Negotiating social medicine in a postcolonial context: Halfdan Mahler in India 1951-61.

Abstract

This article investigates how World Health Organisation (WHO) Director-General Halfdan Mahler's views on health care were formed by his experience in India between 1951 and 1961. Mahler spent a large part of the 1950s in India assigned as WHO medical officer to tuberculosis control projects. It argues that Mahler took inspiration from the official endorsement of the doctrine of social medicine that prevailed in India; even if it was challenged by an increasing preference for vertical, techno-centric campaigns. It shows how, from the outset, Mahler was remarkably hostile towards the highly skilled, clinically oriented doctors, but embraced prevalent ideas of community participation. It suggests that Mahler - although he remained silent on the issue - was impressed by the importance and resilience of indigenous traditions of medicine, despite hostility from leading political figures. In this way, the article attempts to establish links to Mahler's advocacy of primary health care in the 1970s. A broad approach to health, scepticism toward clinically oriented doctors, preference for simple technologies and community participation, as well as an accommodating attitude towards indigenous practitioners, were all features of primary health care, which correlate well with views developed by Mahler as he negotiated social medicine in India between 1951 and 1961.