Research Corporation’s Williams-Waterman FundHe who walks gunless In the jungle must expect To feed the tiger --Kendall King, 1966 People say that history repeats itself, and the proof of that adage is evident today in the Caribbean nation of Haiti. Recent reports of widespread poverty and malnutrition there have sent the rest of the world scrambling to help. Located on the western one-third of the island of Hispaniola, Haiti is the poorest country in the Western Hemisphere, with 80 percent of its roughly 9 million people living in poverty. The World Bank estimates more than 60 percent of the population is undernourished; average life expectancy is under 60 years. Despite years of private and government aid, assistance and education, Haiti's plight has shown little, if any, improvement since the 1950s, when the Williams-Waterman Fund for the Combat of Dietary Diseases, one of Research Corporation's largest programs at the time, tried to make a difference there. A look at the Foundation's records reveals the work undertaken by the program, the people involved in the projects, and a country in turmoil. Sam Smith, then head of grants for Research Corporation, visited Haiti early in 1958 to prepare for a nutritional survey. At that time, the Williams-Waterman Fund was focusing its research and projects on nutrition in general, and on prevention of and therapy for diseases of malnutrition--kwashiorkor, beriberi and pellagra--in particular. Smith's visit report details the impoverished situation in Haiti at the time, as well as the wild and colorful flavor of the country. He describes his taxi ride from the airport: "...you are off on one of the wildest rides this side of an amusement park. Since pedestrians, burros, oxen, dogs, chickens and other forms of life refuse to exercise any caution, it seems necessary to blow the horn every five seconds or so. The horn is also sounded at every intersection, before making any kind of turn, to attract the attention of friends along the street, and just for the heck of it." During his visit, Smith met with medical providers, government officials and clergy and visited numerous cities looking for places where the survey would provide an accurate overview of the population. At the time, Haitians had a per capita income of less then $70 per year. Only 13 percent of the land was arable and that portion of the land was heavily populated. Almost 90 percent of the population was illiterate and education was nonexistent in most of the island. Malnutrition, malaria and tuberculosis were rampant. In a memo dated December 1957, Smith wrote, "Livestock must forage wherever it can. A cow under these conditions may produce two quarts of milk. There are few chickens, thanks to the mongoose....Despite being surrounded by water, fish are not consumed to any great extent even along the coast. Various fruits are, of course, available and, from what I could ascertain, the main problem is one of insufficient protein and calories." Smith also visited clinics and hospitals all over the country. He wrote, "In all of these there was ample evidence of malnutrition, and all of the doctors in charge affirmed that malnutrition, especially protein deficiency, is one of their big problems....In the Cathedrale center [in Port au Prince, the capital of Haiti] I saw my first two cases of classical kwashiorkor." Kwashiorkor is a severe malnutrition which is characterized by failure to grow and develop, changes in the pigmentation of the skin and hair, anemia, edema, apathy and degeneration of the liver. It generally affects young children. Smith said, "It is one thing to see pictures of such victims and another to see it firsthand. You would have to be made of pretty stern stuff not to be moved by it." As Smith traveled from city to city, poverty was evident everywhere he looked. In a hospital/dispensary run by two Catholic sisters in Limbe, Smith spotted a poster encouraging a good breakfast to start the day. Wrote Smith, "I thought of the stream of school children we had seen along the way with books in one hand and their lunch in the other-a five foot length of sugarcane." An important meeting during Smith's visit was with William Larimer Mellon Jr. at the Hospital Albert Schweitzer in Deschapelles. Mellon, an heir to the vast Pittsburgh Mellon steel fortune, was something of an outsider and had been living on a ranch in Oak Creek Canyon, Arizona. In a 1947 Life magazine, he read about Albert Schweitzer's work in Africa and, inspired by the story, Mellon decided to become a doctor. Already in his late thirties, Mellon enrolled in medical school at Tulane University and began searching for an area of the world where he might have an impact. In 1954, he and his wife settled in Haiti where they built and supported a hospital named in honor of his inspiration. Smith wrote to Mellon in December 1957, introducing himself and the Fund and outlining the kind of work that was proposed in Haiti. Mellon responded, "With regard to a nutritional study here in Haiti, let me say at the outset that research is not one of our primary objectives, particularly if human beings enter into the experiment. Pediatrics, however, and especially the nutritional diseases of children problems of deep concern and with which we struggle daily. "If the program you would like to develop here can be somehow reconciled with the above philosophy and at the same time fitted [sic] into the framework of a small rural hospital such as ours is without risk of interrupting the medical service to our community, then I should say that our interest in helping you elucidate the nutritional problems of our part of Haiti would be keen and immediate." After subsequent meetings and correspondence, Mellon offered to provide housing for surveyors and laboratory space for the project. Smith also visited with the flamboyant Right Reverend C. Alfred Voegeli, then the Episcopal bishop of Haiti. Author Barry Paris, in Song of Haiti, a book about Mellon's work in Haiti, noted, "Bishop Voegeli's primary interest was neither medicine nor religion, but Haitian art, and he was one of its earliest and most vital benefactors." The meeting, wrote Smith, was at the bishop's residence, "a villa high above the city that is truly a storybook setting," where "about a dozen people...including a number of the Haitian clergy..." convened. Smith recalled, "There was a sumptuous dinner served on the terrace overlooking the lights of the city while Beethoven symphonies playing in the background." At the end of the evening, the bishop offered to try to arrange a meeting for Smith with François Duvalier, the newly elected president of Haiti. On the last day of Smith's 1958 visit, he was, indeed, granted an audience with the president. Afterwards, Smith recounted, "I was given the opportunity of explaining the background of the Williams-Waterman Fund, some of the work it had carried out and what our plans for Haiti were. "He said ‘You have done all these things and now you want to add Haiti to the list of the Philippines, India, Formosa and all the others. Is that right?' I had some misgivings over what was coming next, but I managed to get out a ‘yes sir.' "The President then said very softly, ‘Will you let us know when you are to start this work and you will have the complete cooperation of the Ministry of Health, the Ministry of Education and the Army.'" The survey, which was conducted during the summer of 1958, included an appraisal of agricultural resources, food habits and vital statistics as well as clinical examinations of more than 3,000 people in representative villages and cities throughout Haiti. Concurrent with the survey, and also sponsored by the Fund, was a clinical appraisal of infants and children up to age three, conducted by Derek and Patrice Jelliffe, a husband-and-wife team who were experts in pediatrics and infant nutrition. In the course of the Jelliffes' project 1,322 children--from 24 rural villages and two slum areas in the capital--were weighed and examined. After the survey was complete, all of the equipment that had been used in the course of the survey was donated to the Haitian Department of Public Health. One of the original surveyors was Kendall King, a biochemist from Virginia Polytechnic Institute, who would spend many years working on projects in Haiti and who developed the Mothercraft concept, a system for teaching mothers how to feed and care for children using simple and inexpensive techniques. Once the data collected during the survey were analyzed and interpreted, the Williams-Waterman Fund established nutrition rehabilitation centers throughout the country. King's Mothercraft concept was later implemented in other developing countries. In a letter to Smith at the end of the survey, King wrote, "La balle finish. La violin au sac! I was able in five days...to secure better than 90 percent of the samples we had hoped to get, to have five breakdowns in the poor little vehicle we had rented, and to become thoroughly fed up for the time being with police states." Though it would be several years before the extent of Duvalier's reign of terror was fully recognized, by 1961 his legacy was in place. In a letter that June, Smith wrote to King, "Unless the Williams-Waterman Fund develops a workable scheme that will withstand the wind of change and keep on growing no matter what may happen in temporal affairs, and unless that scheme is put into operation very shortly, we had better write off Haiti and leave her in the hands of Baron Samedi." In voodoo, which was widely followed in Haiti at the time, Baron Samedi is the lord of death. Some accounts said that the dictator looked exactly like the classic representation of the baron and used this much to his advantage. But Smith was determined and in the same letter said, "I will admit more revulsion than discouragement about the present state of affairs, for let me assure you I have too much time, worry, sweat and gray hairs invested in Haiti to even think of tossing in the towel without taking every swing possible." In their correspondence, Smith and King often mentioned a man they referred to as "M. Small Big" who was obviously a driver during their trips to Haiti. The exchanges imply a teasing and affectionate friendship among the three men. King was living in Haiti in 1960 when Smith was planning a visit to the country. In a letter where the two discussed their upcoming meeting, King wrote to Smith, "The only other indispensible [sic] item to bring along is a bottle of good cheap vitamin pills for Big. A bottle with a colorful label would be preferable since the contents are not as vital as the bottle itself in the case of Big's particular disorder." Smith replied, "Many thanks for your offer to meet me at the airport. You will be able to distinguish me from the other tourists by the typewriter ribbons and graph paper. I will also be bearing a fancy bottle for Big. No female under the age of 80 will be safe after he starts on this treatment." Then, in August 1962, Smith received a letter from King. "It is apparent...that Big's death was no accident," wrote King. "Maybe he spent too much time with us or slipped and spoke his thoughts too often....we may have a very tough problem to solve: "Do we continue to try to move when we may be endangering the lives of anyone with whom we work? Is the choice ours to make or theirs as individuals? And if (as I tend not to think it is) the choice is theirs, how much more difficult will our task be and as a result how much less will be the return on our investment. "As you may have guessed, I have been forced to mull over some of the more sordid aspects of the animal we call man. Don't be alarmed: I still find him a marvelous and, at time, even a beautiful creature. But I'll be damned if I can understand how an incurable ivory-tower academician like me can be involved in such a snarled up ethical mess." Despite the increasing horrors of the Duvalier regime, Williams-Waterman Fund programs were in effect in Haiti for more than ten years. When the Williams-Waterman Fund ended in 1977, over 450 projects had been funded worldwide. In Haiti alone, over 2 million dollars was expended. The Jelliffes continued their humanitarian work with malnutrition. Derrick was the first director of the Caribbean Food and Nutrition Institute of the Pan American Health Organization, and from 1972 to 1990 was chair of public health and pediatrics at University of California. He and his wife have been called "pioneers of health in the Caribbean." In 1969 Kendall King became assistant vice president for grants at Research Corporation. When Sam Smith left Research Corporation to become the first executive director of the M.J. Murdock Foundation in 1975, King headed the Fund, and eventually served as vice president of the Foundation. In a 1975 article about Haiti in Chemtech, Kendall King wrote "A child's entire life is determined in large measure by the food his mother gives him during his first few years. Starve the body and you damage health, stunt growth, and impair mental development. Multiply one child by millions and you produce an entire generation of men and women incapable of functioning at their full genetic potential." Did the Williams-Waterman Fund make a difference in Haiti? Maybe for a few years. But the breadth of the island's problems is evident in a Haitian proverb: "Behind the mountain is another mountain." Thirty years after Research Corporation's involvement there, much of Haiti's potential is still struggling across the next mountain, still waiting to be realized.
Columbus discovered the island of Hispaniola while on the same trip in which he discovered America. Within 25 years of Columbus' discovery, the native population had been virtually annihilated by Spanish settlers. In 1697, Spain ceded the western half of the island to France. Haiti occupies one-third of the island; the remaining land comprises the Dominican Republic. The island's terrain is rough and mountainous, and it lies in the center of the hurricane belt. Deforestation has crippled the island with soil erosion, frequent drought and inadequate supplies of drinkable water. While under French rule, Africans were brought to the island as slaves and the island experienced a period of prosperity through sugar and forestry, though at the expense of its environment. In 1804, Haiti became the first black republic to declare its independence. In The Haitian People, historian James Leyburn wrote "Of the 22 heads of state between 1843 and 1915, only one served out his prescribed term of office, three died while serving, one was blown up with his palace, one presumably poisoned, one hacked to pieces by a mob, one resigned. The other 14 were deposed by revolution after incumbencies ranging in length from three months to 12 years." A brief, unsuccessful U.S. occupation was withdrawn during the presidency of Franklin Roosevelt. The notorious reign of the Duvaliers (father and son ruled the country for almost 30 years, from 1957 to 1986) was defined by violence, corruption and financial malfeasance. Since then, the country has experienced constant political turmoil as different factions struggle for power. Political violence has increased and as many as a million Haitians have fled the country.