found that unless medical and basic education is taken to the African he will be for years deprived of scientific medical care because of transportation difficulties and tribal beliefs. MOBILE-REGIONAL APPROACH EMPLOYED BY AFRICAN RESEARCH FOUNDATION The foundation has made good progress in establishing the mobileregional approach to medicine in Africa. We are now affiliated with a number of fixed hospitals in east Africa. We have had one mobile clinic in the field; two are ready for shipment within the month and another under plans for construction. The foundation has a twinengine Piper Aztec plane in operation which is equipped to carry patients. Plans are now underway to improve communication facilities with all affiliated hospitals and to obtain our first mobile dispensary. The work of the foundation and the mobile concept have been strongly endorsed by African leaders. At this point I would like to request that letters from Julius K. Nyerere, of Tanganyika, and Tom Mboya, of Kenya, be included in the record illustrative of that point. Senator HUMPHREY. They will be included with your testimony. Mr. DANIELS. I would like to describe, if I may, the operation of our mobile clinics. These are vans equipped with examining and emergency operating equipment, laboratory facilities, an X-ray machine, and basic medicines and drugs. In addition to these medical facilities, the van is equipped with a public address system, a tape recorder, and a film projector for educational purposes, and carries its own generator to operate this equipment. An indication of the service which can be rendered by these units is illustrated by a visit of one mobile clinic to an area in Tanganyika. In a period of 9 days 1,129 individuals were examined and treated by a doctor. These examinations included 102 prenatal examinations and 116 gynecological examinations. Additionally, there were 801 laboratory examinations made. No count was made of the number of Africans who attended the educational programs, but they were considerably more than those who were medically treated. To further illustrate the work of the mobile clinics, I would like to have included in the record a letter which we have received from an African doctor, describing his experience. It is too long to read, Senator. it. Senator HUMPHREY. It will be printed in the record. We welcome MOBILE UNITS' STAFF ILLUSTRATIVE OF NEED FOR "MIDDLE MANPOWER" Mr. DANIELS. I think it will be of interest. I would now like to turn to the staff of the mobile units because I think that it illustrates the opportunities and the great need for middle manpower. In addition to a doctor the staff includes a nurse who organizes general examinations, maintains records, gives inoculations, and other such functions; a laboratory technician who categorizes and analyzes specimens and maintains records; an X-ray technician; a dresser who aids the doctor and nurse in bandaging, dressing, setting splints, sterilizing instruments, and so forth; a pub lic health teacher who lectures on child and maternal care, sanitation and cooking; a teacher in basic agriculture, home economics and English; and a driver-mechanic who drives and maintains the ve hicle and auxiliary equipment, such as the generator and the film and public address systems. It is readily apparent that these are positions which require technical skills. With the exception of the doctor, however, they do not require advanced professional training. What they do require is a basic educational background and familiarity with a technical civilization. It is exactly in this area that Africa lacks manpower. There are excellent medical schools in Africa, although all too few, and some African doctors have received training in Europe and the United States. But there is very little in between such people and the untrained, uneducated African. Accompanying each mobile unit are two Africans, who not only assist the work of the mobile clinic but receive basic medical training at the same time. It is our hope that eventually these units can be manned entirely by trained Africans. In the meantime, we feel an immediate medical and educational need is being fulfilled in the operation of these units by Americans. SUPPORT FOR PEACE CORPS We offer our experience as illustrative of the need and opportunity for the type of personnel which the Peace Corps is recruiting. In preliminary discussions with Peace Corps officials concerning the possibility of cooperating with them, we have been impressed not only by their dedication but by their careful examination and practical understanding of the task before them. In conclusion we strongly urge that the Peace Corps bill be favorably reported by this committee. We hope that our experience has been of some value to the committee and greatly appreciate the opportunity to present our views. Thank you. (The documents previously referred to follow :) RIRUTA CLINIC, Nairobi, Kenya, Africa, May 9, 1961. Dr. and Mrs. THOMAS REES, DEAR TOM AND NAN: As I mentioned to you several years ago, the first thing we need in Africa is curative medicine, public health and health education, supported by the more powerful surgical teams and research. To this idea I am glad to see that you have pushed ahead and done the right thing of introducing mobile clinics. In Africa we have to take medicine to the people and later the people will come to medicine. Mobile clinics is the way to do it. I shall leave it to Dr. Hok to give you more detailed information on our work with the mobile clinic. Here I will only mention that on our very first day out in Embu district, we treated 300 patients and stopped before we had finished the crowd that had arrived because of the rain. Five miles farther there were about 600 patients waiting until dark, but there was nothing we could have done for them. The following day we found 2,000 patients waiting, but there was nothing very much we could have done for them. There were many seriously sick people, and because we ran short of medicine we only treated 200. It is impossible to believe the amount of good a mobile clinic like that does unless you have been there to see it yourself. The point I would like to make to you is that most of these patients would have never gone to any hospital with a doctor and their only chance was the mobile clinic. The other thing is that these people want help so much and are very willing and appreciative of getting it. As you can see, on our second day, without advertisement or publication, we had over 2,000 sick people waiting. I do not know how many more we should have had if we went there on the third day. Very sincerely yours, NJOROGE MUNGAL, M.D. LONDON, March 21, 1960. I would like warmly to recommend the project sponsored by the African Research Foundation, which is planning to build a cancer research center in east Africa attached to the Aga Khan Hospital in Nairobi. The African Research Foundation, in cooperation with the Sloan-Kettering Institute for Cancer Research, has already done valuable work in this connection, and a number of cases from Tanganyika have been admitted to the Aga Khan Hospital for treatment. I understand that before long Tanganyika will be visited by mobile medical units staffed by American doctors, who will visit various district and mission hospitals. In a country where there is a desperate shortage of doctors and medical facilities, this kind of work is of immeasurable value, and anything that the American people can do to help the foundation expand its activities will be warmly welcomed by our people. JULIUS K. NYERERE. NEW YORK, April 15, 1961. I feel the African Research Foundation with its aim of providing additional medical service and training in east Africa represents a necessary effort in the development of my country. The foundation has been working in east Africa for several years and has contributed to the scientific community with several responsible projects. Recently, it has begun a medical service and training plan via mobile health units, which will be able to reach many more people in the outlying areas. I am convinced that organizations such as the African Research Foundation, and the American people who support it, will be able to work with us, and we with them, in building a healthy and prosperous Kenya. T. MBOYA, M.L.C., Secretary General, K.A.N.U. METHOD AND AMOUNT OF FINANCING OF THE AFRICAN RESEARCH FOUNDATION Senator HUMPHREY. Thank you, Mr. Daniels. I have just one or two questions. Mr. DANIELS. Yes, sir. Senator HUMPHREY. Who finances the African Research Foundation? Mr. DANIELS. This is financed by private individuals. I do not have a list of contributors. Our airplane, a Piper Aztec, was contributed by Arthur Godfrey, who is not only greatly interested in Africa through his many trips there but, because of his own personal experience, greatly interested in the cancer research that is being conducted by the African Research Foundation in Africa. If the Senator is interested, I would be pleased to supply a list of our other contributors. Senator HUMPHREY. I am not particularly interested in the individuals. I meant the method of financing. I know this is a very respected and respectable and very constructive foundation. I just wondered what your approximate budget for a year is. Mr. DANIELS. Well, this is a rather difficult question because, as I mentioned in my testimony, we have three operating entities, that is, one in New York, in London, and in Africa itself. The other point is that we are a growing organization. Senator HUMPHREY. What approximately did you spend last year? You do not really have to give that information. You are a private organization. I was only interested. Mr. DANIELS. Our total assets, taken from our balance sheet, were under $1 million in 1960. This is the New York office alone. Now, some funds have been sent to Africa directly. Our bookkeeping system is being changed to reflect the operations of our affiliated operations in Africa. Senator HUMPHREY. In other words, it is under $1 million; is that right? Mr. DANIELS. Yes, sir. We hope it will be much over $1 million. We started in this 5 years ago, and it is only in recent years that interest in Africa has really taken hold. POSSIBILITIES OF PRIVATE SPONSORSHIP OF CERTAIN FOUNDATION NEEDS Senator HUMPHREY. Could you use a jeep? Mr. DANIELS. We could use a jeep, we could use more medical mobile clinics. We estimate the cost of one mobile medical unit to be only $10,000, Senator, and you get an awful lot of use out of your money. We do have plans to expand our operations and put as many mobile clinics in the field as we possibly can. Senator HUMPHREY. You may recall that some time ago in one of the press conferences the President was asked a question along these lines: Well, Mr. President, you asked people to sacrifice, asked people to do things. What do you want them to do? What is it that I can do? Well, this is an organization where somebody could sponsor a mobile clinic, couldn't they? Why not? Some union or business club could do this, to mention only two examples, and pay for its operation, not for 1 year, but pledge to support it for 5 years. It is a job that could be done. Some senior class of a university, instead of buying a trophy that they hang up that nobody ever sees, could go ahead and maybe buy a piece of medical equipment. Mr. DANIELS. Absolutely. Senator HUMPHREY. These are the things that can be done. I thought maybe these hearings would perhaps enable us to find ways and means to supplement the activities of some of these organizations. It does not do much good sometimes to buy a piece of equipment unless you are willing to maintain it, because your budgetary problems get out of hand. But there are a lot of things that can be done, are there not? For example, in your case, the pharmaceutical houses could contribute substantial amounts of pharmaceuticals, couldn't they? Mr. DANIELS. Yes, sir; and they would be very well used, I can assure you. Senator HUMPHREY. There is not a drugstore in the United States that does not have in its prescription department one-third of all of its supplies that are no longer usable in the locality. I recommend to my druggist brethren that they go through their inventory and they find out which of these supplies meet the national standards of the Pharmacopoeia or the National Formulary, and make them available to some of these research institutes and foundations, such as yours. They can charge it off for taxes, first of all, if they have not already; and, secondly, these supplies are just taking up space because about every month a new pill comes out that makes the last one obsolete, except that the last one was just about as good as the new one, particularly, if you try it in some uncharted area where they have not had this medicine before. If there are any druggists around I hope they will follow my suggestion. Mr. DANIELS. Maybe we will pass it on to them, Senator. EFFECTIVENESS OF THE FOUNDATION'S MOBILE PROJECTS Mr. DANIELS. I have before me the total operating costs, including the building of the unit and shipping it to Africa for 1 year, which is $80,000, and that includes the construction, the shipping, the operating costs, the entire staff, sending the staff by air to Africa, subsistence, and training and so on. Now, I think for the kind of impact that this medical care has in the back country of Africa, that is a pretty good bargain. If I may take the time, I would like to read a paragraph from a letter from a doctor who traveled with the mobile medical clinic. Senator HUMPHREY. By the way, where do you get these doctors? Mr. DANIELS. Some of them are volunteer American and British doctors who are interested in Africa, interested in going to Africa to do something there. Some of them are also motivated by the research opportunities and the opportunity for service. Some of the doctors that work with us are African doctors who themselves are interested in our program. I would like to read, if I may, just two paragraphs to give you an idea of the magnitude of the job. Senator HUMPHREY. Go ahead. Mr. DANIELS. I will just read a small part: Here I will only mention that on our very first day out in Embu district, we treated 300 patients and stopped before we had finished the crowd that had arrived because of the rain. Five miles farther there were about 600 patients waiting until dark, but there was nothing we could have done for them. The following day we found 2,000 patients waiting, but there was nothing very much we could have done for them. There were many seriously sick people, and because we ran short of medicine we only treated 200. It is impossible to believe the amount of good a mobile clinic like that does unless you have been there to see it yourself. Senator HUMPHREY. Well, that is a wonderful idea. I have often felt that, for example, in the arid regions, particularly certain areas of north Africa and the desert country, mobile clinics, large moving van-type trucks on halftracks to use where there are no roads-we were always able to send tanks over this countryside, and if you can send a tank over it to kill people you can send a halftrack mobile clinic over it to save people's lives-would be an excellent way of bringing 71636-61-12 |