策略与实践:兰安生与洛克菲勒国际卫生部(1917~1927)

Strategy and Practice:John B.Grant and the Rockefeller Foundation's International Health Board in China(1917-1927)

20世纪20年代,美国洛克菲勒基金会的下属机构——国际卫生部,在中国公共卫生事业的发展中扮演了重要角色,其中兰安生(JohnB.Grant,1890~1962)在北京协和医学院的工作甚至得到了中华民国政府的重视。国际卫生部成立早期通常以防治钩虫病这样的单一病种为切入点展开工作并取得成功和认可,但在中国,其在公共卫生教育方面的实践成为它成功的起点。本文即是以此差异的产生及具体情况为主要研究内容,探讨国际卫生部在中国公共卫生工作的策略与实践问题。通过分析洛克菲勒档案馆所藏档案及其他文献资料,本文探讨了兰安生的教学方式与特点,指出他在北京协和医学院开设的公共卫生课程以卫生行政管理内容为主,并侧重卫生实践,意在为培养卫生官员做准备。而国际卫生部向中国提供赴美公共卫生奖学金,也意在布局中国卫生界的人脉网络。文中进一步分析兰安生这一教育内容和方式的形成与国际卫生部在中国进行公共卫生实践的策略直接相关,并揭示了此策略形成的过程与原因。通过此项研究,笔者认为,国际卫生部虽然在中国采取较为特殊的实践方式,但其根本目标和主体策略并未发生实质性改变,即均旨在通过与当地政府合作或建立联系开展公共卫生事业,其在中国的做法可视为其工作策略上的一种调适。本研究体现出中国的医疗和社会与境对国际卫生部开展公共卫生实践、传播公共卫生知识上的形塑。

In the 1920s,the International Health Board(IHB),a subsidiary of the Rockefeller Foundation,played a significant role in the development of public health in China.John B.Grant(1890-1962),a member of the IHB,was a leading figure in its activities,and his work at Peking Union Medical College(PUMC)even gained the attention of the Nanjing Nationalist government.While the IHB,in its early period,primarily achieved success and recognition through its efforts in preventing and controlling certain diseases like hookworm disease worldwide,in China,however,its practice in public health education laid the foundation for its future success.By specifically examining the emergence of this difference,this paper aims to explore the relationship between strategies and practices.By analyzing extensive source materials preserved at the Rockefeller Archive Center and other documents,this paper examines the methods and characteristics of the course on public health given by John Grant at PUMC.The analysis reveals that Grant's course placed greater emphasis on health administration and health practice,indicating his intention to cultivate health officials through teaching.Furthermore,it identifies the IHB's intention of establishing a network of relationships with Chinese health officials in positions of authority by financing public health fellowships in China.It is argued that the educational approaches applied by Grant directly align with the strategy launched by the IHB for public health practice in China,shedding light on the development of and reasons for the formation of this strategy.Through this study,it becomes evident that although in China the IHB adopted a different approach to practice,its fundamental objectives and main strategy remained largely unchanged-to carry out public health work through cooperation or connections built with local governments.The IHB's practice in China can be viewed as an adaptation of its strategy.Moreover,this study presents how the medical and social contexts in China influenced the IHB's implementation of public health practices and knowledge transmission.