World Health

MR. HERMANT: Members and Guests of The Empire Club of Canada: We are to hear an address today by Major-General G. Brock Chisholm, M.D., C.B.E., M.C., E.D., Student, Author, Educator, Physician, Soldier and Administrator. General Chisholm was born and received his early education in Oakville, Ontario. He graduated in Medicine from the University of Toronto; did Post Graduate work in London, England; and then was a Member of the Staff of the Institute of Human Relations at Yale University. He later practised psychological medicine in Toronto. Having volunteered for Active Service at the age of 18 in the First World War Dr. Chisholm has retained his active association with the Army and, during World War II, he became an area Commandant then, in succession, Director of Personnel Selection, Deputy Adjutant-General with the rank of Major-General, and Director-General of Medical Services. At the end of the War he was appointed Deputy Minister of Health, and is now Director-General of the United Nations World Health Organization with headquarters at Geneva, Switzerland This is truly a distinguished career of Service to Canada, the Empire, and the Cause of Free Men everywhere. Major-General G. Brock Chisholm will now address this meeting of The Empire Club of Canada on "World Health".

GENERAL CHISHOLM: First, may I thank you very sincerely for this opportunity to speak to you on a subject which is very important.

Then may I apologize for failing to appear the last time I was scheduled to speak to this Club. Circumstances beyond my control prevented my being here; instead I was in a railroad wreck, and I am eternally grateful to Dr. Blatz for having pinch-hit and for doing such an excellent job on such short notice.

World health is such a great problem, with so many facets and so many things to talk about, that it is impossible for me to give you a complete picture. I would not presume to give you statistics about world health. Most of those published about the incidence of diseases have been made up in somebody's office, and they have relatively little relationship with the facts of life in the country concerned. This is so simply because there is not enough organization in most countries to know even what the population of the country is, let alone the number of diseases amongst millions of peoples where doctors hardly exist at all, nor any qualified people to diagnose the diseases.

The concept of health of course is changing greatly, has changed over past generations and continues to change. At one time health was an individual matter. It was of concern to persons themselves and their own families, and generally speaking ill-health was regarded as the result of offending one or other of the gods, or it was ascribed to the machinations of devils of various kinds.

The treatment in those days consisted in propitiation of those gods or devils, but gradually more intelligent methods developed in many parts of the world, and health was recognized as having some relationship to the environment.

International health has quite a long history. For some hundreds of years arrangements have been in effect between countries to prevent the exportation or importation of epidemics. The latest step in this long progress is represented by the World Health Organization.

The World Health Organization is one of the Specialized Agencies of the United Nations. There is a good deal of misconception about the status of the specialized agencies. They are numerous, they range over most of the fields of responsibility between countries. Besides W.H.O. there are UNESCO, (United Nations Educational, Scientific and Cultural Organization), FAO (the Food and Agriculture organization) the International Trade Organization, (which is still in an interim commission stage) the International Labor Organization, the International Monetary Fund, The World Bank, the Universal Postal Union, and the International Telecommunications Union. This list shows the diversity of activities crossing international boundaries, and the areas in which the countries of the world are co-operating with each other to get things done for the welfare of the peoples of the world.

The United Nations itself represents the latest step in the social development of the world. At this stage the United Nations is still only a hope. It has not yet fulfilled, nor is it in any position to fulfill, its destiny at the present time. The constitution of the United Nations, and those of the Specialized Agencies, are founded on the hope that there may be found in the world, in enough places and soon enough a sufficient number of mature civilized people who are capable of living as world citizens and of carrying the responsibilities there set out. Those responsibilities are not easy, they are very heavy, and they are not yet by any means implemented; but they do raise a very real hope for the human race.

The human race at this stage of its development needs hope, because it has become necessary to recognize that the old behaviour patterns of our ancestors are no longer good enough. The methods by which the race has reached its present stage of development will not serve in the future. Warfare, ruthless competition, has been common in the past. Warfare has been one of the most consistent behaviour patterns of the human race through all recorded history. The time has come when the human race can no longer afford, in self-interest, to behave in those ways.

But this is a very difficult problem. It is not enough for small groups of people here and there to say "the time has come when we do not propose to fight anybody any more." If all groups had come out of what we may call roughly the "Middle Ages", at the same time and in the same direction, we would all be at the same level. But that is not true. At the present time we have large numbers of people who are only just beginning to come out of the Middle Ages; socially and economically they are still back where our ancestors were a long while ago. This is recognized by some of them themselves. For instance, some time ago a Russian, in speaking to me about our difficulties of understanding each other, said he believed that the main trouble was that our values were so different. He said, "The importance you attach to what you call the sanctity of human life does not impress us at all at this stage of our development, but I must remind you, you have been impressed with it only recently. You should see things in their proper perspective: you should remember that many of the great fortunes in the United States and in England were founded on the slave trade." He said, "It is only a hundred years since you were using hundreds of children as chimney-sweeps in London. They all died after a few months and you thought nothing of it." He said, "At that time you were already 600 years beyond your Magna Charta. We are not yet 40 years beyond ours."

This is a fact, and an important fact. That does not mean that we find the methods of some of the peoples in the world any more tolerable to our Western ideas, but it is helpful to recognize the great differences in the stage of development of many of the peoples in the world.

Another Russian said something to me which has important implications. He said, "You know, Dr. Chisholm, you people in the West would also have trouble if you had to live intimately with your own great grandparents." We must recognize that millions of people with whom we have to live intimately, were the sons and daughters of, or were themselves, slaves who could be beaten to death or sold. It is not to be expected that these people can develop over ten generations or so within a few years.

That does not make it much easier for us to be tolerant about their attitudes and practices. Their ideals are often admirable, but we find it difficult to tolerate their methods and practices. We should remember though that our ancestors even as late as Cromwell, would not have found those practices and methods intolerable, but only natural.

This poses a tremendous problem in the world, but there are relieving features. It is well to remind ourselves that even our own ancestors, except by mistake, never took on anyone that was too strong. They only took on the weak people who could be taken over and controlled. That is the pattern, it has always been the pattern of aggressors: they have to believe that they can win, that they can gain something. In times past it was possible to win and to gain, but that time has gone.

At one time warfare could be quite a pleasant occupation, it was pleasant to raid across borders and collect a lot of women and treasure and bring them home, but no longer. In the future no one wins a war. It is true, there are degrees of loss, but no one wins. And that is far truer in the future than it has been in the past. Modern methods of warfare not yet used are so potent that very large populations can be killed very quickly; and there is a certain degree of security in that fact. Very many generals now recognize that they can not win a major war. Nobody can win but an attempted war of aggression can be very expensive and futile.

The time has come when the peoples of the world need to re-examine the whole picture of how to stay alive. But the methods of staying alive for the human race, the methods of survival, need to change drastically.

In a short while the human race has gone a long way, they have been able to defeat other animals and forms of life. They defeated the big animals a long time ago. The medium sized animals are pretty well under control.

Rabbits are still a pest in some parts of the world, and rats can kill many hundreds of thousands of people, but they do not form a real threat to the survival of man. Even the little animals, the bacteria, have been brought pretty well under control, and those that are not under control at the present time are not under control, not because of deficiency of knowledge but deficiencies in man's social development. For instance, such diseases as smallpox, diphtheria, venereal diseases, malaria, and many other diseases, are quite capable of being controlled completely at the present time as soon as man is willing to invest the time and money that will be necessary to control those diseases. That does not mean to say that any one of them is permanently defeated; none of them is ever totally defeated, but for instance it should be a disgrace to any family or community if anyone should die of smallpox or diphtheria. It is not necessary at all. But this is only true as long as man continues to man his defences, to do the things necessary to prevent epidemics.

Internationally something can do done, but it has to come first from national effort. In many parts of the world, nations are beginning to recognize their international and world-wide responsibility for control of diseases.

A country like Canada of course has relatively few health problems as compared with the masses of the world's population. No one in Canada has lived many years without ever having enough to eat whereas in many parts of the world hundreds of millions have never had the experience of having a full belly. Many millions of people have known nothing but hunger from birth on.

The people in Canada hardly know how fortunate they are, and it is not particularly to the credit of the people in Canada to have happened to be born here, as many of us were, but it is an extremely fortunate country. That fortune can not be exploited indefinitely without greatly increased concern for the welfare of other peoples. It is essential that the peoples of the fortunate countries carry a greater load for the less fortunate who can not carry loads for themselves.

This has become a very little world. At the present time hundreds of millions of people are beginning to have a fair idea of the way other people are living. They did not know about these things before, but now there are many people in the world who have nothing, who begin to realize that there are other people in the world who have a great deal, and there is a rising tide of emotional tension as a result. For self-preservation it becomes essential that the "have" nations and the "have people" should begin to carry far more responsibility for the wellbeing of the peoples of the world. Whenever there are enough mature people in the world, this will happen, but our education in the past, generally speaking, has not carried us beyond the local level. Until quite recently, patriotism at a national level was regarded as the highest social development, loyalty to the welfare of one group of people within national boundaries was regarded as the ultimate, and in some places in the world the internationalist was regarded as a contamination.

The time has come when the world must have, for the survival of the human race, large numbers of people capable of functioning as world citizens, equally concerned for the well-being of all the people in the world, quite independent of their colour, race, ideology or religion. This has become a very little world and it is impossible in the future for small groups to feed on and exploit large groups of people.

The United Nations has set a high standard, but not higher than is necessary for the self-preservation of the peoples. The nations of the world have begun to recognize where their security lies. It is clearly seen in the field of working together rather than in ruthless competition.

One of the examples of this is seen in the first statement in the constitution of the World Health Organization. There is there set out a definition of the word Health. 75 nations have now signed this constitution and ratified their signatures. Health is defined there as a "state of complete physical, mental and social well-being, not merely the absence of disease or infirmity." The breadth of this definition is highly significant. It means that the nations of the world have recognized officially the responsibility incumbent on each individual for being a citizen, not just getting along for himself but being able to live advantageously to the world.

There is another statement in that constitution that is of great importance. It says, "The healthy development of children--and of course healthy meaning physically, mentally and socially--is of basic importance. The ability to live harmoniously in a changing total environment is essential to that development." This again is a clear recognition of a drastically changed world, which will continue to change, and it indicates an acceptance of the fact that the old patterns, almost hereditary in their rigidity, are no longer valid.

That is not to say that everything in the past should be discarded. That would be ridiculous of course. It is not to say that many of the principles on which we were brought up should be discarded, but it is clear that no one can be the judge of what should be discarded except this generation, which is living in a new kind of world, and a new kind of world where the old patterns will no longer guarantee the survival of the race.

We have to look to our education, we have to consider what steps should be taken to see that the country in which we may live is contributing its part to the peace of the world. And that means, at the present time, putting armed forces at the disposal of the United Nations. It means corporate strength to prevent aggressions, but it also means helping the next generation to be better citizens than we have been, to be capable of assimilating and being assimilated to a degree to which we have not been capable: to be able to live with kinds of people with whom we have not been able to live peacefully, to recognize that there are hundreds of millions of people in the world with ways of life very different from those which are honoured by us, and that there is something to be learned from all of them. It is true that in each country we find a way of life which the people in that country like, and in many parts of the world we find peoples thinking their way of life represents the ultimate and the highest and best, and that if everyone would adopt this way of life, everything would be very pleasant--which is a nice idea, but it is not true. In the first place, it is utterly impossible, for instance, for the peasant in China, or for the poor agriculturist in India, to adopt a Canadian way of life. How would he go about it? Somewhere, some day, it may be that a common way of life for all the people of the world may be discovered, but that time is not soon.

At the present time there are many experiments in living going on in the world. Most of these experiments have their good points, and most of them have their unfortunate aspects. They all suffer from misinterpretation in other countries, just as life in this Western country suffers from misinterpretation in the Eastern European countries, so life in the East suffers from misinterpretation in the West.

For instance, the picture that is commonly seen, say, of the United States in Czechoslovakia, comes primarily from the American movies. These are largely gangster movies--there are a certain amount of Wild West movies and musical comedies. The people who have not yet developed a broad civilization are naive, and there are many millions of people in the world who believe honestly that the people in the United States cower in doorways to avoid flying bullets. That is what is shown them in the movies, and it is reinforced by newspaper headlines of race riots, gang warfare, of arsenals of machine guns, negroes being tortured and burned. And this is the picture that arises in the minds of many people when anyone refers to the American way of life.

On the other side, in Czechoslovakia not very long ago I asked several Czechs what they meant by Democracy, and they said Democracy was exemplified by their government in Czechoslovakia. I said, "Why do you say you have democracy and other people have not?" Then they explained to me why, and the word means something quite different there from what it means in the Western countries. To them in a Democracy no one inherits any control over anyone else. There may be an absolute dictatorship, but if the dictator came from the people and did not inherit his power, then it is a democratic process.

If a few million people use a word to mean one thing, that is what it means. There is no good in arguing as to what democracy actually means, because it means different things to different people. I asked a lot of these people whether they did not think it would be more democratic if they had more than one political party. They were horrified. They said: "Dr. Chisholm, you would again give power to the aristocracy!" I said, "Not necessarily, but there could be more than one party among the people themselves." Their reaction was, "you would divide the people against themselves, so that the aristocracy would again get power."

In every country, they do not primarily compare their present situation with the situation of other people in other countries. They compare their situation with the situation of their parents and grand-parents, and from their point of view they are much better off than were their parents and grandparents.

I said to several Czechs: "What about purges?" and they said, "What purges?" I said, "People were shot or locked up." "Oh", they said, "that was in Prague. They have always been doing that in Prague, nobody pays any attention to that." From the people I was talking with, I got the same reaction that I would have got from a New Englander to a lynching in the Southern United States.

This is only an indication of the necessity on our part to develop a degree of understanding and tolerance for other patterns of living. In the meantime it is desirable that our strength be sufficient, and not only in the West, it is desirable also that the Eastern countries remain strong enough to be able to resist aggression--because the history of our own peoples back in the past is not encouraging to those people to lower their barriers. It is only very recently indeed that many peoples in the West have said, "Now we have everything we want, and we are not going to be aggressors any more," but the others have not forgotten yet by any means. Still people, politicians, get up and say, "We should attack the Russians now, we should not wait five years." A perfectly ridiculous thing to say, and damaging to an extent unbelievable. I have repeatedly had people in Eastern Europe pull out of their pockets a clipping, which says, "Senator So and So advocates an immediate attack," and I have had peoples in Eastern Europe say, to me, "When is the West going to attack?" And when I say, "They are not going to attack at all, they are only frightened of you people in the East", they don't believe it, because they are so impressed with the potency of the West, that they simply can not understand the feeling in the West that there has been.

At this stage of the development of the human race it is quite true that the human being has not yet learned generally to live peacefully together. When that time will come we don't yet know. In the meantime it is quite apparent that the proper solution is the centralization of certain controls.

I would like to read to you a quotation from a speech by Dr. H. G. Baynes, in London, speaking to a group there some time ago

"The whole future of civilization depends on one single eventuality: namely, whether the conception of the sovereign state is to be absolute or relative. If certain nations cling to the heroic absolute, and refuse in the last resort to submit their national claims to a super-national tribunal, then it means the collapse of civilization. But if the approach of suicide quickens a response that can shake the world to its foundations, it is possible that the idea of a super-national symbol of authority, whom all must obey, will bind the nations together, not from choice but from necessity."

This idea of centralization of responsibility with a certain degree of reservation is not new. It has been done in Canada, it has been done in the United States; it has been done in the British Empire, and many other places. Groups of people, large groups of people, have turned over to themselves, in co-operation with other people, certain aspects of their autonomy and their responsibilities. The time for the next step in that direction is approaching rapidly. It will be necessary in the future for the human race in a corporate body to represent organized strength which will take responsibility for seeing that aggression between groups of people does not occur. Whenever enough people have reached that stage of maturity where they are equally concerned with the welfare of all people in the world, whenever the nations of the world can sink some of their individuality in that degree of co-operation, the time will have arrived when we can really come together to make it possible to hope that our children and grandchildren may survive.

VOTE OF THANKS, moved by Dr. W. E. Blatz, Professor of Child Psychology, University of Toronto.