National Nurses United

The Good Doctors: The Medical Committee for Human Rights and the struggle for social justice in health care By John Dittmer; University Press of Mississippi though originally published in 2009, The Good Doctors was updated and republished last year. We are so glad it was because we now have the opportu- nity to review this chronicling of such an important part of the medical commu- nity's role in civil rights history and the genesis and growth of this generally lit- tle-known organization, the Medical Committee for Human Rights (MCHR). Please don't let the title put you off; while the book is titled The Good Doc- tors, registered nurses play a major role in the plot as well, and in many respects were the heroines in MCHR's work. The story kicks off in late 1963. The state of medical care for blacks, especially poor and rural blacks, in the South is absolutely deplorable. Many black folks had never visited a doctor their whole lives. Despite a 1946 law, the Hill-Burton Act, which banned discrimination based on race in hospitals built with the act's federal monies, southern hospitals were largely segregated with vastly unequal resources and treatment for blacks and whites, including many fewer beds for black patients, segregated waiting rooms, shoddier and crowded wards for blacks, and the demand for payment up front before hospitalization. In addition, almost no black physicians had hospital privileges in southern hospi- tals because privileges were contingent on membership in the local American Medical Association chapter, and the southern chapters were notorious for excluding black doctors. National AMA claimed it was opposed to racial discrimination against black doctors, but for decades refused to control how the local chapters operated, even after protests and even pickets by both black and white physicians. The sheer dearth of black physicians was also unacceptable. As of 1960, there were only about 4,000 black doctors in the entire United States, and only 55 black doctors in the state of Mississippi. It is against this backdrop that the work of what would eventually be called the Medical Committee for Human Rights begins. Its first major project was providing medical support for Freedom Summer of 1964, when a thousand mostly northern white college students flocked to the south to educate and register black voters. Though the organization's regional black doctors had already been providing medical care for demonstrators in the south, the summer project's organizers, Congress on Racial Equality and the Student Non-violent Coordinating Committee, were asking for medical help and presence on an unprecedented scale. MCHR put out a call for doctors, nurses, and medical worker volunteers to come to the South, and they came. Since they could not practice out of their states in Mississippi, their top four functions were to recruit other health care professionals to Mississippi, provide Good Samaritan first aid, gather and educate civil rights workers about how to obtain medical care, and assist local black and white health personnel. They also contributed greatly by providing a medical presence at civil rights protests, marches, and events; visiting arrested protesters to check on their condition and potentially dissuade authorities from abusing them further while in custody; fact gathering about public health needs; and providing federal authorities documentation of segregation and racial discrim- ination in southern hospitals, in violation of Hills-Burton and also later Medicare laws. What all the health care providers quickly realized, however, was that the college civil rights workers were, on the whole, supremely healthy. The people who really needed their help were the poor black residents of the South. So after Freedom Summer, MCHR partnered with organizations such as the Delta Ministry to open up a number of community health programs and clinics in places such as Jackson and Holmes County in Mississippi. MCHR and its members would go on to accomplish a great many firsts. They provided medical aid on a number of seminal marches, including Selma, Jackson, and Meredith. MCHR doctors walked with and accompanied Dr. Martin Luther King, Jr. on a number of occasions as his personal physician. It provided the medical services that were an essential component of the new program, Head Start, by giving kids medical exams; lab, hearing, and vision tests; and immunizations. It helped bring many southern hospitals into compliance with Title VI of the 1964 Civil Rights Act and Medicare. It agitated to force medical and nursing schools to accept more black students. It took a formal position opposing the war in Viet- nam. Its members provided all the medical aid for the Poor People's Campaign march and Resurrection City. MCHR worked with the Black Panthers to open and staff the Panthers' free clinics across the country. Some of MCHR's physician and nurse members conceived of and staffed the nation's first comprehensive community health movement projects, notably the Columbia Point Health Center in Boston (now known as the Geiger Gibson Community Health Center) and the Tufts-Delta Health Center in Mound Bayou, Miss. These centers were revolutionary in that they addressed the root causes of their patients' poor health: offering GED courses to the community at night, training them for jobs in the health center, starting cooperative community farms where residents grew the fruits and vegetables they needed to feed their families. MCHR members experimented with taking over small hospitals and trying to convert them into truly community-run health institutions, such as the Lincoln Collective in the South Bronx. MCHR championed health care as a human right, and in 1971 pushed for not just Medi- care for All, but a comprehensive national health service. The book is honest about many of MCHR's missteps, too. Many white physicians and medical workers who volunteered with MCHR were oblivious to their own racism and patriarchal attitudes. The organization often alienated both local black physicians in areas where it was operating, and white physicians, too, by not reaching out and giving proper respect to their existing work. There were gender as well as generational and ideological divides. But most fascinating, and what Dittmer only alludes to as perhaps leading to the ultimate demise of MCHR in the late 1970s, was its fai- lure to resolve a fundamental existential tension between members who viewed MCHR as a group of medical professionals supporting the civil rights movement and those who wanted to address the health care needs of poor people across the country. Of course, those two missions are inextricably linked, but it was a problem that a signifi- cant proportion of members, particularly the physicians, did not see it that way. They did not understand that to ultimately win equity in health for the people of America did not mean just desegregation of hospitals or letting black doctors have hospital privileges; health equity requires a complete transformation of the social, economic, and racial structures that make health possible or not possible. 16 N A T I O N A L N U R S E W W W . N A T I O N A L N U R S E S U N I T E D . 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