to carry out teaching projects where the teams work in cooperation with indigenous physicians from the countries visited. The most recent such mission has just returned from a 5-week instruction tour in Jordan and Lebanon. The team was made up of a group of surgeons, anesthetists, and nurses from Johns Hopkins School of Medicine. Incidentally, I would like to thank your chairman, Senator Hill for his graciousness in speaking recently at the National Institutes of Health, at which time the Johns Hopkins team reported to the medical profession on their findings in the Near East.

On behalf of the Medical Advisory Committee of MEDICO, I want to state that we fully endorse the legislation before you to establish an International Health and Medical Research Center, as a comstituent part of the National Institutes of Health. We view the passage of such legislation as a long stride in the medical profession's unrelenting fight to conquer disease wherever it may be.

I have one question that I would like members of the committee to comment on if they see fit.

These are the provisions in the draft bill dealing with the exchange of medical and related research personnel and the financing of their activities. This is a matter of particular and special concern to MEDICO because it is our strong feeling that, in view of the fact that we are sending clinical and teaching medical personnel overseas, it would be of great benefit, we believe, to attach research personnel to certain of these missions.

My question, simply put, is this contemplated under the terms of the legislation?

The CHAIRMAN. I will say this, Doctor, that is certainly should be contemplated. If the language is not clear, we will help to make it clear.

Dr. COMANDURAS. Fine.

About 1 year ago, following the recommendations of the officials of the International Rescue Committee and MEDICO, a medical survey of over 20 countries in Africa and Asia, over a period of 4 months, was carried out. The purposes behind this world medical survey were to determine as intimately as possible the medical conditions which existed in the newly emerging countries in various parts of the world.

In the course of the survey I visited the following areas: French Equatorial Africa and Ghana in Africa; Lebanon and Jordan in the Near East; Pakistan, Afghanistan, India, and Ceylon, in central Asia; Burma, Thailand, Cambodia, Vietnam, and Malaya in southeast Asia; Singapore, Hong Kong, the Philippines, Japan, and Korea, in the Pacific; and Haiti, the Dominican Republic, and Puerto Rico, in the Caribbean area.

As a result of this international medical tour, certain outstanding and significant world developments stand out prominently. Amongst these, the following may be cited.

(1) More than three-quarters of the peoples of the world are living in a veritable medical jungle in which diseases, long since conquered and controlled in the western nations, are still raging unchecked and uninhibited.

(2) A seething "revolution of rising expectations" is going on among the peoples in the newly independent countries of the world, sparked and fanned by recent advances of western science, technology, and industrialization.

(3) An increasing realization that the only wise and effective approach to meeting the needs and aspirations of these people at the present time is through international effort and cooperation.

(4) The ecology of disease or the geographic incidence of disease, revealing itself in varying manifestations according to the environmental, sociocultural, and economic factors prevalent in these sections of the world, is a significant aspect of disease which has important ramifications for medical scientific research. International organizations such as World Health Organization, the Health Division of the International Cooperation Administration, the Colombo Plan, the private foundations, such as the Rockefeller Foundation, the China Board Foundation, World Rehabilitation Foundation, and the worldwide missionary organizations, have attempted to effectively meet this global challenge.

MEDICO, realizing that the potentialities of the American medical profession in the form of private practitioners and specialists, were not being utilized by these international agencies in the world arena, has joined these beneficent and humanitarian organizations in the world battle against disease, privation, and suffering.

However, today in these halls it is being recognized that the combined efforts of all of these organizations must be given direction and must be clarified and be made effective by the establishment of the National Institute of International Research. The medical, humanitarian and therapeutic efforts of all of these international organizations must have a central focus through which they can transmit their medical and scientific observations and findings, and from which they can receive diagnosis, advice, and direction.

The ecology or geographic incidence of disease is one example of what may be a fruitful source of discovery and experimentation which can be of inestimable benefit to all mankind. For instance, in the recent medical project in the Near East in which the Johns Hopkins University surgical team, composed of outstanding specialists from the medical school visiting the countries of Lebanon and Jordan under MEDICO auspices, the following significant items of medical interest appear in their reports:

1. Cancer of the cervix in the Arab women seem to be present quite as frequently as in the women of the Western nations. It has long been surmised that cancer of the cervix was rare in Arab women since it is quite infrequent in Jewish women because of the fact that both of these racial and related groups use male circumcision as a religious custom. The medical observation had been made in the past that the rarity of cancer of the cervix in Jewish women was due to the custom of circumcision amongst the Jewish males. This was not borne out by the observations of the Johns Hopkins gynecologists during their brief investigations in Jordan.

2. Despite an excessively dry climate in Jordan, the incidence of chronic sinusitis and respiratory infections was exceedingly high in the refugee children in this area. The American ear-nose-throat specialist on the Hopkins MEDICO team was surprised to make this discovery since it is one of our bits of medical understanding that the high incidence of respiratory infections in the United States is due to our high humidity, and we advise our patients to go to Arizona where a dry climate exists, for the improvement of their condition.

3. An exceedingly high incidence was found in rheumatic heart disease in the very young children in the Arab refugee camps. The woman cardiologist from Johns Hopkins stated that she had never seen such severe heart damage in such very young children at such an early period of life. In addition, the very common finding of congenital heart disease cases was another unusual medical phenomena. The high consanguineous marriages between first cousins and other such close relationship was described as the probable cause of these congenital malformations.

4. The remarkable finding of almost perfect teeth in 90 percent of the refugee children examined astonished the Johns Hopkins physicians who made a survey of over 600 children. Most of these children were brought up during their entire lifetime in refugee camps which, as a whole, lack substantial nutritional fare.

During my personal medical survey in India and in southeast Asia, I was told by the physicians in this part of the world of the increased incidence of cancer of the mouth and pharynx in most of the peoples in this area. This is an uncommon location for cancer in the American and western peoples. In contrast, cancer of the lungs and stomach is not as common in peoples who live in this part of the world as it is in peoples of the American continent and the western nations.

Peptic ulcer, which is found in the hard-pressed, energetic and upper strata of American and European society, is by contrast seen very frequently in the illiterate, uneducated peasants of India.

Coronary heart disease, which has been partly, if not wholly, ascribed to the ingestion of high fat diets in the western countries, is also found quite frequently in the peasants of India who practically never come in contact with foods as luxurious and as fatty as those ingested by western peoples.

These and other diverse manifestations of disease in various parts of the world, is a fascinating subject for scientific medical research.

As I indicated previously, one of the recommendations that MEDICO would like to make in the proper coordination of international clinical research would be the association of research personnel with the medical missions which are actively engaged in medical diagnosis and therapy in various parts of the world. The implementation of such international medical missions by research personnel would facilitate, first of all, in obtaining statistics and material for study and analysis, and secondly, would improve to a considerable extent the efficacy of the medical scientific work that will be done in various parts of the world.

The team of U.S. Army Medical Department's virologists from Walter Reed Hospital who are now carrying on research work in virus diseases in Malaya have made a specific request of MEDICO to send medical teams to Malaya which would cooperate with the Malayan Government and the virus research team in obtaining blood samples and facilitating their research efforts. This is the sort of cooperative effort-between diagnostic and therapeutic and researchthat we think would be fruitful if the new legislation will make it possible.

The establishment of the National Institute of International Research would demonstrate to the peoples of the world that the United States is vitally interested in the disease scourges that are still ravaging three-quarters of the world; that it is taking steps to al

leviate and eradicate human illness and suffering; that it is encouraging the brilliant scientific minds all over the world to come to this country to study, observe and find ways and means to attack disease all over the world, and that it is asking their cooperation to forge weapons, not against humanity, but for and in support of the health and welfare of all peoples.

Thank you.

The CHAIRMAN. Doctor, you gave up a very busy and rewarding practice of medicine here in the city of Washington, the District of Columbia; you gave up the head of an important department of the George Washington University Medical School to become the secretary-general of MEDICO. Having the insight into MEDICO that I was privileged to get the other evening when you and the Johns Hopkins University team that you sent out to Lebanon and Jordan presented their report, I certainly want to strongly commend you, sir, for giving now of your services and your great ability and your fine leadership to this cause of carrying medical service to the underdeveloped areas of the world which will, and must, lead to much better human relations, to adding to the prestige of the United States, and to building friendship for our country.

Dr. COMANDURAS. Thank you.

The CHAIRMAN. Senator Williams?

Senator WILLIAMS. I have no questions. Thank you.

The CHAIRMAN. Gentlemen, we have been very proud to have had you with us this morning, and we certainly want to thank you.

Mr. CHERNE. I would like to leave copies of the study of Soviet Economic Plans to which I referred, with the committee.

The CHAIRMAN. Thank you very much.

Our next witness will be Mr. Basil O'Connor.

May I welcome you. You are president of the National Foundation, originally the National Foundation for Infantile Paralysis, since its inception in 1938; a senior member of the law firm of O'Connor & Farber; former law partner of the late Franklin D. Roosevelt; president of the International Poliomyelitis Congress; president of the American National Council for Health Education of the people; chairman and president of the American National Red Cross from July 1944 to October 1949; president of the Harry S. Truman Library; member of the board of directors of the National Conference of Christians and Jews; sponsor and member of the General Assembly of World Brotherhood; and member of the New York State Committee to Employ the Handicapped.

May I say I had the very happy pleasure and privilege of being present in St. Louis last October when you were the first layman. in history to receive the Albert Lasker scientific award of the American Public Health Association for, and I quote from the citation, "Extraordinary administrative leadership in the eradication of crippling poliomyeltis through the development of an effective vaccine." You will recall I was privileged to be there that evening when you received this award.

I want to say this, too, that in 1955 when this committee was confronted with a pressing and immediate problem of what to do about the Salk vaccine, which was then in short supply, we endeavored to make sure that the supply we did have would go to those who needed it

most, and go where it should go, both to those who could afford to pay and those who could not afford to pay. You came down as the adviser to this committee and you gave us tremendous help and guidance in enactment of the legislation which we passed at that time, and which I think proved out to be a good solution to the problem that confronted us.

You were most helpful, and you certainly gave us your devoted services. We will be forever grateful to you. We are delighted to have you with us this morning.

STATEMENT BY BASIL O'CONNOR, PRESIDENT, THE NATIONAL FOUNDATION

Mr. O'CONNOR. Thank you. Senator Hill and Senator Williams, I am happy to respond to your committee's invitation to testify in regard to Senate Joint Resolution 41 of the 86th Congress, 1st session.

First, may I commend you, Mr. Chairman, and your distinguished colleagues, on the formulation of this resolution as it is now drawn, of what I consider to be basically a sound and a most creative concept in the interest of peace as well as for the advancement of medical knowledge.

Second, may I make such observations as my 35 years of experience as a layman in the field of health may qualify me to contribute.

Health and medical science have always created a form where people of all nations, all races and all creeds could meet on common ground in a common interest and get to know and understand one another better. Science has never known any boundaries of race, creed, or political geography.

Relatively recent increasing nationalism and other "isms" have created fears as to the continued existence of the open forum, but as yet, I think it safe to say that they have not reduced the value of what might be called the internationalism of science as one, if not the most effective, mechanism for peace.

The National Foundation has not been unaware of the value to all of international scientific exchange sometimes effectively accomplished through international medical scientific meetings. During the last 11 years, the National Foundation has sponsored four international conferences on poliomyelitis.

Through these conferences newly discovered knowledge on viruses and viral diseases and on rehabilitation of the disabled was made available to the whole world. Few international conferences on medical science had larger numbers in attendance or more nations represented by that attendance.

In addition, in January 1957, the National Foundation brought together under the auspices of the New York Academy of Sciences a unique conference on cellular biology, nucleic acid and viruses, at which scientists from Europe, South Africa, Canada and the United States exchanged information on the kind of basic research that is designed to throw light on such unsolved problems as cancer, virus diseases, and neurological illnesses.

About half of the American scientists participating were supported by nongovernmental funds given by the American people through the March of Dimes.