.
Several Families of Migrant Workers        in Front of the Lines                  • Note the muddy                    surr...
Hookworm Infection• Hookworms are tiny parasites about one-half of an inch in  length. Although parasitic in the bowel, th...
A Severely Infected Woman     on a Tea Estate                        This 20 year                        old woman        ...
Severely Infected Children     on a Tea Estate                      These two young                      children are at  ...
Deaths from Hookworm Disease  Island Wide vs. PlantationsDeaths Per Million      5000      4500                        Isl...
The Rockefeller Foundation                Men of VisionJohn D. Rockefeller, Sr.           Frederick T. Gates              ...
The International Health Board (IHB) “Henceforth, Thy Field is the World”• In the early 20th century, John D. Rockefeller,...
Rockefeller Philanthropy              in Sri Lanka• The IHB began its hookworm control campaign in Sri  Lanka in 1915.• Th...
A Latrine Constructed During Hookworm      Campaign on a Tea PlantationLatrines constructed with temporary materials laste...
Latrines Built During TreatmentAnother example of latrines built with jute bagging and junglesticks in a tea estate. The t...
Re-Infection of Hookworm     Because of the Lack of Proper LatrinesRate of Re-Infection        100         90             ...
The IHB in Towns and Villages:A Hookworm Demonstration Office                • Educational campaigns to                  p...
Communities Supported the IHB       A Group of Village HeadmenThese men received certificates of merit for their role in h...
Kalutara Health Unit Office, 1926Encouraged by the local support, the Rockefeller Foundationestablished a community-based ...
Dr. S. F. Chellappah         Dr. W. P. JacocksAuthors of the Health Unit Program in Sri Lanka
Local and Foreign Doctors       Involved in the Health Units Program                                                      ...
Mothers and Children Attending a Clinic     at the Kalutara Health UnitHealth Unit activities included the collection of v...
The Malaria Control CampaignOne of the major programs sponsored by the RockefellerFoundation was malaria control work. Mal...
From a Community Project to a                National InstituteThe Kalutara Health Unit was expanded in the 1960s with mod...
National Institute of Health Sciences               (NIHS)Today, the NIHS is the premier training center of public health ...
ACKNOWLEDGEMENTS                                     Photographs and other archival materials courtesy of:          The R...
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International Health and Philanthropy in Sri Lanka

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The following slide show presents two contrasting stories in the history of Sri Lanka:

1) The impact of the British colonial labor practices on the health of South Indian migrant workers on the plantations, and the people of Sri Lanka in general.

2) The role of Rockefeller philanthropy in the development of public health in Sri Lanka during the first half of the 20th century.

Published in: Travel, Health & Medicine
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  • These two issues are presented as historical perspectives of globalization. While colonial economic activity integrated the local economies with the global market, it caused ecological imbalance, exchanged diseases and created widespread poverty. Rockefeller philanthropy responded to these social malaise by extending locally developed science, technology and expertise to the global community.
  • In addition, it provides community health services, medical care services, and undertakes basic research.
  • International Health and Philanthropy in Sri Lanka

    1. 1. Progress through CooperationThe Rockefeller Foundation and International Health Soma Hewa © 2004
    2. 2. History Through the Camera LensThe following slide show presents two contrasting stories in the history of Sri Lanka: • The impact of the British colonial labor practices on the health of South Indian migrant workers on the plantations, and the people of Sri Lanka in general. • The role of Rockefeller philanthropy in the development of public health in Sri Lanka during the first half of the 20th century.
    3. 3. A Group of Workers in India Waiting to Leave for Sri LankaWhen the British established the plantation economy in Sri Lanka inthe late 19th century, they recruited labor from Southern India. By thelate 19th century, about 100,000 workers plus their families arrivedannually in Sri Lanka.
    4. 4. Sri LankaAn Island Nation, South of India Workers came by boats to the northwest coast of Sri Lanka; from there, they walked for about two weeks to the plantations in the central part of the island.
    5. 5. Migrant Workers on a Tea Estate in Sri LankaEntire families worked on the plantations, and childrenstarted working as early as six years of age. Because of theeconomic interests of the planters and the abundance ofcheap labor in India, planters were reluctant to provideeven the most basic facilities for these workers on theplantations.
    6. 6. Typical Living Quarters (Lines) of theMigrant Workers on the Tea Plantations The workers lived in barrack-like “lines,” and as many as 12 people lived in a room 8 by 10 feet. The most unhealthy aspect of these living conditions was that the lines were not provided with latrines. The planters maintained that the “workers would not use them” even if they were built.
    7. 7. A Bird’s Eye View of a LineThere were no windows in the rooms and the verandahswere boarded up to keep out the drenching monsoonrains, a practice that also kept out much needed light.
    8. 8. A Tea FactoryA tea factory built with solid materials with large windowson the hill side of central Sri Lanka.
    9. 9. Several Families of Migrant Workers in Front of the Lines • Note the muddy surroundings in which the barefoot children were playing. • Without adequate sanitary facilities, the workers and their families encountered a wide range of parasitic and infectious diseases. • Of these diseases, hookworm infection (Anchylostomiasis) was the most widespread on the plantations.
    10. 10. Hookworm Infection• Hookworms are tiny parasites about one-half of an inch in length. Although parasitic in the bowel, the worms enter the human body through the pores of the skin when they come in contact with soil polluted by human excreta.• Victims of hookworm infection suffer from under-nutrition, anemia, and lassitude. Drained of blood, they are too weak to resist new infections, which usually cause their death.• By the late 19th century, hookworm infection was a common health problem in many of the British colonies. The hookworm disease was endemic in the darkened regions of the map.
    11. 11. A Severely Infected Woman on a Tea Estate This 20 year old woman is at the last stage of the disease showing considerable swelling of her entire body.
    12. 12. Severely Infected Children on a Tea Estate These two young children are at the last stages of the disease. First, the victims become severely swollen and then they become emaciated and die.
    13. 13. Deaths from Hookworm Disease Island Wide vs. PlantationsDeaths Per Million 5000 4500 Island 4000 3500 Plantations 3000 2500 2000 1500 1000 500 0 1900 1905 1907 1909 1911 1913 1915 Year
    14. 14. The Rockefeller Foundation Men of VisionJohn D. Rockefeller, Sr. Frederick T. Gates Wickliffe Rose“Disease is the supreme ill of human life, and it is the main source of almost allother human ills – poverty, crime, ignorance, vice, inefficiency, hereditary taints,and many other evils.” Gates, 1912
    15. 15. The International Health Board (IHB) “Henceforth, Thy Field is the World”• In the early 20th century, John D. Rockefeller, Sr. became interested in hookworm disease when it was a major health problem in the American South.• Rockefeller and his advisor, Fredrick T. Gates, devised a plan to address the problem with a $1 million contribution.• The experience in the American South encouraged them to extend the work to other countries, and the IHB was born.• Wickliffe Rose, secretary of the IHB, developed a plan to take the hookworm campaign to the British colonies, where the disease was rampant.
    16. 16. Rockefeller Philanthropy in Sri Lanka• The IHB began its hookworm control campaign in Sri Lanka in 1915.• The planters and the Colonial government initially opposed American involvement in the Island, but later conceded when they were shown the economic benefits of a healthy labor force.• The Rockefeller doctors carried out treatments on the plantations and insisted that the planters should build adequate sanitary facilities for the workers in order to prevent re-infections.• The planters showed very little enthusiasm for the project as shown in the shoddy construction of latrines.
    17. 17. A Latrine Constructed During Hookworm Campaign on a Tea PlantationLatrines constructed with temporary materials lasted only a fewweeks resulting in recurring soil pollution and re-infestation withhookworms.
    18. 18. Latrines Built During TreatmentAnother example of latrines built with jute bagging and junglesticks in a tea estate. The tea factory is seen behind the latrines.
    19. 19. Re-Infection of Hookworm Because of the Lack of Proper LatrinesRate of Re-Infection 100 90 Because of the high 80 rate of re-infection due to the lack of 70 cooperation on the 60 part of the planters, 50 the IHB withdrew 40 from the plantations in 1922, and began its 30 work in the 20 surrounding villages 10 and towns. 0 3 Months After 4 Months After 7 Months After 20 Months After Treatment Treatment Treatment Treatment
    20. 20. The IHB in Towns and Villages:A Hookworm Demonstration Office • Educational campaigns to prevent hookworm infection relied on demonstrations, public lectures and films. • Local support was the key to successful public health campaigns in towns and villages.
    21. 21. Communities Supported the IHB A Group of Village HeadmenThese men received certificates of merit for their role in hookworm treatment programs in their communities.
    22. 22. Kalutara Health Unit Office, 1926Encouraged by the local support, the Rockefeller Foundationestablished a community-based primary care program knownas Health Units. The first health unit, established in 1926 atKalutara, provided training for public health personnel forthe RF’s programs in South and South-East Asia.
    23. 23. Dr. S. F. Chellappah Dr. W. P. JacocksAuthors of the Health Unit Program in Sri Lanka
    24. 24. Local and Foreign Doctors Involved in the Health Units Program Standing:Sitting: Dr. de Simon,Dr. Kuriyan, Dr. Jayatilleke,Dr. Sweet, Dr. Fernanado.Dr. Docherty,Dr. Gottlieb, andDr. Jayaram. The Health Units program was developed by Sri Lankan and Rockefeller doctors in view of local health needs. It received broad public support, and was later introduced to other countries in the region.
    25. 25. Mothers and Children Attending a Clinic at the Kalutara Health UnitHealth Unit activities included the collection of vital statistics,health education, control of communicable diseases, immunizationof children, hookworm treatment, malaria control, school hygiene,maternal and child welfare, and a range of public sanitation servicesin local communities.
    26. 26. The Malaria Control CampaignOne of the major programs sponsored by the RockefellerFoundation was malaria control work. Malaria was a scourgein Sri Lanka during the early 20th century.
    27. 27. From a Community Project to a National InstituteThe Kalutara Health Unit was expanded in the 1960s with modernfacilities creating the National Institute of Health Sciences (NIHS)
    28. 28. National Institute of Health Sciences (NIHS)Today, the NIHS is the premier training center of public health personnel for Sri Lanka’s primary health care services. Community Health Services Training Research Medical Services
    29. 29. ACKNOWLEDGEMENTS  Photographs and other archival materials courtesy of: The Rockefeller Archive Center, New York National Institute of Health Sciences, Sri Lanka  Background research materials: Soma HewaColonialism, Tropical Disease and Imperial Medicine: Rockefeller Philanthropy in Sri Lanka University Press of America 1995  Written and Produced by: Soma Hewa Audio Visual Design Elizabeth Moravec Hewa

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