This very committee, in 1957, identified as "the greatest obstacle to the development and expansion of health personnel in other countries," the fact that "most of the underdeveloped countries neither have such personnel now nor have the facilities for training them.”

We raise this point not necessarily to suggest any changes in H.R. 12453 as it stands or to denigrate what is a worthwhile proposal, but simply to attempt to realistically assess the part this measure can play in the overall effort in the field of international health.

H.R. 12453, in and of itself, will not meet many of the problems we face in international health but it will be helpful in taking us further down the road toward our goal of making the presently underdeveloped nations strong enough to stand on their own feet in providing health care for their own people.

People, in the final analysis, are what we are talking about in the entire international health effort; people who are suffering and dying even though there exists elsewhere in the world the means to alleviate that suffering and even save those lives.

Though we face ourselves a very vexing problem in meeting the health needs of our own citizens, who rightfully have a special claim on our attention, we are, as a nation, strong enough in talent and money to spare some effort for others.

A dentist from Detroit, Dr. Herbert J. Bloom, who has spent much time in recent years working on the SS Hope, put it this way in a letter written after the ship had been to South Vietnam:

I will never forget the day I left Saigon; there were hundreds of people on the dock, holding up their children, showing us the cases of cleft palate, tumors, malignancies that we had not the time to treat. If I could put in one word what their eyes so poignantly cried out, it was "hope." We in the United States must answer it because we are humanitarians, and we must answer it if we are ourselves to survive in this world.

Our association believe, with Dr. Bloom, that we must answer this cry. We have already begun to do so in many ways. H.R. 12453 will permit us to take one more step in that effort. We respectfully urge its passage.

Mr. Chairman, the American Association of Dental Schools and the American Dental Association are most grateful for this opportunity to appear before you.

This concludes our testimony and I would be happy at this time to attempt to answer any questions that you or members of your committee may have.

Mr. Moss. Thank you, Doctor.

Mr. Rogers?

Mr. ROGERS of Florida. Thank you, Mr. Chairman.

Thank you, Doctor, for your statement. How many dentists would you say we have now in the international field, in the World Health Organization representing this country or Pan American Health Organization, in any activity, Peace Corps, AID. Do we have any?

Dr. KERR. It would be a difficult thing to assess. Probably a small part of the 234 referred to by the Surgeon General. I would say very few in those particular areas besides those that are in the international religious mission type teaching efforts.

Mr. ROGERS of Florida. What would be the thrust? Do you think we should try to train foreign nationals? Do you think that should be

considered in this program and let them go back, or do you think it is still better to train our people and let them go over there?

Dr. KERR. We believe that we should train the foreign nationals in the area of teacher education, that we should also train this small number of our people to educate them and it is this step-by-step process of education with the ultimate result being better health for the people of their own countries.

We could not attempt remedial care for the nations of the world: no, sir.

Mr. ROGERS of Florida. What about equipment? Do you think it would be necessary for us to provide your equipment so that you could take it overseas to teach them how to use the equipment that we use over here?

Dr. KERR. I think that would be part of the program; yes, sir.

Many nations have developed their own technology and equipment and if we could educate them to use theirs or ours this would be a great step.

Mr. ROGERS of Florida. Are we aware of their technology and equipment in this country?

Dr. KERR. Yes, sir. I spent the last few days just checking some of it myself.

Mr. ROGERS of Florida. Do we have the competence to tell them how to use their own equipment?

Dr. KERR. Absolutely.

Mr. ROGERS of Florida. Thank you.

Thank you, Mr. Chairman.

Mr. Moss. Mr. Devine?

Mr. DEVINE. No questions.
Mr. Moss. Mr. Keith?

Mr. KEITH. No questions.

Mr. Moss. Doctor, I want to thank you for your appearance. I have no questions at this time.

Dr. KERR. Thank you, sir.

Mr. Moss. The committee will now recess and will resume hearings at 1:45 this afternoon.

I might add that at that time we will start with Dr. Charles Hudson, president-elect of the American Medical Association.

(Whereupon, at 12 o'clock, the committee recessed, to reconvene at 1:45 p.m. the same day.)

AFTERNOON SESSION

The CHAIRMAN. The committee will come to order.

We had finished hearing the last witness when we adjourned at noontime.

The next witness to appear would be Dr. Charles Hudson, presidentelect of the American Medical Association.

Dr. Hudson, would you take the stand, please? I want to congratulate you on being president-elect of the very important American Medical Association. We are glad to have you here and you may proceed as you see fit, to give your written statement or to put the written statement in the record and summarize it.

We would like for you to identify your two associates you have with you.

STATEMENT OF CHARLES L. HUDSON, M.D., PRESIDENT-ELECT, AMERICAN MEDICAL ASSOCIATION; ACCOMPANIED BY PAUL R. M. DONELAN AND HARRY N. PETERSON, LEGISLATIVE DEPARTMENT, AMA

Dr. HUDSON. Mr. Chairman and members of the committee, I am Dr. Charles L. Hudson, president-elect of the American Medical Association, and a practicing physician from Cleveland, Ohio, where I have been in the practice of internal medicine for over 25 years.

We me are Mr. Paul R. M. Donelan, on my left, and Mr. Harry N. Peterson, on my right, attorneys on the legislative department staff of the AMA. I would like to read my statement into the record. The American Medical Association is pleased to appear before this committee in support of H.R. 12453, the International Health Act of 1966. Your bill, Mr. Chairman, is in recognition of the great need that exists throughout many areas of the world for the amelioration of human suffering caused by disease.

As we understand it, H.R. 12453 would provide grants to schools of health to train professional health personnel to work in international health and would also augment the ranks of health personnel in the Public Health Service for work in foreign countries. Exporting knowledge to needed areas of the world through increased numbers of health personnel trained in this country would be a significant step in making modern medicine available to developing regions around the world.

This committee is aware that the excellence of medical education in the United States is not surpassed anywhere in the world. This Nation has become the medical training center to which students and physicians now come from all over the world.

Your bill, Mr. Chairman, recognizes the need for health personnel, trained in this country, to go directly into areas lacking adequate facilities, personnel, and the latest scientific know-how. With this humanitarian goal-to make available to these regions of the world the benefits of modern medicine the medical profession has long been in accord.

I should like to briefly relate some of the activities of the AMA in the field of international health. The AMA interest in international health dates back to 1874, when the house of delegates proposed that representatives be sent to the International Medical Congress.

The expanded interest and activities of the AMA in recent years. stimulated the creation in 1961 of the AMA Department of International Health. It is this department which coordinates and supervises the international health activities of the association.

One area of significance and increasing activity concerns the placement of U.S. physicians overseas. There has been a great upsurge in interest among American physicians to serve abroad. The department maintains a greatly expanded registry of opportunities for such service. Various potential sources of such employment are contracted, including a host of industrial corporations, missionary societies, voluntary agencies, governmental organizations, steamship lines, and professional and educational groups.

The association also fosters assistance to physicians who are serving missions in foreign lands. Affiliate memberships in the AMA have

been approved for medical missionaries, and assistance and advice on problems encountered by medical missionaries are offered under this program. Hundreds of complimentary subscriptions to the Journal of the American Medical Association and the nine Archives publications are made available to these physicians of every denomination. The association also arranges speaking engagements and locates continuing medical education courses for furloughed missionary personnel, and will assist in locating used and surplus medical equipment, drugs, medical journals, and textbooks through U.S. collection and distribution agencies.

The AMA also forwards to the appropriate missionary agencies applications from volunteer physicians desiring to serve abroad in mission posts.

Additional activities of the association may be briefly listed as follows:

tion;

Clearinghouse and repository for international medical informaPublication of a directory of international medical material collection programs;

Publication in AMA News and the Journal of reports on international health developments;

Designation of AMA members to attend international congresses and foreign medical society meetings, and the reporting of these proceedings in AMA publications;

Furnishing of simple, basic public health information scripts for transmission abroad;

Furnishing medical literature, radio spot materials and interviews, press releases, feature stories, library materials, and issues of the AMA Today's Health magazine.

Part of the association efforts in the area of international health have been devoted to the sponsorship and participation in conferences and meetings:

In 1962, and again in 1963, the AMA sponsored conferences on international health attended by representatives from over 200 diverse U.S. organizations engaged in international health activities abroad. These were the first time that so many international medical multidisciplinary groups had been convened.

The AMA is currently supporting the third World Conference on Medical Education to be held in India in November of this year. This conference recognizes the need to establish health services in nations at an early stage of development when rapid social change is taking place.

And in November of 1965, the association sponsored a Western Hemisphere congress on nutrition, designed to bring physicians and other informed persons from all nations of the hemisphere to share their experiences with nutrition problems.

The AMA was one of the founders and is a principal financial supporter of the World Medical Association, which has representation from national medical associations in some 57 countries. Physicians are brought together from all over the world for consideration of common problems in medicine and the means to improve its standards. Mr. Chairman, while I have mentioned some of the association activities in the field of international health, two additional endeavors

deserve mention, although you may already be aware of them because of recent publicity concerning them. One concerns the cooperation of the American Medical Association in Project Vietnam. The AMA responded to administration requests and has helped recruit physicians for Project Vietnam, which seeks to send volunteer U.S. physicians to serve civilians in that war-torn land.

The other is a project concerning participation by the American Medical Association with the U.S. Agency for International Development in supporting the faculty of medicine at the University of Saigon. At the request of the U.S. Department of State, a four-member AMA team will make an on-site inspection in Saigon to consider the possibility of developing a program to supplement the Vietnamese teaching faculty at Saigon University with American-trained medical educators and consulting professors. Supporting faculty from the United States would cooperate with the existing faculty of medicine at the university, where a number of new facilities are being prepared for the medical school.

Mr. Chairman, in 1963 it was my privilege to address the second AMA Conference on International Health. I believe that the following from my remarks is pertinent here, and with your permission I would like to read them.

Today we need but look to our dedication as physicians to realize that the knowledge of the medical sciences belongs not to one group or to one nation but to the entire world, and the international meetings on health which are held with increasing frequency nowadays serve as means by which we can share new medical knowledge and techniques with our physician colleagues from every part of the world.

Today the globe has so shrunken that the ills of our neighbor nations are our very own. To do unto them as we do unto ourselves has become a firm rule in the matter of world health. In the words of the American Medical Association, **** international medicine is a forte for truth, compassion and human service. And no political nor ideological considerations can obscure the fact that people and their everlasting need for new routes to healthfulness are that with which the physician-every physician, from every continent and speaking every language-is incessantly occupied."

There can be no disagreement that there exists an urgent need for spreading available medical knowledge to many areas of the world in order to upgrade their existing quality of medical care. Within our resources to do so, our country should contribute its part to accomplish this goal. Mr. Chairman, your committee should be commended for its consideration of legislation intending to help meet this great need.

We wish to thank you for this opportunity, sir, to express the views of the American Medical Association. I shall be pleased to attempt to answer any question which the members of the committee may wish to ask.

The CHAIRMAN. Thank you, Doctor.

I am very much interested in the great interest and activity that your association has had in international health. You have carried this on for a long period of time and it looks to me like you have been a forerunner. I also would like to congratulate you on your statement you made before the conference of UNESCO.

You have said here that you are for the bill, and for the principles of it?

Dr. HUDSON. Yes, sir. We are for this bill.