Myron E. Wegman

A salute to the Pan American Health Organization.

On December 2, 1977, the Pan American Health Organization, the oldest of the international health agencies, celebrates its seventy-fifth anniversary. Limited at the outset in scope and activities, and correspondingly restricted in growth during the first part of this century, PAHO has had impressive expansion in importance and influence in the past three decades. Indeed, worldwide, as well as in the Western Hemisphere, the international health organizations, of all the specialized agencies under the umbrella of the United Nations or the Organization of American States, have shown the steadiest progress. Many observers, with considerable justification, attribute this as much to innate human desire for general understanding and mutuality of interest as to specific progress in health. It seems self-evident that international collaboration, so often frustrated in the political arena, is peculiarly suited to the universality implicit in a health agency. And one must remember that interaction of health and international trade constituted a key factor in the birth, at the tum of this century, of what was to become the Pan American Health Organization.

A tribute to Margaret G. Arnstein (1904-1972).

Margaret G. Arnstein, one of Americas most distinguished leaders of the nursing profession, died at her home in New Haven on October 8, 1972. At a memorial service on October 20, 1972, Myron E. Wegman, President of the American Public Health Association, paid her a personal tribute which we present below. This statement is preceded by a sketch of the salient aspects of her career. Margaret Arnstein was born in New York City, October 27, 1904, and was educated there. After receiving her B.A. from Smith in 1925, she attended the Presbyterian Hospital School ofNursing in New York, graduating in 1928. She then went on to advanced study in public health nursing, receiving an M.A. in Public Health Nursing from Teachers College, Columbia University in 1929, and an MPH from Johns Hopkins in 1934. During the period 1929-1934, Margaret Arnstein served on the staff of the Westchester County Hospital, then from 1934 to 1937 was a Consultant Nurse in the Communicable Disease Division of the New York State Department of Health. In 1937 she moved to the University of Minnesota as Associate Professor ofPublic Health Nursing and Director of the Nursing Course. At the end of three years she returned to the New York State Health Department as a District Consultant, but the entry of the United States into World War II was to give her an opportunity to apply her talents on a larger scale. During 1943-1945, on leave from her New York post, Margaret Arnstein served as Chief Nurse of the Balkan Mission of UNRRA, with headquarters in Cairo. During the war, she was also assigned to the U. S. Public Health Service to set up the first program of federal grants to schools of nursing, the precursor of the Cadet Nursing Program. Following the war, she joined the staff of the U. S. Public Health Service, where for twenty years, from 1946 to 1966, she held various positions. She was Assistant to the Chief, Division of Nursing until 1949 when she was promoted to Chief of the Division of Nursing Resources. In 1957 she was appointed Chief of Public Health Nursing, and in 1960 became Chief of the entire Division of Nursing. In 1966 Margaret Arnstein retired from the Public Health Service to become Professor ofPublic Health Nursing at the School ofPublic Health, University ofMichigan, where she remained for a year, moving to Yale University in 1967 to become Dean of the School of Nursing. She held this position until her retirement in 1971. Throughout her career Margaret Arnstein was active on many fronts. In 1956 she directed the first international seminar in nursing at Sevres, France, for the Florence Nightingale Foundation. In 1964-65, she participated in a Rockefeller Foundation-AID study of health manpower training requirements in developing countries. In addition, she was a consultant to the World Health Organization. Whatever she did was accomplished with verve, intelligence and devotion, and these accomplishments were recognized, as evidenced by the many honors and awards which she received. We may note specifically that in October 1971, she received the Sedgwick Memorial Medal, the highest award of the American Public Health Association. The memory I have ofPeg Arnstein when I first knew her thirty years ago is the memory I have today. In all those years she never lost the curiosity, the drive, the dedication, the capacity for understanding, the openness to new ideas, the ability to think and act boldly but above all, I remember her integrity and courage. It was these same characteristics, plus the loyalty and steadfastness of her friendship, that endeared her to people all over the world. How many times I have basked unashamedly in reflected glory while watching faces light up in Saskatoon, New Delhi, Rio de Janeiro, in all sorts of places when Pegs name would come up. As I listened to the eager questions about her, I had great pride just being able to claim her as a friend. The influence of her personality as a real ambassador and her contribution to so many countries as well as our own simply cannot be over-estimated. Her indefatigability was absolutely legendary to her friends. It seemed there never was a time when she wasnt ready on short notice for tennis, for the theatre, for just plain hard work and endless meetings. I remember so well long sessions at Executive Boards with Peg paying attention always, right up to the last minute, while supposedly strong men were wilting from fatigue. One of the things that hit me hardest and brought her illness really home to me was when she warned me that late night telephone calls didnt go anymore. Just last spring when my counterpart at Johns Hopkins asked me about approaching Peg to consider, since she was stepping down as Dean, coming to Johns Hopkins as Visiting Professor to take the place of a retired professor actually younger than Peg, it seemed to both of us a perfectly natural and reasonable proposal. As a matter of fict, even though Peg thought the idea a huge joke, she didnt quite say no right off the reel. I admit that I connived mightily to bring Peg Arnstein to Ann Arbor to head our Public Health Nursing Program. I wanted the best in the world and she was it. Actually, Ive never quite forgiven Yale for stealing her from Michigan, although deep down and in my saner moments I knew the move was right. But even in the short years she spent in Ann Arbor, she had a tremendous and lasting influence. Peg was honored in many ways, not enough by any manner of means but perhaps as good an illustration of her outlook and courage as one could ask for took place last year when unexpected hospitalization prevented her from coming to the University of Michigan to receive an honorary Doctor of Science degree. The University, breaking all precedent, offered to have me come to New Haven to present the degree to her here in a special ceremony but Peg would have nothing to do with it. She insisted that seeing her friends in Ann Arbor meant as much to her as the degree. And she did come to the next commencement last May and she did receive the degree and she looked perfectly beautiful. But what I like to remember most about her honors and about her were the words of our own Ira Hiscock when he presented Peg with the Sedgwick Medal just a year ago this month, as he turned to her saying, And Peg, this medal is all gold-just like you. Myron E. Wegman

Children in the Community. The St. Paul Experiment in Child Welfare

known, in the various nations and islands of the world and he philosophizes as to its cause. He suggests that the substitution in modern times of steel rollers for the stones of olden times used in milling wheat or other grains for flour may be the cause. Modern methods produce a refined product from which many of the ingredients of the whole grain flour, formerly present, have been removed with adverse effect upon the gastrointestinal tract and an increase in the incidence of appendicitis. He hypothesizes that modern diet may lack sufficient cellulose, be too fluid, and probably some necessary celluloselinked vitamin has been removed from it. This results in the much higher morbidity rates of appendicitis, a disease only recently becomesignificant. The book adds nothing to present American literature on the subject. .ALBERT G. BOWER

Postgraduate Education of Physicians in Pediatrics

ATTEMPTS to provide for postgraduate education of general practitioners have taken many directions. The physician in the city has available hospital clinics, lectures, and staff conferences. He usually has fairly frequent medical society meetings with speakers to cover the newest advances in the various branches of medicine. In addition he has the priceless boon of library facilities. The rural practitioner, on the other hand, unless he is particularly fortunate, has almost none of these opportunities. This deficiency has been recognized and measures have been taken to overcome it. One of the most successful has been the holding of so-called institutes where short intensive courses are given by men of ability. Such institutes, however, must be given at some central point and are intended to attract physicians from a large area. This, of course, entails the necessity of some of the men coming very long distances, and to get any real benefit from the course of lectures, they must remain away from their practices anywhere from a few days to 2 weeks. Such a course is often impracticable for many country practitioners. Although these