From Hookworm Disease Control to Public Health Education: The Shift of Public Health Practice in China by the Rockefeller Foundation

Since 1913, the Rockefeller Foundation (RF) had begun to carry out extensive public health activities, such as hookworm disease control, around the world. This included the hookworm disease control project launched at Pinghsiang Colliery (Pingxiang Meikuang 萍乡煤矿) in China in 1917. Strangely enough, however, after only two years, this project in China was cancelled, and instead a new course on public health was taken through teaching at the Peking Union Medical College (PUMC, Beijing Xiehe Yixueyuan 北京协和医学院). This article argues that there was a causal relationship between these two seemingly separate practices, and attempts to figure out how this shift could happen. By detailing and analyzing relevant source materials preserved at the Rockefeller Archive Center, this paper points out that three conditions underlie the shift in public health practice in China. First, the hookworm disease project in China had provided the leading practitioner, John B. Grant, a good opportunity to gain a better understanding of China's social and cultural conditions, which allowed him to form and present a reform plan; second, the RF adopted a special deployment method for its work in China. Two subsidiaries were launched, the International Health Board (IHB) taking care of public health practice, and the China Medical Board (CMB), committed to the development of medical education, providing a great deal of support to Grant; third, among the different parties of the RF (i.e. CMB, IHB, and Grant), although their original intentions and working philosophies were diverse, they each managed to keep in line with their own standpoints when implementing the new practices, and, based on this, consensus was reached. Although it seems that the IHB made a significant compromise during this process, this paper argues that the shift did not change its fundamental goal, that was to build connections with government authorities through public health practice. As for the IHB, the new practices could also help it to fulfill its aims. Through public health education and cultivating talent, crucial connections could be built, based on which the IHB hoped a centralized health agency in China could eventually be established. Therefore, this paper reveals the complexity and specificity of the process of localization, and the uniqueness of the RF's public health practice in China as compared with other countries in which it worked.