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The U.S. Role in International Disability Activities: 
a history and a look towards the future 

by Nora Groce 

a study comissioned by the World Institute on Disability, the 
World Rehabilitation Fund and Rehabilitation International 


The U.S. Role in 
International Disability Activities: 
a history and a look towards the future 

Author: Nora Groce 

Editors: Barbara Duncan, Diane Woods & Judy 
Heumann 

Design & Layout: Kathy Marchael 

Photographs: selected from RI archives and captioned 
by Barbara Duncan 

Cover Photograph: Reproduction by permission from 
the Kansas Collection, University of Kansas Libraries, 
Lawrence, Kansas 

This study was published in 1992 as a collaborative effort of the 
International Disability Exchanges And Studies (IDEAS) Project administered 
by the World Institute on Disability and Rehabilitation 
International, supported by Grant # G0087C2013 from the National 
Institute for Disability and Rehabilitation Research; and of the 
International Exchange of Experts and Information in Rehabilitation 
(IEEIR) Project, administered through the World Rehabilitation 
Fund, supported by NIDRR Grant # H133D0001. 


The U.S. Role in 
International Disability Activities: 
a history and a look towards the future 

by Nora Groce 

a study commissioned by the World Institute on Disability, the 
World Rehabilitation Fund and Rehabilitation International 


Table of Contents 

Introduction 1 
Project Background 1 
Methodology 2 
Conference 2 
Historical Overview 3 
Uniform Concepts 3 
Disability Rights 4 
Structure of Study 4 

Chapter I 7 
Disability in Early American Society 7 
19th Century Developments in Disability 8 
European Influences in Early American Society 9 
Divisions Within the Disability Community 11 
International Exchange of Ideas at the Close of the 19th Century 12 
1900-1920: World War I as a Watershed Period 13 
State and Federal Involvement and Disability 14 
Concept of Employer Responsibility 15 
The Aftermath of World War I: Private initiatives 15 
The International Society for Crippled Children (Rehabilitation International) 17 
Other Non-governmental Groups 20 
The Depression 22 
Medical Progress 23 
Public Attitude and Media Attention Between the Wars 24 
Chapter II: Rehabilitation and Disability in the United States, 1940-1970 25 
World War II 25 
Bell Greve 25 
Government Programs during the War 26 
Rehabilitation and the American Armed Forces 27 
Military Personnel and Rehabilitation 27 
Henry Kessler 28 
Howard Rusk 28 
Improved Technologies 29 
The late 1940s and the 1950s: renewed interest 30 
National Studies Reveal Great Need 30 
Employment as a Key Issue 32 
The President's Committee for the Employment of the Physically Handicapped 32 
Significant U.S. Rehabilitation Centers in the Post-War Era 33 
The Institute of Physical Medicine and Rehabilitation 34 
The Kessler Institute for Rehabilitation 36 
Henry Viscardi 38 


Eleanor Roosevelt 38 
Mass Media: An Increasingly Educated Public 39 

U.S. Based International Rehabilitation Activity Revives 40 
New American Leadership 40 
The Late 1940s: Renewed Government Efforts 41 
Rebirth of Non-governmental Organizations: The International Society for the Welfare of Cripples 41 
Early United Nations Activities 44 
The Council of World Organizations Interested in the Handicapped (CWOIH) 47 
The World Rehabilitation Fund 47 
Additional International Work 51 
Federal Government Involvement in the 1950s and 1960s 53 
Mary Switzer 53 
PL.480 57 
America's Presence in Rehabilitation 60 
Cold War Politics 61 
Academic Links 62 
The Broadening Agenda: The Parent's Movement and Mental Retardation 64 
New Research Initiatives in Mental Retardation 67 
The West Point Conference 71 
Public Discussion of Retardation: A Change of Public Attitudes 71 
Mental Illness 73 
Summary of the Era 1940-1970 74 
Chapter III 77 
The Present: 1970-1990 77 
The Disability Rights Movement: Cross-Disability Unification 77 
United States-Based International Work 79 
International Disability Activities within the United States Government 79 
International Efforts Undertaken through NIDRR 81 
UCIR 81 
Additional Rehabilitation/Disability Work through other Government Agencies 83 
AID 83 
Congressional Support of Development Activities 83 
Peace Corps 83 
Inter-regional Cooperation 83 
NGOs in the 1970s and 1980s 84 
The World Rehabilitation Fund 84 
International Society becomes Rehabilitation International 85 
Rehabilitation and the New Disability Rights Movement 87 
The Winnipeg Congress: 1980 88 
Disabled Peoples' International 89 
World Institute on Disability 89 
Additional Work by United States Based NGOs 89 
Disability and Heritage 90 
Shifts in Policy and Focus 91 
The Independent Living Movement 92 
Legal Redefinitions and Provisions for Disability 96 
Shift from Western Medical Models: Culturally Appropriate Planning 96 
Cooperation within and between United States Based Groups 97 
American Participation in United Nations Activities 98 


Special projects for the International Year of Disabled Persons, supported by the USA 99 
Plan of Action 100 
Additional U.S. Leadership in International Disability Activities 105 
Chapter IV: Recommendations for the Future 107 
Section 1: Improved National Coordination Efforts 107 
Section 2: Training of Personnel 112 
Section 3: International Cooperation 115 

Brief Biographies 

Bell Greve 122 
Henry H. Kessler, M.D. 123 
Howard Rusk, M.D. 126 
Mary Switzer 128 

The Next Generation: 

Norman Acton 132 
Irving Blumberg 134 
Elizabeth Monroe Boggs 135 
James Burress, Ph.D. 136 
Francis Connor, Ed D 138 
Gunnar and Rosemary Dybwad 139 
Herman J. Flax, M.D. 141 
William Gallagher, Ph D 143 
Mervin Garrettson, Ph.D. 144 
James Garrett, Ed.D. 145 
Ignacy Goldberg, Ed.D. 147 
Joseph LaRocca 149 
Virginia Grace (Gini) Laurie 150 
Romaine Pryor Mackie 152 
Col. William P. McCahill 153 
Harold John Russell 154 
Henry Viscardi, Jr 156 
Helen Payne Wilshire Walsh 157 
Dorothy Warms 159 
Harold Wilke 161 
Donald Von Stein Wilson 162 
About the Author 164 
Footnotes 165 
Bibliography 167 


This study was undertaken to present an initial 
introduction to United States involvement in 
the field of international rehabilitation and disability. 
Little has been written on this subject or 
the individuals, policies and programs within this 
sphere that have been significant over the past 
century. The subject itself is so broad that while 
the highlights and some of the most important historical 
events and ideas are addressed in this 
monograph, the entire report must be viewed as a 
cursory overview. The issues, the individuals and 
the programs to which they contributed richly 
deserve separate studies of their own. 

Project Background 

This study is a collaborative effort funded 
through the IDEAS Project, jointly administered 
by Rehabilitation International and the World Institute 
on Disability, and through the IEEIR 
Project administered through the World 
Rehabilitation Fund. Both projects are funded 
under the auspices of the National Institute of Disability 
Research and Rehabilitation (NIDRR), 
Grants #G0087C2013 and #H133D0005, respectively. 


It began in 1989 at the Society for Disability 
Studies Meetings in Denver, Colorado. There, Barbara 
Duncan of Rehabilitation International, 
Diane Woods from the World Rehabilitation Fund 
and Judy Heumann and Mark Conly of the World 
Institute on Disability met to discuss joint 
projects. At that time, Gini Laurie, a well 
respected senior member of the field, was dying in 
St. Louis, and the talk soon turned to her and 
then to other senior members in the field of international 
rehabilitation with whom these individuals 
had worked for years. It became evident 
as they spoke that although Duncan, Woods, 
Heumann and Conly had themselves spent 
decades in the fields of international rehabilitation, 
disability rights and special education, there 
were many unknowns about the people and 
events that had preceded them. Nor was there 
anywhere to obtain such information easily. Although 
many of the people who had played key 
roles in the development of the field were still alive 
and active, no attempt had been made to compile 

Introduction 

what they knew or remembered of individuals and 
events in the field that had gone before them, or 
in which they had played important roles. 

Moreover, the field of international rehabilitation, 
as it stands today is a compilation of a number 
of different and very distinct fields and social 
movements, among them fields such as rehabilitation, 
disability rights, special education; and 
professions such as physical therapy, medicine 
and education. Indeed, it is not so much a unified 
field as a collection of disability related efforts 
with common international perspectives and experiences 
linking people and programs. Because 
of this, there is no central or unifying organization, 
and no academic base that has systematically 
compiled and analyzed the history and 
theoretical underpinnings of efforts in the arena. 
It seems that information about what had taken 
place in the past has been passed on from one person 
to the next, and it is clear that much has 
been lost along the way. This was in part due to 
the fact that little was written down, apparently 
because the field has always been small and unconnected 
to formal research efforts. With only a 
few people actively participating in the organizations 
and advocacy movements, there seems to 
have been little need to record events or their significance. 
Indeed, it is interesting to note that at 
one point during the Second World War, one 
woman, Bell Greve, was responsible for much of 
the field. 

In the discussions that followed, the four representatives 
of RI, WRF and WID decided that a 
history which would provide an overview of the 
origins and development of international 
rehabilitation work in the United States was in 
order. Its importance lay not only in what such a 
history could tell us about the past, but also because 
as a renewed interest is generated in international 
rehabilitation and disability issues, it is 
important to know where we have been. "Those 
who do not know the past are destined to repeat 
it," may have become a cliché, but in some cases, 
it is an appropriate thought. This is one. The field 
of international rehabilitation is still small, but 
growing, with limited numbers of experts, advocates 
and monies available. It is important to 

HISTORY OF INTERNATIONAL REHAIBILITATION 1 


It is important to know where we 
have been, as organizations and as a 
nation, so that we derive benefit from 
programs and policies that have 
proved effective, and can avoid those 
proven ineffective. 

know where we have been, as organizations and 
as a nation, so that we derive benefit from 
programs and policies that have proved effective, 
and can avoid those proven ineffective. 

Methodology 

This history has been compiled over the past 
18 months. The author, a medical anthropologist, 
has used a combination of methodologies to pull 
together many of the historical issues and incidents 
in what is today referred to as "international 
rehabilitation." All existing references and 
records that could be located have been reviewed; 
however, as noted above, the amount of published 
documentation and unpublished papers, memos 
and manuscripts within the field, is not large, and 
it was found that many historical facts, figures 
and incidents have simply not been documented. 
Furthermore, much of what at one time was put 
in written form has simply not been preserved. 
Compiling a history based only on written sources 
would have provided some background to the 
field, but would have yielded a much drier and incomplete 
account of the people and events behind 
the programs and decisions. 

Fortunately however, in addition to written 
documents, another source of information was 
also available—an oral historical account based 
on the participants themselves. Several dozen 
Americans now in their 70s, 80s and 90s who 
were involved in helping to establish and oversee 
some of the most important programs and research 
in the field are still alive. And, almost all of 
them continue to be active in the field. 

Of these senior individuals, (who came to be 
called "distinguished elders" during the course of 
the project) 21 were selected for extended oral historical 
interviews. These individuals were selected 
by Duncan, Heumann, Conly and Woods, the 
selection based both on their individual contributions 
and on an attempt to include participants 
from a diversity of disciplines, organizations and 
disability groups. The relatively short length of the 
study and the need for diversity and emphasis on 
international aspects of United States rehabilitation 
efforts, made these people candidates for this 
particular study. However, there were an equally 

large number of senior scholars whose careers 
and experiences warrant similar studies. It is 
hoped that others will pursue future interviews 
with and research about many of these people 
and the work they have participated in. 

The individuals interviewed during the 
course of this project were: Norman Acton, Irving 
Blumberg, Elizabeth Boggs, James Burress, Francis 
Connor, Gunnar and Rosemary Dybwad, Herman 
Flax, William Gallagher, Mervin Garrettson, 
James Garrett, Ignacy Goldberg, Joseph La 
Rocca, Romain Mackie, William McCahill, Harold 
Russell, Henry Viscardi, Helen Wilshire Walsh, 
Dorothy Warms, Harold Wilkie and Donald Wilson. 

Each of these individuals was interviewed 
either in person or by telephone by the author, 
with interviews lasting one to five hours in length. 
The interviewees were asked to relate their own 
backgrounds and education, their involvement in 
the field and their memories of key events, individuals 
and ideas with which they had some 
contact. In addition, they were asked to provide 
recommendations for the future of the field, based 
on what they had seen work, and not work, over 
the course of their own careers. The interviews 
were open ended and those interviewed were 
specifically asked to speak not only to the issues 
raised by the author, but also to note what had 
been overlooked that was of historical significance 
in their opinion. (This question proved important 
for a number of individuals, programs, meetings 
and events came to light that would have been 
otherwise missed). A number of those interviewed 
also provided references and written documents 
arid were very helpful in supplying additional information 
and clarifying points over the course of 
the writing process. 

The interviews themselves were tape 
recorded, (although several individuals felt more 
comfortable speaking with the author taking written 
notes, which was done in those cases). All interviews 
have been transcribed, and copies of the 
actual tapes and transcriptions will be placed in 
the archives of Rehabilitation International, The 
World Rehabilitation Fund and The World Institute 
on Disability, so that they can be available 
for future researchers. 

Conference 

The information and ideas gained through interviews 
with the 21 senior members of the field 
was further supplemented by a conference held in 
Washington, D.C. in January, 1990, which 
brought together 18 of these leaders for an open 
discussion of the programs, ideas and policies for 
which they had been responsible over the past 50 

2 HISTORY OF INTERNATIONAL REHABILITATION 


The field of disability and rehabilita


tion internationally, as it exists 

today, is the antithesis of such a 

model. It has its roots in dozens of dif


ferent historical movements, events, 

organizations, academic disciplines 

and professional fields. 

years. Called the "Oral History Conference", it 
proved to be a fascinating conference for many as 
it helped to illustrate for the audiences the historic 
affiliations, agreements and disagreements, 
within the field. 

The information presented in this study is an 
historical overview based on the written and oral 
historical sources. In addition, several of the interviewees 
have written memoirs of their lives and 
careers, which have proved both interesting and 
informative. It is through a combination of these 
historical sources that the following history has 
been written. Without the input of the "distinguished 
elders" however, much of the information 
included here would have been missing or poorly 
documented. 

Historical Overview 

Historians are given to conceptualizing movement 
over time in the form of "trees," with small, 
early efforts forming the trunk and larger scale, 
later efforts springing from the trunk as so many 
branches, expanded outward. The field of disability 
and rehabilitation internationally, as it exists 
today, is the antithesis of such a model. It has 
its roots in dozens of different historical movements, 
events, organizations, academic disciplines 
and professional fields. For example, schools and 
advocacy groups for deaf, blind and mentally 
retarded children and adults existed from the 
early 19th century on, bringing, for the first time, 
some attention to the needs and concerns of these 
individuals. Rehabilitation, as a medically based 
discipline, did not arise until several decades 
later, and would concern itself primarily with 
those who were physically disabled until well after 
World War II. Vocational Rehabilitation as a field 
took form slowly in the first part of the 20th century 
in response to a series of state and federal 
legislative acts and administrative decisions. Advocacy 
by people with disabilities themselves was 
an important factor by the early 19th century, but 
there was a lack of strong on-going cross-disability 
coalitions for many years and the effectiveness 
would wax and wane. Not only were these 
major groups growing and developing at different 

rates, but because of prevailing social, economic 
and conceptual issues they rarely worked cooperatively 
with one another, and often found themselves 
in open competition for scarce funding 
sources and public attention. 

Uniform Concepts 

The historical unity disabled individuals or 
disability organizations had was in the general 
definition given socially and legally to persons 
with disabilities, as "objects of charity," and in a 
later period, as potential beneficiaries of medical 
and rehabilitative initiatives. The charity and 
medical/rehabilitative models shared as a basic 
premise, the assumption that people with disabilities 
needed to be cared for, and that such 
care was provided by the general society as it (not 
they) saw fit. Those who were physically or mentally 
impaired, it was believed, had no legal or ethical 
right to demand anything of society, they 
could only hope that society would provide 
programs and opportunities for them after weighing 
their needs against other social priorities, and 
budgeting accordingly. 

The charity and medical/ rehabilitative models shared as a basic 

premise, the assumption that people 

with disabilities needed to be cared 

for, and that such care was provided 

by the general society as it (not they) 

saw fit. 

Because of the nature of the historical 
developments within "rehabilitation", assembling 
an overview of the activities, fields and individuals 
who have played a part in international disability 
and rehabilitation work proved to be a far more 
complex task than it initially appeared. Even the 
terminology is difficult to disentangle. Today, 
"rehabilitation," is often used in two senses: as a 
specific field within the realm of medicine and allied 
professions, and as a general term somewhat 
loosely associated with organizations and movements 
involving "disability rights" and advocacy. 
"Rehabilitation" in fact, was a term that rarely appeared 
in the broader medical community or 
among the general public before World War II, (although 
many of the basic concepts in the field 
long preceded this). Moreover, until some 20 years 
ago, "rehabilitation" was used to refer primarily to 
attempts to restore some physical function or 
vocational self-sufficiency to some physical dis-

HISTORY OF INTERNATIONAL REHABILITATION 3 


ability. Blindness, deafness, mental retardation 
and mental illness were not usually included within 
the realm of "rehabilitation" programs. These 
other sensory or mental impairments were often 
represented by people and organizations whose 
constituencies were concerned with specific disability 
groups —"the blind," "the deaf' and so 
forth. It has only been in the last two decades that 
all these pieces have come together in a larger puzzle, 
and a rethinking of the basic assumptions 
within the field has taken place. Looking back, it 
may seem obvious to many in the 1990s that the 
early work with and among disabled groups in the 
United States, no matter what the specific physical 
and mental impairments might be, shared 
common concerns. Today, these might be considered 
civil rights and social policy issues—the 
recognition that people with disabilities have a 
right to participate openly and fairly in society as 
individuals, who happen to have some form of impairment. 


Today, these might be considered 

civil rights and social policy issues— 

the recognition that people with dis


abilities have a right to participate 

openly and fairly in society as individuals, who happen to have some 

form of impairment. 

Disability Rights 

Advocates of the Disability Rights Movement 
and the Independent Living Movement have 
fostered attempts to work together within the 
field. Cross-disciplinary and cross-disability in nature, 
and drawing on ideas and movements from 
many nations, individuals and groups of people 
with disabilities from around the world have come 
forward to demand civil rights as citizens, rather 
than as recipients of charity or patients within a 
medical or vocational mode. In the U.S., significant 
advances, such as the recently passed 
Americans With Disabilities Act, are evidence of 
the effectiveness of such collaborative efforts. 
Many older national and international organizations, 
societies and professions working on disability 
issues have altered their conceptions to be 
more in tune with this new thinking. 

It would be misleading to look back at the 
history that brought us to this point and see it all 
as part of a plan, building towards the increasing 
cooperation of disability-related groups, organiza-
tions and fields that exist today. In fact, much 
that went on was done in fits and starts, and the 
movement was not always forward. Indeed, it is interesting 
to note that some of the very earliest concepts 
at the core of recent international 
attention—equal treatment before the law, the 
right to accessible housing and transportation, 
fair employment practices—are not new. It is striking 
how often these concepts come up in the 18th, 
19th and early 20th centuries in Europe, North 
America and elsewhere—raised by both people 
with disabilities themselves and many who have 
worked on their behalf. 

It is interesting to note that some of 
the very earliest concepts at the core 
of recent international attention— 
equal treatment before the law, the 
right to accessible housing and 
transportation, fair employment practices—
are not new. 


Structure of the Study 

This study is divided into three parts. The 
first is a history of the field. The second is a compilation 
of recommendations for the future based 
upon the ideas and suggestions of the "distinguished 
elders" interviewed for this report. The 
third is a series of short biographies of the 21 individuals 
interviewed for this study. 

From the early 19th century onward those involved 
in international rehabilitation in the U.S. 
had two primary channels of communication: a 
formal and an informal network. Continuing international 
contact has been maintained through formal 
organizations, (governmental or intergovernmental 
such as the United States Rehabilitation 
Services Administration and its predecessor agencies, 
the United Nations programs, and voluntary 
organizations such as Rehabilitation International 
[founded 1922], the World Rehabilitation Fund 
[founded 1955], and later, the World Institute on 
Disability [founded 1982]). Informal networks were 
often the result of immigration, foreign educational 
exchanges, religious/missionary outreach 
programs or the outgrowth of international research 
in related fields, such as special education 
or physical therapy. 

These two channels were not mutually exclusive 
and many individuals participated in both. 
Hence, although there were a large number of 
programs and events, in fact, the number of individuals 
involved in the United States in interna


4 HISTORY OF INTERNATIONAL REHABILITATION 


flowed from one arena to the other and back

The number of individuals involved in 

again. In large measure, this seems to be because

the United States in international 

individuals who became prominent in the internarehabilitation 
work has always been tional rehabilitation movement usually were notsmall. tapped for overseas projects until they were al


ready influential figures on the national level. 

tional rehabilitation work has always been small. 
Even in the zenith of the United State's involvement 
in international work in the 1950's and 
1960's, probably fewer than 50 people were the 
primary decision makers. Their names appeared 
time and again, they sat on many of the same 
committees, often called upon each other to serve 
on boards and councils and frequently were personal 
friends. Many knew and worked with each 
other on a daily basis over the course of 30 or 40 
years. Because of this, the infoi alai network appear 
to have been as significant and in some 
cases, more significant than the formal ones. 

Moreover, the historical distinction between 
national and international rehabilitation activity 
is somewhat artificial. For many years ideas 

Ideas, approaches and concerns that 
American leaders were instrumental in developing 
within the United States, were carried on into 
their work abroad. Likewise, ideas and innovations 
to which United States leaders were exposed 
in international rehabilitation programs were 
often quickly incorporated into programs in the 
United States. This rapid absorption of ideas from 
other countries was due, in part to the fact that 
those Americans involved in overseas work were 
already senior enough to command the attention 
of fellow professionals here in the United States. 

Finally, it should be noted that the shift over 
the past century within the field of disability and 
rehabilitation from a group of fragmented 
programs, disciplines and experts, to an increasingly 
unified disability rights movement echoes 

"Noted Author Visits UN Headquarters" was the headline of a 1949 UN press release announcing the arrival of Helen Keller to one of its first meetings. 
Miss Keller is shown above at the Lake Success (temporary) offices of the UN with her secretary, Polly Thompson, interpreting the debate. 

HISTORY OF INTERNATIONAL REHABILITATION 5 


similar trends in many other significant social That the model has now shifted to a "civil 
movements, such as the Women's Movement and rights" basis, in which individuals with dis-
the Civil Rights Movement. abilities are considered to be entitled to equality 

Much of the progress that has been made before the law, and to programs and policies that 
could not have been accomplished had a small assist them in attaining this equality—is a tribute 
and dedicated group of individuals and organiza-to many of the leaders and organizations that 
tions spent decades prior to this laying what have worked for years on disability-related issues. 
would eventually become the groundwork. Change could not have occurred, had the ground-

The past two decades have been a period uni-work not be laid by individuals and organizations 
que in the history of the disability field. At the as far back as the 19th century. And the amount 
start of the period, there was no clear perception and types of change seen in the past two decades 
of disability as a unifying concept on the part of would not have occurred unless individuals with 
most Americans—non-disabled individuals and in-disabilities themselves were influencing the 
dividuals with disabilities alike. Two theoretical process—advocating on their own behalf, and in 
models were in operation in general society and in growing numbers, increasingly vocal about setting 
the eyes of the law—one which considered people priorities and establishing programs to address 
with disabilities to be ultimately, "objects of their needs. As the precursors of what is known 

charity," who should be grateful for whatever today as the Disability Rights Movement got unsociety 
chose to allow them to receive. The other derway, the ability of the disabled community, 
model, a `rehabilitative one' assumed that most in-some thoughtful and committed professionals, 
dividuals with disabilities were, in one guise or and organizations and agencies working on dis-
another, `patients' or `clients' that needed to be ability issues, to come together and present a 
restored to society. Perhaps not sick, but never to unified front seems to have made the critical difbe 
cured, they would need to be looked after by a ference. The gains that have resulted are a 

well-intentioned but paternalistic group of or-product of generations of work, ideas and initiaganizations 
and agencies. tives on the part of committed individuals. 

Table 1. Barr's educational classification of the feeble-minded. 

IDIOT. 
Apathetic. Unimprovable.

— Profound. 
1_Excitable. -I 

Asylum Care. Apathetic. Improvable in self-help only.

Superficial. 

1_ Excitable. 

IDIO-IMBECILE. 

Improvable in self-help and helpfulness. 
Trainable in very limited degree to assist others. 

MORAL IMBECILE. 
Mentally and morally deficient.

Custodial Life 

Low Grade: Trainable in industrial occupations; temperament bestial.

and Perpetual 

Middle Grade: Trainable in industrial and manual occupations; a plotter of mischief.

Guardianship. 

High Grade: Trainable in manual and intellectual arts; with a genius for evil. 

IMBECILE. 

Long Apprentice-Mentally deficient. 
ship and Colony Low Grade: Mentally deficient. 
Life Under Middle Grade: Trainable in manual arts and simplest mental requirements. 
Protection. High Grade: Trainable in manual and intellectual arts. 


BACKWARD OR MENTALLY FEEBLE. 

Training for a Mental processes normal, but slow and requiring special training and environment to 
Place in the prevent deterioration; defect imminent under slightest provocation, such as excitement, 
World. over-stimulation or illness. 

Chart produced by Martin Barr, USA, 1904, reprinted from A History of Mental Retardation, P.C. Scheerenberger, Brookes Publishing Co., 1983. 
6 HISTORY OF INTERNATIONAL REHABILITATION 


Disability in Early American 
Society 

The history of disability and rehabilitation in 
the United States long precedes the turn of the 
20th century, and it is important to understand 
how this field grew and developed over time, for 
the ideas and assumptions which have guided 
many American efforts internationally are based 
on specific historical developments and cultural 
perceptions within the United States itself. 
American ideas and attitudes towards disability 
and disabled people, in fact, long precedes the settlement 
of the United States. England, home to 
many of the early settlers of Eastern North 
America, provided the American settlements with 
a culture, langauge and legal system upon which 
much of America's subsequent history would rest. 
It is therefore significant that shortly before the 
major immigration to the New World began, 
England passed its first major piece of legislation 
related to those who were disabled, the Poor Relief 
Act of 1601. 

The importance of this Act is that for the first 
time, a national government acknowledged a 
responsibility to "disabled in need" with a clear 
distinction made between those who were deemed 
"worthy" of such help and those who were not. 
Local assistance for individuals with disabilities 
had long been available to at least some disabled 
people before the Act was passed, but it was up to 
individual families, local communities and the 
church to provide such aid, and it was provided 
on a case by case basis. Times were changing however. 
People were beginning to find work in cities 

The Poor Relief Act had one significant 
flaw that would impede the 
progress of individuals with disabilities 
for generations to come. By 
defining "worthy" and "unworthy" 
poor, a distinction was made, with 
priority given to those whom society 
deemed to be "productive." 


Chapter I 


Peter Stuyvesant, last Dutch director-general of New Amsterdam, 
defiantly rips up a surrender summons from the British in 1664. 
Stuyvesant, who 20 years before had lost a leg fighting the Pore 
tuguese in the West Indies, stayed in Manhattan under the British until 
his death eight years later. (Source: Performance, 1976-77) 

far from their native towns, traditional support 
systems no longer played such an all encompassing 
role and the central government began to take 
a more dominant role in everyday life. 

The Poor Relief Act is a milestone in the history 
of social legislation. It did more than influence 
American laws—for the first 150 years of 
the colonies' existence, it was American law. After 
the Revolution, it would remain the model for subsequent 
Congressional legislation. Unfortunately, 
among other problems, the Poor Relief Act had 
one significant flaw that would impede the 
progress of individuals with disabilities for generations 
to come. By defining "worthy" and "unwor-

HISTORY OF INTERNATIONAL REHABILITATION 7 


thy" poor, a distinction was made, with priority 
given to those whom society deemed to be 
"productive." (And this no doubt, did not originate 
in the Law itself, but only reflected then-current 
thinking in the broader English society). Whatever 
its origin, the distinction, and the right granted by 
society, rather than individuals with disabilities 
themselves to define who was "worthy" and by extension, 
"worthwhile", would haunt society for 
centuries. 

While the significance of the 17th century act 
may have been the identification of the impoverished 
disabled population as an issue of 
public responsibility and concern, it was the 18th 
century Enlightenment, with its emphasis on the 
systematic compilation and analysis of bodies of 
information, that encouraged regular inquiry into 
disability as a human condition. Interest in "the 
disabled" began to be considered a valid scientific 
topic. 

Prior to the 18th century, writers might note 
if a person was in some way physically or intellectually 
disabled, but few scholars questioned what 
the causes, consequences or ramifications of 
being disabled might be for the individual. Until 
then, virtually no seriously disabled individuals 
seem to have left a record of their own thoughts or 
experiences. Then, in the early 18th century, 
throughout Europe, well educated men (and 
women), with growing regularity, debated and 
wrote treatises on deafness, blindness, mental 
retardation and other disabling conditions, combining 
observation with philosophical inquiry. 
How could profoundly deaf people think without 
language, philosophers asked—if they could not 
think, how could they know of the existence of 
God? "What," scholars questioned, "did blind 
people imagine everyday objects looked like? What 
was the potential of a blind child if he or she were 
to receive a good education?" Reflecting assumptions 
that would be maintained for the next three 
centuries, few writers addressed the underlying 
social issue of disability, except in the broadest of 
terms—the attention was invariably on the effect 
on the individual of a specific type of physical or 
mental disability. 

Many of these inquiries about human nature, 
thought and disability initially had a distinctly 
"guinea pig" quality about them. Individual deaf 
or blind people, usually children, would be 
trained using a specific technique with a body of 
scholars, (and sometimes, although not always, 
medical personnel), looking on and debating the 
outcome. Subsequently, soon such inquiry led to 
the discovery that these individuals with dis


abilities, when provided with the same educational 
and social advantages as non-disabled individuals, 
often demonstrated great promise and 
potential. Scholars began, by trial and error, to 
develop educational schemes and techniques. By 
the late 18th century, a few committed individuals 
in Europe had begun organizing schools and institutions 
for children and adults with some 
specific types of disabilities. 

In Europe, with these schools in operation, a 
gradual change in the perception of disability 
began to be discernible among the general public. 
It became apparent that people with disabilities 
whose lives would traditionally have been quite 
limited, could do more. This realization was considered 
to be so new and remarkable that schools 
for blind and deaf children became regular stopping 
points on travelers' venues, and some 
prominent schools for blind and deaf pupils 
presented weekly public demonstrations of their 
students' accomplishments. 

The shift from indiscriminate lumping 
of "the infirm" or "the cripples" found 
in an earlier era, gave way to 
bounded interest groups. 

19th Century Developments in 
Disability 

In the first several decades of the 19th century 
schools, institutions, benefit societies and advocacy 
groups were founded throughout Europe. 
These organizations were invariably dedicated 
specifically to one particular type of disability— 
blindness, deafness and so forth. There was no 
cohesive community of people with disabilities, 
only groups of individuals who shared a particular 
physical or mental impaiiment. 

This division of the disabled community by 
specific disability might be viewed as part of a 
process of historical maturation. The shift from indiscriminate 
lumping of "the infirm" or "the cripples" 
found in an earlier era, gave way to bounded 
interest groups reflecting a growing interest and 
knowledge in scientifically and systematically 
identifying information of direct relevance to 
specific groups. The concept of 'the disabled' as a 
group with unifying experiences and common interests 
was not yet formulated. This seems to 
have reflected that the general public and experts 
alike placed primary emphasis on the physical 

8 HISTORY OF INTERNATIONAL REHABILITATION 


The general public and experts alike 
placed primary emphasis on the 
physical limitation of the individual, 
and not on the common social restrictions 
such individuals faced. 

limitation of the individual, and not on the common 
social restrictions such individuals faced. 
The emphasis on differences between various disabilities 
rather than on common concerns of 
people with the disabilities would became a legacy 
that would carry on until the rise of the Disability 
Rights Movement barely 20 years ago. 

A "pecking order" also arose among these 
groups, with certain types of disability conditions 
eliciting much more interest, concern and support 
among the general public than others. Blindness, 
followed by deafness, were conditions that stirred 
genuine concern among the public in the 19th 
century. Mental retardation, on the other hand, 
rarely struck a responsive chord within the 
general population, and those working on behalf 
of retarded groups found it much harder to obtain 
money, support or public involvement. 

European Influences in Early 
American Society 

The founding of schools for various groups of 
disabled children and young adults, and organizations 
run largely for, rather than by individuals 
with disabilities in Europe in the 1780s and 
1790s, was not immediately replicated in the 
United States, although the European efforts were 
not unknown. Linked by a shared history, culture, 
academic and literary tradition, the Revolution 
and the economic and social upheaval that 
followed may have slowed the transfer of 
knowledge and experience. By the early 19th century, 
however, children from at least a few wealthy 
American families were being sent to 
European schools, such as Braidwoods School for 
the Deaf in Edinburgh. Interest in establishing 
special programs for disabled people—especially 
disabled children, began to grow in the United 
States in the first quarter of the 19th century and 
international links began to be established. 

Americans, interested in organizing 
programs for various groups, initiated correspondence 
with colleagues in Europe, and traveled to 
the continent to meet leaders in the field. 

Thomas Rowlandson (English, 1756-1827), THE AMPUTATION, 1785. 

HISTORY OF INTERNATIONAL REHABILITATION 9 


Jean-Louis-Andrd-Theodore Gericault (French, 

European pioneers in deaf and blind education, in 
mental retardation, and those working on new 
techniques for the physically disabled regularly 
received interested American educators, 
physicians and disabled citizens. The latest concepts 
in the field were translated and published in 
a host of newly instituted United States-based 
professional journals and a growing number of 
popular magazines and weeklies featured stories 
on individuals with disabilities, schools that 
served deaf or blind children and 'interesting' 
medical conditions, bringing new information into 
the homes of an increasingly literate public. Some 
European experts themselves came to North 
America to lecture and consult, and a few 
remained for part or all of their following careers. 

Many of the most prominent 
European authorities sent several of 
their own students to the U.S. to initiate 
programs similar to well established, 
on-going ones in Europe. 


10 HISTORY OF INTERNATIONAL REHABILITATION 

1791-1824), A PARALYTIC WOMAN, 1821 

Many of the most prominent European authorities 
sent several of their own students to the U.S. to 
initiate programs similar to well established, ongoing 
ones in Europe. For example, in 1816 the 
Abbe Sicard of the National Institute for Deaf 
Mutes in Paris gave permission for one of his 
senior teachers, Laurent Clerc, to accompany 
Thomas Gallaudet back to Connecticut so that he 
could help establish what is today the American 
School for the Deaf. Samuel Gridley Howe, while 

assisting in establishing what is today The 
Perkins School, hired two blind instructors in the 

1830s, one from France, the other from Scotland, 
to teach. When the need arose for a teacher to organize 
the new Massachusetts School for Idiotic 
and Feebleminded Youth, Itaid's disciple, Edouard 
Sequin, was brought from Paris. 

Gradually, the interchange of ideas from 
abroad and a general redefinition of social welfare 
and education sparked the establishment of 
schools, institutions and associations for and by 
deaf and blind groups and for mentally retarded 
children and adults throughout the United States. 
The growth of these institutions, schools and ad



vocacy groups was significantly aided from the 
mid-19th century and by the growth (and flourishing) 
of a tradition of organized social charities, 
which worked on behalf of, (but rarely included or 
consulted with), individuals with disabilities. 

Divisions Within the Disability 
Community 

In both Europe and America, organizations 
for those who had physical or intellectual impairments 
were increasingly divided and isolated 
along the lines of specific types of disabilities. Organizations 
for blind groups did not regularly communicate 
with deaf advocacy groups, 
organizations for the mentally retarded did not 
seek support from well-organized deaf or blind 
groups. Interestingly, those who were physically 
disabled were rarely considered, by themselves or 
by the general public to be a distinct group, in the 
same sense as were blind, deaf or mentally 
retarded individuals. In fact, the historical 
development and treatment of physical disability 
as a distinct category, appears to have differed significantly 
from that of other disability groups. 

Unlike services for the the deaf and blind 
communities, almost all facilities for physically 
disabled people were tied directly or indirectly to 
hospitals. Medical issues and medical definitions 
of priorities and concerns predominated. This may 
have been partly because there was more that 
19th century medicine could do to treat, if not 
fully cure, some physically disabled individuals 
than those who were deaf or blind. In part, the difference 
in approaches to the deaf and blind as opposed 
to the physically disabled community may 
have been only an historical accident—the organizing 
of institutions and schools for those who were 
physically disabled, for example, took place 
several decades later than for most blind and deaf 
groups, just at the time established medicine 
began to become a stronger voice in American 
society. 

In Europe, organizations and institutions for 
and of blind and deaf children and adults 
flourished in the late 18th and early 19th centuries. 
While an early institution for those with 
physical disabilities was founded in 1780 in Orbe, 
Switzerland, it was not until 1832, that the first 
school for "crippled children," the Royal Bavarian 
School and Home for Crippled Children, was 
founded in Germany. Prior to this, those who had 
physical impairments were simply kept at home, 
their inclusion in the family and community 
based on prevailing beliefs and their family's social 
and economic needs. From the 1930s on, 
similar schools and institutions gradually spread 

It was not until 1832, that the first 
school for "crippled children," the 
Royal Bavarian School and Home for 
Crippled Children, was founded in 
Germany. 


throughout Germany, France, Great Britain, Switzerland 
and Italy. A hospital-based system, it differed 
significantly from the deaf and the blind 
communities, where a system of prominent, well-
respected educational institutions were centers 
from which ideas and advocacy was disseminated. 
Early advocacy efforts among blind and deaf 
groups were frequently run by individuals with 
disabilities themselves, often utilizing a network 
of contacts and connections made as students. As 
such the adult deaf and blind groups often functioned 
much like alumni organizations, and were 
often extremely effective. While the growing power 
of the medical establishment in the latter part of 
the 19th century would "medicalize" some issues 
for blind and deaf individuals, the strong 
academic and advocacy heritage would provide a 
balance within the community as a whole. 

For those who were physically disabled in the 
United States, during the mid-to-late 19th century 
numerous hospitals, schools and institutions 
were established. American surgeons who had 
Civil War service were among the first to explore 
what would come to be known as "rehabilitation," 
an attempt to improve or restore some physical 
functioning to an individual with a physical impairment, 
a term not in regular use until after 
World War I. For example, when noted Civil War 
surgeon Dr. Simon Baruch became Chair of the attending 
staff at New York's Montefiore Hospital 
after the War, he set up a program for physically 
disabled patients and in 1885 wrote about his 
work in terms that are strikingly familiar to many 
who would approach the field a century later. "It 
is a proud achievement," he noted, "when our 
records will tell that a goodly proportion of those 
who have entered our gates only to die in peace 
have again issued from them entirely or partially 
restored and enabled again to enter upon the battle 
of life from which they had regarded themselves 
as permanently banished." (Rusk: 1972:57). 

Despite the good intentions of physicians 
such as Baruch, the services available to those 
who were physically disabled was by no means 
comprehensive. Medical care or surgery was followed 
by prolonged bed rest attempt to coordinate 
attendant care, help locate or fit prostheses or 
retrain individuals for employment. Most children 

HISTORY OF INTERNATIONAL REHABILITATION 11 


or adults with significant physical disabilities 
were relegated to life as "invalids"—physically, socially, 
legally and economically under the supervision 
of family members if they were fortunate, in 
an institution or a state-run poor farm if they 
were not. 

The pattern of importing ideas and expertise 
from Europe to the United 
States remained significant 
throughout the 19th century. 

International Exchange of Ideas 
at the Close of the 19th century 

The pattern of importing ideas and expertise 
from Europe to the United States remained significant 
throughout the 19th century. There was 
an occasional American contribution to the Continent. 
For example, an American, Francis 
Campbell, a former Perkins teacher, founded the 
Royal Normal College for the Blind in England. 
The establishment of a college for deaf education 
in 1864, today known as Gallaudet, brought comment 
and observers from throughout the Continent. 
However, such examples are few and far 
between. For the most part, the later 19th century 
saw America continue to be primarily a recipient 
of European ideas, rather than a source of innovation. 
Contact with other parts of the world on disability 
matters was virtually non-existant. 

The only significant exception to this pattern 
was the limited American contributions to a scattering 
of programs in what is today called the 
"Developing World." The late 19th century was the 
heyday of American missionary efforts abroad, 
and small institutions and schools for various 
groups of disabled populations—a school for the 
deaf here, an institution for blind youngsters 
there, were set up in Africa and Asia. However, 
these were usually small scale efforts, and the 
Americans who taught in these places were receiving 
their information and training third hand— 
they were trained in American institutions using 
European ideas and bringing these to the Third 
World for further dissemination. Moreover, in 
many cases their approach to "serving" those with 
disabilities reflected their own social and religious 
orientations rather than addressing directly the 
needs of those with whom they worked. And an 
unsettling undercurrent in many missionary-
based accounts and reports indicated that many 
missionaries considered doing such work particularly 
arduous and praiseworthy. 

Louis-Leopold Boilly (French, 1761-1845). THE BLIND, 1825 

Occasional contact was also made between 
American schools and institutions, such as 
Perkins and Gallaudet, and people interested in 
establishing similar schools or clinics overseas. 

The exchange of infoiniation between Europe 
and the United States, while on-going throughout 
the 19th century, took place between a relatively 
small number of people who kept in regular contact 
and knew each other personally. In many 
ways, the network, once established, took on the 
characteristics of a small town, with many of the 
strengths and some of the weaknesses (rivalry, 
personal vendettas), attendant in any such small 
scale social situation. Within the deaf and the 
blind communities, regular ties were maintained 
with individuals and similarly organized advocacy 
groups throughout Western and Eastern Europe. 
Although interpersonal contact among medical 
personnel, educators and other professionals became 
more faunal with the introduction of journals, 
training programs and annual meetings 
among professional groups, by the close of the 

19th century, the patterns had been established. 

The U.S. nucleus of international disability work 

The U.S. nucleus of international disability 
work was dependent on a 
handful of key people, few of whom 
were themselves disabled. 

12 HISTORY OF INTERNATIONAL REHABILITATION 


was dependent on a handful 
of key people, few of whom 
were themselves disabled. 
Much of the work, particularly 
by the women in the field, 
was done on a voluntary 
basis, and there were deep 
divisions within the work of 
disability related efforts based 
on disability categories. 

1900-1920: 
World War I as a 
Watershed Period 

The early years of the 
20th century saw a continuing 
interest in disability-related 
work in Europe and in 
the United States, with significant 
progress in organizational, 
medical and legal 
approaches to disability issues. 
In the United States, 
the years during and following 
World War I were years of 
intense activity with initiatives 
divided between state 
and federal agencies and 
private voluntary organizations 
and advocacy groups. 

In Europe and in the 
United States, World War I 
might be considered a watershed 
for the field of rehabilitation, 
as massive casualties Lithographie von Andre Helle, Le Rire, 20. Juni 1908. (Source: Der Gezeichnete Mensch, p. 39) 

forced refinements of surgical 
and post-surgical care. For 
the severely injured survival rates were not significantly 
better than they had been in the 19th 
century. For example, of the 400 American servicemen 
who became quadriplegic during World 
War I, half died on the battle front and eight out 
of ten who survived died within 90 days of returning 
home. For those whose injuries were less 
severe, surgical techniques and medical procedures 
had undergone some improvement. How-

Albee argued that disability had to 

be addressed by a scheme which 

would include "three legs of the 

tripod"— physical restoration services, vocational guidance and placement. 

ever, a comprehensive or coordinated approach by 
the medical establishment or social agencies for 
those who had received severe physical injuries 
was still lacking. There were no programs of exercise 
or training following injury; even prosthetics 
and orthotics were not usually a concern of medical 
professionals, as most patients were responsible 
for locating competent limb makers, and 
learning to use the such devices on their own. 

Medical care for physically disabled children 
and adults even in the most advanced civilian 
hospitals, was no better. Henry Kessler, the orthopedic 
surgeon who would later play a significant 
role in both domestic and international 
rehabilitation, recalled that during his surgical 
residency in New Jersey just after World War I, 
many of the methods used were "left over from Victorian 
days." Paraplegic patients for example, "... 

HISTORY OF INTERNATIONAL REHABILITATION 13 


were allowed to lie in a bed of sawdust, treated almost 
like animals. The theory was that if their 
bowel and bladder could not be controlled, at 
least the bed could be kept clean by removing the 
sawdust." (1968:53) 

An exception in this era was the work of Dr. 
Fred H. Albee in New Jersey. Albee was, by training, 
an orthopedic surgeon who had already 
gained international fame by adapting techniques 
devised for tree grafting to the grafting of human 
bones. In touch with physicians throughout 
Europe and familiar with such pioneering 
rehabilitation work as that of Drs. Paul Pastur 
and Azer Basque with disabled French soldiers, 
Albee was concerned both with immediate medical 
needs and with the restoration of war injured 
veterans to society. Albee argued that disability 
had to be addressed by a scheme which would include 
"three legs of the tripod"— physical restoration 
services, vocational guidance and placement. 
Although acceptance of the self and self-determinates 
by disabled individuals were not part of 
Albee's agenda, it must be remembered that, for 
the times, Albee's "tripod" was revolutionary, and 
by the then-current practices, exceptionally broad. 

When the United States entered World War I, 
Albee wrote to the Surgeon General of the United 
States War Department proposing the establishment 
of three comprehensive rehabilitation 
hospital facilities for injured soldiers. Only one 
was actually built, the 2000 bed United States 
General Hospital Number 3 in CoIonia, New Jersey. 
Although in existence for barely 16 months, it 
was revolutionary in design. Featuring services for 
medical, surgical, physical and occupational 
therapy, it also contained an artificial limb factory, 
a brace shop and departments of psychology 
and social services. More than 30 trades were 
taught and social workers followed up with 
patients as they were discharged into civilian life 
(Kessler:1968:41). Over the short span of time the 
hospital was functioning, more than 6000 servicemen 
were treated and released. 

The hospital at Colonia reflected all the lessons 
Albee had learned from his experiences in 
Europe and Canada. It would remain unique in 
the United States for the next 30 years. With the 
end of the War however, the military closed the 
hospital. An attempt to establish a comparable 
hospital through the state of New Jersey was not 
successful, although Albee did persuade decision-
makers to establish the first state sponsored 
rehabilitation clinic in the country and the first 
Rehabilitation Commission to administer it. 
Albee's own private practice and continuing international
work did not allow him time to develop 
his ideas in the field further. 

The lack of a supporting constituency in the 
medical community or in broader society meant 
that there was also no on-going support or advocacy 
for Albee's ideas or approach. Slowly, 
memory of Albee's hospital began to fade. Fortunately, 
one of Albee's most successful accomplishments 
was the training of a young chief 
resident named Henry Kessler, who would be able 
to carry on and greatly expand upon many of 
Albee's early ideas. Kessler soon became Medical 
Director of the recently established New Jersey 
State Rehabilitation Clinic, then a four-bed facility 
located in an old factory building in Newark. For 
two decades Kessler would remain one of the few 
medical doctors in the country with an expertise 
in rehabilitation medicine. 

The concept of employer responsibility 
for workers disabled while on 
the job was in its infancy. 

State and Federal Involvement 
and Disability: 

In the years between the turn of the century 
and Second World War in the United States, state 
and federal government agencies became increasingly 
involved in disability issues. Particular emphasis 
was placed on assisting those whose 
physical disabilities had occurred in the work 
place. In part, this reflected a response to the new 
dangers more complex manufacturing and 
processing technologies brought to the mines, 
fields and factories. In part, it was a consequence 
of the demographic changes brought by the movement 
of workers from small towns to big cities 
where, should they become permanently disabled, 
family and community support networks were 
lacking. (The emphasis on targeting services to 
foinier able-bodied workers was a haunting 
reminder of the distinction between 'deserving' 
and 'undeserving' poor and disabled set down in 
the 17th century English Poor Relief Act). 

The concept of employer responsibility for 
workers disabled while on the job was in its infancy. 
Worker injuries were considered a misfortune, 
but not requiring the on-going responsibility of 
employers who might provide a small sum of 
money for the newly injured worker but rarely 
had in place an on-going pension system to provide 
help. The injured worker was responsible for 
him or herself, and the family was responsible if 

14 HISTORY OF INTERNATIONAL REHABILITATION 


the worker was too severely injured to continue. 
Injury to a principal wage earner often brought 
poverty to an entire family and a life dependent on 
what little charity was available. The only exception 
to this was the long-established practice of 
providing small pensions to those severely injured 
in warfare—soldier's pension plans in Europe and 
the U.S. provided a very modest existence to those 
fortunate enough to receive them. 

Despite opposition, in 1920 the Vocational 
Rehabilitation Act was passed 
by Congress. 


Concept of Employer 
Responsibility 

Workmen's compensation schemes 
originated in Europe and as early as 1893, U.S. 
President Benjamin Harrison was urging Congress 
to pattern a program of compulsory insurance 
for workers after one that had been 
adopted in Germany in 1883. Between 1910 and 
1920, 42 states passed laws compensating 
workers for the loss of income due to an accident 
while on the job. 

Worker compensation was given a boost 
when the Federal government for the first time, 
passed legislation on disability and rehabilitation. 
Known as the Soldier's Rehabilitation Act, it was 
approved unanimously by both House and Senate 
in 1918, but was intended solely as a program for 
returning veterans. A civilian agency, the Federal 
Board of Vocational Rehabilitation, was 
authorized to serve those disabled veterans who 
were still in hospitals and encampments. The 
legislation provided an opening for similar initiatives 
to be introduced and Congress was soon 
debating national bills to provide vocational 
rehabilitation programs for civilians "disabled in 
industry or otherwise." Strong opposition to these 
plans was mounted, particularly by industry 
leaders who viewed such programs as dangerously 
'socialistic.' 

Despite opposition, in 1920 the Vocational 
Rehabilitation Act was passed by Congress. It was 
strikingly limited by today's standards—it did not 
provide any benefits other than direct work training 
and was intended primarily for workers who 
had become disabled at the work site, not for 
those born with a disability or disabled in 
childhood. Yet, it remains significant as the first 
federal act to provide any vocational rehabilitation 
services for disabled citizens. 

Vocational rehabilitation itself began to be 
defined as a distinct field, where counselors 
familiar with disabiliity issues and social concerns 
helped "guide" disabled adults to what they 
believed to be appropriate areas of employment. 
Initially, these counselors had little formal training, 
although increasing concern about training 
and improving shared bodies of knowledge, led to 
the establishment of the National Rehabilitation 
Association in 1925. 

The Act also established, for the first time, 
an on-going office dedicated to disability issues 
within the Federal government, This office, in its 
various incarnations, would provide a focal point 
for future activity in the field and bring together a 
nucleus of concerned individuals who would eventually 
form national and international networks 
disseminating ideas and information. The Act is 
also of importance as it was incorporated into the 
Social Security Act in 1935 virtually unchanged. 
If the Vocational Rehabilitation Program had not 
existed, and an on-going office was not already 
functioning on behalf of disabled constituents, it 
is probable that the Social Security Act would 
have been far less focused on disability issues. 

Other state and federal efforts on behalf of 
disability groups were low-key, many merely continuing 
support for schools and institutions first 
begun in the 19th century. Although a national 
policy was not established, there was, in the early 
years of the century, a tremendous growth on a 
state-by-state basis in the area of special education 
and specific disability-related institutions. 

The Aftermath of World War I: 
Private initiatives 

In the years following World War I new voluntary 
groups began to flourish, particularly in the 
field of physical disability. One of the first national 
efforts to focus specifically on rehabilitation in 
the United States was the establishment, in 1917, 
of the Red Cross Institute for the Crippled and 
Disabled (now the International Center for the Disabled 
RCM. The Institute initially sought to serve 
the war injured veteran but soon expanded its 
focus to include the civilian population. Stressing 
vocational rehabilitation for the physically disabled 
adult, the Institute was located in New York 
City and supported heavily by the philanthropist, 
Jeremiah Milbank. 

The ICD was not the first rehabilitation institute 
in the United States. The Cleveland 
Rehabilitation Center was established in 1889 to 
provide since direct services to disabled children. 
however. ICD, however, seems to have been the 


HISTORY OF INTERNATIONAL REHABILITATION 15 


HE -.-CRIPPLE 


(Previously THE CRIPPLES' JOURNAL). 

TABLE OF CONTENTS. 
APRIL, 1929. 


EDITORIAL NOTES. 
VILLAGE SETTLEMENTS: III.-RESULTS AND RATIOS. 


P. C. VABRIES-JONES, M.A., M.B.C.S., 
MAP SHOWING ORTLTOP.EDIC CENTRES. 
ALONG THE ROAD : A LITERARY INTERLUDE. 
V.-MRS. MAPP AND OTHERS. E. MUIMHE AD LITTLE, F.B.C.S. 

LETTERS FROM CORRESPONDENTS: 
IRELAND. SIB. W. I. DE C. WHEELER, F.R.C.S.I. 
SCOTLAND. THE REV. T. RATCLIFFE BARNETT. 
UNITED STATES OF AMERICA.. HARRY II. HOWETT. 
ONTARIO, 1929. H. W. HOPPER. 

CENTRAL COUNCIL FOR THE CARE OF CRIPPLES. 
NOTES AND NEWS. 


EMPLOYMENT SUPPLEMENT. 
THE CRIPPLE AND HIS JOB. MARION HATHWAY. 
VOCATIONAL REHABILITATION IN AMERICA. PERCY ANGOVE. 
OPENINGS FOR THE TRAINED PHYSICALLY DEFECTIVE. T. S. OWEN. 
THE INJURED AND CRIPPLED IN RELATION TO ECONOMIC EMPLOYMENT AND THE 

APPLICATION OF INSURANCE. D. McCitsa Arrxxx, F.R.C.S. 
EMPLOYING THE " UNEMPLOYABLE." REYNELL WREFORD. 
REHABILITATION TYPES. SISTER TERESA. 
HOLLAND AND HER DISABLED. TH. W. TE NUYL. 
E MPLOYMENT FOR CRIPPLED BOYS AND G/B.LS IN LONDON. 

MISS PHYLLIS WINDER. 
EMPLOYMENT OF THE CRIPPLE. - MISS F. M. RIMMER. 
EMPLOYMENT OF CRIPPLED WOMEN. Miss A. B. EVANS. 
EMPLOYMENT DIFFICULTIES. MISS ETHEL B. RADCLIFFE. 
THE LIVERPOOL WORKSHOPS. TI'q S FORBES BELL. 

Above is a 1929 table of contents of "The Cripple," an international 
journal published in London, and below are two of its 
more prominent advertisements. 

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16 HISTORY OF INTERNATIONAL REHABILITATION 


first the first organization intended to serve nationally 
as a clearinghouse for information on 
physical disability. The Institute, very early on, became 
a place where much of the latest information 
on a wide range of topics and disabilities was 
collected and dispersed. The Institute's first Director, 
Douglas C. McMurtrie, became a highly effective 
spokesman for rehabilitation, frequently 
testifying before Congress throughout the following 
decades. 

In 1919, in one of its earliest efforts, 
the Institute for Crippled and Disabled, 
in conjunction with the Red 
Cross Institute for the Blind, held an 
international conference on 
"Rehabilitation of the Disabled" in 
New York City. 


In 1919, in one of its earliest efforts, the Institute 
for Crippled and Disabled, in conjunction 
with the Red Cross Institute for the Blind, held an 
international conference on "Rehabilitation of the 
Disabled" in New York City. It may have been the 
first international conference on rehabilitation of 
the physically disabled held in the United States 
and seems to have sparked considerable interest. 
Dominated by a medical orientation that would 
remain in the field for decades to follow, most who 
attended were physicians, many prominent medical 
officers from the allied willies of Belgium, 
France, Italy, Britain and Canada, as well as the 
United States. The conference, described in the 
program as "an unofficial conference on rehabilitation," 
proved to be a valuable assemblage of ideas 
and approaches. "Moving pictures" were even 
shown, with film titles such as "The Way Out— 
The Conquest of Disability" and "French War Cripples 
Return to the Farm". 

The International Society 
for Crippled Children 
(Rehabilitation International) 

In 1922 the earliest incarnation of what is 
now Rehabilitation International, was founded in 
Elyria, Ohio. The organization grew out of the interests 
of a local businessman, Edgar F. (Daddy) 
Allen. Looking back over time, Allen would seem 
to have been an unlikely choice for a visionary in 
the field of disability, yet he was to become a very 
effective thinker, spokesman and organizer. 

Allen's participation in the field evolved 
gradually. He had no international links and pos-

Edgar F. Allen 

sibly had never traveled outside the mid-West. A 
well-respected middle-aged businessman in the 
small town of Elyria, he began his career as a 
hardware salesman and eventually made a small 
fortune supplying telegraph poles to industry. His 
life changed dramatically however, when a streetcar 
accident took the life of his teenaged son and 

15 others who might have been saved, had a 
hospital been nearby. Allen, distraught, immediately 
retired from his own business to head the 
citizen's fund raising committee to establish a 
local modem hospital. 

After the hospital was built, Allen was an active 
board member. Several years later, a disabled 
child being treated at the hospital needed assistance 
and Allen was contacted. The problems the 
child was encountering within the medical system 
were not isolated ones, and the medical staff 
prevailed on Allen to oversee a survey of physically 
disabled children in the county to assess local 
needs. 

Few statistics were available at that time on 
disabled children, and Allen's survey identified 
over 200 children "hidden away" in homes all over 
the county. The number of disabled children was 
many times greater than anticipated by the local 
physicians, and the children identified were in 
dire need of medical attention and educational op-

HISTORY OF INTERNATIONAL REHABILITATION 17 


INTERNATIONAL CONFERENCE REHABILITATION OF DISABLED 

'Using the Findings of Industrial Surveys, Miss Gertrude Stein, 
Chief, 'Employment Department, Red Cross Institute for Crippled 
and Disabled Men. 

XIV Methods of Training. 

Thursday, March 20, at 8 p.m. 

Re-education ini France. Dr. MauricePourrilion,President, Comite 
Permanent Interaffii, Director, Ins titut national-Professionnef 
des lavalides de fa Guerre, St. Maurice, Paris, France. 

The Re-education Experience of Belgium. Louis Altman, Chief of 
the Educational-Staff, Institut Mifitaire Beige des Invalides et 
Orphelins de fa Guerre, Port-Nitres, France. 

Training Practice in Great Britain. MajorRa ben Mitchell Director 
of Training, Ministry of Pensions, London, 'England 

Canadian Methods- of Re-training. 'Walter E. Segeworth, Director 
of Vocational-Training, Department of S ofdiers ' Civi Re-es tab 
fishment, Ottawa, Canada. 

Friday, March 21, at 10 a.m. 

Should Serious Training Be Started in Hospital or Deferred until 
after Military and Medical-Discharge? 

Dr. Maurice Bourriffon, President, Comite Permanent 
Interaffii, Director, Institut national Prolessionnef des Invalides 
de fa Guerre, St. Maurice, Paris, France. 

Edmond Dronsart, Director, cote Professionnelle des Blesses, 
Montpellier, France. 
Dr. Andre Treves, Chief of Staff Centre d'Appareillage et de 
Reeducation Professionnelle, Rennes, France. 

Louis Apeman, Chief of the Educational Staff Institut 
Mifitaire Bete des Invalides et Orphelins de fa Guerre, 
Port-Viffes, France. 

Mrs. Ethel 'Wood, Secretary, Local 'War Pensions Committee, 
London, England. 

Major H.P. Stanley, D,S.O., formerly Assistant District Vocational 
Officer, Department of Soldiers' Civil Re-establishment, 
Montreal. 

Colonel FrankBiffings, Chief Division of Physical-Reconstruction, 
Office of the Surgeon General 'U.S. Army. 
Major F.9. Cotton, Office of the Surgeon General, U.S. Army. 
Major A.C. Monahan, Division of Physical Re-construction, 
Office of the Surgeon General US. Army. 
Training after Discharge in Special. Schools or Classes versus 
Training in Standard Institutions. 

[10] 
Edmond Dronsart, Director, Ecole Professionneffe des Blesses, 
Montpellier, France. 

Louis Allman, Chief of the Educational Staff Institut 
Mifitaire Beige des Invali,des et Orphelins de fa Guerre, 
Port-Viffes, France. 

Mrs. Ethel 'Wood, Secretary, Local 'War Pensions Committee, 
London, 'England. 

Professor F.9-1 Sexton, District Vocational-Officer for Quebec 
and Maritime Provinces, Department of Soldiers' Civil Reestablishment. 


Louis Roil/lion, Red Cross Institute for Crippled and Disabled 
Men, New York, 
Dr. john Culbert Farces, Red Cross Institute for Crippled and 
Disab fed Men, New York, 

Training in Factories. 
Dr. Maurice Bourriffon, President, Comite Permanent 
Interaffii, Director, Institut national Professionnet des 
lavalides de fa Guerre, St. Maurice, Paris, France. 
Miss Grace Harper, Chief Bureau of Re-education and 
Reconstruction, American Red Cross, Paris, France. 

Mrs. Ethel 'Wood, Secretary, Local. 'War Pensions Committee, 
London, 'England. 
Major RT. MacKeen, District Vocational Officer for Province 
of Quebec, Department of S (alas ' Civif Re-establishment. 

Training the Disabled Civilian. 
Dr. Maurice Bourriffon, President, Comiti Permanent 
Interaffie, Director, Ins titut national Profe,ssionnet des 
favalides de la Guerre, St. Maurice, Paris, France. 
Edmond Dronsart, Director, Ecole Professionnelle des Blesses, 
Montpellier, France. 
Dr. Charles H. Yaeger, Assistant Professor of Orthopedics, 
ColumbiaUniversity; formerly Director, Trade School-of the 
Hospital of Hope. 
Dr. john Culbert Faries, Red Cross Institute for Crippled and 
Disabled Men, New York 
Louis Rouilfion, Red Cross Institute for Crippled and Disabled 
Men. 

XV. Educational Work in Military Hospitals. 
Friday, March 21, at 3:15 p.m. 

Methods and Results. Round Table. 
Major Bird T Baldwin, 'Walter Reed Hospital, 'Washington, 

D.C. 
Above is part of the program for the 1919 "International Conference on Rehabilitation of the Disabled" held in New York. Day sessions were at 
the Waldorf-Astoria Hotel and evening sessions were in Carnegie Hall. Official delegations of "the principal allied countries" attended from 
France, Belgium, Italy, Britain and Canada. 

18 HISTORY OF INTERNATIONAL REHABILITATION 


portunities. Parents were keeping their physically 

disabled children close to home, some apparently 

concerned with how the child would be treated in 
the community, and many also fearing that their 
children would be taken from them by local 

authorities and placed in institutions. 

Allen's initial response to the survey findings 
was to organize another fund raising drive to 
found a special medical facility for disabled 
children in Elyria. However, Allen also realized 
that the data from Ohio reflected a tremendous 
unmet need for care of and information about disabled 
children throughout the United States. 
Teaming up with the newly formed local Rotary 
Clubs, in 1922, Allen and a small core of volunteers 
organized a Society, initially named the National 
Society for Crippled Children, to provide 
local care and services for physically disabled 
children. In addition to offering immediate clinical 
services for some children, a basic goal of the new 
Society was to serve as a clearinghouse for information 
on medical, social, educational and legislative 
policies that concerned these children. 

The fledgling group, to accommodate 
their Canadian colleagues, officially 
changed its name to the "International 
Society for Crippled Children," and 
a new direction in rehabilitation was 
begun. 

The international activities of the new Society 
began soon after its founding, although the initial 
manifestation of this was quite limited in scope. 
The trial program of clinics and services begun in 
Ohio by Allen and his local Rotary group was 
copied by fellow Rotarians in Michigan the following 
year. These programs received a good deal of 
local attention and in 1923, Rotarians across the 
border in Ontario, Canada expressed interest in 
joining the new group. The fledgling group, to accommodate 
their Canadian colleagues, officially 
changed its name to the "International Society for 
Crippled Children," and a new direction in 
rehabilitation was begun. 

The International Society quickly became a 
clearinghouse for information about disabled 
children, and increasingly, adults with disabilities 
as well. As an organization, its strength lay in its 
ability to disseminate information and to serve as 
the hub of a network, putting people and groups 
in touch with each other and raising money to encourage 
the exchange of ideas and information. 
The organization had no single direction and is


sues were addressed as they arose—a packet of information 
on physically disabled children would 
be assembled and sent to Greece, a letter requesting 
information from a teacher in Japan would be 
answered and a volunteer would give a lecture in 
Grand Rapids to try to raise $500 for work with 
disabled children in Bulgaria. 

The emphasis of the Society was specifically 
on physical disabilities in children. Although occasionally 
in touch with deaf and blind advocacy 
groups, the International Society rarely joined forces 
with other disability organizations. Organizations 
for and by deaf and blind constituencies had 
already established a circuit of schools and institutions 
with their own national and international 
networks. The International Society did not use 
these established networks regularly. Instead they 
established new links with individual medical 
facilities and civic organizations that had not previously 
been involved with international rehabilitation 
work. 

The lack of services and organized advocacy 
groups for physically disabled children was so 
great that although it remained a small voluntary 
organization, the International Society soon became 
influential. Allen, who remained President 
until his death, was in frequent contact with interested 
individuals throughout the United States 
and Europe and began to count national leaders 
and politicians, including Franklin Delano 
Roosevelt, as personal friends. 

Very early on, however two different foci 
emerged, one national and one international. 
Some within the group felt that pressing needs at 
home should be addressed first. Others, who had 
already had some international experience, felt 
there was much to learn and do internationally 
and were more keenly aware that no other international 
organization was addressing these issues. 
Within a few years, these differing foci resulted in 
a formal division within The International Society. 
That part of the Society which had a national 
focus renamed itself The National Society for Crippled 
Children and Adults, and changed its name 
again later to the National Easter Seal Society for 
Crippled Children and Adults to reflect their most 
successful fund raising technique. Among other 
activities, this National Society continued and expanded 
its program to fund medical care for 
children. Rotary remained closely involved and 
during the 1920s, most of the funding for disabled 
child services and hospitals in the United 
States were furnished by Rotarians. Not until 

1935, with the passage of the Social Security Act 

which had provision for "crippled children" did 

most states begin to establish independent 

HISTORY OF INTERNATIONAL REHABILITATION 19 


programs for disabled children, the pioneering 
work done by Easter Seals and the Rotary 
provided a model for many of these. 

The international segment of the organization 
retained its name, the International Society 
for Crippled Children. There would be several subsequent 
name changes: The International Society 
for the Welfare of Cripples, the International 
Society for the Rehabilitation of the Disabled and 
finally, in 1972, Rehabilitation International. It 
would maintain its strong international focus 
throughout the years.' 

While both formal and informal meetings 
related to rehabilitation were 
nothing new to the Europeans, the 
Geneva meeting is of note for 
Americans, as it gave many their first 
organized exposure to delegates from 

other countries. 

In 1929, the International Society became incorporated 
under the laws of the state of Ohio, 
and in that same year, it had grown large enough 
to hold its First World Congress in August, in 
Geneva, Switzerland. This was not the first international 
conference to be held on the subject of 
physically disabled children. A previous international 
meeting on much the same subject had 
been organized in 1927 in Ostend, Belgium, in 
conjunction with a Rotary International Assembly. 
Nevertheless, some 50 people attended the First 
World Congress in Geneva and although organized 
under the auspices of the Americans, a 
dozen countries were represented. Many of the 
participants were Europeans who had long been 
active in rehabilitation issues. While both formal 
and informal meetings related to rehabilitation 
were nothing new to the Europeans, the Geneva 
meeting is of note for Americans, as it gave many 
their first organized exposure to delegates from 
other countries. 

Much of the early success of The International 
Society was due to Edgar Allen's ability to articulate 
international concerns, and these are 
particularly striking given his small town roots. 
His thinking may, in part have been influenced by 
Rotary, which traditionally has maintained a 
local/global view. It may also have been a logical 
assumption on Allen's part to believe that if disabled 
children were undeserved and in need in 
the heart of Ohio, their existence in other parts of 
the globe must have been at least as precarious. 

Whatever the source, it is remarkable that 
even in the very earliest years of the Society, Allen 
and his associates were raising issues that are 
current today. For example, Allen insisted that disabled 
individuals were limited by social attitudes 
far more than by physical impairments. He clearly 
articulated the argument heard throughout the 
subsequent decades that it made good economic 
sense for disabled adults to receive a solid education 
and job training, as they would return the expenditures 
may times over as tax payers. Finally, 
in an era in which almost all services for disabled 
individuals were still presented as "noble" and 
"charitable", Allen strongly argued that disabled 
individuals had a right to independence and equal 
opportunity. 

Allen's early work was amplified by his successor, 
Paul H. King, an active Rotarian and 
Federal judge in Detroit, Michigan, who followed 
Allen as President in 1935. King's familiarity with 
legal issues apparently prompted him to increase 
the legal and policy oriented approach of the organization. 
The influence that the International 
Society for Crippled Children had was felt no 
more strongly than in Ohio itself, which became a 
hot bed of activity. Because of The Society's work, 
Ohio became an important center for Americans 
interested in rehabilitation. By the late 1920s, 
Ohio led most other states in its legislation on dis-
ability-related issues, 2 as well as having a number 
of solid regional medical and educational 
programs for children with disabilities. 

Finally, in an era in which almost all 
services for disabled individuals 
were still presented as "noble" and 
"charitable", Allen strongly argued 
that disabled individuals had a right 
to independence and equal opportunity. 


Other Non-governmental Groups 

The years following World War I saw the establishment 
of a number of private voluntary organizations 
specifically devoted to physical 
disability issues within the United States. Some 
were local or regional, others were national in 
scope. Almost all these groups, however, targeted 
distinct sub-populations within the disabled community, 
concentrating on research and services 
for individuals with specific impairments. These 
joined the already established local, state and 
regional advocacy groups and societies working 

20 HISTORY OF INTERNATIONAL REHABILITATION 


on behalf of blind, deaf and mentally retarded 
children and adults. 

Most European nations would 

develop centralized or closely coor


dinated governmental or semi


governmental approaches for 

programming and planning. 

The sheer numbers of these voluntary organizations 
is uniquely American. Although some 
nations, such as England, had a long history of 
private voluntary organizations carrying out social 
work as a supplement to more centralized government 
planning, most European nations would 
develop centralized or closely coordinated 
governmental or semi-governmental approaches 
for programming and planning. In the United 
States, however, no centralized or coordinated national 
approach to disability developed, although 
a number of different care and funding delivery 
mechanisms have been founded through a variety 
of legislative acts and federal programs. 

Private voluntary organizations seem to have 
had, from the beginning, a much stronger voice in 
directing local and national policy and molding 
public attitudes. Whether a more centralized system 
would have been developed by the Federal 
government, had these organizations not already 
become so well established, is an interesting question, 
and takes on more of a chicken-and-egg argument 
than can be adequately reviewed here. 
What is clear is that in the years following World 
War I, these private efforts filled a vacuum and no 
significant coordinated government "safety net" or 
service structure for American children or adults 
with disabilities developed. Most of these private 
voluntary organizations grew out of a sense of 
civic duty and were supported by religious 
denominations or were linked directly or indirectly 
to hospitals or institutions. 

What is clear is that in the years fol


lowing World War I, these private ef


forts filled a vacuum and no 

significant coordinated government 

"safety net" or service structure for 

American children or adults with dis


abilities developed. 

The population's heavy reliance on voluntary 
organizations rather than on a more unified 

Franklin Roosevelt during his recovery from polio which he contracted 
in 1921. 

Federal role, has had wide repercussions and continues 
to influence how the United States approaches 
disability issues. Among the significant 
characteristics of the voluntary system with 
strong historical roots that today continues to 
pose problems, are: 

a) "Helping the disabled" continues to be 
defined as a valid charitable act—a good deed. 
Responsible citizens (presumably all non-disabled), 
are assured that they are performing their 
"civic duty" by contributing to one of the many 
non-profit, tax-deductible organizations that ask 
for help. Many of these organizations also receive 
state and federal assistance for their programs. 
Such a model places disabled individuals in the 
role of being continual recipients of charity, rather 
than competent citizens and taxpayers, who are 
considered to have a right to some assistance 
when it is needed. 

b) Because all of these organizations and 
their constituents were dependent on voluntary 
contributions of funds from the general public, 
the system as it arose, encouraged fierce competition. 
This has tended to fragment disability interests, 
rather than encourage collaboration or 
consolidation. Organizations were often pitted 
against one another in the competition for 
monies, slowing the free exchange of ideas and innovations. 


c) A further outgrowth of this competitive 
system seems to have been the need to portray 
the particular disease or disability for which one 
is requesting funds in the most pathetic terms, to 
appear to be most deserving of contributions. It 
was through such a system that approaches such 
as "the poster child" came into being. 

HISTORY OF INTERNATIONAL REHABILITATION 21 


These approaches are not absent from 
Europe, Asia, South America and other parts of 
the world but are of specific concern in the United 
States—a product of a uniquely American historical 
process. This competitive and decentralized 
system which evolved between World War I and 
World War II is a continuing source of much of 
the current confusion in the responsibilities and 
roles of state and federal government, the rights of 
disabled citizens and the future roles and directions 
of private voluntary agencies. Moreover, 
these factors play a part in American activities in 
international rehabilitation and disability. Interestingly, 
it should also be noted that although the 
voluntary organizations have a large voice in setting 
national agendas, they often rely heavily for 
their own funding upon local, state and federal 
grants and allocations. The public has relied 
heavily on these already established organizations 
to provide administrative, social and medical services 
within many communities, although such organizations 
are rarely directly accountable to the 
general public. 

The Depression 

The number of organizations and individuals 
involved in disability issues grew throughout the 
1920s, only to diminish precipitously as the 
Depression deepened in the early 1930s. Although 
some new legislation, including the Social 
Security Act, evolved, and some national 
programs began or continued, the Depression 
eroded the national tax bases, and, more seriously 
for private organizations, voluntary contributions 
from the public. Programs, such as those in 
special education funded through local taxes administered 
through Education Departments, were 
the first to be cut. Schools, hospitals and training 
centers faced limited budgets and trained personnel 
left when programs were curtailed. A generation 
of trained personnel was lost to the field. 

The only internationally focused American-
based disability society, the International Society 
for Crippled Children continued to function 
throughout the 1930s, although the Depression 
hit hard at both membership and donations, and 
support for travel and international exchanges 
were much reduced. The organization's Second 
World Congress took place at The Hague, Netherlands 
in 1931 and the Third in Budapest in 1936. 
At the Budapest meetings, a committee on reorganization 
was appointed and a new constitution 
was drafted. The proposal to change the 
organization's name to the International Society 
for the Welfare of Cripples, was formally adopted 
at the Fourth World Congress in London in 1939, 

which attracted 412 delegates from 45 countries 
despite the rising political tensions in Europe. The 
change of name reflected a broadening concern 
for adults as well as for children with physical disabilities. 
A review of the Proceedings of the Congresses 
in Budapest and London also reveals 
policy statements, scheduled discussions and 
panel topics on broad social issues such as education, 
economics, and employment. Even discussion 
of architectural barriers and social equality 
appear in various forms, although the terminology 
used often differs from that of more recent years 
(Acton: 1986:148-49). 

Bell Greve at a UN dinner, New York, 1950s. 

In addition to holding conferences and serving 
as a resource center, International Society officials 
were active on the organization's behalf. 
Kessler was a regular figure at international conferences, 
and Bell Greve, a Cleveland-based social 
worker who had already become a significant figure 
within the International Society, was instrumental 
in helping to establish a number of 
national organizations overseas, such as the Hellenic 
Society for Disabled Children in 1937. 

The International Society was not the sole 
American-based player on the international scene. 

22 HISTORY OF INTERNATIONAL REHABILITATION 


The years between the First and 
Second World Wars also brought 
growth in medical and rehabilitation 
knowledge of the realities of physical 
disabilities. 

American schools and organizations for deaf and 
blind children and adults maintained international 
links. The National Organization of the Deaf, an 
active and strongly pro-Sign Language group was 
regularly in contact with foreign national deaf associations. 
American blind groups, always active 
internationally, continued to conduct outreach 
and a new era in international liaisons was begun 
when Dr. Edward Allen initiated the Perkins' 
Teacher Training Program specifically for teachers 
of the blind overseas. American professional journals, 
newsletters and newspapers for these communities 
were regularly filled with the latest news, 
ideas, (and occasionally gossip), from Europe. Increasingly, 
brief accounts of programs and meetings 
in Asia, Latin America and Africa also found 
their way into print. 

Medical Progress 

The years between the First and Second 
World Wars also brought growth in medical and 
rehabilitation knowledge of the realities of physical 
disabilities. Several important figures are of 
note in this period. 

Dr. Henry 
Kessler was redefining 
the field of 
rehabilitation, writing 
extensively in the 
medical literature on 
injury cause and 
prevention, developing 
technical innovations 
in surgery and 
authoring text books 
presenting overviews 
of the field. Kessler 
regularly traveled to 

Europe to attend meetings, present lectures and 
papers and discuss surgical rehabilitative issues 
with colleagues. 

Also of note is the work of the American 
physician Frank H. Krusen, who established the 
Department of Physical Medicine at Temple 
University in 1929. He joined the Mayo Clinic in 
1935, and was to become President of the Sister 
Elizabeth Kenny Foundation in later years. He 

was prominent on the 
national scene along 
with Kessler, and although 
he was not as 
involved with international 
issues or train-

Pioneer in Physical Medicine

ing, his work was 
known and respected 
throughout the medical 
world. 

Kessler and 
Krusen were not the 
only physicians working 
on issues of physical 
disability and 
rehabilitation. There 
were a number of hospitals 
and institutions for "cripples" where medical 
services were provided; however, in these 
centers, the focus was solely on direct medical 
care. There still was nearly no rehabilitation or follow 
up, as it is understood today. Patients 
received surgical and post-surgical care, but 
preparing people for some participation in the 
community was not addressed. Children born 
with significant physical disabilities might spend 
the first six to ten years of their lives in facilities 
for "crippled" children, rarely or never returning 
home or seeing their parents. Hospital-based 
schools provided education for thousands of 
children who today would be incorporated in the 
regular classroom setting. 

Hospitals and institutions dedicated to disabled 
children and adults, increasingly common 
in the first three decades of the 20th century, continued 
to exist outside the mainstream of the 
general medical community. While improving surgical 
techniques might allow for an improved 
quality of life for some, and better prosthetics and 
orthotics permitted greater mobility for a few, little 
was done to integrate physically disabled people, 
particularly those with significant physical impairments, 
into the broader society. Moveover, ideas 
and advances developed in these specialized 
centers made little dent on established medical 
thinking of the era. Few physicians, outside of the 
handful of surgeons who specialized in the area, 
had ever heard of the subspeciality of rehabilitation 
and no national academy of physicians working 
in rehabilitation existed to formally organize 
information or oversee training in the field. Physical 
therapy, as a profession was relatively new— 
(the National Rehabilitation Association was 
organized in 1923), and the focus of the field continued 
to be work with post-operative patients, 
rather than work on a continuing basis to improve 
a disabling condition. 

HISTORY OF INTERNATIONAL REHABILITATION 23 


Public Attitude and Media 
Attention Between the Wars 

The period between World War I and World 
War II was also one of growth of public awareness 
on disability in various aspects. For one, public 
debate about eugenics and by extension, disability, 
which had been growing since the turn of 
the century, increased internationally, particularly 
after the rise of the Nazi party in Germany. Although 
eugenics had already begun to be 
discounted as a valid theory by most scientists, it 
continued to be an issue of great interest to the 
general public and the popular press. 

Media attention also began to be focused 
with increased regularity on people who were disabled. 
Most of this attention centered around unusually 
accomplished individuals presented in an 
inspirational fashion, rather than on the problems 
and potentials faced by the average disabled child 
or adult. Nonetheless, issues of physical disability, 
deafness and blindness for the first time were 
being addressed in the media in a relatively 
straightforward manner. Much of the Victorian 
sentimentality was gone, although it would still be 
many decades before descriptions of a disabled 
person's daily life would omit terms such as 
'noble', 'inspirational' and 'courageous.' Not all 
types of disabling conditions received this new attention 
equally. It was only after World War II that 
public discussion of mental retardation would 
begin, and not until the 1970s that a comparable 
development would occur for those who were mentally 
ill. 

Interestingly, Franklin Delano Roosevelt, the 
individual who dominated much of this era politically 
in the United States, was himself disabled. 
Although significantly impaired by polio, the extent 
of his disability was downplayed both by him 
and those around him. (Gallager: ) Although he 

Tribute to Jacobus ten Broek by the (former) 
International Federation of the Blind, 1974. 


Jacobus ten Broek, American, lost his eyesight in early 
childhood in an accident. He first attended the school for the blind 
in California, where he excelled by assiduity, attentiveness and a 
clear intellect. Well skilled and gifted, he fulfilled the basic requirements 
to go in for a university education in law. He took a doctor's 
degree and was later on appointed professor at the University of 
California. Besides his profession, he felt a passionate urge to 
devote himself fully to the destiny of his many companions, the 
blind. Around him, and on a larger scale, he saw that a lot still had 
to be done in the field of politics, organization and social integration 
of the blind. Hence, he set to work eagerly and started by founding 
the "National Federation of the Blind" in California, and became its 
first President. By doing so, the first organization of the blind had 
been created outside Europe. The Californian foundation was the 
starting-point for succeeding national American organizations, 
founded by ten Broek and constantly inspired by him in different 

24 HISTORY OF INTERNATIONAL REHABILITATION 

was instrumental in helping to initiate programs 
such as the March of Dimes (now known as the 
National Foundation), in 1938, Roosevelt seems to 
have participated in disability organizations in the 
guise of an influential benefactor, rather than as 
an individual who was disabled. Eleanor 
Roosevelt however, had an abiding interest in disability 
issues begun in the 1920s, which would 
continue to grow, making her an important player 
in rehabilitation issues after World War II. 

From the late 1930s on, tenBroek, of 
the National Federation of the Blind, 
was insistent that people with disabilities 
be recognized as their own 
spokespersons. 


Nor was all the disability advocacy done by 
organizations or non-disabled individuals. On the 
international scene, in addition to Allen, King and 
Kessler, a significant individual, whose ideas 
would not be recognized as important until 
decades later was the blind lawyer and Berkeley-
based professor Jacobus tenBroek. From the late 
1930s on, tenBroek, of the National Federation of 
the Blind, was insistent that people with disabilities 
be recognized as their own spokespersons. 
The concept did not of course, originate 
with tenBroek. Certainly, there had been repeated 
calls for self-determination, particulary in the 
blind and the deaf communities both in the 
United States and in Europe throughout the 19th 
century. However, in the decades following World 
War I, tenBroek was one of the few who did not 
waver in his vocal insistence that disabled people 
had the right to equal treatment and self-determination.
3 

ways. Until his early death he was and remained the patron and 

intellectual advocate of the American organizations of the blind. He 

published a number of scientific writings on welfare legislation for 

the blind. In 1964, on occasion of the Congress of the World Council 

of Welfare for the Blind, he founded a sub-organization of UNES


CO, the "International Federation of the Blind", together with a 

number of experienced politicians of the blind, by initially uniting 

10 national organizations in the IFB. He was the originator of the 

American Act on the white cane as the sole aid for the blind in 

traffic. This idea conquered the whole world because of its impor


tance in traffic. He was also the creator and publisher of the first 

American magazine of the blind, The Monitor" in which his 

thoughts, ideas and appeals were widely spread. It was also on his 

initiative that the World Council decided in 1964 in New York that 

50% of the delegates had to come from organizations of the blind. 

On his death-bed he completed a scientific work on legislation for 

physically handicapped people. 


Chapter II:
Rehabilitation nd Disability 
in the United States, 1940-1970 

World War II 

The growth of disability organizations and advocacy 
groups which had slowed during the 
Depression was further set back by the start of 
the Second World War. As often has been the case 
historically in times of political or economic 
stress, disability issues fell to the bottom of the 
list of social concerns, as War came to dominate 
daily life. The War efforts left little time for attention 
to voluntary groups or advocacy, even for 
those who had been very active. There was a disruption 
of state and federal programs, and 
schools and training facilities that had managed 

to survive the Depression closed or were consolidated, 
as funds were allocated elsewhere and 
administrators, staff and transportation became

difficult to locate. 

If national programs for disabled groups were 
slowed, those with an international perspective all 
but ground to a halt. Up until the Second World 
War, the International Society had been a voluntary 
organization. With the War effort underway, 
little time or attention could be spared and travel 
was virtually impossible. Planned international 
meetings were cancelled, no monies entered the 
treasury, and the whole movement effectively 
stopped. The reason it did not unravel completely 
was due to the vision and energy of one early 
leader who today is largely forgotten, Bell Greve. 

Bell Greve 

Bell Greve, the Director of the Cleveland 
Rehabilitation Center, had become Secretary 
General for the International Society for Welfare of 
Cripples in 1939. When World War II began, 
Greve decided that it had become her responsibility 
to keep the organization alive. Although 
the Mexican physician, Juan Farrill, was named 
President after Paul King's death in 1942, it was 
Bell Greve who actually kept the organization intact 
and maintained contact, where possible, with 
members worldwide. When funding and support 

(Source: Performance, 1976-77) 

disappeared, she moved the organization's files to 

her own office in Cleveland and ran the Society 

out of a file cabinet in the corner for nine years. 

Contributing her own time and personal savings 
to keep it solvent, she made plans for reviving the 
organization at the end of the War. Few documents 
have survived from this period (probably 
few were needed, as much of it was carried in 
Bell's own head), but those that have show that 
Greve was regularly in touch with officers and 

HISTORY OF INTERNATIONAL REHABILITATION 25 


The War also brought forward a new 
generation of leaders in American-
based international rehabilitation— 
individuals with formal training in 
international policy and administration 


members of the organization. Always able to envision 
projects and programs on a large scale, she 
foresaw the pressing needs for rehabilitation in 
many countries when hostilities ceased and 
busied herself drafting proposals and reports, 
such as plans to set up a rehabilitation program 
for disabled soldiers and civilians in mainland 
China (Greve and Chang: nd). 

A social worker and lawyer by profession, 
Greve had more international experience than any 
of the senior officers before her. She served with 
the Red Cross in Czechoslovakia after World War 
I, and later worked in Greece and Armenia as a 
consultant in rehabilitation representing the 
ISWC and the Near East Foundation. It is unclear 
when Greve became affiliated with Allen's International 
Society. She was still in Czechoslovakia 
when the organization was formed in 1922, 
returning to Ohio only in 1924 to become Superintendent 
of the Division of Charities in the State 
Welfare Department. She was apparently active in 
the Society by 1933, when she became Executive 
Director of Ohio's Association for the Crippled and 
Disabled, for she actively lectured on its behalf 
throughout the mid-West and was responsible for 
organizing the Third World Congress in Budapest 
in 1936, and the Fourth in London in 1939. 

If actual development of international organizations 
and informal networks was slowed because 
of the War, the War itself served as a catalyst 
for the subsequent commitment to the war 
wounded, the need to involve disabled adults in 
the work place and the need to accurately assess 
the number of disabled individuals and their capabilities 
for planning purposes. The combination of 
these factors served as a stimulus to the tre-mendous 
growth in rehabilitation that began in the 
later years of the War and increased dramatically 
in the following decades. The War also brought forward 
a new generation of leaders in American-
based international rehabilitation—in( !duals 
with formal training in international pu-cy and administration 
who had gained extensive experience 
working in the international arena. This growth 
and leadership would help to place the United 
States rehabilitation community in a prominent 
international role in the post-War years. 

26 HISTORY OF INTERNATIONAL REHABILITATION 

Government Programs 
during the War 

In distinct contrast to the major disruptions 
caused by the War to voluntary and non-profit 
groups and programs, the conflict brought a new 
Federal involvement with disabled groups and 
programs. Two major issues were involved. The 
first was the need to utilize all available manpower 
on the home front. The second, was the 
need to rehabilitate injured veterans. 

The issue of "manpower" arose very early in 
the War as disabled men and women began to be 
identified as an untapped workforce for the War effort. 
As skilled craftsmen left for the armed services, 
many of their jobs were broken down and 
simplified so that they could be done by less well 
trained workers. While the intention was often to 
allow untrained women and older men to perform 
these tasks, there were an increasing number of 
jobs that more seriously disabled individuals 
could do as well. It is widely believed that many 
disabled men and women, unemployed 
throughout the Depression, were then sought out 
by wartime employers, although actual statistics 
on employment rates for disabled adults during 
these years have yet to be extensively researched. 

Legal entitlements were expanded as well. 
The Vocational Rehabilitation Act which had become 
law in 1920, for the first time, received 
strong support from both government and industry. 
The role played by the Federal government 
was further strengthened with the passage of the 
Barden-LaFollette Act (PL 113) in 1943, which 
broadened the civilian Vocational Rehabilitation 
Act and established the Office of Vocational 
Rehabilitation. No longer designed simply to provide 
job training, the expanded program provided 
medical, surgical and mental health services, and 
physical rehabilitation. These additional services 
helped to increase the numbers of disabled individuals 
who could more fully participate in both 
the work force and in broader society. The reorganization 
within the Federal government also 
created the Federal Security Agency which united, 
under one roof, the major government programs 
in health, education, social security and welfare. 
Rehabilitation was an important aspect of this 
new agency and the Office of Vocational 
Rehabilitation was established in 1943 within the 
Federal Security Agency. Its first Director was 
Michael J. Shortley. 

In addition to "manpower" issues for disabled 
adults, it was also now important for state and 
federal governments to pay closer attention to 
what essential services were required and how 
many people needed to be served. The initial sur



veys undertaken to answer these questions led to 
a realization that the civilian U.S. disabled population 
was much larger and much less well servedthan had been assumed. 

Rehabilitation and the American 
Armed Forces 

The public enthusiasm for assistance to disabled 
servicemen presented the second great impetus 
to disability issues. As the size and 
complexity of the needs of newly disabled servicemen 
became clearer during the course of the 
War, the United States military scrambled to provide 
services. These innovative programs and 
talented individuals initially attached to the 
military would have a tremendous impact both nationally 
and internationally for years to come. 

At the outset of the War, the programs that 
the United States military had for permanently 
disabled servicemen were not significantly better 
than those available at the close of World War I. 
Nor were these services significantly different from

those for the civilian population. 

At the outset of the War, the 
programs that the United States 
military had for permanently disabled 
servicemen were not significantly 
better than those available at the 
close of World War I. 

Rehabilitation Medicine was simply not yet a 
recognized component of organized medicine and 
the medical establishment within the military 
reflected this. Walter Reed Hospital, nerve center 
of all medical programs within the vast United 
States Army system, had only two physical 
therapists at the outset of the war, and they 
worked with post-operative patients but had no 
training in rehabilitation. Permanently disabled 
servicemen remained in the hospital until 
medicine could do no more for them, then were 
discharged to civilian life. Any assistance needed 
by these men after discharge was supposed to be 
provided by the Veterans Administration. Unfortunately, 
the Veterans Administration had no 
programs. Sending disabled servicemen home in 
the early years of World War II was, according to 
Howard Rusk "like sending them into limbo" 
(1972:58). "It was survival of the fittest," wrote 
Howard Russell, "beer and tears for the rest" 
(1981:11). 

As World War II progressed, the lack of services 
became more critical as improved evacuation 

Two stills from the Army training film, "Diary of a Sergeant" (1940) 
which brought disabled serviceman Harold Russell to the attention of 
a Hollywood director. 

methods and new antibiotics to control infections 
meant that more men survived initial injuries. The 
numbers who survived with very serious injuries 
and significant permanent disabilities also rose

markedly. 

Military Personnel and 
Rehabilitation 

Rehabilitation was an idea whose time had 
come and several individuals in the military 
played a prominent role. Two physicians who 

Rehabilitation was an idea whose 
time had come and several individuals 
in the military played a 
prominent role. 

HISTORY OF INTERNATIONAL REHABILITATION 27 


The War was a significant stimulus 
in the development of vastly improved 
medicines and medical technologies 
that would help to place the 
United States in the forefront of international 
rehabilitation work after the 
close of the War. 


played key parts during the War were Henry 
Kessler and Howard Rusk. The disabled advocate 
Hank Viscardi also made a significant contribution. 
A number of other future leaders gained expertise 
during these years that would be 
significant in their subsequent work. 

Henry Kessler 

At the start of the War, one of the few 
American professionals with significant rehabilitation 
experience was Henry Kessler. Kessler had already 
worked in the rehabilitation field for two 
decades and was internationally reputed for his innovative 
surgical techniques and activity in 
workman's compensation programs. As a regular 
participant in international conferences, he was 
also one of the few American physicians familiar 
with state-of-the-art ideas in medical rehabilitation 
from around the globe. 

This initially made very little difference to the 
Navy. Kessler, a member of the Naval Reserves at 
the start of the War, was called up as a 
Lieutenant Commander and quickly found himself 
stationed in the South Pacific performing 
front line surgery. In 1943, however, Kessler was 
transferred back to the United States to head a 
new amputation center, the Mare Island Naval 
Hospital, in California. 

Kessler came to Mare Island with the understanding 
that he was to transform the hospital 
into a leading military rehabilitation facility. He 
soon found he had his work cut out for him. "The 
Navy," he later wrote, "treated the wound not the 
man." Very little was being done for permanently 
disabled servicemen once their injuries had 
healed. As soon as Kessler arrived, he insisted 
that a comprehensive program was needed and 
enthusiastically set out to establish one. 

Kessler's enthusiasm was not shared by his 
superiors, who lacked both the vision and the 
funding to enlarge the scope of the Mare Island 
facility. Fortunately, Kessler's skill was enhanced 
by both vision and humor. Taking nt.,' ters into 
his own hands, (he would in later yea.., claim to 
have a very serious lack of patience for red tape), 

he approached a faltering local race track with a 
proposition if they would hold a fund raiser for 
the Hospital, he would be pleased to split the 
profits. The resulting three day "Mare Island 
Sweepstakes" combined entertainment with 
patriotism and the crowds poured in. The event 
netted Kessler's hospital over $75,000, enough to 
build a modern artificial limb shop, a facility that 
was to train many limb makers and encourage 
patients to become informed consumers. Kessler's 
work brought Mare Island a considerable amount 
of attention and hundreds of medical professionals 
as well as recently disabled servicemen, 
were exposed to rehabilitation for the first time. 

Dr. Rusk passes on his skills. 

Howard Rusk 

Equally as successful and in some ways, better 
known to the broader medical community, was 
the work of Howard Rusk. An internist from St. 
Louis, Rusk enlisted in the Army Air Force and 
was put in charge of Medical Services at the Jefferson 
Barracks in Missouri. Rusk had no training 
in either disability or rehabilitation, but he soon 
realized that his patients made better progress if 
they were challenged physically and intellectually. 
He began by designing simple programs to keep 
patients busy and to get them back on their feet 
quickly. He enlarged his programs and increasing


28 HISTORY OF INTERNATIONAL REHABILITATION 


ly focused his attention on patients who had become 
permanently disabled. 

Rusk quickly acquired an expertise in the 
area, and gradually formulated a new concept: 
rehabilitation as a specialty within general internal 
medicine. Previous to Rusk, physicians dealing 
with physical disability were almost 
exclusively surgeons. By the very nature of their 
specialty, physical rehabilitation for these surgeons 
was usually something that took place after 
they had done as much as they could in the 
operating room. Rusk, an internist, made a seminal 
contribution to rehabilitation when he emphasized 
"rehabilitation of the individual" as the 
central issue rather than as a handmaiden to 
surgery. 

Rusk's insight was wedded to strong organizational 
skills and the ability to inspire those 
around him. He quickly moved up the ladder 
within the military, and was soon in charge of initiating 
rehabilitation programs in all Air Force 
hospitals. His concepts were continually expanding 
to encompass physical, psychological and 
vocational services for the newly disabled service 
man. 

The Air Force already had specialty hospitals 
for those with long term illnesses and in 1943 
Rusk was allowed to open a special convalescent 
center in Pawling, New York dedicated to 
rehabilitation. Rusk's program at Pawling was so 
successful that soon hundreds of medical personnel 
were receiving their first exposure to rehabilitation 
as part of his program. Rusk was fortunate to 
have the assistance of Dr. George Deaver, from 
the Institute for Crippled and Disabled in New 
York City. A pioneer in the field, Deaver was one 
of the first to prove that paraplegic individuals 
could walk if properly braced. Deaver himself took 
charge of much of the training organized under 
the auspices of Rusk and the Center and soon as 
many as 200 Air Force physicians, physical 
educators and therapists, were being brought in 
groups to be introduced to ideas and techniques 
in rehabilitation. The program run by Rusk and 
Deaver was so successful that it quickly ran out 
of space and had to be transferred to Mitchel Field 
on Long Island. 

Within three years, Rusk was able to introduce 
rehabilitation programs into 12 Air Force 
medical centers. His new approach was strongly 
supported by influential individuals and shortly 
after the end of the War, Rusk's proposal for 
rehabilitation throughout the military found its 
way to President Truman's desk. Truman quickly 
made it standard policy throughout all branches 
of the United States armed forces. So effective was 

Rusk at convincing and inspiring others that fellow 
Missourian Truman himself became an advocate 
of rehabilitation. 

Improved Technologies 

The War was a significant stimulus in the 
development of vastly improved medicines and 
medical technologies that would help to place the 
United States in the forefront of international 
rehabilitation work after the close of the War. 

The development of antibiotics and other 
drugs which permitted longer and healthier lives 
for disabled individuals revolutionized life for 
many. Equally as important were advances in 
prosthetics and orthotics that began during the 
war and progressed rapidly in the next decades. 
At the outset of the War, U.S. prosthetics and orthotic 
technologies were little different from the 
long static situation found in most other industrialized 
countries. By 1945 the United States 
had pioneered the use of new, light-weight 
materials, such as plastics to replace the heavier 
and more cumbersome steel and wood that had 
been used for decades. 

The impetus for American involvement in 
this field seems to be ultimately traceable to a key 
meeting at the Walter Reed Army Medical Center. 
It was in fact, a confrontation involving both 
Henry Viscardi and Howard Rusk. Henry Viscardi, 
who would play a major role in the rehabilitation 
community after the War, spent the War years as 
an American Red Cross volunteer at Walter Reed 
Hospital. Viscardi had joined the Red Cross to 
teach amputees to walk. An early disabled advocate, 
Viscardi uses two artificial legs and had little 
patience with the 
second class citizen 
approach to services 
for disabled 
soldiers. 

Viscardi forced 
the government's 
hand and directly 
affected government 
subsidies to 
technological research 
the day he 
walked into Howard 
Rusk's office at the 
Pentagon with what 
Rusk later recalled 
as "the three 

Henry Viscardi, who in 1949 founded

angriest young men 

Just One Break (JOB), one of the
I had ever seen." All world's first placement agencies 
three were Air specializing in disabled workers. 


HISTORY OF INTERNATIONAL REHABILITATION 29 


Force pilots who had lost legs and had been given 
shoddy wooden ones as temporary substitutes. 
This was standard military procedure at the time. 
No effective program existed anywhere in the 
military to provide recent amputees with adequate 
equipment until after discharge and even then, obtaining 
such aids proved to be difficult. 

No effective program existed 
anywhere in the military to provide 
recent amputees with adequate equipment 
until after discharge and even 
then, obtaining such aids proved to 
be dcult. 

Viscardi felt that such an approach toward 
providing prosthetics was simply unacceptable. 
Rusk, who agreed wholeheartedly, immediately 
took Viscardi and the pilots to the office of his immediate 
superior, who, equally outraged, took 
them at once to see the commanding officer, 
General Arnold. Arnold prided himself on making 
sure he got the best services available for his men. 
The General listened to the story Viscardi and the 
pilots presented and, in turn, became so irate that 
Rusk, a well trained physician, recalled, "I 
thought he was about to have a stroke." Arnold, 
"reached over and pushed down every button on 
his squawk-box. 

Rusk recalled that pandemonium ensued: 

"... in ran Robert Lovett, the Assistant Secretary of War 
for the Air along with a flood of three- and four-star 
generals. By this time, General Arnold was on his feet, 
pacing back and forth behind his desk. "This is the god-
damnedest outrage I ever saw!" he cried. "By God they're 
going to have the best legs.' With that he grabbed his 
telephone, called the Army Surgeon General and began 
dressing him up one side and down the other." 
(Rusk:1972: 60-61). 

Arnold, by this time on a real tear, announced 
that he not only wanted "his boys" to 
have the best legs available, but he wanted research 
to develop some better legs, and if the program 
was not in place in 30 days, he was "going 
directly to the President." Within several weeks, 
the Army had instituted an ongoing research 
project on prosthetics, and Congress had adequately 
funded the prosthetics research program 
from which many improved and innovative 
protheses were developed over the next decades. 

The close of World War II marks the 
beginning of a new era for rehabilitation 
in the United States and a blossoming 
of its involvement in 
rehabilitation on an international 
level. 

The Late 1940s and the 1950s: 
renewed interest 

The close of World War II marks the beginning 
of a new era for rehabilitation in the United 
States and a blossoming of its involvement in 
rehabilitation on an international level. 

Rehabilitation efforts in the Untied States 
were faced with the challenge of starting over. Although 
cohesion within the deaf and the blind 
communities had survived the intervening years, 
rehabilitation efforts for physically disabled individuals 
were substantially weakened and almost 
all international links had withered. Programming 
in special education had all but disappeared, and 
advocacy groups for those with mental retardation 
and mental illness were virtually non-existent. In 
addition, there continued to be few alliances between 
various disability-specific groups and organizations 
which further divided the already 
small field. 

The issue was not simply organizational. 
With the exception of a few individuals such as 
Greve and Kessler, most early American leaders 
active in the international arena in the 1920s and 
1930s (never a large group to begin with) had 
retired or died. With only the vestiges of international 
societies and no organized academic 
programs in national or international rehabilitation 
to consolidate and pass on information, the 
result was a deep chasm in "institutional 
memory" throughout the international disability/
rehabilitation field. 

National Studies Reveal Great 
Need 

This lack of programs and people was offset 
by a renewed interest in rehabilitation and in disability 
advocacy. The late 1940s was a significant 
watershed, both in terms of national and international 
disability work. Again, the two are intertwined, 
and their reorganization and revival was 
initiated gradually. First came activity on the national 
level and it is important to discuss this in 
somewhat greater depth here, for it has bearing 

30 HISTORY OF INTERNATIONAL REHABILITATION 


on how many United States 

governmental and non-governmen


tal programs would be organized. 

At the close of the War government 
and civilian agencies began 
to commission studies to determine 
how to best serve returning 
disabled veterans. Although it was 
soon apparent that the veterans 
were fairly well served by existing 
programs, these committees were 
shocked to learn that the needs 
within the disabled civilian population 
was not only many times 
greater, but also largely unmet. 
Perhaps the most influential of 
these Post-War studies was the 
report issued in 1945 by the 
Baruch Committee on Physical 
Medicine. Financier Bernard 
Baruch had created the Committee 
in 1943 to help anticipate the 
rehabilitation needs of returning 
veterans and the unmet needs of Group at the First International Poliomyelitis Conference, New York City, July 1948. Left to 

civilians. (The influential commit-right: Mr. Basil O'Connor, Drs. Hart Van Riper, T.M. Rivers, and John R. Paul. 
(Source: History of Poliomyelitis, p.321)

tee was funded in honor of 

Baruch's father, Civil War surgeon 
and early rehabilitation advocate, Dr. Simon 
Baruch). The report estimated that 23 million 
Americans were in some way disabled. Few in the 
public or private sectors had anticipated such 
high numbers. 

Furthermore, the population of disabled 
Americans was growing due to 
advances in medicine, surgery and 
antibiotics enabling many to survive 
longer. 

Furthermore, the population of disabled 
Americans was growing due to advances in 
medicine, surgery and antibiotics enabling many 
to survive longer. This can be seen in a comparison 
of survival rates of World War I and World 
War II paraplegic causalities. Only 10% of those 
injured during the First World War survived the 
first year, almost all dying of infection; whereas 
80% of World War II paraplegic veterans were 
alive and active a decade later. Survival rates for 
spinal cord injured individuals were equally 
dramatic in the civilian population. 

In addition, the post-war baby boom enlarged 
the actual number of infants born with impairments, 
and the polio epidemics of the late 

1940s and early to mid-1950s further added to 
this population. Moreover, the lack of services 
throughout the Depression and War years 
resulted in a backlog of individuals who had need 
of rehabilitation services. 

There was also a concurrent demographic 
change in many parts of the United States that 
was to have a direct impact on disability-related 
programs. The United States was now a nation on 
the move. Up until the War, much of America's 
population lived nearby family members in rural 
areas or small towns. The extended family could 
help to care for a disabled member, and some 
employment could often be established for the disabled 
adult on the small family farm or shop. Increasingly, 
in the years following the Second 
World War, families moved far away from their 
traditional support networks, and growing numbers 
of people once at home and able to assist disabled 
family members, spent the work day in 
offices, stores and factories, where management 
was often far less willing to hire disabled workers. 
New support systems were needed and people 
looked to the government to help provide these. 

At the same time, both the medical establishment 
and the general public became much 
more aware of 'rehabilitation' as a process. This interest 
in rehabilitation was sparked, in part by 
professionals, administrators and disabled servicemen 
who had seen the benefits of what came 

HISTORY OF INTERNATIONAL REHABILITATION 31 


Newly disabled returning veterans, 
and the advocacy organizations they 
formed at the close of the war, were 

particularly effective in detailing the 

needs and aspirations of signant 

members of disabled Americans. 

to be known as Rehabilitation Medicine 
demonstrated in the military. Newly disabled 
returning veterans, and the advocacy organizations 
they formed at the close of the war, were particularly 
effective in detailing the needs and 
aspirations of significant members of disabled 
Americans. 

Employment as a Key Issue 

A universal issue among all disabled groups 
at the close of the War was an enormously high 
unemployment rate and a poverty level existence. 
With little provision for meaningful employment 
and few assistance programs available to help supplement 
incomes, the majority of disabled Americans 
lived hand to mouth. For economic 
assistance to be granted, a disabled individual 
had to be in dire need, having first depleted 
resources and often the resources of their families 
as well. Aid was often an issue of charity, 
provided on a case-by-case basis. (Social Security 
would not offer programs of supplemental assistance 
to disabled individuals for many years to 
come). In addition, large numbers of newly disabled 
veterans who wished to return to the work 
force, became increasingly vocal about their difficulties 
in finding jobs. Vocational rehabilitation 
remained a fairly small profession and many who 
may have benefitted from such guidance did not 
receive counseling. 

Because of these factors, by the late 1940s, 
employment became the prominent issue for disabled 
individuals and groups. Attention to employment 
issues was not new. A long term campaign 
for the designation of a week featuring handicapped 
employment had been carried on before 
Congress for years by Paul Strachan, President of 
The American Federation of the Physically Handicapped. 
Strachan, almost single-handedly 
shepherded a campaign through many sessions of 
Congress, urging the establishment of what he 
called "National Employ the Physically Handicapped 
Week." Support for such a program was 
limited. Even veteran's groups were so preoccupied 
with other issues in the final days of World 
War II that they did not come to the aid of the bill. 

A younger Bill McCahill receives a 1967 leadership award from Leon 
Chatelain, then President of the National Easter Seal Society. 

Despite this, Strachen, who was himself disabled, 
was not deterred. Not one to mince words, 
he argued effectively that it was in America's best 
interest to institute a more coherent effort to find 
employment for disabled adults. Taking up an argument 
as relevant today as 40 years ago, 
Strachan summed up the concerns of several 
generations when he stated: 

"Sometimes it takes the American people quite a while to 
get an idea. I do not believe they have really sensed yet 
that the disabled are not a charity proposition. Helping us 
isn't wholly based on humanitarian concepts. It is 
primarily a great economic problem. I hope that every 
member of this committee will take to heart this fact: either 
you treat, train and educate the handicapped and place 
them in suitable employment, or you keep them in a 
submarginal existence of misery and want. And pay for 
it anyhow out of your tax money, in public assistance." 
(Russell: 1981:159) 

The President's Committee 
for the Employment of the 
Physically Handicapped 

In 1945, Strachen's "Week" was passed by 
Congress, which helped pave the way for President 
Truman to begin to organize The President's 
Committee on the Employment of the Physically 
Handicapped during the last days of the War. Admiral 
Ross M. McIntyre, Roosevelt's personal 
physician, was appointed the first Chair and 
Truman began asking leading medical experts, administrators 
and disability advocates to serve in 
the voluntary effort. 

William McCahill, returning from war time 
service in public relations with the Marines, was 


32 HISTORY OF INTERNATIONAL REHABILITATION 


given responsibility by Truman for shaping the 
committee into a workable enterprise. McCahill 
remained Executive Secretary of the President's 
Committee from its inception until his retirement 
in 1973, 27 years later. Under his direction, the 
Committee grew from a staff of one to 39. At the 
same time, the initial participation by several 
dozen experts increased to an appointed membership 
of hundreds and the Committee began to 
hold annual conferences. Work was begun in each 
state in affiliation with Governor's Committees, extending 
the participatory process down to 
grassroots levels. 

Appointments by Truman to the Committee 
were a fairly balanced number of prominent disabled 
individuals and health professionals. 
Truman was convinced that this Committee would 
answer an unmet need and would be an immediate 
success. As William McCahill recalled in his interview 
for this project, Truman was so interested 
in the Committee that he took time to address its 
first meeting held at the 600 seat Labor Department 
Auditorium in Washington in 1947. A distinguished 
group of 73 national leaders had 
assembled for this meeting, but the auditorium 
appeared empty. McCahill, in charge of the meeting, 
called Morris Coburn, the Secretary of Labor 
minutes before the President's entourage pulled 
up and threw himself on his mercy. Coburn ordered 
all available employees in the building to 
rush to the auditorium and shortly thereafter, 
Truman mounted the stage and looked approvingly 
out over the packed house. "I knew this program 
was going to be a success," Truman 
enthusiastically remarked, "and all I have to do is 
look at this wonderful audience to tell me how 
successful it really is." 

The Committee, although not formally part of 
the Federal government, was an early national 
voice speaking out on behalf of employment for 
disabled individuals. The Committee's work 
yielded some significant results. There was an increase 
in the numbers of disabled individuals 
hired, and a growing awareness of disability-related 
issues by the general public although by 
today's standards the numbers who actually 
found work and the ideas disseminated to the 
public seem rather limited. Indeed, only physical 
disability was included in the first years; mental 
retardation and mental illness were not covered 
by the program until the 1960s. 

The President's Committee also generated 
two important byproducts that were to have significant 
international repercussions: The first was 
that the Committee's concerns broadened dramatically 
over time as the concept of employment ex


tended into life in the community. Providing someone 
with a job meant little if the person was unable 
to travel to the work site, enter the building, 
obtain technical aids or pursue career ad- vancement. 
"Employment" therefore led to questions of 
transportation, accessibility and workmen's compensation, 
and by further extension, issues of concern 
to disabled consumers, such as legal 
protection, independent living, social equality and 
ultimately, civil rights. 

Second, the President's Committee provided 
a unique central meeting ground, with experts 
and advocates on physical disability convening annually. 
It was the first regular opportunity for advocates 
and professionals from various disciplines 
to meet. Since the 1920s there were numerous 
local, regional and national disability groups but 
relatively little communication among them. The 
President's Committee was, for many years, one of 
the few national forums where governmental and 
voluntary organizations could meet to compare 
notes, set agendas, discuss ideas and disseminate 
information. 

Second, the President's Committee 
provided a unique central meeting 
ground, with experts and advocates 
on physical disability convening annually. 


The annual meetings also attracted a steady 
stream of foreign participants. Their numbers 
were never large; a dozen or so might attend any 
given meeting. William McCahill would regularly 
extend invitations to visiting foreign experts or advocates 
who might be in the Washington, DC area 
in the spring, and introduce them to colleagues 
during the course of the meeting. In this manner, 
over the years, a number of foreign experts were 
introduced to ideas and programs within the 
United States, and a number of Americans made 
initial liaisons with foreign colleagues that would 
grow over time. 

Significant U.S. Rehabilitation 
Centers in the Post-War Era 

In the late 1940s and early 1950s, the significant 
focal points for the revitalization of international 
rehabilitation efforts were the 
development of major centers founded as models 
of rehabilitative care, and professional and vocational 
training. The long-established Institute for 
Crippled and Disabled in New York, was joined in 

HISTORY OF INTERNATIONAL REHABILITATION 33 


The significant focal points for the 
revitalization of international 
rehabilitation efforts were the development 
of major centers founded as 
models of rehabilitative care. 

the post-War period by the increasingly active 
Cleveland Clinic, under the Directorship of Bell 
Greve, which would later change its name to the 
Cleveland Rehabilitation Center. Also active in 
North America, was the Canadian Rehabilitation 
Center in Toronto under the Directorship of Dr. 
Harold D. Storms, which was in regular contact 
with its American counterparts. 

Sister Elizabeth Kenny of Australia, the "bush nurse" who dared to lecture 
eminent doctors on post-polio treatment. 

An overseas influence came through the 
Sister Kenny Institute founded in Minneapolis in 
1942, concentrated initially on the care of 
children and adults with polio. Elizabeth Kenny, 
("Sister" was the title she gained working as a 
head nurse in the British medical system during 
the First World War), was an Australian nurse 
who came to the United States to gain recognition 
for her innovative physical therapy techniques. 
Kenny had failed to win wide support for her work 
in Australia, for her ideas were often controversial 
and she herself, at times, contentious. However, 

many of Kenny's ideas were well received in 
America, both because of a renewed emphasis in 
the post-War era on carefully researching new 
techniques to verify results, and because much of 
what Kenny proposed fit in well with the newly 
emerging field of physical and rehabilitative 
medicine being established by Rusk, Kessler and 
others. (The wide acceptance of Kenny's ideas in 
the U.S. provided both the scientific and financial 
support that enabled her and her colleagues to 
subsequently introduce Kenny ideas to a number 
of other developed and developing countries as 
well.) 

None of these programs however, seems to 
have initially had a coherent training program in 
rehabilitation for administrative and medical 
professionals. 

The first two American-based rehabilitation 
programs to provide fellowship training which 
would develop on-going international significance 
were the Institute of Physical Medicine and 
Rehabilitation in New York, and the Kessler Institute 
in West Orange, New Jersey. 

The Institute of Physical 
Medicine and Rehabilitation 

At the close of the War, Howard Rusk had become 
so committed to the idea and the potential 
of rehabilitation that the prospect of returning to 
a private internal medicine practice in Missouri 
held little interest for him. Unfortunately, no 
hospital or medical school in the country had a 
program or department in which he could work exclusively 
on physical rehabilitation issues. 

Undeterred, Rusk decided to create his own 
center, with the idea that such a center could 
develop into a leading and innovative model. In 
1945, Rusk, (with the assistance of several supporters 
who were well connected at New York 
University), was able to convince the University 
administration that a rehabilitation program had 
promise, and he was invited to set up a Department 
of Physical and Rehabilitative Medicine. 
Rusk obtained a small grant from the Baruch 
Committee and in March 1949 opened the Institute 
of Physical Medicine and Rehabilitation, 
renamed the Rusk Institute in 1989. At first it 

The 34-bed facility was filled to 
capacity from the day it opened by 
the United Mine Workers which sent 
men for treatment, with local referrals 
providing the rest. 

34 HISTORY OF INTERNATIONAL REHABILITATION 


Rusk himself became the leading 

spokesman for the newly forming 

field of Rehabilitation Medicine, and 

his Institute was the first to offer or


ganized training in rehabilitation for 

medical personnel. 

was housed in temporary quarters, a small 
revamped bath house, on Thirty-Eighth Street in 
New York City. The 34-bed facility was filled to 
capacity from the day it opened by the United 
Mine Workers which sent men for treatment, with 
local referrals providing the rest. By 1950, work 
had begun on a much larger permanent two million 
dollar facility on Thirty-Fourth Street and 
First Avenue in New York. The new facility opened 
in early 1951 and it continues to provide services 
for people with disabilities. 

Affiliated with the New York University-Bellevue 
Medical Center, the Institute quickly attracted 
attention worldwide, as Rusk and his staff 
developed new and creative approaches to 
rehabilitation. Rusk himself became the leading 
spokesman for the newly forming field of 
Rehabilitation Medicine, and his Institute was the 
first to offer organized training in rehabilitation 
for medical personnel. Others, such as the 
Cleveland Clinic, the Toronto Clinic and the Sister 
Kenny Institute, welcomed observers, but at first 
only Rusk had an actual training and fellowship 
program. 

Rusk was also growing increasingly influential 
on the national level. He was a driving force in 
the formation of a Veterans Administration 
rehabilitation program and was appointed by 

An early model of the Drinker Respirator known as the "iron lung." 
(Source: History of Poliomyelitis, p. 327) 

President Truman as Chair of the National Health 

Resources Planning Board, partly to further the 

cause of civilian rehabilitation in the United 

States. He had the ear of many prominent 
Americans and was tireless in his efforts to advo


cate on behalf of rehabilitation. 

Rusk furthered his own ideas through public 
speaking and writing, gaining considerable influence 
and attention through a weekly medical 
column in The New York Times, regularly featuring 
rehabilitation-related stories. Actually, Rusk's 
New York Times column and many of his other 
publications and speeches were written by his key 
staff associate, Eugene (Jack) Taylor. Taylor, a 
speech pathologist from Kansas, had met Rusk 
while in the Air Force, and became part of many 
of the activities in the Institute. By all reports, 
Taylor rapidly developed an encyclopedic 
knowledge of the substance and personnel in the 
field, and played a critical role in translating 
Rusk's ideas into action. 

Rusk was also fortunate to have two other 
outstanding experts on his staff. One was James 
Garrett, who received his doctorate in clinical 
psychology from the Columbia University and was 
one of the first to study and write on the 
psychological and behavioral aspects of living with 
a disability, Garrett, disabled by polio in his early 
childhood, had already directed a vocational 
rehabilitation program for the Institute for Crippled 
and Disabled. In the late 1940s, Garrett had 
been responsible for establishing and overseeing 
the Veterans Administration's first guidance center. 
Already known to Rusk, Garrett was invited to 
join the staff soon after the Institute opened its 
doors. Until he left for Washington several years 
later, Garrett administered and developed the 
psycho-social component of the rehabilitation activities 
at the Institute. 

Dr. George Deaver played a significant role in 
the medical management of the Institute. Deaver 
came to New York University from the Institute for 
Crippled and Disabled, and had, as noted earlier, 
worked closely with Rusk during the War. Deaver 
was already well known in the field and had 
developed the concept that the first responsibility 
of rehabilitation should be to train individuals in 
the daily living skills required for self-sufficiency. 
He and his therapists had developed a check list 
of activities for daily living, an idea he and Rusk 
later expanded by adding a vocational component. 

Rusk actively sought physicians interested in 
training for careers in what he came to call 
rehabilitative medicine, a field which combined 
medicine, surgery, physical therapy and psychology 
to provide a holistic perspective on the rnedi-

HISTORY OF INTERNATIONAL REHABILITATION 35 


So effective was Rusk, that by 1956, 
three-quarters of all the medical 
schools in the country had started 
coordinated teaching programs in 
rehabilitation. 


cal, psychological and social needs of the disabled 
patient. In 1947, thanks in large measure to lobbying 
efforts by Rusk, rehabilitation medicine became 
a specialty approved by the American 
Medical Association as the American Board of 
Physical Medicine and Rehabilitation. 

Rusk soon began to gain an international 
reputation. While most of his first fellows were 
from the United States, increasingly others came 
from overseas. Soon regular flow of medical fellows 
began to be referred for training to the Institute 
from the United Nations, and agencies 
within the United States government. In addition, 
Rusk's writing in The New York Times gained for 
him additional students who would come across 
his articles or see reprints of his columns in their 
own national papers. 

So effective was Rusk, that by 1956, three-
quarters of all the medical schools in the country 
had started coordinated teaching programs in 
rehabilitation. In his autobiography, A World To 
Care For (1972), Rusk took particular pride in 
relating that "we have trained more than 1000 
doctors from 85 countries, 95% of whom returned 
home to practice." Theses fellows and students in 
direct contact with Rusk returned home to train 
thousands more. For example, Dr. Herman (Jake) 
Flax studied with Rusk in 1947 and completed a 
fellowship in 1951. In 1950, Flax and his colleagues 
organized the first Institute on Physical 
Medicine and Rehabilitation held in Puerto Rico. 
A large collection of leading figures in the field, 
Howard Rusk, Henry Kessler, Bell Greve, Harold 
Storms, and representatives from the Departments 
of Health, the Department of Education, 
the Department of Labor and the Veteran's Administration 
participated. The audience was largely 
Puerto Rican and the event can be considered 
the first effective regional rehabilitation meetings 
in the Caribbean. By 1957, Flax had organized a 
residency program, and his Puerto Rican-based 
training program began to attract physicians from 
throughout Latin America and the Caribbean. 

In addition to direct contact, and contact 
through students, Rusk and Jack Taylor kept in 
contact with thousands of additional colleagues 
who wrote or called to ask questions or request 
guidance. The Rusk staff replied to countless 

queries and Rusk himself proved to be a generous 
and thoughtful colleague to many fellow professionals. 
A dedicated physician, his interests were 
broad, he had a strong sense of purpose, a good 
sense of humor and, as one colleague recalled "he 
could charm a bird out of a tree." He was as 
hospitable to patients, students and volunteer 
staff as he was to leaders of industry and 
prominent politicians. His influence would continue 
to grow in the years that followed. 

The Kessler Institute for 
Rehabilitation 

Henry Kessler, who had run the Mare Island 
Hospital during the War, found himself in a position 
similar to Howard Rusk's at the close of hostilities. 
Although he initially tried to return to 
private practice in New Jersey, the facilities where 
Kessler had worked had no real awareness of 
rehabilitation. Kessler found much of his time and 
energy spent trying to eke out small levels of 
cooperation from institutions, professional colleagues 
and insurance companies. He was further 
dismayed to find that the state rehabilitation program 
he had struggled to establish and promote 
since the early 1920s, had simply been dismantled 
while he was away in the Navy. 

A non-profit rehabilitation facility, it 
was, in Kessler's words, removed 
from the "red tape and other 
problems which invariably are associated 
with government control of 
such establishments." 


Kessler's solution was to set off on his own 
and to do that, he established the Kessler Institute 
for Rehabilitation in West Orange, New Jersey. 
A non-profit rehabilitation facility, it was, in 
Kessler's words, removed from the "red tape and 
other problems which invariably are associated 
with government control of such establishments." 
It opened its doors in 1949 in a small building 
with five patients (all coal miners referred to 
Kessler through the United Mine Workers). The Institute 
quickly grew much larger, eventually serving 
thousands of patients annually, and training 
hundreds of rehabilitation professionals from over 
two dozen countries. 

With Rusk's and Kessler's centers, the 
greater New York area became a focal point for 
much rehabilitation work both nationally and internationally. 
Although the institutions themsel


36 HISTORY OF INTERNATIONAL REHABILITATION 


STOCK H riLDf. ! 

This last week-end while forty-
eight nations were signing the 
Japanese peace treaty In San 
Francisco, here, halfway around 
the world, the fifth World Congress 
of the International Society for the 
Welfare of Cripples was attacking 
the problem of world peace and 

cooperation from a different approach. 


Doctors, social workers and interested 
citizens rather than diplomats. 
the 750 delegates were concerned 
with disability rather than 
politics. By working together to 
provide a richer, fuller life for millions 
of the world's handicapped 
they, too, were statesmen. They 
were forging the international 
links of unc.:Tsi sliding and common 
concern fee mutual problems, 
the only fbundetions upon which 
the work of the San Francisco 
meeting can have lasting significance. 


Founded in 1922, the Internat 
ional Society for the Welfare of 
Cripples is a federation of twenty 
non-governmental national organizations 
engaged in programs for 
t he welfare of the disabled. Through 
its secretariat in New York it 
s=erves as a clearing house for information 
concerning the physi,:
ally disabled of the world, assists 
in the establishment of national 
organizations for the handicapped, 
promotes scholarships, fellowships 
and International excliengo of rehabilitation 
specialists, provides 
consultation services for the United 
Nations World Health Organization 
and other official international 
bodies and arranges conferences 
such as that held this 
week. 

Progress of the Movement 

Previous world congresses of 
'he society were held in Geneva in 
1.929, The Hague in 1931, Budapest 
in 1936 and London in 1939. The 

Zly Nei' Lark irnto 

NEW YORK, SUNDAY, SEPTEMBER 16, 1951. 

Specialists From 20 Nations 
Advance Welf ate of Crippled 


Statesmanship in the Conquest of Disability 

Is Exemplified at Stockholm Congress 

By HOWARD A. RUSK. M. D. 

newest national organization to 
join the society is Haiti, whose 
membership was voted this last 
week. The newest project of the 
society is assisting the United Nations 
Korean reconstruction agency 
in planning services for disabled 
Korean veterans and civilians. 

The society's national affiliate 
In the United States is the National 
Society for Crippled Children 
and Adults. Its president for 
the last three years has been Dr. 
Henry H. Kessler of Newark, an 
international authority on rehabilitation. 
Succeeding him for the 
next term will he Konrad Persson, 
general director of the Royal Pension 
Board of Sweden, who served 
as congress president this week.

At the closing session on Friday 
the society paid special tribute to 
Miss Bell Greve, director of the 
Cleveland rehabilitation center, 
who served as the society's secretary 
general for many years and 
who was largely responsible for 
continuing its operation single-
handed during tho war years. 

Speaking at the opening session 
in the Swedish House of Parliament, 
Dr. Harold Hahne, consultant 
in rehabilitation to the United 
Nations, told the delegates of 
plans for increased activity by the 
United Nations and its specialized 
agencies in services for the handicapped. 


At no tint! in the history of the! 
world. he said has there been sn 

much international interest and 
activity in the rehabilitation of 
the disabled. This interest he attributed 
to both technical advances 
in rehabilitation resulting from 
the war and the existence of governmental 
and voluntary programs 
through which these advances 
could be translated into 
direct service programs in the 
various nations. 

Exhibition of New Devices 
Exhibits at the meeting verified 
his statement. In one corner of 
the exhibit hall was a display of 
photographs from an occupational 
therapy school in India. 
Facing it was a demonstration of 
prosthetic devices used in rehabilitation 
centers in Western Germany, 
and down the corridor were 
photographs of a crippled children's 
school in South Africa. 
Outstanding among the exhibits 
was a display of technical aids for 
the handicapped which have been 
developed in Sweden. Built with 
the pi ecision for which Sweden is 
noted, the gadgets included mechanisms 
for getting an invalid in 
and out of a bathtub, household 
helps for persons with paralyzedlimbs and even an electrically 
operated wheelchair with rubber 
treads similar to those used on 
tractors that enable It to climb 
stairs. 
Oymplcs' for Paraplegics 
Among the most heartening reports 
was that of Dr. I. Guttman 

of the Spinal Injuries Center at 
Stoke Mandeville, England, who 
said that of more than 700 paraplegis 
trained at this center, 74 
per cent were living out of the hospital 
and most were employed full 
time. Many of the group live in a 
new specially deSigned hostel in 
London and commute to and from 
their work. 

Dr. Guttman told of an archery 
exhibition given by paraplegics recently 
at. the Festival of Britain. 
Here two paraplegics, shooting 
from their wheel-chairs, made a 
score of 57 as compared with 78 
made by two British Olympic team 
archers. He suggested that. a special 
"paraplegic Olympics" be held 
at which paralyzed persons front 
all nations might compete in basketball, 
archery, javelin throwing 
and wheel-chair polo. 

This suggestion in itself shows 
how paraplegia has changed within 
a few years from a hopeless condition 
to one of opportunity and self-
sufficiency. 

Even more striking than the exhibits 
were the dedication and enthusiasm 
shown by the delegates 
who worked from early until late 
each day collecting new ideas and 
every available scrap of information 
they could carry home to improve 
the services in their own 
countries. 

This was an international meeting 
in which there were no dissenters 
and from which no one "took 
a walk." For six days the delegates 
discussed the education of 
cerebral palsied children, training 
in walking for the paralyzed, teaching 
self-care aetivities to arthritics, 
job placement of the blind and 
housing for paraplegics. 

From Helsinki to Delhi to Cape-
town to Quebec each had a different 
national tongue, but this week 
spoke a common international language— 
man's interest in helping 
his fellow man. 

A sample New York Times article by Dr. Rusk, touching on Sweden's budding acumen in technical aids and the birth of the idea of a "paraplegic

Olympics." 

HISTORY OF INTERNATIONAL REHABILITATION 37 


Both Kessler and Rusk were heavily 

involved with rehabilitation work na


tionally and internationally, and very 

frequently were involved in the same 

projects. 

ves were distinct and did not usually "officially" 
collaborate, both Kessler and Rusk were heavily 
involved with rehabilitation work nationally and 
internationally, and very frequently were involved 
in the same projects. Both men, for example, 
served as President of the International Society for 
the Welfare of Cripples, and both men were 
regularly consulted by the U.S. Congress and by 
the new and growing body of United Nations organizations 
and programs. Kessler and Rusk apparently 
held a good deal of respect for one 
another, and their relationship was a very cordial 
one. Kessler was a generation older than Rusk, 
and Rusk, although perhaps better known to the 
general public always considered Kessler a 
pioneer in the field, and treated him as a 
respected senior colleague. Kessler, who was 
universally admired, was a good natured, fair and 
thoughtful colleague with very broad interests. He 
even took time out of his busy career to write 
books and articles on local history and 
biographies of early Dutch New Yorkers. 

Henry Viscardi 

In the years following World War II, not all 
rehabilitation efforts were medical. Henry Viscardi, 
who had been born with a significant impairment, 
had mastered the use of prosthetic legs and 
volunteered his time during the War years to train 
newly disabled servicemen at the Walter Reed 
Medical Center. Viscardi had returned to the New 
York area after his wartime work, to begin a highly 
successful career in business. 

As a prominent business leader, Viscardi was 
invited to join 'Just One Break' (JOB), a committee 
of business leaders who met regularly to locate 
jobs for disabled individuals. Although the Committee 
did place some people, Viscardi was quick 
to see that many more jobs were needed than a 
single committee could provide, and more importantly, 
that many of the more severely disabled individuals 
were simply unable to find any work. He 
decided that if no one else would hire them, he 
would. The fact that, at the time, he had no company, 
barely slowed him down. 

In the summer of 1952, Viscardi borrowed 
$8000, rented a vacant garage in West 
Hempstead, Long Island, and opened "Abilities, 

38 HISTORY OF INTERNATIONAL REHABILITATION 

Inc.". He appointed himself President and went 
out to seek assembly line work from local factories. 
His initial work force of five expanded to 

160 within two years and the organization has 
gone on to train thousands in the intervening 
decades. Abilities, Inc., eventually grew into the 
Human Resources and Training Institute, with 
education, research and training components. 
Soon articles by and about Henry Viscardi and his 
organization appeared in newspapers, magazines, 
and journals. Reader's Digest, with a readership 
in the millions, carried several stories on his work 
into dozens of different countries. Viscardi himself 
wrote eight well-received books on various aspects 
of his life and work, and lectured widely. A compelling 
writer and fine public speaker, Viscardi 
was able to present his arguments effectively, and 
a number of leading disability advocates in 
Europe, Asia and South America, as well as North 
America, trace their initial involvement with 
rehabilitation and disability rights to articles or 
books by Viscardi. Abilities, Inc., and the Human 
Resources and Training Institute flourished and 
have since provided the models for some 40 
Abilities, Inc., in 37 different countries. 

Henry Viscardi, who had been born 
with a significant impairment, had 
mastered the use of prosthetic legs 
and volunteered his time during the 
War years to train newly disabled 
servicemen 


Eleanor Roosevelt 

There was, in the post-War years, one more 
prominent American individual from the New York 
area whose work greatly influenced the rehabilitation 
field nationally and internationally. From the 
late 1940s until the time of her death in 1962, 
Eleanor Roosevelt's name regularly appears on 
Boards of Directors for rehabilitation related 
programs and organizations. She wrote introductions 
to several books on rehabilitation, but as 
there are few other written records to indicate her 
support, it could be assumed that she was simply 
a well-known figurehead, only tangentially connected 
with rehabilitation people and programs. 

In fact, discussion with individuals for this 
study and a close review of the documents shows 
that Eleanor Roosevelt was very active in 
rehabilitation circles from the closing days of 
World War II onward. Although her work in this 
field began with disabled servicemen during 
World War II, her commitment to the issues 


Eleanor Roosevelt, accustomed to a background role, was an avid 
supporter of disability advocates. 
(Photo source: FDR's Splendid Deception, p. 143) 


seems to have grown over the years and extended 
to broader disability concerns. She not only 
served as an honorary figure on many committees, 
but became a close personal friend to a number 
of leading disabled activists in the late 1940s 
and 1950s, always ready to listen to personal 
problems, and regularly attending their family 
events. (Henry Viscardi for example, notes that 
Eleanor Roosevelt attended the baptism of each of 
his four daughters). Most of this work was "behind 
the scenes", but until her death, when clout 
was needed for a disability project, she could be 
counted on to pick up the phone and make a personal 
call. 

Eleanor Roosevelt was very active in 
rehabilitation circles from the closing 
days of World War II onward. 

Mass Media: An Increasingly 
Educated Public 

In the past-War years, growing public awareness 
about disability issues was brought about 
not only by the individual efforts of committed 
professionals and disabled activists and advocates. 
From the late 1940s on, the American mass 
media—movies, newspapers, magazines and 
radio—began to cover disability issues with growing 
frequency and candor. And in an era when 
United States mass media was gaining more influence 
than ever before worldwide, such attention 
carried changing perceptions of disability to 
all corners of the globe. 

By far, the single most effective and far-reaching 
effort seems to have been the Hollywood version 
of the screenplay, Glory for Me. Retitled Best 
Years of Our Lives, it depicted the return to 
everyday civilian life of four veterans, one of 
whom, "Homer Parrish", had lost both hands in 
the war. Harold Russell, a returning Army sergeant 
who was a bilateral amputee, was chosen 
for the part. Russell, a veteran from Cambridge, 
Massachusetts was cast in the role after the film's 
director, William Wyler, spotted him in an Army 
training film entitled Diary of a Sergeant. Russell 
was not an actor. He had been a meat cutter in a 
local food market before the War, and he had 
returned home to begin classes at Boston University 
in business administration. The phone call 
from Samuel Goldwyn's Hollywood studio offering 
Russell the part had to be repeated, since Russell 
hung up the first time, sure that the call was a 
hoax. 

The Best Years of Our Lives opened to rave 
reviews in 1946, swept the Oscar ceremonies in 
1947, (including two Oscars won by Russell himself), 
and was ultimately seen by over 60 million 
people in 35 countries. (Television and more 
recently, video have introduced the film to at least 
as large again an audience). While the film was 
not intended to promote disability awareness per 
se, the dignity and self-assurance of Russell's 
characterization made a powerful impression on 
audiences. For most viewers, the only previous exposures 
to disabled people in films were one-sided 
portrayals of either benignly weak invalids, (who 
would usually die conveniently before the end of 
the film), or malevolent villains. In either case, the 
roles were consistently played by non-disabled actors. 
Russell himself then became an articulate 
spokesman for handicapped rights and veterans 
affairs, volunteering his time and energy to 
dozens of issues and causes. He was recruited by 
Truman to join the President's Committee for the 
Employment of the Physically Handicapped in 

HISTORY OF INTERNATIONAL REHABILITATION 39 


Harold Russell with his two "Oscars" for the same role in The Best 
Years of Our Lives, which swept the Academy Awards in 1947. 

1947, becoming the Vice Chairman of the Committee 
in 1962 and the Chairman in 1964, a voluntary 
position he would hold for the next 25 years. 

The Best Years of Our Lives opened 

to rave reviews in 1946, swept the 
Oscar ceremonies in 1947, (including 
two Oscars won by Russell himself), 
and was ultimately seen by over 60 
million people in 35 countries. 


Other individuals who were disabled also 
began receive increasing media attention. Helen 
Keller received significant amounts of media exposure 
throughout her life, and books and films 
about her were popular around the world. Mass 
market maga-zines began to regularly feature disabled 
people. Reader's Digest for example, regularly 
carried "true life" stories about a child or adult 
facing, (and almost invariably 'overcoming') a disability. 
Although many of these stories were intended 
to be "inspirational," for the first time, 
disability conditions and related medical and social 
issues were presented in detail, and more 

stories were now focused on "average" people and 
families coping with these situations. Dr. Howard 
Rusk's regular New York Times column, should 
also be included in this category. It often dealt 
with issues of rehabilitation and was quoted widely. 
Still a long way from discussing disability issues 
in the relatively realistic ways of today, these 
mass media presentations were important, creating 
a worldwide image of the United States as a 
"land of opportunity" for disabled people. 

U.S. Based International 
Rehabilitation Activity Revives 
The period from 1945 to the early 1950s is 
also marked by a rebirth of American-based international 
rehabilitation efforts initiated by both 
government and nongovernmental organizations. 
The revival of international activity at this point is 
especially striking considering that at the close of 
the War, private voluntary organizations and 
federal programs had little to offer. The only U.S.based 
rehabilitation organization with expressly 
international interests, the International Society 
for the Welfare of Cripples, was barely surviving. 
Cooperative exchanges between American-based 
individuals, institutions and schools overseas had 
been largely severed. The Federal government had 
no involvement with international pro-grams 
specifically addressing disability issues before the 
War with the exception of its largely symbolic 
membership in the International Labor Organization 
(ILO), a vestigial organization established 
under the Treaty of Versailles and the last functional 
part of the League of Nations. 

Disability issues were not a high priority as 
War reconstruction efforts got underway. Yet 
within a decade, public and private rehabilitation 
efforts in the U.S. would place this country in the 
forefront of the rehabilitation field. Several major 
factors would play a significant role in revitalization. 
These involved people, organizational restructuring 
and a shift in the U.S. federal government's 
commitments to international work. 

New American Leadership 

A significant part of the credit for the rebirth 
of United States participation in the international 
rehabilitation scene must go to the innovative 
ideas and administrative skills of a new generation 
of leaders. Interestingly, few had experience 
with disability issues before the War. Their 
strengths lay in the administrative skills and overseas 
experience they had developed as part of war 
efforts. People such as Donald Wilson, Norman 
Acton, Joseph LaRocca and William McCahill, 

40 HISTORY OF INTERNATIONAL REHABILITATION 


whose specific roles are discussed elsewhere, were 
all involved in the War effort. 

The tide of war-related immigration brought 
several other future leaders to this country. For 
example, Gunnar Dybwad had arrived in the 
United States in 1934 to many his American-born 
wife, Rosemary, as his native country of Germany 
fell under increasing control of the Nazi party; and 
Ignacy Goldberg who fought in the ex-patriot 
Polish Army in North Africa, came in the late 
1940s, and would contribute substantially to U.S. 
special education. Unlike those who had worked 
on international issues before the War, the core of 
the disability leadership in the United States in 
the 1950s and 60s had first-hand experience with 
international developments and were accustomed 
to reaching beyond the United States' borders to 
find solutions and to extend assistance. 

For the first time, some programs that 
related to rehabilitation and/or disability 
were incorporated into foreign 
policy and development initiatives, 

The Late 1940s: Renewed 
Government Efforts 

In the late 1940s the United States was 
emerging as a world benefactor through programs 
such as the Marshall Plan. Without setting out to 
do so, the United States government became involved 
in a number of programs that touched 
upon rehabilitation issues, many a byproduct of 
aid programs aimed at the restoration of war-torn 
Europe. Academic exchanges, such as the 
Fulbright Scholarship Program soon began to 
bring experts, including those interested in disability, 
from around the world to study and observe 
in America. New university and 
institutional-based training programs around the 
country, many funded by federal dollars, began to 
get a trickle of overseas participants. 

During much of the late 1940s and early 
1950s, the bulk of American overseas support in 
rehabilitation went to Europe, primarily through 
medical and maternal/child relief efforts. 
Decimated by the War, many European nations 
were perceived to be more "Developing" than 
"Developed" during those years and the need for 
programs expressly targeted for disabled groups 
quickly became apparent. For example, the Polish 
city of Warsaw had more children and adults who 
were amputees as a direct or indirect result of the 
War than the United States Army, Navy and Air 

Force combined—and most of Warsaw's medical 
infrastructure had been destroyed. 

The post-War efforts in Europe permitted a 
redefinition of rehabilitation programs. For the 
first time, some programs that related to 
rehabilitation and/or disability were incorporated 
into foreign policy and development initiatives, 
rather than being automatically assigned to educational 
or social exchanges. This era laid 
groundwork which would permit other Federal 
agencies in the ensuing two decades to promote 
international rehabilitation ventures as a component 
of general foreign policy. 

In 1949, the International Society for 
the Welfare of Cripples moved to New 
York, with its first full-time staff 


Rebirth of Non-governmental 
Organizations: The International 
Society for the Welfare of 
Cripples 

Although the International Society for the 
Welfare of Cripples was still technically active at 
the close of the war, the organization had not had 
a fonnal meeting since 1939. President Juan 
Farill from Mexico had had little time to devote to 
the organization and the War had hampered his 
ability to travel widely on its behalf. 

Bell Greve, as Secretary-General, had kept 
the organization alive by mail, and as soon as hostilities 
ended, began to re-establish energetic contacts 
with leaders of rehabilitation movements in 
a number of countries. By late 1945, she had 
revived enough interest to put through a mail vote 
to the membership for a re-organization of the 
Society. Funds for travel were still difficult to 
come by, but to breathe some life into the organization, 
a Pan-American conference was held 
in Mexico in 1948. Nineteen representatives from 
Latin American countries attended and strong 
support was voiced for a renewal of the Society 
(Kessler: 1968:153). This meeting was followed by 
another small meeting held in Hawaii in 1949, 
this time to introduce rehabilitation concepts and 
techniques to United States Army and Navy medical 
personal. 

Following the Hawaii meeting, Bell Greve and 
the newly-elected president, Henry Kessler, met to 
consider the future of the organization. They both 
had come to the realization that the International 
Society could not continue to function on an entirely 
voluntary basis. A paid administrative staff 

HISTORY OF INTERNATIONAL REHABILITATION 41 


was needed to coordinate efforts, meetings and 
programs. Money, or rather the lack of it, was the 
issue. Although Society account books from that 
time have yet to be located, apparently, by 1949, 
the Society had less than $2000 in its entire 
budget. 

Then, out of the blue, help arrived. A woman 
somewhere in the mid-West had, years before, 
heard Bell Greve present a lecture on disabled 
children overseas. This woman had been so impressed 
that she left an inheritance of $16,000 for 
Greve to use as she saw fit. Its arrival could not 
have been more timely. The inheritance was designated 
as seed money for a staff and New York City 
was chosen as its base of operations, in large 
measure because it had recently been designated 
the home of the new United Nations. 

In 1949, the International Society for the Welfare 
of Cripples moved to New York, with its first 

full-time staff. Bell Greve selected Donald Wilson 
as the new Executive Director. Trained as a 
lawyer and a social service administrator, Wilson 
had first worked with Greve as a young staff member 
at her Association for the Crippled and Disabled 
in Cleveland, as a social and rehabilitation 
worker in Ohio, Illinois and Louisiana. He served 
in Japan as a member of the United States Occupational 
government after the close of the War 
and had returned to Ohio in 1948 to become 
Dean of the School of Applied Social Sciences at 
what is now Case Western University. 

To keep costs down, Greve, who was also on 
the Board of Directors of the Near East Foundation, 
made arrangements with that organization 
for the loan of a small office in its building on 
64th Street in New York City. The Society's new office 
was located in the former servants' quarters of 
an old brownstone townhouse that had seen bet-

Henry Kessler, Bell Greve and Helen Keller at an awards dinner in the 1950s. 

42 HISTORY OF INTERNATIONAL REHABILITATION 


ter days. As Wilson recalls, "the filing cabinet ar


rived, a telephone was installed and we were in 
business." Noiman Acton joined the staff in 1951, 

at first as director of a small program run through 
the International Society in collaboration with the 
International Refugee Organization, to assist in 
the resettlement of war refugees who were disabled. 
Acton, in addition to his other responsibilities 
spent an increasing amount of his time 
working for Society projects, and by year's end, 
was officially named Assistant Secretary General. 
The Society consisted of Wilson, Acton and a 
secretary. As Acton recalls, "we sat up there in 
solitary splendor for a couple of years." 

Money would continue to be tight for many 
years. Early and important support was given to 
the Society by Lawrence J. Linck, then Executive 

Director of the Easter Seals Society. Although 
Easter Seals at that time had a strong mid-
Western base and little involvement in overseas issues, 
Linck recognized the significance of the 
renewed International Society. Some $6000 annually 
was provided for U.S. support of international 
activities just as the organization was 
starting up. Although not an enormous sum, the 
backing and support of Easter Seals at that very 
critical moment gave a respectability to the international 
organization. Future directors of Easter 
Seals were not as enthusiastic about funding the 
International Society; however as long as Linck 
served as Director, some support was provided. 

Additional annual support (some $5000) and 
respectability came from Leonard W. Mayo in his 
capacity as Executive Director of the Association 

Former RI Secretary General Donald Wilson with Dr. Harold Balme of England in the early 1950s. Dr. Balme was instrumental in establishing the 
United Nations rehabilitation program and also advised the World Health Organization and UNICEF on their first disability programs. 

HISTORY OF INTERNATIONAL REHABILITATION 43 


By the time Wilson left 18 years later, 
the Society had 108 member organizations 
in 63 countries 


for the Aid of Crippled children. A New York based 

agency, it had recently been bequeathed a sub


stantial sum of money. Mayo, prominent both na


tionally and internationally on a number of social 

service and child health issues, including 

rehabilitation, was a highly respected ad


ministrator, whose support greatly enhanced the 

credibility of the organization. 

As Secretary-General, Donald Wilson focused 
on encouraging a growing number of nations to 
join the International Society, and re-establishing 
and reinforcing links that had existed before the 
War. Although the Society would continue to draw 
heavily on its American based leaders and 
American financial support for a number of years 
to come, increasingly, emphasis began to be 
placed on making the organization truly international 
in scope. When Wilson came to the Society 
in September of 1949, it had 12 national member 
organizations, and $18,000 in the bank. There 
were no full-time paid staff other than himself and 
no assured future income. There were also funds 
enough for only one year's operation. By the time 
Wilson left 18 years later, the Society had 108 
member organizations in 63 countries, and an income 
and an endowment fund large enough to 
permit it to undertake continuing operations and 
to permit long term planning. (Wilson: nd) 

The Society also found itself in a unique position 
as it regained strength. Its initial emphasis 
on physical disability already permitted it a 
broader scope for action than many of the other 
organizations which were specifically tied to one 
disabling disease or condition. The Society began 
to broaden its perspective still further after the 
War, emphasizing both policy and practice and expanding 
its programs to include all types of disabilities. 
This very broad perspective initially 
begun by Allen and King and emphasized under 
Bell Greve's stewardship, was stressed by Donald 
Wilson throughout his tenure. Wilson also wrote 
and spoke regularly and eloquently about 
rehabilitation standing on four pillars: medical, social, 
vocational and educational, and urged coordination 
of effort by professionals in all these 
areas. 

The resumption of international conferences 
and exchange programs began with the International 
Society for the Welfare of Cripples' Fifth 
World Congress in Stockholm in 1951. The 1951 

Congress meeting was the first international 
rehabilitation meeting since World War II. Attracting 
nearly 700 participants from 35 nations, it 
marked the re-establishment of organized international 
meetings as a platform for comprehensive 
discussion of disability issues. Since funding for 
travel was still extremely difficult to obtain, 
Donald Wilson cleverly addressed this problem by 
arranging for this and many early Society meetings 
to "piggyback" with those of other larger organizations. 
For example, a meeting of the World 
Veterans Organization in Rome, or an international 
polio conference in Copenhagen would be followed 
by an International Society meeting 
somewhere on the continent two or three days 
later. 

The Society began to broaden its 
perspective still further after the War, 
emphasizing both policy and practice 
and expanding its programs to include 
all types of disabilities. 


The organization began a series of regional 
meetings in part to attract participants who could 
not afford to attend the World Congresses, the 
first being the Pan-Pacific Congress that was held 
in Sydney, Australia in 1958. Regional meetings 
in the Pacific, Latin America and the Mediterranean 
were held, in addition to the World Congresses. 
Some regional meetings were more 
successful than others, but the significant outcome 
overall was the involvement of an increasing 
number of participants who could make contacts 
and establish networks and joint projects or research 
with others working within their 
geographic region. International meetings 
provided not only information, stimulation and encouragement, 
but also enabled people to identify 
sources of information abut standards, techniques, 
legislation, public education, and increasingly, 
grassroots advocacy. 

Early United Nations Activities 

Revival of the International Society for the 
Welfare of Cripples, and a number of bilateral exchanges, 
was matched by the birth and growth of 
activity within the United Nations. At the outset 
the United Nations had no defined programs in 
the rehabilitation or disability field, and thinking 
on disability issues within the United Nations' system 
was fuzzy at best. Most probably this was because 
"disability" fell into so many administrative, 
social, economic and medical arenas that it was 

44 HISTORY OF INTERNATIONAL REHABILITATION 


Acton, Wilson, Rusk, Kessler, Greve 

and others were instrumental in help


ing to better delineate rehabilitation 

issues for the UN Secretariat and in 

building support for rehabilitation 

throughout the system. 

difficult to conceptualize which entities or sections 
within the United Nations agencies should 
take primary responsibility for the array of 
programs that were needed. 

Within the United Nations, ideas from United 
States based and trained experts began early on 
and their input was significant. The International 
Society for the Welfare of Cripples was involved 
from the outset. Norman Acton recalled that the 
first United Nations contacts he had were when 
the organization was still based in Lake Placid, 
New York. Acton, Wilson, Rusk, Kessler, Greve 
and others were instrumental in helping to better 
delineate rehabilitation issues for the UN 
Secretariat and in building support for rehabilitation 
throughout the system. Indeed, Norman 
Acton, then Assistant Secretary General to the International 
Society and primary liaison between 
the Society and the United Nations, authored the 
first United Nations publication on rehabilitation 
in 1950. The earliest involvement of these 
Americans in United Nations 
activities meant 
that American ideas and 
approaches, including 
the strong emphasis on 
the newly emerging 
physical medicine and 
rehabilitation played significant 
roles in future 
United Nations efforts. 

The earliest United 
Nations programs connected 
to rehabilitation 
extend back to the First 
General Assembly which 
in December 1946, 
adopted Resolution #58 
establishing a program of 
social welfare services. 
"Rehabilitation of the 
handicapped" was specifically 
mentioned as an 
area in which technical 
assistance should be 

1947, experts, fellowships and technical equipment 
have been provided by numerous countries 
within the UN system and international seminars, 
conferences and study groups have also been organized 
under its auspices. 

The earliest United Nations programs 
connected to rehabilitation extend 
back to the First General Assembly 
which in December 1946, adopted 
Resolution #58 establishing a program 
of social welfare services. 

The Universal Declaration of Human Rights, 
written under the supervision of Eleanor 
Roosevelt, enacted by the United Nations General 
Assembly on December 10, 1948, established the 
framework for many of the specific disability-related 
Declarations that would follow. In July of 
1950, the United Nations' Economic and Social 
Council passed a resolution formally adopting the 
principle of rehabilitation services for all and establishing 
a coordinated program for social 
rehabilitation of physically disabled persons. The 
Council furthermore offered advice and technical 
assistance to nations within the United Nations 
system. The response was immediate and almost 
overwhelming. Yugoslavia, the first nation to 

made available to govern-

The 1951 RI World Congress in Stockholm drew crowds to see a newly-developed vehicle for disabled

ments. Thus, since early 

drivers. 

HISTORY OF INTERNATIONAL REHABILITATION 45 


First United Nations Conference of Non-Governmental Organizations in the disability field, held February 1953 at UN Headquarters. Representatives 
from 26 organizations attended. 

apply, hosted Henry Kessler in the winter of 1950. 
In 1951, the Rehabilitation Unit for the Disabled 
was established within the United Nations Social 
Development Division. 

In 1951, the Rehabilitation Unit for 
the Disabled was established within 
the United Nations Social Development 
Division. 


By 1952, an agreement had been worked out 
informally that allowed disability questions to be 
addressed by the UN and its specialized agencies: 
the World Health Organization was responsible for 
medical aspects, UNESCO for educational issues 
and the International Labor Organization for vocational 
concerns. Meanwhile, the United Nations' 
[General Assembly] Rehabilitation Unit took 
primary responsibility for social concerns and for 
prostheses (The General Assembly assuming 
responsibility for social and civil rights issues 
make some sense, but the issue of prosthetics is 
less clear. Apparently, the member states of the 
General Assembly were anxious to be responsible 

46 HISTORY OF INTERNATIONAL REHABILITATION 

for prostheses, as it was considered that development 
of rehabilitation equipment and centers was 
a highly visible and fairly straightforward program 
that could provide immediate results). 

While the concept of rehabilitation was accepted 
by the United Nations in 1950, the 
response by United Nations specialized agencies 
was still uneven. For example, UNICEF was initially 
slow to respond to disability matters, arguing 
their primarily responsibility was disability prevention. 
While pouring effort into massive inoculation 
programs and other medical efforts to prevent disability, 
UNICEF spent little energy on those 
children who were born disabled or for whom the 
prevention programs had not been successful. 
Donald Wilson and Norman Acton spent a good 
deal of time in the very early years trying to encourage 
UNICEF to address the immediate needs 
of disabled children, but were unable to stir up 
enough interest within the organization to make it 
become a priority. 

UNESCO, responsible for educational issues, 
including special education, was also slow to 
respond to disability issues. Although they sent 
representatives to meetings and organized several 
conferences that touched upon disability issues, it 


did little of direct relevance to disabled children or 
adults until the 1970s, when its activity in these 
spheres increased significantly. 

One United Nations agency that was active 
throughout the period was the International Labor 
Organization (ILO), sole survivor of the international 
bodies established after World War I under 
the League of Nations. The ILO had been involved 
in rehabilitation and employment of disabled 
workers since its inception, although it had been 
limited in the early stages to studies and reports. 
After the Second World War, however, newly affiliated 
with the United Nations, it began to be 
more involved in intergovernmental and voluntary 
groups, organizing projects such as regional training 
courses in physical and vocational rehabilitation 
and sponsoring workshops in conjunction 
with the United Nations, the World Veterans Fund 
and the International Society for the Welfare of 
Cripples. 

The Council of World 
Organizations Interested in 
the Handicapped (CWOIH) 

The fragmentation of rehabilitation/disability 
issues within the United Nations system made it 
all the more imperative that disability organizations 
with an international focus keep in close 
contact with one another. The United Nations, in 
a sense, forced the issue. The United Nations 
Economic and Social Council maintained "consultative 
relations" with non-governmental organizations, 
entitling these organizations to participate 
in meetings, submit statements and generally 
have some influence on the thinking in that particular 
field. Although willing to address some disability 
issues, the UN's resources and abilities 
could not cover response on an individual basis to 
every disability group. 

The coordinating body would eventually 
be composed of more than 50 
international groups representing 
many disability-specific and advocacy 
organizations as well as a 
wide array of professional groups. 


For the first time, it became important for internationally 
based disability organizations to 
come together to identify priorities for, and to advocate 
as a collective advisory group to, the 
United Nations. To this end, The Council of World 
Organization Interested in the Handicapped, 
(CWOIH) was formed in 1953, through the efforts 

of Norman Acton, to coordinate activities of international 
disability organizations in consultative 
status with various United Nations agencies. The 
coordinating body would eventually be composed 
of more than 50 international groups representing 
many disability-specific and advocacy organizations 
as well as a wide array of professional 
groups. The worlds of physical impairments, blindness, 
deafness and later mental retardation and 
mental illness began to draw closer on an international 
scale. 

Now called the International Council on Disability, 
it continues to meet. Although not active 
independently of the United Nations, the Council 
was one of the first truly international forums for 
the exchange of ideas and for significant networking 
to take place. What the Council also provided 
was a formal forum in which a cross-pollination of 
ideas and coordination of initiatives could be undertaken. 


The World Rehabilitation Fund 

By 1954, when Dr. Howard Rusk became 
President of the International Society for the Welfare 
of Cripples, the organization was beginning to 
get on firmer ground. Donald Wilson had successfully 
built both membership and funding and had 
increased the Society's participation in the United 
States government and the United Nations 
rehabilitation programs. Under his guidance, the 
first two modern era international Congresses had 
been held, and preparations were underway for 
the third post-War World Congress in London in 
1957. The International Society was not out of the 
woods yet, money was still tight, the staff was 
small and obligations were steadily increasing. 
However, it was well launched. 

As President, Howard Rusk felt increasingly 
that, in addition to being a clearinghouse for information, 
organizing conferences and networking, 
the International Society should also offer more in 
the way of direct medical/clinical services and 
training. Rusk had been training a number of 
foreign Fellows for several years and was interested 
in expanding upon these exchanges. 

In 1955, at the behest of William Donovan, 
United States Ambassador to Thailand, Rusk initiated 
a program to bring over several teams of 
medical professionals from Thailand to receive 
training at his Institute and was pleased with the 
results. However, he had found that the usual 
channels through which such fellowship exchanges 
took place, the State Department, the United 
Nations, and the World Health Organization, 
worked very slowly, and gave such low priority to 

HISTORY OF INTERNATIONAL REHABILITATION 47 


rehabilitation issues that it took years to get 
much accomplished. "What we needed," Rusk 
later wrote, "was an agency that would be free to 
move quickly when someone asked us for help." 
(Rusk: 1972:221) 

Rusk decided to organize such exchanges 
through the International Society for the Welfare 
of Cripples. To that end, the World Rehabilitation 
Fund was formally established in December of 
1955. Its basic aim was to sponsor international 
projects to train rehabilitation professionals and 
facilitate the exchange of new ideas and techniques 
in rehabilitation throughout the international 
medical community. 

Originally, the World Rehabilitation Fund 
was established as a fund within the International 
Society, with the idea that the monies raised 
would be dedicated to training medical personal 
and the transferring of information about clinical 
and medical rehabilitative services. 

The disagreement went beyond personal 
beliefs and reflected a larger 
debate that was just beginning to 
emerge; the resistance by some to a 
medical dominance in the rehabilitation 
field. 


The World Rehabilitation Fund attracted contributions 
from the start, allowing Rusk to begin 
planning regular exchanges of personnel and the 
sponsorship of technical and training workshops. 
At some point, however, the issues of organizational 
priorities and allocation of funds for projects 
came into contention, with Wilson and Rusk disagreeing 
strongly about priorities. Part of their disagreement 
might have been rooted in their 
professional backgrounds. Wilson, an experienced 
administrator, was concerned about long term 
planning and development of the organization for 
which he was responsible. Rusk, a compassionate 
physician, wanted to address the immediate 
needs he saw internationally in a more direct 
fashion. The disagreement went beyond personal 
beliefs and reflected a larger debate that was just 
beginning to emerge; the resistance by some to a 
medical dominance in the rehabilitation field. 

By 1956, frank discussions were held, followed 
by a parting of the ways, with Rusk himself 
incorporating the World Rehabilitation Fund as a 
separate organization with a specific mandate to 
train overseas personnel in rehabilitation 
medicine, prosthetics and orthotics. Howard Rusk 

48 HISTORY OF INTERNATIONAL REHABILITATION 

ARTIFICIAL 
"HAND" MUST BE 
FINGERPRINTED 


An American manufacturer has produced 
an artificial hand so lifelike 
that its fingerprints have to be regis


tered with the F.B.I. 

Sir Kenneth Coles, 
chairman of t h e 
New South Wales Society 
for Crippled 
Children, said this 
yesterday at Mascot 
Airport. 


He had arrived from 
San Francisco after having 
attended the seventh 
World Congress of the 
International Society for 
the Welfare of Cripples. 


The conference had 
elected Sir Kenneth president 
of the International 
body—the first time an 
Australian has held this 
Position. 


Representatives from 45 
nations, including Poland 
and Yugoslavia, had attended 
the conference. 


"Cosmetic" 

Sir Kenneth said Sydney 
would be host in November 
next year to the 
Inter national Society's 
Pan Pacific Conference. 


Sir Kenneth said the SIR KENNETH COLES 
life-like artificial hand, 
which had to be fingerprinted, 
was one of the 
many exhibits at the London 
Congress. 

The hand, which could 
also be made into a 
forearm, was being 
manufactured with 12 
different finger-prints. 


-So of 12 people with 
this artificial hand. each 
one of them has a different 
finger print," Sir Kenneth 
said. 


Sir Kenneth said the 
hand or forearm was not 
a functional but a "cosmetic" 
appliance. 


It was for appearances 
only and would match the 
wearer's complexion. 


"But with two fingers of
this hand a person can lift 
a -glass of beer," Sir Kenneth 
added with a smils 


By the late 1950s fascination with American gadgetry had reached 
around the world. Above article appeared in the Telegraph of Sydney, 
Australia, August 15, 1957. 


Members of the Rusk Mission leave the Ministries of Health and Welfare after conferences with Korean officials in Seoul, March 1953. 

Gen. Mark Clark briefs members of the Rusk Mission at his headquarters in Tokyo prior to their departure for Korea. Left to right: Dr. Leonard 
Mayo, Director, Association for Aid of Crippled Children; Mrs. Rusk; Mrs. Bernard Gimbel, board member of the American-Korea Foundation; Gen. 
Clark; Dr. Rusk; Mr. Palmer Bevis, Director of the Foundation; and Mr. E.J. Taylor, assistant to Dr. Rusk. 

HISTORY OF INTERNATIONAL REHABILITATION 49 


remained President of the International Society 
until the next World Congress in 1957, but when 
he completed his term, the Fund went with him to 
new headquarters at the Institute for Physical 
Medicine and Rehabilitation across town. 

Rusk assembled a distinguished Board of 
Directors for the World Rehabilitation Fund. The 
honorary chairman of the new organization was 
former President Herbert Hoover, and prominent 
individuals such as Harry Truman, Dr. Albert 
Schweitzer and Bernard Baruch sat on its first 
Board. The Fund became an on-going entity in its 
own right. A system of training fellowships sponsored 
by American industries was established 
with Rusk regularly meeting with leaders of industry 
and finance to explain the program and its 
objectives. At the beginning, a fellowship cost only 
$5000, to cover airfare to the United States and a 
per diem similar to that received by American 
physicians in training. Additional funding would 
eventually come from interested individuals in the 
United States, as well as from United States 
government projects and programs. The Fund concentrated 
on providing a medical rehabilitative approach 
to physical disability and was organized 
from the outset as an American organization pursuing 
international work, as distinct from the International 
Society which had a worldwide focus 
and was simply based in the United States. 

It is speculated that as many as 4 
million individuals have been fitted 
with prosthetics and orthotics as a 
result of individuals trained under 
the auspices of the Fund. 


The physician training program was only one 
part of the focus of the new World Rehabilitation 
Fund. Of equal importance was the program of 
training for artificial limb and brace makers 
around the world. In 1957, Rusk was fortunate to 
find Juan Monros, a physical therapist from 
Spain, who joined the staff on a four-year fellowship 
basis to study prosthetics. Monros quickly 
became one of the world's leading authorities on 
low-cost methods of prosthetic manufacture and 
usage and represented the World Rehabilitation 
Fund for the next three decades, establishing 
workshops and running training sessions in over 
70 countries. 

There has been some shift in direction of the 
World Rehabilitation Fund over the years. Rusk's 
original plans placed emphasis on bringing in


dividual professionals to the United States for 
short periods of time to allow them to work in the 
model facility he was so carefully developing in 
New York. Early on however, Rusk became concerned 
with the number of individuals who came 
to receive training at his Institute and at other 
centers in the U.S. and then decided to remain in 
the United States. Worried that programs such as 
the World Rehabilitation Fund were contributing 
to the "brain drain" in the Developing World, Rusk 
and his staff at the World Rehabilitation Fund 
began financing the travel of experts from the 
developed world to the developing world to conduct 
training and workshops. 

Much of the credit for the day to day workings 
of the organization must go to Jack Taylor, 
who kept an eye on the activities of the staff and 
trainees while at the same time making sure that 
the latest ideas and technologies in the field were 
integrated into the training process. It was Taylor 
who kept in close touch with the thousands of 
professionals who annually wrote to the Fund, 
received training or requested information. Over 
the years, the World Rehabilitation Fund has 
worked with professionals in 150 countries and 
trained more than 6000 specialists in advanced 
rehabilitation techniques. It is speculated that as 
many as 4 million individuals have been fitted 
with prosthetics and orthotics as a result of individuals 
trained under the auspices of the Fund. 

The International Society, while continuing 
involvement in medical programs, increasingly 
turned its attention to becoming a comprehensive 
clearinghouse of information and ideas for a full 
range of disability related issues: medical, 
economic, social, educational and increasingly, 
legal and civil rights as well. The International 
Society also maintained and fostered a strong international 
membership. Although United States 
based, over the years increasing emphasis was 
placed on encouraging participation and policy 
design from all member nations and its priorities 
and concerns became increasingly international. 

The separation between the International 
Society and the World Rehabilitation Fund was initially 
awkward. The still small field of international 
rehabilitation suddenly found itself with two 
New York City based international agencies, with 
many prominent leaders in the field linked to both 
organizations through personal interests, commitments 
and friendships. Fortunately, there was improvement 
over time, fostered by a willingness to 
work together on the part of both organizations. 
Because the international aspects of the field continued 
to be small, there was also a great deal of 
cross-over between professionals, with members 

50 HISTORY OF INTERNATIONAL REHABILITATION 


of the Society and Fund regularly serving on each 
other's advisory committees, boards and research 
teams. In such an atmosphere, prolonged wrangling 
simply made little sense, and everyone 
seems to have realized that there was more than 
enough work and need on the international scene 
to go around. Over time, the two organizations 
eventually established a more cordial working 
relationship. 

In addition, the Perkins Teacher 

Training Program, initiated in 1921, 

continued. (By 1987, it had trained 

more than 350 teachers from 63 dif


ferent countries). 

Additional International Work 

Although organizations such as the International 
Society for the Welfare of Cripples and the 
World Rehabilitation Fund were the most 
prominent United States based international 
rehabilitation agencies during these years, it 
would be misleading to imply that they were the 
only American groups fostering international exchanges. 


In addition to the larger voluntary organizations, 
much activity was on-going in smaller institutions 
and agencies and among and between 
academic centers. Most of these took the form of 
unilateral or bilateral exchanges, with specific organizations 
or academic institutions concentrating 
their efforts on a single type of disability or a 
training program for a specific academic discipline. 
For example, at The Perkins School for the 
Blind, the Director, Dr. Gabriel Farrell, became increasingly 
involved in international affairs 
throughout the late 1940s, and 1950s. He regularly 
represented the blind community on United Nations 
commissions, organized significant Post-War 
conferences on international blindness and served 
as a special consultant to the Department of Social 
and Economic Affairs within the United Nations. 
In addition, the Perkins Teacher Training 
Program, initiated in 1921, continued. (By 1987, 
it had trained more than 350 teachers from 63 different 
countries). 

A number of academic institutions with growing 
undergraduate and graduate programs in special 
education, rehabilitation, physical therapy, 
nursing, and other disability-related areas, established 
liaisons with individuals and academic institutions 
overseas, often on a one-to-one basis. 
The numbers of individual foreign scholars and 

professionals training in many of these programs 
was small. Two foreign students would attend a 
master's program in physical therapy at a land 
grant college in Iowa, for example, while three special 
educators would earn degrees in New Jersey 
or Oregon. However, all together, these types of 
programs brought thousands of professionals in 
rehabilitation, special education and medicine to 
the United States from the late 1940s on. These 
programs rarely addressed international or cross-
cultural concerns, but those foreign students 
trained in them did take home the latest 
American ideas on disability and integrated the 
concepts into their own regional and national disability 
programs, further disseminating ideas and 
technologies initially developed or refined in the 
United States. 

In addition to institutional and academic 
liaisons, veterans' groups played a significant role 
in the field. The American Veterans of World War 
II (AMVETS) placed great emphasis on securing 
benefits and rehabilitation services for disabled 
vets. The World Veterans Federation, (which was 
based in Paris, but had strong United States involvement), 
had three key issues on its agendas: 
economic development, human rights and 
rehabilitation. The links between these issues 
echoed then current concerns, foreshadowed future 
disability rights agendas and were very distinct 
from the more exclusively technical roles of 
many physical rehabilitation agencies then 
dominant in the field. Many prominent leaders of 
the American rehabilitation community were also 
actively involved in these veterans groups. For example, 
Norman Acton left the International 
Society for the Welfare of Cripples in 1958 and 
went to Paris to serve as Deputy Secretary 
General of the World Veterans Federation. He 
remained with the World Veterans Federation as 
its Secretary General until 1967 when he 
returned to the International Society. Howard Russell 
became a leading figure in AMVETS, eventually 
serving for a time as National Commander. He 
also served as Vice President for the World 
Veterans Federation, (which was subsequently 
renamed the International Federation of World 
War Veterans). 

In addition to academic exchanges and 
veteran's groups, throughout the 1950s meetings 
and conferences with international components 
brought growing numbers of people working in 
the disability field together. There were several 
contributing factors: commercial aviation made it 
possible for more people to travel to more places 
more frequently; and telephone, radio and 
television allowed more regular individual and 
group communications. Improved travel and corn-

HISTORY OF INTERNATIONAL REHABILITATION 51 


In addition to academic exchanges 
and veteran's groups, throughout the 
1950s meetings and conferences 
with international components 
brought growing numbers of people 
working in the disability field 
together. 


munication to both large and many smaller 
programs and conferences exposed rehabilitation 
experts and disabled individuals in the United 
States to their first international experiences. An 
indication of the growth in interest in rehabilitation 
issues was seen at the Eighth World Congress 
of the International Society for the Welfare 
of Cripples held in New York City in 1960. The 
meeting drew over 3000 participants from more 
than 80 countries. (Reflecting new terminology, 
the Congress also voted to change the 
organization's name to the International Society 
for the Rehabilitation of the Disabled). 

Despite the formal connections developed 
through professional meetings and official exchanges, 
However, leaders in international rehabilitation 
were also part of a small or more informal 
network. Many working in the still relatively small 
field saw each other regularly and appointed each 
other to committees, boards and conference roles. 
Outside the well-established circuit of nongovernmental 
organizations and projects, the 
talents and support of this groups was often marshalled 
to help individuals trying to develop overseas 
programs. For example, the Episcopal sisters 
of St. Margaret in Boston had sent a member of 
their order to Haiti to establish a program for the 
blind. Sister Joan Margaret, while committed to 
the program for blind children, had been trained 
as a physical therapist and quickly expanded her 
program to serve a wide range of disabled 
children. Based at the St. Vincent School for Crippled 
Children, Joan Margaret received help from 
many in the United States. Bell Greve helped set 
up an informal assistance program through back 
channels. She organized a small organization 
called "Friends of Haiti" and collected and coordinated 
the shipment of donated clothes, food and 
technical aids. Greve persuaded Herman Flax in 
Puerto Rico to donate his medical skills and by 

1951, Flax was traveling to Haiti two or three 
times a month to see disabled children for Sister 
Joan Margaret at her school. The Center in Haiti 
was operational and served as a development base 
for the Haitian Society for Crippled Children, a 
program influential throughout the Caribbean. 

Early in her career, Dorothy Warms, who 
would become a cornerstone of the International 
Society for the Rehabilitation of the Disabled, 
recalled that she was sent to the Dominican 
Republic on a site visit to a project run by Mary 
Maranzini. So impressed was Warms by both 
Maranzini's commitment and by the overwhelming 
need, that she actively campaigned for additional 
help and was instrumental in locating 
emergency medical aid and supplies to stem the 
tide of a polio epidemic. 

Not all international meetings and organizational 
initiatives were successful. For example, 
The First International Medical Conference on 
Mental Retardation held in Portland, Maine in 
1959 was a promising gathering. Organized by 
two local physicians from Maine's Pineland Hospital 
and Training Center in Pownal, it attracted 70 
leading figures in genetics, biochemistry and 
neurology from throughout North America, with 
several scholars traveling from Europe and Asia. 
The published Proceedings noted that the 1959 
Conference was the first of "a permanent international 
forum to ensure continued communication" 
in mental retardation research (Bowman and 
Mauter:1960). Having concluded this, it seems to 
have then sunk from sight like a stone for reasons 
that are not clear. 

0,* 
( AUG. 

28 
9..00 A.M. 


FIRST DAY OF ISSUE 

1960 

N. • 
The Eighth World Congress of the International Society for the Welfareof Cripples, the first such Congress to meet in the Western Hemisphere,
brings to North America professional and volunteer leaders in the field ofrehabilitation and employment of the handicapped from countries around theworld. The President of the United States and the Prime Minister of Canada 
are Honorary Presidents of this Congress, and the Commemorative Stampreleased today is an expression by the host country and of all those attendingof confidence in the productive abilities of qualified handicapped workerseverywhere. The Post Office Department and all other major Departmentsof the United States Government know from experience that ability and notdisability is the true measure of a person's worth on the job. America isproud to welcome the Eighth World Congress to our shores and hopes thatdelegates and guests from other lands will share with us their experiences,
their hopes and their aspirations in what is truly one of the greatest People-
to-People movements of our time, the proper rehabilitation and utilization ofhandicapped workers. 

POSTMASTER GENERAL. 

First day of issue of special U.S. postage stamp on disability released 
to coincide with RI World Congress in USA. 

52 HISTORY OF INTERNATIONAL REHABILITATION 


The Post-War era in the United States 

is notable not only for the rise of lead


ing individuals and American based 

private agencies, but also for the first 

real involvement of the United States 

government in overseas rehabilitation 

programs. 

Federal Government 
Involvement in the 

1950s and 1960s 

The Post-War era in the United States is 
notable not only for the rise of leading individuals 
and American based private agencies, but also for 
the first real involvement of the United States 
government in overseas rehabilitation programs. 
The funding available for foreign rehabilitation 
programs was quite small when compared to the 
funds made available for other types of international 
aid programs, such as nutrition projects or 
roadway and hydroelectric dam construction. 
However, the programs are of note because they 
expanded and lent legitimacy to a small and previously 
ignored field. 

The earliest manifestations of United States' 
government involvement in rehabilitation internationally 
can be traced back to immediate post-War 
relief efforts in Europe. The Marshall Plan, the 
Fulbright Programs and other programs funded 
scholarly exchanges, some of which had some 
relevance to (although rarely a central focus on) 
disability and/or rehabilitation. In the 1950s and 
1960s however, serious efforts were made to 
specifically incorporate rehabilitation services into 
broader American outreach programs. The vast 
majority of these programs are traceable directly 
or indirectly to the vision and commitment of a 
single brilliant administrator and her equally effective 
staff in the Office of Vocational Rehabilitation. 
Her name was Mary Switzer. 

The earliest manifestations of United 

States' government involvement in 

rehabilitation internationally can be 

traced back to immediate post-War 

relief efforts in Europe. 

Mary Switzer 

The era of Mary Switzer began when she 
came to the Office of Vocational Rehabilitation 

(OVR) as its new Director in 1950. Originally from 
Massachusetts, Mary Switzer had joined the 
Federal government in 1921 and had worked her 
way up through the ranks within the Treasury 
Department. She had innovative ideas and a 
genius for bringing individuals and programs 
together to reach a workable consensus. 

Mary Switzer at UN dinner for disability leaders, 1953. 

Prior to her OVR position, Switzer had had a 
long standing interest in rehabilitation through 
prior personal and professional contacts with 
such national rehabilitation leaders as Tracy 
Copp and Howard Rusk. She had also had an ongoing 
interest in international issues, and effectively 
integrated this into her work at the Office of 
Vocational Rehabilitation. For two decades, Switzer 
was a central force in the field of rehabilitation 
in the United States and virtually dominated the 
field within the Federal government. Her offices, 
known by some as "Switzerland", were involved in 
almost all aspects of rehabilitation activities. 

A woman of real commitment and true 
vision, Mary Switzer was instrumental in broadening 
the mandate of federal and state disability 
programs to support a much wider variety of dis-

HISTORY OF INTERNATIONAL REHABILITATION 53 


For two decades, Switzer was a 
central force in the field of rehabilitation 
in the United States and virtually 
dominated the field within the 
Federal government. 

ability-related both nationally and internationally. 
An effective administrator and excellent speaker, 
she commanded a great deal of respect in Congress 
and was able to lobby effectively for both improved 
legislation and better funding. Howard 
Russell recalled "... when you sent Mary up to 
Congress for a budget of $18 million, she came 
back with a budget of $36 million ... if you wanted 
more money, send Mary up to the Hill became she 
could get it." In the 17 years Mary Switzer headed 
the Office of Vocational Rehabilitation, funding for 
the program increased 40 fold. 

Switzer's program began to attract attention 
because, although a small program, it encouraged 
individuals with disabilities to become self-sufficient. 
These "restored taxpayers," studies found, 
returned $10 for every one that had been invested 
in their rehabilitation. The program, in short, 
produced results in an era when taxpayers were 
becoming increasingly critical of large and, to 
some, apparently wasteful social programs. Its 
success was seized upon by politicians who 
regularly used it as an example of a productive 
public program which justified the expenditure of 
tax dollars. 

A major coup occurred in 1954, when Switzer, 
along with her close associate Howard Rusk, 
pushed Congress to pass the Vocational 
Rehabilitation Amendments of 1954, which 
broadened existing state-federal programs and 
revised the grant system. These changes allowed 
states more flexibility in administering programs 
and authorized federal funding to help in the establishment 
of public or nonprofit rehabilitation 
facilities. 

Most significantly, these Amendments 
enabled the Vocational Rehabilitation program to 
change from a single-grant system to a multi-program 
approach. This meant that in addition to 
providing the basic program of grants to the 
states for vocational rehabilitation services, a 
separate program of grants became available for 
research in rehabilitation, and training of 
rehabilitation personnel. 

In one fell swoop, Mary Switzer was now empowered 
to fund, in effect, whatever she chose 
within the field of rehabilitation. She chose wisely. 

She began by funding training and research programs. 
Emphasis was placed on establishing 
university-based training programs, particularly 
on the graduate level, so that a core group of 
leaders in the field could be trained and in turn, 
train others. (It was, in a sense, a type of academic 
trickle down theory). Under the sponsorship of 
Switzer's funding, over 100 university-based 
rehabilitation-related training programs were established 
accommodating thousands of future 
professionals. The effects were significant. Professional 
fields such as rehabilitation counseling and 
special education benefited immediately. These 
fields, which formerly had few agreed-upon formal 
academic training programs or minimum standards 
for certification, were now able to establish 
guidelines and provide formal training programs. 

Under the sponsorship of Switzer's 

funding, over 100 university-based 

rehabilitation-related training 

programs were established accom


modating thousands of future profes


sionals. 

Rehabilitation counseling had the "unique 
distinction" of being the only profession established 
by an act of Congress (Wright: 1980: 21). 
Emerging as a speciality in the years following 
WWI, it was shaped by a series of legislative and 
administrative decisions at the state and national 
levels, (Blanch: 1938) and finally folinally recognized 
by Public Law 565 in 1954. 

Research on the social, educational, 
psychological and behavioral aspects of a wide 
range of disabling conditions were also funded 
under the program, and for the first time, information 
on disability began to be systematically collected, 
studied and integrated into professional 
training, policy and programs. The United States 
quickly became a leading player internationally in 
both training and research. 

The United States quickly became a 
leading player internationally in both 
training and research. 

Switzer's support was not confined to 
academic institutions or professional development 
alone. Under her guidance, the Office of Vocational 
Rehabilitation began funding a range of 
programs including support for some disability 

54 HISTORY OF INTERNATIONAL REHABILITATION 


groups that had previously received little attention, 
such as mental retardation and mental illness. 
There was funding for previously ignored 
approaches as well. Some of the first movements 
towards independent living and disability rights 
sprang from programs which were funded by 
Mary Switzer and her staff. Playwrights received 
support to write pieces that would introduce disability 
issues to the non-disabled, film captioning 
for deaf viewers was pioneered and the National 
Theater of the Deaf received its first seed money. 
Funding was also made available for hundreds of 
conferences, large and small. The consolidation of 
fields, and the nurturing of professional networks 
was further aided by subsidies to academic and 
trade journals. 

Switzer did not jump from issue to issue, but 
rather, building on programs her office had already 
funded, gradually expanded her vision to 
meet the needs of the population she served. 
Central to her vision and perhaps most significant 
of all was that, very early on, Mary Switzer became 
convinced that individuals with disabilities 
themselves had to be involved in planning at all 
levels and she was adamant in this conviction. 

Mary Switzer became convinced that 
individuals with disabilities themselves 
had to be involved in planning at 
all levels and she was adamant in 
this conviction. 

Under a different administrator, perhaps, 
none of these programs and exchanges would 
have taken place. The effective funding of a whole 
range of programs and professional exchanges 
that comprised much of the core of the United 
States rehabilitation efforts from 1950 through 
the 1970s is directly attributable to Mary 
Switzer's vision and foresight. 

Switzer was strongly supported by a very 
talented staff. Her key assistant, James Garrett, 
joined her at the outset of her career at the Office 
of Vocational Rehabilitation, transferring to 
Washington from Rusk's Institute of Physical 
Medicine and Rehabilitation in 1951. Garrett was 
sympathetic to Switzer's goals and as Associate 
Commissioner of Research and Training, quickly 
became familiar with the projects and individuals 

The 1960 winnters of the triennial Albert Lasker Awards were: (left to right) Gudmund Harlem, M.D. of Norway for his leadership in rehabilitation in 
Northern Europe, Miss Mary E. Switzer of the USA for her role as architect of the government and voluntary partnership in the disability field, and 
Dr. Paul Brand of the USA for his development of reconstructive hand surgery for people wih leprosy. The prestigious Lasker Awards for recognition 
of achievement in rehabilitation were given for many years by the Albert and Mary Lasker Foundation of the USA to world leaders on the occasion 
of RI World Congresses. 

HISTORY OF INTERNATIONAL REHABILITATION 55 


Increasingly, Mary Switzer's vision 
was an international one. 


who had become linked to the Office. Garrett assumed 
responsibility for a well thought out and 
coordinated research and training program, an approach 
that was at times made more complicated 
by Switzer's spontaneity and rapid decision-
making style. (Walker: 1985:169) 

Together, Switzer and Garrett proved to be a 
particularly effective team, continually expanding 
the horizons of what rehabilitation programs 
could and should attempt to do. Backing Garrett 
as leading staffers were professionals whose individual 
influence in the field would continue to 
grow over the years, such as Joseph LaRocca, 
Joseph Traub and James Burress. (The specific 
contributions of these men will be discussed in 
the next section). The concentration of these 
talented individuals in Switzer's department 
provided a nucleus of energy that sparked dozens 
of programs. 

Increasingly, Mary Switzer's vision was an international 
one. Her first formal introduction to 
the international world of rehabilitation was at 
the World Congress of the International Society 
for the Welfare of Cripples in Stockholm in 1951. 
There she was profoundly impressed by the numbers 
of committed individuals from dozens of different 
countries working on disability issues. She 
also saw a direct link between disability advocacy 
and the ability to "promote democratic values" 
and "world understanding," as these issues were 
conceptualized in the early Cold War period. As 
Rusk recalled "...this was the trigger that 
launched Mary into a new orbit of action and 
probably the most important one in her career." 
(Rusk: 1972a) 

Her initial work in international rehabilitation 
took the form of participation in conferences, 
including the First World Congress on Mental 
Health and her work on the constitution of the 
World Health Organization. Her justification for 
enlarging what was essentially a national program 
into an international one was that there was 
much to be learned. As she wrote, "In the field of 
health and medical affairs, there is no national 
boundary to the development of new knowledge 
and the improvement of services ..." 
(Walker: 1985:204). Early on, Switzer began to 
regularly authorize funds for her staff to attend international 
meetings with the expectation that 
they might both contribute and learn. The 1958 
regional Pan-Pacific Meetings of the International 

Society for the Welfare of Cripples in Sydney, 
Australia was one of the first where Switzer's 
Department was represented in force. 

Switzer's staff began to amass international 
expertise. In 1954, one of the first comprehensive 
overviews of the then-current state of rehabilitation 
internationally was published by the Office of 
Vocational Rehabilitation. Written by Joseph La-
Rocca and titled Rehabilitation of Disability in Thirty-
One Countries, it was a comprehensive attempt 
to survey rehabilitation information in these nations. 
The information was gathered by the local 
American embassies at the request of the State 
Department and the publication is filled with page 
after page of detailed information on government 
and private voluntary organizations serving 
specific disability groups. An updated version of 
this first overview, also assembled by Joseph La-
Rocca, was issued in 1964 titled Rehabilitation of 
the Disabled in Fifty-One Countries. 

Dr. James Burress 

Regularly sent overseas on fact-finding missions 
and to oversee and evaluate programs sponsored 
by the Office of Vocational Rehabilitation or 
other United States government related projects, 
Switzer's staff soon acquired individual expertise 
on issues and regions. For example, James Burress, 
a senior staff member under Switzer who 
would go on to head the Denver regional office for 

56 HISTORY OF INTERNATIONAL REHABILITATION 


the Department of Vocational Rehabilitation, first 
attended an international meeting in 1956 when 
he was sent to the Pan-Pacific Meetings held by 
the International Society in Australia. Burress, 
himself the first Afro-American vocational 
rehabilitation counselor in the United States, was 
struck by the lack of information available on 
rehabilitation efforts in Africa. (In fact, Africa is 
strikingly absent from rehabilitation literature 
and exchange networks before 1960). While in 
Sydney, Burress organized a very informal discussion 
for a dozen or so representatives from African 
nations attending the conference. At this meeting, 
the African representatives expressed interest in 
establishing an informal exchange network. Burress 
volunteered to serve as the coordinator for 
the network, and was soon duplicating and sending 
literature and information to individuals and 
government officials throughout Africa. Within a 
few years, Burress was regularly hosting colleagues 
from abroad and actively fostering a large 
and growing African network. He made several 
multi-nation tours of Africa as a representative of 
Switzer's program, as well as traveling to India 
and elsewhere on behalf of the program. 

The Office of Vocational Rehabilitation, not 
only ran its own programs but also provided a 
central focus for rehabilitation issues throughout 
much of the Federal government. It served as a 
clearinghouse for rehabilitation information and 
contacts within the federal bureaucracy, in 
cooperation with the United Nations and the State 
Department. It was regularly called upon to arrange 
for the training of foreign nationals through 
special scholarship programs, and to identify 
specialists to be recruited for assignments abroad, 
through US AID, the State Department, the Peace 
Corps and other governmental agencies. Switzer 
and her staff also provided consultative services to 
international agencies and technicians on international 
programs. In close touch with Rusk, 
Kessler and Greve, Switzer also began to provide 
some funding for the International Society for the 
Rehabilitation of the Disabled and the World 
Rehabilitation Fund to support travel and training 
efforts, some meetings and publications. 

PL.480 

One of Mary Switzer's most effective international 
efforts was The International Rehabilitation 
Research and Demonstration Program, (PL 83840 
and 86-610), using funds generated through 
Public Law 480, initiated in August 1961. This 
program was based on an agricultural program already 
underway in the 1950s when the United 
States government began shipping massive 

One of Mary Switzer's most effective 
international efforts was The International 
Rehabilitation Research and 
Demonstration Program. 

amounts of grain to some countries in the 
Developing World. In exchange, a program was initiated 
in which the recipient nation would repay 
the American government in their local national 
currencies. These "counterpart funds" would not 
leave the country. Instead, part of these monies 
were used to run the local American embassy and 
pay for other United States government operations 
in these nations. Whatever monies remained 
were initially earmarked for the exchange of 
knowledge and training of agricultural experts, 
under the Agricultural Trade, Development and 
Assistance Act. 

Joseph LaRocca, one of the keystones of the PL 480 program. 

In 1961, working closely with Howard Rusk, 
Switzer secured the enactment of PL83-840 and 
86-610, which amended the Agricultural Act, 
redirecting some of these funds to the Office of 
Vocational Rehabilitation to pay for cooperative 

HISTORY OF INTERNATIONAL REHABILITATION 57 


rehabilitation research and 
demonstration projects. Funds 
were also made available for an 
on-going exchange of United 
States and foreign rehabilitation 
experts, through travel, training 
and conferences. 

The best funded and one of 
the most successfully administered 
of any United States 
government rehabilitation efforts 
abroad, the PL. 480 program 
grew rapidly. In 1961, the first 
year of operation, PL-480 with a 
budget of just over $900,000, 
supported 13 projects. By the 
second year, the number tripled. 
By 1967, close to 125 projects 
were placed in operation, with a 
budget of three million dollars. 
Eventually, 14 countries were included 
in the project with Shown above are the 1966 winners of the Albert and Mary Lasker Awards for outstanding achieve-

rehabilitation activities spon-ment in the international rehabilitation field. From left to right are: Poul Stochholm of Denmark, 
recognized for founding training courses for rehabilitation physicians from around the world; Mr.

sored in Bangladesh, Brazil, 

Eugene J. Taylor of the USA, Secretary Treasurer of the World Rehabilitation Fund, recognizedBurma, Egypt, Guinea, India, Is-for his many years of service to the Fund, the UN and RI; and Dr. Wiktor Dega of Poland, one of 
rael, Morocco, Pakistan, Poland, Europe's leading orthopedic surgeons, for his international stimulation of advanced rehabilitation 

techniques. Dr. Dega was active in the U.S. exchange of experience program known in the dis-

Sri Lanka, Syria, Tunisia and 

ability field as "PL 480." Now more than 90, Dr. Dega is actively advising a new generation of dis-Yugoslavia. ability specialists in Poland. 

Switzer's key staffer, James 
Garrett, was in charge of administrating PL 480 
from 1960-65. Joseph LaRocca helped to organize 
the project and to oversee the results. LaRocca 
had been involved with rehabilitation issues since 
1933, when, as an administrator for a Words and 
Progress Administration program he helped 
develop a system that would help train people 
with disabilities for WPA jobs. He subsequently 
gained international experience through War time 
and post-War work on the Marshall Plan in 
Greece, and with UN administrative work in New 
York. 

Working on behalf of the government, 
Boyce Williams, who was himself 
deaf, was the key individual who 
opened many doors for deaf professionals 
and groups. 

Garrett and LaRocca administered funds, ensured 
that they were being properly distributed, 
and evaluated the results. Between them, they 
were responsible for annual site visits to funded 
programs. They would regularly divide up the 

world, with each man selecting the countries to 
which he would travel that particular year. They 
developed an extensive network of contacts in PL 
480 recipient counties and placed great emphasis 
on participatory planning. They would regularly 
assemble committees of 20-30 experts to jointly 
develop a plan for the next five years of research 
and training. Eventually, LaRocca and Garrett 
would be joined by Martin McCavitt and Joseph 
Traub who also worked on international projects 
for the Office of Vocational Rehabilitation for 
many years. 

The projects funded under PL 480 covered a 
great range of disabling conditions and issues, 

e.g. cardio-vascular disorders and cancer to physical 
rehabilitation and counseling to hearing and 
visual problems, alcoholism and drug abuse, mental 
illness, and mental retardation. The establishment 
and the operation of several 
rehabilitation facilities were undertaken as well as 
independent living programs. 
Money was provided for programs and meetings 
that enabled deaf organizations and representatives 
to come together and begin to establish 
networks and working cooperatives. Counterpart 
monies through PL 480 funded the exchange of 

58 HISTORY OF INTERNATIONAL REHABILITATION 


In fact, as a result of these exchanges, 
United States-based programs in 
Rehabilitation Medicine and orthopedics 
benefited significantly from 
ideas and techniques introduced from 
participating countries. 

deaf professionals, with international exchanges 
beginning to take place between deaf organizations, 
colleges and universities. Working on behalf 
of the government, Boyce Williams, who was himself 
deaf, was the key individual who opened 
many doors for deaf professionals and groups. Williams 
was one of the first administrators to appreciate 
Sign Language and its importance to a 
deaf sense of identity and to ensure that monies 
would be forthcoming to support interest and research 
in these areas. 

A provision in the initial legislation specified 
that the United States was to receive some benefit 
from these exchanges reflecting an attitude too 
often absent in international development projects 
that the United States might have something to 
learn from other countries. In fact, as a result of 
these exchanges, United States-based programs 
in Rehabilitation Medicine and orthopedics 
benefited significantly from ideas and techniques 
introduced from participating countries. For example, 
Polish techniques on the immediate or 
early post-surgical fitting of prostheses, group 

Dr. James Garrett 

methods of dealing with retarded children and 
adults, the introduction of improved prosthetic 
technology such as the Jaipur Foot and the use of 
mobile eye clinics in rural areas, were examples of 
new ideas and technologies introduced to this 
country through PL 480 exchanges. New ideas 
from India, Pakistan and Israel on rehabilitation 
of heart disease victims were piloted here, as was 
the introduction of lightweight plastics developed 
in Israel for prosthetics and orthotics. 

An important component of PL 480 was to 
link United States organizations—preferably those 
that were university-based, with counterparts in 
other countries. For example, a medical school in 
South India working on leprosy was linked with 
the University of North Carolina and the University 
of Pittsburgh for an exchanges of people interested 
in plastic surgery. A burn project in Bombay 
was linked with burn centers in the United States. 
Most of the time, the exchanges included 
teachers, heads of medical and social work 
schools and national organizations. No American 
salaries were provided for visiting foreign 
scholars, only living expenses and travel. 

In 1980, a major conference summarizing 
PL 480 activities reported 
that over 275 research projects had 
been developed under the program 
and over 500 researchers had 
received funding. 


PL 480 was hardly a lavish program. The exchanges 
generally were of two to six weeks duration. 
Transportation was covered but living 
expenses and per diems were usually picked up 
by the hosting university or institution. No health 
insurance was provided for foreign experts and officials 
at the Office of Vocational Rehabilitation 
and host institutions lived in fear that a visiting 
scholar would have a major medical problem that 
could not be paid for. (Fortunately, the exchange 
scholars were an unusually healthy lot, and the 
few medical crises that arose were taken care of 
by sympathetic local physicians). 

In 1980, a major conference summarizing PL 
480 activities reported that over 275 research 
projects had been developed under the program 
and over 500 researchers had received funding. 
(Garrett:1981) The conference also found that 
many of the overseas PL 480 programs had a significant 
influence in their own countries, proving 
to be self-sustaining after PL 480 funds ended, 

HISTORY OF INTERNATIONAL REHABILITATION 59 


with some projects serving as the cornerstones for 
the development of national programs. Less 
measurable, but perhaps of even greater significance, 
the exchange of experts provided an 
array of formal and informal institution-to-institution 
and person-to-person consultations, exchanges 
and agreements. 

All was not perfect. Funds tended to be 
directed heavily toward prosthetics and orthotics, 
because there was always an easily documentable 
need and their introduction produced dramatic 
and visible results. Many programs were also 
heavily oriented to vocational rehabilitation because 
that was the orientation of the sponsoring 
agency in Washington. However, vocational 
rehabilitation was not always the most immediate 
need for the individuals or the developing nation 
being served. Indeed, it is of interest to note that 
despite a number of years of training, vocational 
rehabilitation as a field has not met with overwhelming 
acceptance, particularly in the developing 
world. On the other hand, the American 
vocational rehabilitation system had some success 
in Australia, where a concerted effort was 
made to train and educate people about it. A 
similar American effort to introduce the field to 
Egypt, however, proved to be far less successful. 

Still more seriously, because of the requirement 
that PL 480 projects be tied to activities in 
the United States, there was a disproportionate 
emphasis within the program on high-tech, medically-
oriented approaches to rehabilitation that 
might not have been the most appropriate approach 
for reaching the majority of the populace 
in many of the host countries. Usually missing 
was support for indigenous approaches, such as 
low-tech, community-based solutions, non-
Western oriented medical approaches and consideration 
of the social implications and 
adaptation to disability. This was not, of course, 
unique to PL 480 programs. Much aid from the 
United States and other industrialized nations, 
throughout the 1950s and 1960s placed great emphasis 
on large-scale, Western approaches to international 
development. Enormous hydro-electric 
dams, modern airports and highway projects that 
cut through jungles and deserts dominated the 
era. Programs such as those sponsored through 
PL 480, although often emphasizing a Western, 
medical approach, were reasonably culturally sensitive 
by comparison. 

Nor were all foreign nations equally enthusiastic 
about the cooperative program. Some 
developing nations placed rehabilitation low on a 
long list of economic and health concerns, and 
were not particularly interested in devoting scarce 

foreign funds resources to disability services. 
Several nations were simply suspicious of anything 
American. One representative from Burma 
for example, told a visiting rehabilitation expert 
that the rehabilitation program would not be well 
received since everyone knew that the grain being 
sold to his country had been poisoned. 

Unfortunately, making the program dependent 
on revenues generated by foreign grain 
surpluses eventually placed the funding for PL 
480 in a Catch-22 situation. While the Office of 
Vocational Rehabilitation was busy building 
programs dependent on the sale of American 
grains, other government agencies, such as US 
AID, the State Department, the Department of 
Agriculture, and United States funded intergovernmental 
agencies such as the World Bank 
and the International Monetary Fund, were spending 
billions to make the same countries agriculturally 
self-sufficient. The result was that need for 
United States grains eventually declined and with 
it the allocated monies available for rehabilitation. 
In theory, if funding by the United States government 
through surplus grain sales was the key, 
one could either have starving nations with good 
rehabilitation assistance or agriculturally self-sufficient 
nations with virtually no rehabilitation assistance. 
Under the system, as it had been 
designed, these countries were not going to get 
both. The PL.480 programs and funding declined 
throughout the 1970s and early 1980s and only a 
vestige of the program remains today. 

Europe, just recovering from World 
War II could offer relatively little help 
to other nations in the 1940s and 
1950s. 


America's Presence in 
Rehabilitation 

In some ways, the mid-1950s through the 
late 1960s were the heyday of United States' 
based rehabilitation ideas and expertise. Medicine 
and technological advances, ever increasing 
hierarchies of professional training, research and 
increasingly sophisticated legislation on disability 
were all touted as waves of the future in rehabilitation, 
and the United States was preeminent in 
these. In addition to its own programs in disability, 
the United States government was also the 
single largest contributor to the United Nations 
and its specialized agencies, and thus further 
financed disability-related work internationally. 

60 HISTORY OF INTERNATIONAL REHABILITATION 


Europe, just recovering from World War II 
could offer relatively little help to other nations in 
the 1940s and 1950s. European nations initially 
turned inward, planting the seeds for national 
health services and social welfare programs that 
would address the need of their own citizens with 
disabilities. As Europe gradually recovered, patterns 
developed following colonial affiliations with 
European rehabilitation groups usually establishing 
their strongest ties with nations which 
were their former colonies. 

Viewed from a distance, the late 1940s to the 
late 1960s was an era when the United States was 
in the vanguard of rehabilitation medicine, with 
increasingly sophisticated medical technology and 
professional training programs being developed to 
address the medical needs of children and adults 
with disabilities. Legislation on behalf of disabled 
individuals was moving forward, with emphasis 
placed on placing disabled adults into the work 
force. Moreover, a significant percent of the 
world's literature on rehabilitation and disability 
was originating in American-based journals and 
books. 

International activity within the United 
States rehabilitation community during this era 
reflected not only American strengths, but weaknesses 
as well. Despite the pioneering work of 
Mary Switzer and her associates in encouraging 
and funding consumer advocacy within the field 
of rehabilitation, there was, on a national level, 
relatively little input from disabled consumers in 
the broad field of rehabilitation. The central focus 
of many government and privately sponsored, 
United States-based international disability 
programs in the 1950s and 1960s were on issues 
of vocational rehabilitation and counseling, reflecting 
the professional bias and funding mandates 
found within the sponsoring federal agencies. 
Much of the remaining attention was directed 
towards innovative medical practices and technologies. 
Most foreign exchange programs encouraged 
foreign rehabilitation personnel to come 
to the United States for training, or sent experts 
overseas for relatively short periods of time. Few 
stressed the design, development and integration 
of non-medical concerns in rehabilitation within 
the social, economic or political frameworks of nations. 
Fewer still identified the disabled consumer 
as a source of reference or decision making. 

Cold War Politics 

It is difficult to discuss international policy 
from the late 1940s through to the 1970s without 
acknowledging the influence of Cold War politics. 

Federal rehabilitation policy, particularly on the 
international level, was not immune to the politics 
of the era. 

International activity within the 
United States rehabilitation community 
during this era reflected not 
only American strengths, but weaknesses 
as well. 


Many, including Rusk and Switzer were not 
above utilizing the dominant political Cold War 
themes. Both frequently argued that rehabilitation 
programs were highly visible, relatively low-
cost ways of promoting American goodwill and 
democratic values. As Rusk wrote in his New York 
Times column one Sunday, "frequently this writer 
has commented on how America's participation in 
international rehabilitation projects has furthered 
our foreign policy through the dramatization of 
the high values we in a democracy place upon 
human dignity and the worth of the individual 
(Rusk:1956). Mary Switzer would justify her 
program's international work before Congress by 
noting that, in her opinion, "rehabilitation was the 
best demonstration of democratic forces at work" 
(Walker: 1985:133) 

The potential benefits of 'rehabilitation' fit 
well into the tenor of the times. Framing United 
States based international rehabilitation efforts as 
links in a Cold War chain helped to increase funding 
from many politicians and government agencies 
that might ordinarily have cared little about 
disability-related issues. Emphasis on the political 
benefits of rehabilitation also had a negative side, 
however. Politicians often expected a political 
benefit and at times urged that programs and services 
be designed around immediate political concerns 
rather than long-term disability needs. Not 
surprisingly, with the government funded 
programs, the greatest number of contacts were 
with United States allies. Countries with special 
significance to United States foreign policy in the 

1950s and 1960s such as South Korea, Japan, 
Pakistan, Egypt, Israel, Taiwan, and the Philippines, 
for example, were afforded greater attention. 
Federally subsidized programs and 
professionals were only peripherally in contact 
with programs and colleagues in the Soviet Union, 
Hungary, Czechoslovakia, Yugoslavia and other 
Iron Curtain countries. An on-going link with 
Poland, that included PL 480 funding, was an exception 
during this era. Contact with China or 
mainland Chinese representatives was not al-

HISTORY OF INTERNATIONAL REHABILITATION 61 


Switzer, for example, was very vocal 
in insisting that the federal policy forbidding 
government officials to attend 
any meeting which also allowed attendance 
by representatives from 
Communist China was "extremely 
short sighted" and "regrettable." 

lowed in federally funded exchanges. Such restrictive 
policies however, drew fire from many in the 
rehabilitation field. Switzer, for example, was very 
vocal in insisting that the 
federal policy forbidding government 
officials to attend any 
meeting which also allowed attendance 
by representatives 
from Communist China was 
"extremely short sighted" and 
"regrettable." Some areas considered 
to have little United 
States strategic importance, 
such as sub-Saharan Africa, 
were largely ignored. One 
leader in the field recalled that 
she at times felt like a pawn, 
more than once having been 
sent to one country and then 
pulled out because there had 
been was some change in 
government policy. 

The Cold War linkage between 
politics and rehabilitation 
was by no means, solely 
an American problem. For example, 
Dr. Jaroslav Stuchlik of 
Czechoslovakia reported to The 
International Mental Health Research 
Newsletter in June of 
1960, that, "I think it necessary 
to state that in connection 
with the over-all political conception 
in the Eastern 
countries we have no problem 
of mental hygiene per se, since 
the problems in this field may 
be reduced to questions relating 
to the re-education of 
society along the lines of 
Socialist thought. Owing to 
that, no mental hygiene 

centrated all of the mental hygiene activates in its 
hands, has been completely inactive." (Whether 
this statement reflected his beliefs, is unknown). 
Exchanges and contacts through the voluntary organizations 
were usually on a more neutral level, 
not tied to the political outlook of any particular 
country. 

Academic Links 

The world of rehabilitation and disability that 
began to crystalize in the late 1940s, lacked a key 
component—a unifying academic link that was 
cross-disciplinary and cross-disability in focus. 

In the early 1970s U.S. President's Committee on Employment of the Handicapped Chairman Harold

problems officially exist. And 

Russell meets with Alan Reich, then Deputy Assistant Secretary of State. A 1972 memo of this meet-

that is also why the Society for 

ing documents Reich's commitment to attracting outstanding disabled persons from overseas to theMental Hygiene, which in annual meetings of the President's Committee. Reich went on to found the U.S. National Organization 
on Disability and played a preeminent role in U.S. support for the International Year of Disabled

former times practically con-

Persons and the UN Decade of Disabled Persons. 

62 HISTORY OF INTERNATIONAL REHABILITATION 


On the whole however, there was 
very little of the policy analysis and 
the cross-disability, cross-disciplinary 
collaboration that would be a 
hallmark of the later Disability Rights 
Movement. 

This is not to say that specific interest groups and 
emerging professional societies did not have solid 
academically-based training programs. Thanks in 
large part to the commitment made by Mary Switzer 
and the Office of Vocational Rehabilitation, 
government funds were available to individual 
schools and departments and more than 100 different 
programs flourished at two and four year 
colleges and graduate schools. Training programs 
in fields such as physical therapy, occupational 
therapy, vocational rehabilitation counselling, social 
work, special education, speech pathology 
and rehabilitation medicine attracted and trained 
thousands. 

Nor did these emerging professions ignore activity 
and scholarship in allied disciplines. Ideas, 
literature and programs were shared by many in 
the system, and students of different disciplines 
were taught to work with, rely on and make referrals 
to one another. Professionals in vocational 
counselling, for example, were expected to be 
knowledgeable in aspects of rehabilitation 
medicine, psychology, physical and occupational 
therapy as well as local, regional and federal 
programs available to their clients, the local job 
market and educational opportunities. Those in 
special education had to be knowledgable in medical 
and psychological issues, social and family factors, 
physical and occupational therapy and state 
and federal programs as well as mastering the 
field of special education. 

Communication between these fields however, 
often lagged behind communication within 
these fields. Moreover, there were few forums in 
which to analyze or conceptualize disability at a 
broader policy level, which would be both cross-
disciplinary and cross-disability in nature. The 
many disability-related professional specialties 
were often in the process of defining or redefining 
their own identities. Many professional groups 
were specifically organized to provide services to 
individuals, and the emphasis therefore was often 
placed on the individual's experience of disability, 
rather than on the social and political issues that 
might contribute to that experience. The division 
within academics also reflected the historic 

divisions within the private organizations of and 
for specific groups of disabled people, where 
scarce funding and scant public attention often 
drove professional groups to compete rather than 
to collaborate. 

It would be misleading to state that no 
academic programs, professions or advocacy 
groups addressed broad policy issues. Prior to 
World War II, for example, the New York School of 
Social Work at Columbia University, was training 
students to think broadly about disability in 
society. In the post-War years, the Department of 
Special Education at Columbia and Syracuse 
University were significant forums for the cross-
pollination of ideas. On the whole however, there 
was very little of the policy analysis and the cross-
disability, cross-disciplinary collaboration that 
would be a hallmark of the later Disability Rights 
Movement. The emphasis for most in the field, 
was on how the disabled individual could better 
adapt to the society. The sociological concept of 
"stigma" dominated the era (Goff-man:1963). The 
idea that society might be in need of adapting to 
better accommodate the individuals with a disability 
had not yet taken hold. 

While American students were often 

well trained in the latest ideas and 

federal and state programs, few were 

directly exposed to programs or litera


ture from overseas. 

Not only was the academic training on disability 
and rehabilitation related issues organized 
on the basis of established disciplines, within 
American schools during these decades there was 
very little attention paid to international issues. 
While American students were often well trained 
in the latest ideas and federal and state programs, 
few were directly exposed to programs or literature 
from overseas. With the exception of individuals 
such as Ignacy Goldberg at Columbia 
who actively promoted comparative special education, 
few educators regularly taught students to 
question how similar issues might be approached 
in different political or cultural contexts. This inwardly 
centered programming was carried out 
despite that hundreds of foreign students came to 
the U.S. to participate in these programs. Training 
programs throughout the country would regularly 
include one or two foreign students in each entering 
class. Little emphasis was placed on altering 
program requirements to better address their future 
professional challenges working with dif-

HISTORY OF INTERNATIONAL REHABILITATION 63 


ferent, and often traditional, medical, educational, 
social and legal systems. 

Moreover, there were no programs that attempted 
to train individuals for disability-related 
work outside the United States. Unlike fields such 
as public health and international development, 
training in cross-cultural or international 
rehabilitation did not develop a foothold at the 
university level. As a result there was no university-
based training level to feed young professionals 
into the junior ranks of 
internationally-based rehabilitation programs and 
agencies early in their careers. In part, as a consequence, 
there were few younger American-trained 
professionals who entered the international field 
over the years, and relatively little activity at the 
academic level in studying and analyzing ideas 
and programs from overseas, particularly from 
non-Western countries. 

The pattern in international efforts, which 
had been in operation from the late 19th century 
on, of drawing on young people with solid but 
broadly based academic backgrounds, into the international 
field, continued, with relatively little 
new blood coming from programs which were 
specifically designed to train rehabilitation professionals. 


The Broadening Agenda: The 
Parent's Movement and Mental 
Retardation 

The early 1950s through the late 1960s 
marks not only the birth of a renewed social commitment 
to disability in general, but a new interest 
in several fields of social action that were not 
allied closely with disability and rehabilitation at 
the outset. These developing fields and movements 
are of great significance, for they would 
eventually overlap and begin to unite with 
rehabilitation. The Parent's Movement on behalf of 
mentally retarded children and in support of special 
education, is certainly one of the most significant 
of these. 

While other types of disabilities were relatively 
openly discussed, mental retardai was still 
rarely mentioned. Programs for mentally retarded 
children were not new to the United States. Near 
the turn of the century, the development of intelligence 
testing lead to the identification of large 
numbers of mildly to moderately retarded children 
within the community. (Prior to this, only the 
most severely retarded were identified and most of 
these individuals had been institutionalized from 
the middle of the 19th century onward). 

Indeed, most educators felt little 
could be done for "the retarded child" 
and that the burden of his or her 
education was not necessarily the 
responsibility of the public school system. 


Research in Europe had already established 
that many mildly to moderately impaired children 
would flourish in special education situations. Following 
the European lead, American educational 
initiatives were launched. Special classes in 
public schools for mentally retarded children 
began in Providence, Rhode Island in 1896; 
Springfield, Chicago, Boston and New York 
provided classes before 1900; and others followed, 
although they were still the exception rather than 
the rule in most American school districts. Indeed, 
most educators felt little could be done for 
"the retarded child" and that the burden of his or 
her education was not necessarily the responsibility 
of the public school system. With such an 
attitude, it is not surprising that special education 
programs were the first to go when the 
Depression began to squeeze school budgets. The 
'higher functioning' retarded children were sent to 
languish in the back of the regular classroom, 
while those children who were more severely impaired 
were simply sent home or institutionalized. 

By the late 1940s, the tradition of education 
for retarded children had receded into the 
shadows. For example, because of program cutbacks 
and withdrawal of funding over the years, 
states such as New Jersey, despite sizeable increases 
in overall population over the years, had 
more children in public school special education 
classes in 1918 than in 1950. Even the most 
basic of social services were missing, particularly 
for those families who chose not to institutionalize 
their children. Their needs or even their existence 
was not acknowledged or addressed by any 
regional or national teaching organizations and 
few public school systems believed they could do 
much for these children even in a special classroom 
situation. Fewer still even acknowledged any 
responsibility for them. 

Mental Retardation and Social 
Stigma 

Retardation was still considered a shameful 
condition for some, a reflection of "weak" or "poor" 
genes on the part of the parents, for others, 
evidence of a "punishment" or "cross to bear" 

64 HISTORY OF INTERNATIONAL REHABILITATION 


caused by God. Parents with such children were 
encouraged to keep them 'in a back room,' or better 
yet, institutionalized. It was not unusual for 
parents to inform siblings and close relatives that 
a new baby or young child had died, when in 
reality, the child had been sent to a public or 
private institution for the mentally retarded. 

Then in the late 1940s, the first of what 
would be a number of significant advances was 
made on behalf of retarded children. The late 
1940s and early 1950s marked the beginning of a 
parents' movement which sought to obtain services 
for developmentally disabled children and 
adolescents. Occurring concurrently in the United 
States, Europe and elsewhere, the movement was 
to give rise to a number of major American organizations 
which were to play significant roles 
nationally and internationally. More than any previous 
disability-related social action in the 20th 
century, the United States parents' movement on 
behalf of developmentally disabled children was 
consumer driven. 

The beginning was modest indeed. A mother 
in New Jersey wrote to her local paper, The Bergen 
Record with a simple request. Her severely 

Dr. Elizabeth Boggs 

More than any previous disability-related 
social action in the 20th century, 
the United States parents' 
movement on behalf of developmentally 
disabled children was consumer 
driven. 


retarded son was a resident of the Woodbine 
Colony, an institution at the opposite end of the 
state. This mother wanted to get in touch with 
other parents of children at the school, so that 
they could coordinate efforts to keep in closer 
touch with their children and with activities at the 
institution. The editor of The Bergen Record initially 
refused to publish the letter, and balked at the 
idea of publishing it with the mother's name attached—
he feared a lawsuit from her once she 
realized the public shame and humiliation that 
would result. 

At around the same time, a woman from 
Brooklyn, New York put a notice in her local 
paper asking other parents if they had a child 
whose symptoms were similar to those of her own. 
She described a child with cerebral palsy, for 
whom doctors could provide little information on 
future prospects or potential. The New Jersey 
group became a core group of parents with a growing 
network which would form the basis of National 
Association for Retarded Children (NARC). 
From the group brought together by the woman in 
Brooklyn came the founding members of United 
Cerebral Palsy. 

In New Jersey, the parents' group battling for 
improved services for retarded children, were 
joined in 1950 by an individual who would have a 
significant voice in the field for years to come— 
Elizabeth Boggs. 

Boggs had received her doctorate in mathematical 
chemistry from Cambridge University in 
England in 1939, and had spent the War years 
working in munitions research. In 1945, shortly 
after the end of the War, her son David was born. 
Although not disabled at birth, meningitis at ten 
days of age left him severely retarded. Indeed, the 
disease would probably have claimed his life if antibiotics 
had not been made available to the 
civilian population several weeks prior to his 
birth. As David grew, it became increasingly clear 
that there were significant delays and Boggs, 
rather than returning to research as she had 
planned, began to involve herself in David's education. 


Boggs quickly discovered that the answers experts 
were giving her were often inadequate. 

HISTORY OF INTERNATIONAL REHABILITATION 65 


When her son reached school age, 

Boggs began organizing classes for him 

and other retarded children in her own 

home and in church basements and 
Boy Scout halls. To better fit herself for 
the task of advocating on her son's behalf, 
she returned to school to take classes 
in special education and social work 
administration. Boggs was soon working 
as a volunteer on issues of legislation 
and public policy and became one 

of the most influential members of the 

National Association for Retarded 

Children. 

In 1950, the first nationwide convention 
of the National Association for 
Retarded Children (NARC) was held in 
Minneapolis. From its inception, the organization 
distinguished itself by its uncompromisingly 
grassroots stance and 
emphasis on consumer advocacy. NARC 
proved to be a tremendous success. By 
1956, it had well over 50,000 members, 
with branches in every state, dealing 
with legislation, parent education and 
training of personnel. 

The organization followed recently-
established European leads. At the 
close of World War II, no country had a 
nationwide voluntary citizens' group 
devoted primarily to mentally retarded 
people. The National Society for Mentally Handicapped 
Children led the way in England and 
Wales in 1947. A European League of such 
societies formed in 1960. 

Within the United States, a few associations 
for retarded children had existed before World 
War II. These tended either to be affiliated with 
specific institutions and state schools, or were locally 
based groups such as the Council for the 
Retarded Child in Palo Alto, California. A scientific 
organization, The American Association on Mental 
Deficiency, had functioned since 1896 when it 
was founded by the visiting French scholar, 
Edouard Seguin. Although it was a large multidisciplinary 
organization, it had little to do with consumer 
or advocacy issues. 

The first Executive Director of NARC, Dr. Salvatore 
G. DiMichael came to the organization from 
Switzer's Office of Vocational Rehabilitation in 
Washington, with an expertise in legislation. 
DiMichael's successor was Gunnar Dybwad, who 
joined NARC in 1957. Formerly the Executive 
Director of the Child Studies Association of 
America, Dybwad had worked widely in prison 
and child advocacy programs, as well as holding a 

Rosemary and Gunnar Dybwad 

degree in law. His experience with families in 
stress, parent groups, voluntary organizations 
and government programs would prove invaluable. 
Most importantly, Dybwad's background as 
a lawyer meant that advocacy issues for the first 
time were framed in legal terms. This approach 
would be a major contribution not only to the 
mental retardation field, but would eventually influence 
the whole disability community, for many 
landmark decisions would be based on legal 
precedences established in the field of mental 
retardation. Dybwad's unequivocal support for the 
parent/consumer focus advocated by NARC further 
enabled him to frame issues from the perception 
of consumer entitlement. 

Under Gunnar Dybwad's directorship, NARC 
early recognized the need for international ties 
and began to establish formal liaisons with its 
European counterparts. In 1959, a first step 
toward an international organization was taken 
when leaders of the movement in Holland, 
England and Germany met to plan a European 
League of Societies for the Mentally Handicapped. 
Formally established in 1960, the First Congress 
of the European League held in 1961 drew 400 
people from 12 European countries, as well as rep


66 HISTORY OF INTERNATIONAL REHABILITATION 


In 1959, a first step toward an inter


national organization was taken 

when leaders of the movement in Hol


land, England and Germany met to 

plan a European League of Societies 
for the Mentally Handicapped. 

resentatives from NARC and other non-European 
groups. 

In hiring Gunnar Dybwad, NARC gained not 
only an exceptional and tireless advocate for 
retarded children, but an entire international 
division in the person of Gunnar's wife, Rosemary 
Dybwad. Rosemary Dybwad had received her doctorate 
in Sociology from the University of Hamburg 
in the late 1930s and had worked in social 
work and prison reform in several states before 
she retired to raise their young children in the 
1940s. By the late 1950s, the Dybwad's children 
were older and Rosemary began to come in to 
NARC to volunteer some of her time. She soon uncovered 
a large stack of letters and queries from 
parents and organizations around the world that 
had been left unanswered for want of anyone with 
the time and inclination to tackle the job. The international 
link must have been natural to 
Rosemary. The great-granddaughter of missionaries 
to the Indians in the West, and 
granddaughter of a missionary to China, she had 
spent part of her childhood in the Philippines 
where her father also did missionary work. Her 
college career took her to Germany where she met 
and married Gunnar—himself of Norwegian as 
well as German descent. Hired by NARC as 
Secretary of the International Activities Committee 
for $1 a year, Rosemary began to maintain the international 
correspondence, as well as publish an 
International Newsletter, issued three times a 
year. Within a decade, the Newsletter was reaching 
thousands of people in 70 different countries. 

An indication of the extent of Rosemary's 
knowledge of the international community working 
on mental retardation issues can be seen in 
an early memo Elizabeth Boggs recently located in 
her files. Boggs was on her way to Holland and apparently 
requested any information that 
Rosemary might have on and activities in that 
country. In a one-page memo, Rosemary Dybwad 
lists the names of 13 board members of parents' 
associations in Holland, describes several institutions 
that should be visited, provides the references 
to several background articles Boggs might 
look at, as well as noting a book or two written by 
people with whom Boggs is scheduled to meet. 
Rosemary Dybwad was central to the development 

of the International League of Societies for the 
Mentally Handicapped and editor of its newsletter, 
as well as Secretary of the Joint Commission on 
International Aspects of Mental Retardation. 

Gunnar and Rosemary Dybwad became the 
center of an extensive international network in 
mental retardation advocacy, with Gunnar appointed 
Chairman of the International League of 
Societies for the Mentally Handicapped in 1956. 
When Gunnar Dybwad retired from his post as 
Director of NARC in 1963, he and Rosemary became 
Co-Directors of the Mental Retardation 
Project of the International Union for Child Welfare, 
based in Geneva. From 1963-1966, the Dywbads 
traveled the world, meeting with parents, 
government officials and medical and academic experts 
to teach people how to organize their advocacy 
efforts. They continued their work after 
1966 from Gunnar's new base at the Heller 
School at Brandeis University. 

From 1963-1966, the Dywbads 
traveled the world, meeting with 
parents, government officials and 
medical and academic experts to 
teach people how to organize their advocacy 
efforts. 

New Research Initiatives 
in Mental Retardation 

Parents involved with NARC quickly became 
aware that medical and educational professionals 
often knew little about mental retardation beyond 
their ability to identify and name specific conditions. 
Information about how mentally retarded 
children and adults could function in the world 
was scarce, In response, NARC and other advocacy 
groups dealing with retarded and multiply 
handicapped children began to fund research. 

Initially, even basic statistics and information, 
such as how many retarded individuals lived 
at home, what services they needed and what issues 
their families had to deal with in a community 
setting, were lacking. In 1956, in an early 
effort simply to assess the priority of needs of 
retarded children and their families, NARC hired 
Ignacy Goldberg, the principal of the Muscatatcuk 
State School in Indiana. One of the few educators 
in the nation with a doctorate in special education, 
Goldberg traveled the country meeting with 
parents, providing information and organizing advocacy 
groups. Despite warnings from colleagues 

HISTORY OF INTERNATIONAL REHABILITATION 67 


In the early 1950s, research on mental 
retardation was in its infancy. 


that, in affiliating himself with a parents' group he 
was committing "professional suicide," Goldberg 
spent 1956-57 touring 30 states. He was struck 
by how drastically resources for parents and 
children varied not only between regions or states, 
but from one city to the next. The information 
Goldberg assembled helped to provide a national 
needs assessment upon which future programs 
were based. 

In the early 1950s, research on mental retardation 
was in its infancy. Only 14 universities in 
the country had any sort of leadership training 
program for special educators and in the country 
as a whole, only some 11 doctorates in Special 
Education were being awarded annually. Even 
such basic tasks as the identification of children 
believed to be retarded was surprisingly crude. In 
some school districts, for example, any available 
"professional" was considered capable of labeling 
a child retarded. In an early survey, Goldberg and 
Connors found that in several New York school 
districts, assessment exams and IQ tests were 
being administered by the local minister and an 
entire educational plan for the child was based on 
the results. 

The situation began to improve, although 
slowly. In 1957, the Office of Education, under 
the stewardship of Romaine Mackie and later 
Samuel Kirk, began to support teacher training 
programs in special education, particularly those 
aimed at fostering leadership within the ranks of 
special educators. Along with training came support 
for research both from Mary Switzer's Office 
of Vocational Rehabilitation and through Romaine 
Mackie in the Office of Education. 

Mackie, who arrived in Washington after her 
work in Ohio, New York and California, was one of 
the few people in the country who had dealt with 
special education as a teacher, a school principal, 
a college professor and an administrator at the 
state and federal level. She established a strong 
foothold in the U.S. Department of Education and 
was instrumental in channeling funds into some 
of the pioneering special education research 
projects. 

In addition, Mackie herself ran a major survey 
through the Department of Education in the 
early 1950s, with Lloyd Drem and Frances Connors 
as her key assistants, undertaking a nationwide 
review of special education programs, and 
developing training curricula and protocols for 
teachers of each specific disability group. 

By the very nature of her position, Mackie 
was increasingly sought out by visitors to 
Washington interested in special education and 
rehabilitation. The "grand tour" for rehabilitation-
oriented visitors to Washington for many years 
was a stop at Mary Switzer's Office of Vocational 
Rehabilitation and a meeting with Romaine 
Mackie and Frances Connor at the Office of 
Education. Mackie and Connor both began to 
receive regular invitations to travel overseas, requests 
for copies of their publications, which were 
used widely, and inquiries from dozens of 
countries as to how to establish and administer 
special education programs. 

Prof. Frances Connor 

A focal point for much of the on-going research 
was the Department of Special Education 
at Columbia University Teachers' College. Mackie 
had concentrated on special education while earning 
her doctorate at Columbia, although Teachers' 
College had yet to organize a formal special education 
program. Frances Connors and Ignacy 
Goldberg were two early graduates of the new special 
education program in the early 1950s. In 
1962, Frances Connor who had already been 
teaching part-time at Columbia for several years, 
(while commuting to Washington weekly to continue 
her work with Mackie), was named Chair of 
the Department. That same year, she also became 
President of the Council for Exceptional Children 
and soon Columbia became the focus of ground-
breaking research by Connor and Ignacy 
Goldberg. At Columbia there was a constant flow 
of international students through the Department, 
with additional astudents coming from 
other universities and from the Peace Corps train


68 HISTORY OF INTERNATIONAL REHABILITATION 


Hospital-based schools were frequently 
held to lower standards than 
regular classrooms and disabled 
children who were hospitalized for 
months or years often fell far behind 
their non-disabled contemporaries. 

ing programs which were based on campus. The 
ideas and international perspective of Connor and 
Goldberg influenced hundreds of future educators. 

Goldberg had joined 
Columbia University Teachers 
College as the Assistant Director 
of the Mental Retardation 
Project on young children 
with retardation in 1957. In 
addition to his other work, 
Goldberg became interested 
in comparative special education, 
i.e. cross-cultural comparison 
of educational 
approaches with retarded 
children. He soon began to 
write and speak on the subject. 


One of Connor's primary 
contributions to the field was 
her insistence that education 
be incorporated into disabled 
child care programs. In many 
instances, disabled children, 
both in developed and 
developing countries, were 
beginning to receive good 
medical care, but attention to 
their education was minimal. 
Hospital-based schools were 
frequently held to lower standards 
than regular classrooms 
and disabled children who 
were hospitalized for months 
or years often fell far behind 
their non-disabled contemporaries. 


Connor and Goldberg 
also were early advocates for 
mainstreaming whereever possible. 
Special Education they 
insisted, should be part of a 
public school curriculum, and 
children should not be shut-

their non-disabled peers. The field was still so 
tenuous that Connor and Goldberg initially could 
not even fight for mainstreaming as it is known 
today—much of their energy was at first spent 
simply in trying to convince public educators that 
they had a responsibility for these children. 

Although interest was growing in early 
childhood special education, little was known 
about the process or the potential of the children 
to be educated. Working from two major grants 
funding early childhood research—one from the 

U.S. Office of Education and the other funded by 
Eunice Kennedy Shriver, sister of President Kennedy, founded the Special Olympics in 1968. The intled 
off to institutions or ternational Special Olympics program is now active in more than 110 countries and currently negotiatschools 
far from home where ing with the former U.S.S.R. republics in a new Eastern Europe venture. Historians in the 

developmental disabilities field agree that the Kennedy public support and exposure provided a quan


they eoulf never interact with 

tum leap in attention to the needs of people with intellectual impairment. 

HISTORY OF INTERNATIONAL REHABILITATION 69 


The study showed conclusively that 

even children with more severe forms 

of retardation benefited significantly 
from early intervention. 

United Cerebral Palsy Associations, Connor, 
Goldberg and Fouracre set out to determine some 
guidelines for these children. The first significant 
study undertaken at Columbia was funded 
through the U.S. Office of Education under the 
direction of Romaine Mackie. This grant provided 
support for a five year research study that yielded 
some of the first solid data on retarded preschoolers. 
The study showed conclusively that 
even children with more severe forms of retardation 
benefited significantly from early intervention. 
In conjunction with this, Connor and 
Goldberg developed curricula that were published 
and distributed worldwide. 

The second large grant, funded through 
United Cerebral Palsy in the late 1960s, further 
looked at children from birth to three years of age, 
and examined the manner in which transdisciplinary 
teaching methods could benefit those with 
Cerebral Palsy. As with their first study, the 
second received wide attention from special 
educators, professionals from related fields and 
parents. It was translated into Spanish and 
Japanese and distributed worldwide. 

Because of the importance of their work, Connor 
and Goldberg became increasingly active internationally. 
Leonard Mayo had involved Frances 
Connor in work being done through the Pan 
American Health Organization in South America. 
In 1962, Connor and her husband, Leo Connor, 
an educator in the field of deafness, included a 
site survey for the International Society for the 
Rehabilitation of the Disabled within a trip 
around the world, visiting a number of programs 
in rehabilitation centers sponsored by American-
based organizations. 

The parent's movement was not content 
simply to address educational issues. As the 
children of those parents grew older, the focus on 
special education broadened from that of special 
education to issues of preparing the mentally 
retarded child and young adult for a "normal" life. 
The idea of "normalization" began to blossom in 
the early 1960s in Scandinavian countries and 
Americans began to look to Scandinavia as 
models of the "normalization" movement. Although 
the tremendous growth and spread of the 
"normalization" process appears to have been, in 
part, an idea whose time had come, Dr. Bengt 

Nirje, of Sweden, credited by many as the "inventor" 
of the normalization principle, told Ignacy 
Goldberg that he had picked up the idea during 
his travels to the United States. Nirje recalled "normalization" 
as an obvious idea and that people 
talked about it at centers such as Syracuse 
University, where Wolf Wolfensberger taught was 
an early proponent of age appropriate activities 
for retarded individuals in an environment approximating 
one's peers; an early interpretation of 
mainstreaming. While people such as Wolfensberger 
strongly argued against institutionalization, 
no one had actually attempted 
to implement the idea. One of many scholars who 
had visited the United States in the years following 
the War, Nirje had simply brought the idea 
home and put it to the test. 

From the 1950s, the field progressed rapidly. 
When NARC began its work, severely retarded 
children simply did not exist in the eyes of the law 
and established educational systems. Although 
public education and the concept of what became 
"mainstreaming" were identified early as important 
goals within the parent's movement, initially 
many parents dared not push for too much. At 
first, many believed that their involvement in the 
movement might simply help to make institutions 
more liveable for their retarded sons and 
daughters. 

As the children of those parents grew 

older, the focus on special education 

broadened from that of special educa


tion to issues of preparing the mental


ly retarded child and young adult for 

a "normal" life. 

However, thinking within the movement 
progressed so rapidly that as early as 1954, when 
the initial civil rights legislation, (Brown vs the 
Board of Education), went before the Supreme 
Court, it occurred to at least a few in the special 
education movement that the rules being 
redefined for African-American children were also 
pertinent to retarded children. Some felt that special 
education advocates missed a major opportunity 
in 1954 by not tying themselves closely to 
the civil rights legislative efforts, although in 
retrospect, the field simply may not have had the 
maturity to muster the broad base of support 
needed to place retardation and disability issues 
within the broader civil rights agenda. 

By the early 1960s, increasing numbers of 
retarded children were being served, and for the 
first time, the more severely retarded children 

70 HISTORY OF INTERNATIONAL REHABILITATION 


Interest in mental retardation and 
special education, already picking up 
steam throughout the 1950s, was 
helped enormously by the establishment 
of The President's Panel on 
Mental Retardation in 1961. 


were also beginning to receive educational attention. 
The progress was often discouragingly slow. 
Despite a decade of work, in 1960 no more than a 
quarter of the mentally retarded children in the 

U.S. eligible had been enrolled in special public 
school classes. Many parents still preferred to 
avoid public stigma by institutionalizing their 
children or keeping them at home, and medical 
personnel were still recommending institutionalization 
to parents of newborns and 
young children for whom significant retardation 
had been diagnosed. 
Interest in mental retardation and special 
education, already picking up steam throughout 
the 1950s, was helped enormously by the establishment 
of The President's Panel on Mental Retardation 
in 1961. Initiated by President Kennedy 
and chaired by Leonard Mayo, the President's 
Panel purposely set out to learn from other 
countries. At its first meeting, Chair Mayo and the 
assembled group of experts and advocates agreed 
to look at community outreach, education and 
guidance, residential programs, as well as research 
and training overseas. The Panel dispatched 
groups of members on four 'missions' to 
foreign countries, each group of three to four 
members going on intensive field study visits that 
lasted a month or more. These site visits convinced 
panel members that many potential improvements 
could be made by and for retarded 
Americans.4 

The West Point Conference 

An early, and particularly significant international 
meeting on special education took place at 
West Point, New York in 1960. Sponsored by the 
International Society for the Welfare of Cripples, 
(soon to be renamed the International Society for 
the Rehabilitation of the Disabled) and held immediately 
before its Eighth World Congress in New 
York City, it brought together, for the first time, 
leaders in special education and the parents' 
movement from around the world. 

Participants in the three day meeting were 
bused to the Thayer Hotel at West Point, a small 
Hudson River town, where the meeting featured 

small group discussions rather than large sessions 
or formal addresses. The relatively isolated 
venue and informal discussion format apparently 
encouraged participants to spend more time 
together than might have been the case otherwise. 
(Certainly, several participants felt they were far 
enough away from a major metropolitan area, so 
that considerable discussion went into emergency 
contingencies, should Eloisa de Lorenzo of 
Uruguay, by then extremely pregnant, go into 
labor). Daytime discussions continued on through 
dinner and then far into the night. 

Over the three days they were together, participants 
had a chance to compare notes on 
health, education and legislation. Participants 
began to realize, many for the first time, that they 
were part of an international movement that was 
gaining momentum and that in many counties 
real progress was being made, particularly in 
education and legislation. "People," educator Francis 
Connor recalls, "were overpowered with the 
things they were learning." "Hope" is a word that 
comes up regularly in reference to the West Point 
meeting. For many Americans who would later 
work internationally, such as Ignacy Goldberg 
and Francis Connor, West Point was their first exposure 
to the international scene. Professional 
and personal links were established that would 
last a lifetime. 

Public Discussion of Retardation: 
A Change in Public Attitudes 

Slowly, primarily as a result of parent advocacy, 
mental retardation began to come out of 
dark closets. For the first time, some parents were 
speaking, not only to each other, but publicly as 
well. Books by two well known parents, Nobel 
laureate Pearl S. Buck's The Child Who Never 
Grew and actress Dale Evans' Angel Unawares 
brought the topic of mental retardation to the 
general reading public. In both cases, these 
famous parents were openly discussing their 
child's retardation for the first time, and their examples 
encouraged many parents to begin admitting 
and addressing the needs of their children. 

Of all the personal admissions made public 
during this era, by far the most significant was 
that of the Kennedy family. John F. Kennedy's 
mentally impaired sister, Rosemary, had played little 
part in family affairs, and was reported by the 
family to be a "teacher" of retarded children at St. 
Colleta's School in Wisconsin. All other associations 
with retardation were downplayed. When the 
Association of Retarded Children's publication, 
Children Limited, showed a front page photograph 
of the President-elect receiving a planter from a 

HISTORY OF INTERNATIONAL REHABILITATION 71 


six-year-old girl with mental retardation, the organization 
was told behind the scenes not to 
repeat such an association. 

It was Kennedy's sister, Eunice Kennedy 
Shriver, who finally broke the silence. Officially appointed 
a Consultant to the President's Panel on 
Mental Retardation, she decided to announce the 
family's interest publicly. The September 22, 1962 
issue of The Saturday Evening Post carried the article. 
It was not only written after express consent 
was given by the Kennedy clan, but John F. Kennedy 
himself, (with the Cuban missile crisis looming 
on the horizon), took time out to personally 
edit the manuscript before it was given to the publisher. 


Suddenly, politicians, as well as 
medical experts and educators were 
more willing to take issues of retardation 
seriously. 

The revelation was, to the movement, a completely 
unanticipated event. So closely had the 
family guarded the secret up until that time that, 
with the exception of Elizabeth Boggs and a few 
others, even most leaders in the field were unaware 
of the family's personal involvement in the 
subject. Gunnar Dybwad, who had been Executive 
Director of NARC since 1957, compared the 
revelation to "a bombshell." Suddenly, politicians, 
as well as medical experts and educators were 
more willing to take issues of retardation seriously. 
Leading foreign politicians, such as the French 
president Charles DeGaulle, for the first time addressed 
some attention to programs for retarded 
children and adults. 

The Kennedy family's involvement in mental 
retardation has strongly impacted beyond U.S. 
borders. First the International Special Olympics, 
founded by Eunice Kennedy Shriver grew into a 
majro worldwide event and second, the International 
Very Special Arts organization is also taking 
hold in a growing number of countries. 

Although the public slowly began to take a 
more enlightened attitude toward mental retardation, 
it still had far to go. Issues concerning mental 
retardation were similarly "closeted" in the 
rehabilitation community. Many in fact, hesitated 
to link physical or sensoral disability issues with 
those of the mentally retarded or the field of special 
education, fearing that their own cause would 
suffer. For example, more than one member of the 
President's Committee for the Employment of the 
Physically Handicapped objected to broadening 

72 HISTORY OF INTERNATIONAL REHABILITATION 

Dorothy Warms, who had joined the 
International Society in 1958 as an 
administrative assistant and quickly 
became a leading figure in the field, 
was always sympathetic to the movement 
in general and supportive of 
parents/grassroots involvement in 
particular. 

the committee's mandate to include mentally 
retarded individuals. (One member recalled that 
many Committee members initially believed mental 
retardation and mental illness were one and 
the same thing and that other members feared 
that physical disability issues would be "diluted" 
by broadening its concern to those who were mentally 
retarded). Although the word "Physically" 
was eventually dropped from the Committee's title 
to reflect the inclusion of mentally retarded (and 
later mentally ill) people, many Committee members 
remained displeased with the change. 

There were some exceptions to this. Howard 
Rusk and Jack Taylor took mental retardation issues 
very seriously, as did Mary Switzer who 
pioneered many of the early federal programs in 
mental retardation. Dorothy Wain's, who had 
joined the International Society in 1958 as an administrative 
assistant and quickly became a leading 
figure in the field, was always sympathetic to 
the movement in general and supportive of 
parents/grassroots involvement in particular. Her 
sommitment to significant parent participation 
and her inclusion of parents at organizing meetings, 
conferences and programs enhanced the 
parents' presence and visibility in the field significantly. 


In this era retarded children could not go to 
schools for physically disabled children, nor could 
children with severe physical handicaps attend 
schools for children with mental retardation. 
When New York City established some of the very 
earliest classes for children with cerebral palsy, 
the ground rules were very clear. A child had to 
have an IQ of 70, be able to eat a sandwich by 
himself and have self-toileting skills. Many physically 
disabled children with IQ's far higher than 
70 were automatically excluded. Little wonder 
that when special educator Frances Connor established 
a program for multiply handicapped 
cerebral palsy children in the Suffern Public 
Schools for residents of Rockland County, New 
York, a significant number of families simply 
moved from the New York City area to Rockland 
County to be able to take advantage of the service. 


Preface by Robert Coles 

The classic autobiography of Clifford Beers, A Mind That Found Itself, 
copyrighted in 1907, has been reprinted 41 times and still commands 
substantial public interest. Reviewers agreed that this book 

"did for the American mental health movement what Thomas Paine's 
Common Sense did for the American Revolution." After recovering 
from his illness, Beers began a life long crusade to revolutionize the 
care and treatment of those with similar problems. 

Through the aggregate work of Connor, 
Goldberg, Gunnar and Rosemary Dybwad and 
Elizabeth Boggs as well as work by NARC and the 
President's Panel, the United States quickly 
achieved a significant presence in the mental 
retardation/special education movement. Research 
and teacher training supported by Mackie 
and Switzer also gave the United States particular 
prominence in these areas. 

Mental Illness 

Mental illness, one of the most frequent and 
potentially disabling disabilities, finally began to 
be much more openly discussed and addressed in 
the 1960s and early 1970s, two decades after 
mental retardation began to receive public attention. 


Despite the fact that Clifford Beers presented 
a clear and loud consumer voice as early as 1909 

in his book The Mind that Found Itself, his pleas 
failed to attract interest or understanding among 
the general pubic, nor was he able to spur others 
who were mentally ill to come forward to advocate 
on their own behalf. The National Committee for 
Mental Hygiene that Clifford Beers and Dr. Adolf 
Meyer (later Head of Psychiatry at Johns Hopkins), 
founded several years later, was to remain 
essentially a professional movement. Nor was this 
the only attempt to build an advocacy organization 
for those concerned with mental illness. 
During World War II, the conscientious objectors 
who selected work assignments in mental health 
facilities and institutions organized a national institute 
in Philadelphia, which undertook an outstanding 
public information campaign over a 
period of several years. 

Congress established the National Institute 
of Mental Health in 1945 to pursue research and 
training. In 1950, The Conscientious Objectors organization 
merged with the National Committee 
on Mental Hygiene to form National Association 
for Mental Health. Internationally, in 1948, the 
World Federation for Mental Health was organized 
and by 1960, there were groups organized in 43 
counties. It would not be until the late 1970s, 
however, that American consumers who had experienced 
mental illnesses began to take a more 
active role. 

One of the earliest activists in the field has 
been New York based Irving Blumberg. Unlike almost 
all who discussed mental health and mental 
illness issues publicly early on, Blumberg was not 
a mental health professional, but a person with 
firsthand knowledge—his mother had experienced 
mental illness. Long before mental illness became 
an issue that was openly discussed in public or 
treated with sympathy or understanding by lay or 
professionals, Blumberg was insisting not only 
that care and services be provided, but actively advocating 
for humane treatment and civil rights for 
persons with mental illness. Blumberg was instrumental 
in the founding of the International 
Committee Against Mental Illness and has played 
a leading role in a number of other international 

Mental illness, one of the most fre


quent and potentially disabling dis


abilities, finally began to be much 

more openly discussed and ad


dressed in the 1960s and early 

1970s, two decades after mental 

retardation began to receive public at


tention. 

HISTORY OF INTERNATIONAL REHABILITATION 73 


mental health organizations, as well as representing 
mental health concerns to United Nations 
organizations. 

In collaboration with the physician Nathan S. 
Kline, Blumberg organized and ran the first International 
Conference on Productive Participation 
Programs for the Mentally Ill in Helsinki, Finland, 
October 1971, as well as a number of other international 
conferences. In later years, he was to 
author the Declaration of Barcelona on the 
Rehabilitation and Human Rights of the Mentally 

Ill which was accepted by the World Association 
for Psychosocial Rehabilitation (WAPR) in 1989. 

Summary of the Era 1940-1970 

The era between the close of World War II 
and the late 1960s was one marked by a major 
presence of the United States in rehabilitation efforts 
internationally. United States ideas, technologies, 
publications and individuals played 
prominent roles throughout the era, while the 
United States also became the single largest 
trainer of professional personnel working in the 
disability arena. It is easy to overstate the amount 
of activity taking place, however. 

The field of rehabilitation remained small 
and relatively little was being done on an international 
scene by any other national governments. 
Under such conditions, initiatives such as the 
United States' PL 480 programs could and easily 
did become major players in the field. 

There were certainly a number of 
people, including many of those interviewed 
for this study, who were keenly 
aware that all types of disability 
had much more in common than in 
contention. 

The growing numbers of U.S. private and 
voluntary programs that addressed individual disabled 
groups and constituencies, when seen in 
retrospect, seem to have developed in a piecemeal 
fashion. Each organization had a mandate and a 
population to serve, and although groups that addressed 
similar issues—groups dealing with blindness 
or deafness for example—at times joined 
forces sporadically to advocate legislation or 
policies, both nationally and internationally, the 
field continued to be fragmented by the long established 
practice of dividing the disabled population 
on the basis of age, sex and specific type and 
sometimes origin of disability. Such divisions were 

present in other countries, but were often carried 
to further extremes in the United States, where 
specific charities and institutions delivered services 
to individuals with specific disabilities on 
the basis of race, ethnic or disability origin or 
religious affiliation. 

It is not that people working on the various 
aspects of disability did not perceive shared 
problems and common interests. There were certainly 
a number of people, including many of 
those interviewed for this study, who were keenly 
aware that all types of disability had much more 
in common than in contention. The American system 
that encourages competition rather than 
cooperation to attract nongovernmental and 
governmental support also complicated issues. 
On the other hand, it was during this era that 
unifying forces, such as Mary Switzer's Office of 
Vocational Rehabilitation, the President's Committee 
for the Employment of the Handicapped on 
the national scene and the International Society 
for the Rehabilitation of the Disabled, and the International 
Council of Organizations Interested in 
the Handicapped on the international scene were 
increasingly important forums for the cross-pollination 
of ideas and affiliations. 

In summary then, the period from the end of 
World War II to the early 1970s, seems to have 
been a period of tremendous growth with much of 
the energy being devoted to developing specific 
responses to very specific needs for closely defined 
and targeted groups. These developments represented 
significant progress; an enormous amount 
of groundwork was being laid. When "disability" 
began to be re-defined as a civil rights issue in the 
late 1960s, the foundation was already in place 
for a new and more united grassroots movement. 

In many ways, 1970 is a natural dividing line 
between disability eras, past and present. On the 
Federal level, in 1967 Mary Switzer was appointed 
Administrator of the new Social and Rehabilitation 
Services—combining four previously distinct 
social service Departments within the new Department 
of Health, Education and Welfare. She now 
was responsible for programs serving the poor, 
young families and the elderly, as well as those 
children and adults with disabilities within the 
newly renamed Rehabilitation Services Administration. 
Her budget went from 300 million to 
6 billion dollars overnight. Switzer's primary allegiance 
remained with the rehabilitation community; 
however, her attention could no longer be 
directed exclusively to them. In 1971 Switzer was 
squeezed from office, and she retired from the 
Federal government to take up the position of Vice 
President of the World Rehabilitation Fund. In 

74 HISTORY OF INTERNATIONAL REHABILITATION 


The international program Switzer 
had initiated was carried forth by 
James Garrett and Martin McCavitt, 
who, along with Joseph LaRocca, 
Joseph Traub and George Engstrom, 
were responsible for research and 
development. 


charge of initiating the WRF's Washington office, 
Switzer's clout in he capitol was still significant, 
and she, without doubt, would have continued to 
have great influence within the field. Unfortunately, 
however, only a short time after she began her 
new position, Switzer discovered that she had an 
advanced form of cancer. She died in 1972. 

Mary Switzer's Social and Rehabilitation Ser


vices Administration did not fall apart immediately 
after she retired. The international program 
Switzer had initiated was carried forth by James 
Garrett and Martin McCavitt, who, along with 
Joseph LaRocca, Joseph Traub and George 
Engstrom, were responsible for research and 
development. These men oversaw international 
and national programs for a number of years, and 
kept PL 480 activities alive, but they faced increasing 
difficulties. Budget cuts curtailed their ability 
to conduct programs, and senior administrators 
were brought in as political appointees who were 
often far more concerned with domestic issues, or 
with their own career objectives than with international 
disability. Garrett would retire at the beginning 
of the Nixon Administration and start work 
with the World Rehabilitation Fund; LaRocca, 
Traub and McCavitt continued to maintain the PL 
480 program despite a decline during much of 
that period in funding and administrative support. 

Two prominent Americans whose public education efforts 
in the mental retardation field reverberated around 
the world: Pearl S. Buck (left) who wrote about her 
daughter and spoke out on behalf of early 1960s campaigns 
of the (then) National Association for Retarded 
Children; and President John F. Kennedy, who created 
the President's Committee on Mental Retardation in 

honor of his sister Rosemary. Above, Rosemary Kennedy (right) and Eunice Shriver (left). Photographs reprinted from Civilization and MentalRetardation by Cliff Judge, 1987, Magenta Press, Australia. 

HISTORY OF INTERNATIONAL REHABILITATION 75 


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The Present: 1970-1990 

The past two decades have been years of tranformation 
for the field of rehabilitation and for the 
disability community. So much has occurred that 
the following pages can provide only a brief overview 
of some of the most influential events and individuals 
that have played a role in the United 
States international disability efforts. 

A review of the past two decades must also 
be undertaken on several levels. It is important to 
provide background on the people, politics and 
events that have been influential, but it is also important 
to look beyond the participants and 
events, to the ideas that influenced and inspired 
them. 

Disability, many began to insist, was 
not an issue of specific medical diagnosis 
but a minority status, and 
deserved the same rights and protections 
granted other minority groups. 


The Disability Rights Movement: 
Cross-Disability Unification 

The 1960s and 1970s were years of great social 
change across the nation with many minority 
groups coming forward to demand concrete changes 
in the status quo, through protest, civil disorder 
and consumer/voter power. The social unrest 
that reached all corners of American society 
sparked action in the disability community as 
well. Some disabled individuals who had been 
divided on the basis of their specific disabilities 
nto distinct constituencies, (and often placed in 

he position of vying for what little public support 

existed), began to argue that their shared con


:erns far outweighed their perceived differences. 

hey argued that no matter what type of disability 

In individual might have, most now dealt with 

omrnon problems: their lives were structured and 

heir options determined by complex medical, 

•gal and educational bureaucracies; by a social 
;:curity system not really designed to serve those 
CHAPTER III 


The International Symbol of Access was created in 1969 and disseminated 
worldwide in 19 70 by Rehabilitation International. Americans, including 
Mary Switzer and leaders of the (then) President's Committee 
on Employment of the Handicapped and the National Easter Seal 
Society were active in identifying the need for an international symbol. 
RI and its "technical arm", the International Center for Technology and 
Accessibility (ICTA) conducted the project to create a symbol and 
defined standards for its use throughout the world. In many countries, 
the nucleus of disability activism was first formed around accessibility 
issues. 

individuals with disabilities who wanted some 
measure of independence and self-determination; 
and by the broader society where prejudice and 
stereotypes were still widespread. Many disabled 
Americans realized that they were dealing with issues 
analogous to those of other minority groups. 
Disability, many began to insist, was not an issue 
of specific medical diagnosis but a minority 
status, and deserved the same rights and protections 
granted other minority groups. 

With this shift in perception came a new activism. 
Much of the methodology and the formulas 
for action, both in North America, Europe and 
elsewhere were patterned after minority movements 
of the late 1960s and early 1970s, such as 
the Civil Rights Movement in the United States, 
the student protests and the international 
women's liberation movement, and the Gay Rights 

HISTORY OF INTERNATIONAL REHABILITATION 77 


1977 White House Conference on Handicapped Individuals 


The 1977 White House Conference on Handicapped 
Individuals was held May 23-27 in 
Washington, DC. It was called for by the 
Rehabilitation Act Amendments of 1974. President 
Jimmy Carter appointed Mr. Henry Viscardi 
as Chairman, who administered a process that brought together 3700 people from all states and territories. Delegates were selected 
from pre-conference state and local meetings according to the following formula: 50% individuals with disabilities, 25% parents or guardians 
and 25% representatives of service delivery organizations. Shown above are President Carter, Hank Viscardi and an interpreter 

for deaf delegates. 

Movement. By the mid-1970s numerous organizations 
run for and by people who were themselves 
disabled had been founded to address political, 
economic and social concerns, and these were indreasingly 
worked in close cooperation with one 
another. It was a social movement that came to be 
collectively known as the Disability Rights Movement 
or the Independent Living Movement. 

The philosophy that people with disability 
are equipped to direct and control 
their own lives, challenged the 
paternalistic role not only often assumed 
by 'society-at-large,' but also 
by many rehabilitation professionals 
and organizations. 

Activism within the disability community was 
not new. Regional, national and international organizations 
of deaf and blind people that have existed 
since the 19th century, and these groups 
frequently took stands that were quite radical for 
their time and place. Nineteenth century organizations 
of deaf persons, for example, battled unsuccessfully 
for decades to keep Sign Language in 
deaf educational curricula. (By the 1850s, deaf activist 
John Flourney became so enraged at the 
lack of rights and respect accorded deaf 
Americans that he campaigned to have Congress 
allocate lands in the newly opened American West 

78 HISTORY OF INTERNATIONAL REHABILITATION 

for a commonwealth exclusively for deaf adults 
and their families). At various times, groups such 
as disabled veterans, parents of mentally retarded 
children, blind adults and many more had marshalled 
considerable monetary and legal backing 
to ensure that specific programs be established or 
legislation passed on a local or national level. 

The Disability Rights Movement however, 
had a new and unique aspect to it that marked it 
as different from all preceding efforts. For the first 
time there was significant and on-going cooperation 
among many disabled groups and individuals. 
This new and increasingly united front 
gave the entire movement an unprecedented 
strength. The central concept behind this new 
movement was very straightforward: in both the 
charity model and the medical/rehabilitation 
model, the individual with a disability is seen as a 
passive recipient of care rather than as an active 
participant in the process. Now individuals who 
were disabled began to openly advocate for far 
more independent roles in society, and a much 
greater say in organizations established and 
decisions made on their behalf, and organizations 
run by and for disabled individuals began to be 
formed. 

The philosophy that people with disability 
are equipped to direct and control their own lives, 
challenged the paternalistic role not only often assumed 
by 'society-at-large,' but also by many 
rehabilitation professionals and organizations. 
Voluntary organizations established to assist 


people with disabilities were now asked by advocates 
in the disability community to include individuals 
with disabilities in decision-making 
capacities: to shift from being organizations for 
disabled persons, to being organizations of disabled 
persons. Rehabilitation specialists who were 
not disabled were asked by disabled consuemr 
groups to shift from the role of decision maker to 
that of technical advisor. Some organizations and 
non-disabled experts are accepting these challenges 
better than others. 

Many organizations reoriented themselves 
significantly during these times, others paid lip 
service to the new ideas, and although they would 
add a few individuals with disabilities to their 
Boards, staffs or committees remained substantially 
unchanged. Some organizations ignored the 
new ideas and carried on as usual. 

It is not surprising that American disability 
activists were strongly involved in the very earliest 
stages of this movement. Ideas of independence 
and self-determination resonated well with other 
social movements then gaining momentum in the 
United States. 

A new international perspective also 
emerged, as American advocates increasingly incorporated 
innovative ideas from other countries 
into their approaches. The new activism in the 

U.S. is reflected in changes in national legislation, 
the restructuring of some organizations to enable 
increasing input from disabled leaders, the rise of 
new 'disability run' organizations, and an increasingly 
better educated public. Activity on an international 
level was reflected in significant attention 
to disability issues by the United Nations and its 
affiliated international bodies. 
United States-Based 
International Work 

In the past 20 years, the American disabled 
community has undergone a revolutionary transformation. 
Individuals and groups, although often 
differing over specific ideas and approaches, have 
united to form an extremely effective and coherent 
social movement. However, this era of intense 
growth and change domestically was, at the same 
time, a period of withdrawal and diminution of 
many United States activities on the international 
scene. Part of the slowing of international activity 
can be traced to changes of priorities with increasing 
amounts of attention being focused on disability 
issues on the national level. Concurrently, 
there was an overall diminution of funds for social 
programs in general throughout the government 
system. For many advocates and administrators, 

it became important that the U.S. put its own 
house in order before expanding work on an international 
scale. Certainly, there was some activity 
and a number of significant programs and events 
that deserve mention, but there was little coordinating 
of efforts towards disability internationally, 
such as there had been in Mary Switzer's time. 

It is important to divide the field into several 
distinct areas during this time period: those working 
on international projects sponsored by the 
United States government, activities sponsored by 
international voluntary organizations that had already 
been long active in the field, and activity by 
new groups concerned with international disability 
work run by disabled individuals themselves. 
Finally, work done by organizations with 
which the United States was affiliated, such as 
the United Nations, the World Health Organization 
and the International Labor Organization 
must also be considered. 

While most industrialized countries 
built up their international research 
exchange and development aid 
programs in the disability field during 
these decades, the United States 
programs lost ground. 


International Disability 
Activities within the 
United States Government 

The United States government, primary 
agent of direct and indirect funding for international 
rehabilitation and disability outreach 
programs in the 1950s and 1960s, went through 
a period of retrenchment that affected many social 
programs in the 1970s and 1980s. While most industrialized 
countries built up their international 
research exchange and development aid programs 
in the disability field during these decades, the 
United States programs lost ground. 

There were several reasons for this. Within 
the Federal government, international rehabilitation 
programs had historically depended upon individual 
leaders who developed a strong and 
continuous personal commitment to the field. An 
administrator such as Mary Switzer or James Garrett 
understood the significance of rehabilitation, 
linked it to broader United States interests and 
was able to actively campaign for its incorporation 
into international policy planning and aid 
programs. There was, however, no unified lobby 
or interest groups within the government to speak 

HISTORY OF INTERNATIONAL REHABILITATION 79 


As funds for all social services were 

reduced in the 1970s and 1980s, na


tional programs took priority, and in


ternational projects were slashed to 

free up funds for programs that ad


dressed domestic needs. 

on behalf of international rehabilitation/disability 
issues or projects. Because the programs were 
tied to individuals, a change in personnel often 
meant a substantial reduction in the importance 

(and funding) available for international work. As 
funds for all social services were reduced in the 

1970s and 1980s, national programs took 
priority, and international projects were slashed 
to free up funds for programs that addressed 

domestic needs. 

This was compounded by the fact that funding 
and location of international rehabilitation 
work had been placed within Departments responsible 
for programs of an essentially national nature. 
Despite that international work was clearly 
mandated (within 202(4)(6), the Rehabilitation 
Acts of 1973 and 1978 amendments, the emphasis 
has remained concentrated on national 
programs. What little Federal attention to disability 
had been allocated has usually been with 
disability prevention efforts undertaken through 
child health initiatives under U.S. AID and other 
agencies. Far less attention has gone to serving 
children and adults who already have a disability. 

The lack of attention to international 

issues has been compounded by the 

numerous administrative changes 

that have occurred. 

The lack of attention to international issues 
has been compounded by the numerous administrative 
changes that have occurred. For example, 
Switzer's original Office of Vocational 
Rehabilitation became part of the Social and 
Rehabilitation Administration and then, in 
another reshuffling, was placed within the Office 
of Human Development, the program itself having 
been renamed the Rehabilitation Services Administration 
(RSA) Research Wing. Moved again in 
1977 from with the Department of Health, Education 
and Welfare to the new Department of Education, 
it became the National Institute of 
Handicapped Research (NIHR) and recently was 
renamed the National Institute on Disability and 
Rehabilitation Research (NIDRR). Its mandate and 

The 1975 appointment of Ed Roberts by Governor Jerry Brown as the 
first disabled Director of California's state rehabilitation services was a 
beacon of the growing influence of the young independent living movement. 
Roberts, a founder of the first Center for Independent Living in 
Berkeley, was once rejected by this same state rehabilitation agency 
having been assessed as unemployable. His "Horatio Alger success 
story" and his vision of an international independent living movement 
earned Roberts speaking invitations around the world. 

reporting chain changed slightly or significantly at 
each restructuring. 

For example, NIDRR is located within the 
Department of Education, while within the federal 
system, international aid, including links to the 
United Nations, are carried on largely in conjunction 
with the State Department. Until now, the 
State Department has had few connections with 
or responsibility for disability/ rehabilitation issues, 
and few who can advocate on their behalf. 
Had the original Office of Vocational Rehabilitation 
been affiliated with the State Department or 
the Social Security Administration, the international 
aspects of its programs may well have fared 
better in the interdepartmental realignments that 
are continually part of Washington bureaucracy. 
NIDRR is currently designated the central federal 
agency to support disability research. Given its 

80 HISTORY OF INTERNATIONAL REHABILITATION 


mission and its location within the Department of 
Education, it is often difficult for NIDRR to pursue 
as wide a range of international programs, as did 
the original Office of Vocational Rehabilitation 
under Mary Switzer. Nor is it administratively 
easy for it to take the lead in organizational or 
United Nations related matters. 

Many industrialized and many other nations 
have a mechanism to involve their education, 
labor, social security, health, veterans and foreign 
ministries in support of their domestic disability 
council (or office or disability minister), which also 
has responsibility for international outreach. 
Such a multi-agency approach would be a valid 
approach for the United States government role. 
Among United States agencies with an international 
focus, only the Peace Corps has identified services 
for disabled persons—particularly special 
education and rehabilitation as a major role. 
Funds for international programs from other 
federal agencies, have been assigned on a project 
by project basis, rather than allocated as part of 
well planned, on-going programs. Despite its constraints, 
NIDRR has supported a number of 
programs over the past two decades that have 
produced noteworthy results for international disability 
projects. 

tzi\loos 

World 

Rel-nbilitRtion Fund 

IntErnntionnl ExcHnng€ of Information in Reiinbilitntion 

An early World Rehabilitation Fund monograph by Victor Finklestein, 
disability activist from Britian, who explores the thesis that 'disability" 
is a social construct, characterized by oppressive social relationships. 

International Efforts Undertaken 
through NIDRR 

United States government support for international 
disability work in the 1970s and 1980s, 
was primarily centered in the National Institute 
for Handicapped Research, now NIDRR. NIDRR 
maintains several international projects, as well 
as support for a number of national research 
programs. Some of these international programs 
are of long-standing. For example, a vestige of PL 
480 remains and is being revived, with work currently 
on-going in Egypt and with the government 
of India developing services for persons with disabilities 
in rural communities. The Indian project 
has been supported by two 5-year research 
programs, the second beginning in 1990 under 
the direction of Paul Ackerman. 

In addition, NIDRR has awarded two 
$200,000, 3-year grants to expand exchange of research 
and experience capacities of nongovernmental 
international rehabilitation 
organizations. The original grant initiated in this 
program dates in 1978 for the support of the International 
Exchange of Experts in Infonnation in 
Rehabilitation Project, initiated under the World 
Rehabilitation Fund. A second, he International 
Disability Exchanges And Studies (IDEAS) Project, 
is administered by the World Institute on Disability 
in collaboration with Rehabilitation International. 
Currently, the World Rehabilitation Fund 
grant focuses on research in Africa, Asia, the 
Pacific Basin and the Middle East. The World Institute 
on Disability/RI efforts concentrate on 
Canada, Europe, Latin America and the Caribbean. 


UCIR 

Also of note in an overview of recent federally 
funded international support initiatives was the almost 
decade long support for the Michigan-based 
University Center for International Rehabilitation 
(UCIR). 

The University Center for International 
Rehabilitation (UCIR) was established at Michigan 
State University in 1976, and remained in operation 
until 1985. This facility was intended to serve 
as a university-based, international think tank, 
providing an environment for the serious study of 
policy issues and concerns relating to national 
and international disability issues. 

The concept behind UCIR was a good one. At 
that time, it was the only academically based program 
anywhere in the world dedicated to coordinating 
cross-cultural and international 
rehabilitation and disability research between dis-

HISTORY OF INTERNATIONAL REHABILITATION 81 


Judy Neumann (center) was 
active in identifying the goals 
of the Women's Caucus at 
the 1977 White House Conference 
on Handicapped Individuals. 
Neumann was one 
of the first American disability 
rights advocates to envision 
the international possibilities 
of the independent living 
movement and began working 
with disability groups in 
other countries in the early 

1970s. 

ciplines, organizations and among academic institutions. 
As an academic center, it was intended 
to provide a forum for investigation, critical thinking 
and policy analysis. Thoughtful reflection and 
summation of activity and research in the field 
would, it was hoped, draw together international 
disability work into a better defined discipline, a 
body of knowledge that could and would coherently 
be passed on to the next generation. Additionally, 
as a university based program, it was, at least 
theoretically, intended to be removed from some 
of the continual scrambling and realignments 
found in the political arena. 

UCIR attracted a considerable number of 
American students as well as many foreign 
scholars, and some outstanding research, meetings 
and publications resulted. Unfortunately, the 
center itself began on shaky ground. It did not 
arise through a common mandate among the leading 
organizations and experts in international 
development and rehabilitation. Rather, the program 
was conceptualized by John Jordan, a 
professor from Michigan State University. 

Jordan persuaded his local Congressman to 
sponsor a bill allocating money for the Center, 
and the legislation, slipped into a larger bill, 
sailed through Congress. Money was appropriated 
for the Center before others in the field of interna


82 HISTORY OF INTERNATIONAL REHABILITATION 

tional rehabilitation even knew of its existence 
and Jordan was named the Center's Director. Although 
Jordan had done some work with 
rehabilitation in Costa Rica through the Partners 
in the Americas, he was not well known in the 
field, and was anxious to establish himself and 
his Center as the focal point around which much 
of the United States' international policy would 
turn. 

Without much advanced warning however, individuals 
and groups who had worked on 
rehabilitation internationally for decades, often 
surviving on shoe string budgets, were asked to 
coordinate their efforts with a comparatively well-
funded newcomer, who had little to offer them in 
return. Organizations that had worked for years 
to establish international networks and individual 
public and private colleges and universities with 
on-going reciprocal research and training 
projects, had put time, money and energy into 
developing these. They were not willing to simply 
give them away. Jordan named his new program 
the International Rehabilitation Special Education 
Network (IRSEN), but he remained Director only 
briefly. Despite the able guidance of the project's 
second Director, Donald Galvin, who changed the 
program's name to UCIR and solidified its objectives, 
the program simply did not have the 
seniority and stature in the field to effectively mar



shall forces. At the end of two grant cycles, the 
funding agency, the Department of Education 
decided to allocate dollars elsewhere. 

Additional Rehabilitation/ 
Disability Work through other 
Government Agencies 

AID 

There are other large agencies within the 
federal government that currently are, or have in 
previous years, funded programs that relate directly 
or indirectly to disabled populations. Perhaps 
the most prominent of these is United States Agency 
for International Development (US AID). AID 
has no legislative mandate to address disability or 
rehabilitation issues, and generally does not 
weigh disability issues heavily in its regular 
bilateral programs. However, over the years it has 
provided millions of dollars in assistant to 
projects concerned with disability in the Developing 
World. 

In addition to these, some AID funds have 
been channeled through private voluntary organizations. 
For example, a half-million dollar 
grant for education and rehabilitation of blind individuals 
is being funded by AID and administered 
through Helen Keller International as a 
demonstration project in Thailand and some support 
has been given to Goodwill for vocational 
rehabilition projects in English-speaking Africa. 
The World Rehabilitation Fund has received 
regular and increasing support for its specific 
rehabilitation projects and training seminars over 
the past decade. For example, with US AID funding, 
the World Rehabilitation Fund began a training 
program for war injured civilians in the 
Lebanese Civil War. Initiated and run by James 
Garrett and Joseph LaRocca, the program established 
a Rehabilitation Center in Cyprus for 
Lebanese civilians from both sides of the fighting. 
In the spirit of building bridges through rehabilitation, 
the program has expanded to include Greek 
and Turkish Cypriots. 

In 1989, US AID also began to receive $5 million 
annually through Congress specifically to be 
used in assisting civilian victims of civil wars. This 
program, under the direction of Joseph LaRocca, 
has delivered through services and training to 
countries including Uganda, Mozambique and 
Laos. The legislation initially limited funding to 
providing artificial limbs, but in 1991 it was expanded 
to include medical and related assistance, 
as well as vocational rehabilitation and training. 

In addition, US AID supports a wide array of 

local and national economic development projects 
throughout the Developing World. A number of 
these help to raise the standards of living for disabled 
individuals as participating members of the 
society. However, an improved economy or greater 
social and economic productivity for members of a 
community does not automatically translate into 
a better life for disabled members of that community, 
who may not be included in the improved 
prosperity. 

Congressional Support of 
Development Activities 

In addition to the support for international 
development provided directly by US AID, the 
Inter-American Foundation, established by Congress 
in 1969 as a public corporation supporting 
self-help and poverty in Latin America and the 
Caribbean has dealt with disability-related matters. 
The Inter-American Fund responds directly 
to requests for assistance from local and private 
grassroots organizations. Over the past two 
decades, the Inter-American Foundation has supported 
some 22 disability-related projects in 15 
nations. A similar program, still small, has more 
recently been established by Congress for Africa. 
Called the African Development Foundation, it 
began operating in 1984. 

Peace Corps 

In many countries, the Peace Corps has been 
an important player in introducing and supporting 
disability and special education programs and 
projects. Although Peace Corp efforts in the disability 
arena are of note, they have been and continue 
to be relatively small in size and scope. 
Currently, there are some 150 Peace Corp volunteers 
(most of whom are not themselves disabled) 
working in 14 countries on disability issues 
(GAO:1991:25). 

Inter-regional Cooperation 

Regional organizations are also assisting in 
disability related activities in various developing 
countries. In Latin America for example, the Organization 
of American States (OAS) has for the 
past few years been active in special educational 
programs and rehabilitation training. 

Since 1969, over 20 Latin American and 
Caribbean countries have benefitted from special 
education and vocational rehabilitation programs 
sponsored by the Organization of American 
States. Although the OAS programs have been 
generally small in size and scope, they have 
provided an initial introduction to disability is-

HISTORY OF INTERNATIONAL REHABILITATION 83 


sues for many and helped to foster regional networks 
and training. The first regional meeting to 
discuss current and future needs for the region 
was held in March 1991 and brought representatives 
from throughout Latin America, the 
Caribbean basin and the USA to discuss a number 
of small community-based projects. 

NGOs in the 1970s and 1980s 

The 1970s and 1980s were years of significant 
change within national and international 
non-governmental organizations dedicated to disability 
issues. Much of this change revolved 
around disability rights issues, as individuals 
with disabilities themselves demanded to participate 
at all levels within these organizations. Indeed, 
many programs were redesigned to meet the 
needs of disabled individuals as they prioritized 
them, rather than as able-bodied people had 
designated them. 

Americans with disabilities were not entirely 
absent in many organizations prior to the 1970s. 
Interestingly, a number of the leading figures in 
government and private voluntary organizations 
in the 1950s and 1960s, such as James Garrett, 
James Burress, were themselves disabled. But 
many of these leaders viewed themselves as administrators 
or educators first, well enmeshed in 
professional networks, and often seem to have personally 
identified more with their professional colleagues 
who were running programs and less with 
the disabled persons their programs set out to 
serve. 

Jim Garrett (far right) listens 
to Gerben de Jong 
(standing) and Adolph 
Ratzka (seated) discuss 
the implications of 
Ratzka's World Rehabilitation 
Fund monograph on 
personal assistance services 
for disabled people 
in Sweden. This meeting 
was one of an on-going 
series of WRF seminars to 

disseminate findings of its 
international fellowship 
and monograph program, 

founded by Garrett. 

In part, this reflected the tenor of the times. 
There was relatively little emphasis on or empathy 
with consumer advocacy. Professionals who were 
themselves disabled, while often relying on their 
own experiences as individuals with disabilities to 
identify issues and design policies, would frame 
their ideas and proposals in a professional format 
that would allow these to be introduced easily at 
an organizational level. 

In addition to professionals who were disabled, 
a number of active and exceptionally effective 
advocates laid the groundwork for much of 
what was to follow. Henry Viscardi and Harold 
Russell for example, were prominent advocates 
with regular access to the mass media and the 
general public. Paul Strachan, Jacob ten Broek 
and many others raised disability-related issues 
in front of legislatures, professional societies and 
in academic arenas. However, in the 1970s and 
1980s, the number and diversity of individuals 
with disabilities speaking up for self-determination 
and equal rights, began to soar. The following 
are some of the significant highlights of the past 
two decades within U.S.-based international organizations: 


The World Rehabilitation Fund 

In 1978, James Garrett was retired from his 
federal post and became Executive Vice President 
of the World Rehabilitation Fund. Garrett worked 
closely with Rusk, designing programs and 
developing ideas. As Rusk gradually retired, Garrett 
took over much of the administration and im


84 I IISTORY OF INTERNATIONAL REHABILITATION 


plementation for World Rehabilitation Fund activities. 
Garrett continued the medical orientation 
of the Fund, as well as undertaking new projects, 
such as national and regional surveys. Utilizing 
his first-hand knowledge of the U.S. federal 
government, Garrett was instrumental in obtaining 
some funding from US AID and other federal 
agencies for rehabilitation work. He oversaw 
major projects in Lebanon, Cyprus, Oman and a 
number of other countries, often with the assistance 
of his long time colleague, Joseph LaRocca. 

Under Garrett's leadership, several World 
Rehabilitation Fund Regional Training Centers in 
Prosthetics and Orthotics were established. 
Centers, located in Taiwan, India and Brazil, offer 
courses in prosthetics and orthotics to health personnel 
from throughout these regions. In addition, 
the World Rehabilitation Fund with Garrett's 
leadership helped to develop physical therapy and 
occupational therapy programs for these areas. 

Garrett was also responsible for the development 
and implementation of the International Exchange 
of Experts in Information in Rehabilitation 

One of Norman Acton's more far-reaching initiatives 
was the joint UN and RI project to organize the first international 
experts meeting on barrier-free design 
and widely disseminate its findings. The resulting 
report served as the seminal international reference 
in this field for many years and was a catalyst for 
numerous national barrier-free design laws and 
projects. The meeting took place in 1974 in New York 
and the report was published in 1975. 

project begun in 1978. The grant itself was written 
by Leonard Diller, Chief of Behavioral Sciences 
at the Rusk Institute. Diane Woods was 
brought on board in the late 1970s to run the 
projects and has continued to oversee the exchange 
ever since. Under Woods' guidance, the 
program has expanded to include not only professionals 
interested in specific aspects of disability, 
but also an increasing number of disability advocates 
interested in the historical, social and policy 
aspects of disability cross-culturally. 

International Society becomesRehabilitation International 

In 1967, Norman Acton was elected the new 
Secretary-General of the International Society, 
replacing Donald Wilson who had held that post 
since 1951. Acton had served as Assistant 
Secretary General in the early 1950s and in the intervening 
years, had directed first the American 
Committee for UNICEF and then, the World 
Veterans Federation in Paris. When Donald Wilson 
called Acton to let him know he was soon to 

HISTORY OF INTERNATIONAL REHABILITATION 85 


leave the International Society to become the new 
Director of the Leonard Wood Memorial Leprosy 
Fund, he had asked Acton whether he was interested 
in applying for the open position of 
Secretary-General. Acton said he was definitely 
not interested. Arriving at the opening reception of 
the World Congress in Weisbaden several weeks 
later Acton found himself being heartily congratulated 
and soon learned that he had been elected 
the new Secretary-General. Despite his initial misgivings, 
after discussion with Gudmund Harlemof 
Norway, then the President of the International 
Society, Acton agreed to take the position. 

In 1968, Acton conceptualized and 
conducted the first world-wide census 
on disability, producing the widely 
quoted United Nations sanctioned 
estimate of 450 million. 

Acton joined the staff in New York the following 
year, ably supported by Dorothy Warms, who 
served as Deputy Secretary General from 1960 
until her retirement in 1972, and on whose 
shoulders was placed much of the daily responsibility 
for the running of the Society. They soon 
acquired two additional staff members. Susan 
Hammerman, who had recently returned from a 
stint with the Peace Corps in Nepal, was referred 
to Dorothy Warms as a possible assistant. 
Dorothy Warms hired her in 1969 and was soon 
relying on her organizational and diplomatic 
skills. In 1970 Barbara Duncan, who had recently 
graduated from college and moved to New York, 
joined the staff to edit publications and organize 
information. 

Acton found a Society much different from 
the one he had left years earlier. On much firmer 
footing financially, and with a large and growing 
international membership, the Society had become 
an established force within the world 
rehabilitation community. Poised on the brink of 
the Disability Rights Movement, it also would expand 
to become a more truly international organization 
as European and non-aligned nations 
began to challenge the American domination of international 
non-profits that had often characterized 
the 1950s and early 60s. 

An indication of the speed with which the 
field of rehabilitation had been changing can be 
seen even in the name changes the International 
Society underwent. In 1960, the International 
Society for the Welfare of Cripples officially became 
the International Society for the Rehabilita


tion of the Disabled. By 1960, the term "Cripples" 
was no longer acceptable, and "rehabilitation" was 
far more acceptable (at least to non-disabled individuals) 
than "welfare," which had a strong air 
of 'charity' about it. By 1970, however, the new 
name for the Society was already outdated. An organization 
for the rehabilitation of the disabled 
had paternalistic overtones that were beginning to 
become increasingly out of sync with the new activism 
within the disabled community. 

In 1972, Norman Acton was responsible for 
another organizational name change, this time to 
Rehabilitation International. 

During Acton's tenure as head of Rehabilitation 
International the Society expanded in two 
arenas. The first was in the efforts made to 
broaden the participation in, and orientation of RI 
to reflect the concerns and concepts of disability 
cross-culturally. In the 1950s and 1960s, work on 
disability and rehabilitation was largely defined in 
medical terms. Under Acton, and continuing on 
under Susan Hammerman, emphasis was placed 
increasingly on assessing the status and needs of 
disabled populations cross-culturally and on the 
broader social policy implications of disability. 

During his time as Secretary General, 
Donald Wilson had established a number of technical 
or medically-oriented committees to foster 
working networks on specific issues. Under Acton, 
these committees were assisted to develop into 
full-fledged organizations in their own right. Thus, 
independent organizations such as the International 
Society for Prosthetics and Orthotics based 
in Denmark and the International Society for 
Cerebral Palsy based in England were spinoffs of 
groups originally organized within RI. 

In 1968, Acton conceptualized and conducted 
the first world-wide census on disability, 
producing the widely quoted United Nations sanctioned 
estimate of 450 million. Among the other 
significant activities carried on during the 1970s 
and 1980s were major RI-organized, UN-sponsored 
conferences on barrier free design, the 
economic and social consequences of investment 
in rehabilitation; and the first international conferences 
on legislation concerning disabled 
peoples, (the first in Rome in 1971, the second in 
Manila in 1978). Work done through Rehabilitation 
International allowed clarification and reconceptualization 
of disability-related issues for 
UNICEF, UNESCO, the United Nations Development 
Program (UNDP), and the United Nations 
General Assembly. Indeed, it was during the 

1970s and 1980s, the central role of Rehabilita


tion International as a clearinghouse for all types 

of disability related materials, information and 

86 HISTORY OF INTERNATIONAL REHABILITATION 


networking, became well 
defined. The organization served 
to gather and assess materials 
for a full range of United Nations 
activities as well as being a 
source of information and ideas 
for other multilateral and 
bilateral disability programs. 
(The concept of placing 
Rehabilitation International in 
the center of a disability network 
and using it as a clearinghouse 
and focal point of an 
international network was something 
that both Edgar Allen and 
Bell Greve had long envisioned 
as a particularly important 
aspect of the organization). 

Emphasis was not only 
placed on arranging for meetings 
and conferences. Increasingly, 
interest and emphasis 
within the Society was directed 
towards addressing the issues 
and concerns raised by activist 
disabled individuals and groups, 
who were beginning to organize 
and protest in both North 
America and Europe. New 
groups of disabled advocates 
were coming of age in the 1970s 
and 1980s. A significant number 
of these new advocates had 
been trained in established 
professional programs, although 
some felt alienated from their 
professional group and no 

The late Liam McGuire, leader of the Irish Wheelchair Association, and Diane Latin of the U.S.
longer participated in profes-President's Committee on Employment of Persons with Disabilities in 1976 at RI's 13th World Consional 
networks. These were 

gress in Israel. McGuire, an early disability rights advocate, warned the Congress about disabled 
people's growing dissatisfaction with the dominance of the service providers' influence on the dis


grassroots activists. Some ar


ability field and inaccessibility of disability conferences.

gued that many organizations 
working of behalf of populations 
of disabled people did not have a history of listening 
carefully nor of being responsive to the most 
pressing of their concerns. Many activist groups 
also found that some of the long-established organizations 
were dominated by professionals who 
were not accustomed to participating on an equal 
basis with persons with disabilities, but to 
making decisions on behalf of "patients" or 
"clients" or "benefit recipients". 

Rehabilitation and the New 
Disability Rights Movement 

In conjunction with this activism, a new international 
network began to crystalize. Tradition


al links with institutions, organizations and 
professionals in medicine, vocational rehabilitation 
and education were often bypassed. Disabled 
people and organizations began to establish direct 
links between disabled advocacy groups in the international 
arena. More than ever before, disabled 
individuals and leaders were talking directly to 
one another, exchanging ideas, and supporting 
new legislation. Although long established national 
and international organizations were often 
turned to when funding was required for specific 
projects, when help was needed to initiate new 
ideas, or to sponsor meetings where new network


ing could take place, disability activists insisted 
they have the final say in what occurred. It was 
an era of realignments, and it would take some 

HISTORY OF INTERNATIONAL REHABILITATION 87 


The change in focus between the old 
and new guard begun in the early 
1970s was a challenge to many on 
both sides of the fence. 


time for an organizational framework to begin to 
develop within these new networks. 

The change in focus between the old and new 
guard begun in the early 1970s was a challenge to 
many on both sides of the fence. 

The new emphasis on self-determination 
proved to be disturbing to some professionals who 
believed that they knew what was best for people 
with disabilities, and who argued that their professional 
expertise and ability to view disability issues 
with some detachment, were assets. Such 
individuals often responded to the new movement 
with reserve, feeling their professional careers and 
credibility were being questioned. Other professionals 
listened carefully and were open enough 
to begin to rethink many of their most basic assumptions. 
(Interestingly, several of those interviewed 
for this monograph now recall that the 
systemic shifts that occurred in the 1960s and 
1970s, left them deeply troubled by their inability 
to see obvious problems or inequalities in the earlier 
era). And a number of non-disabled professionals 
initially welcomed the disability rights 
movement, only to grow increasingly uncomfortable 
with the movement as stresses mounted and 
the power base began actually shift under them 
and their colleagues. 

The growing rifts between many who advocated 
self-determination, and those non-disabled 
professionals who were in charge of organizations 
dedicated to serving various disabled populations, 
was most apparent in the United States, Scandinavia 
and Western Europe. Throughout the 
1960s and 1970s, stresses between the two 
camps were building. 

The growing dissention within the ranks 
brought with it increasingly heated debate. The 
Rehabilitation International World Congress in 
Winnipeg in 1980 proved to be a convenient 
forum to air a number of grievances. 

The Winnipeg Congress: 1980 

In a sense, Rehabilitation International's 
14th World Congress in Winnipeg was a very successful 
meeting. It was, for many in the disability 
rights community, the first major meeting that allowed 
a great deal of international networking to 
take place; it gave rise to a new disability-run in


ternational advocacy organization and it certainly 
helped the various factions represented to define 
positions. 

Interestingly, it was the first International 
Congress in which Rehabilitation International 
had purposely arranged for a large number of the 
leading international figures in the disability 
rights movement to speak or attend. A number of 
travel grants and fellowships had been arranged, 
with the hope that new international networks 
among disabled activists and between disabled activists 
and professionals in the field would take 
place. Over 250 disability advocates from around 
the world attended the Winnipeg meeting. By the 
time Rehabilitation International officials arrived 
in Winnipeg, however they were fairly certain that 
there was a confrontation brewing. 

It was, by all accounts a stormy meeting. Dissention 
could be traced at least as far back as the 
mid-1970s, primarily with the Swedes, the Dutch, 
the Danes and some British, who began to insist 
upon a larger representation of disabled people in 
Rehabilitation International governance. 
Rehabilitation International leadership under Norman 
Acton agreed to do this, but felt the change 
in leadership should be made gradually. The 
Swedish delegation proposed an amendment to 
the Constitution of Rehabilitation International 
that would have immediately required a majority 
of the voting delegates be people with disabilities. 
After heated discussion both behind the scenes 
and on the floor, the amendment was voted down 
by a large majority. 

A decision was reached by some of 

the most adamant of disabled 

delegates that a separate, disability-

run forum was needed. 

There remained however, a real air of dissatisfaction 
among many at the Congress: some 
able-bodied participants felt their years of work 
on behalf of disability issues were not appreciated, 
and many participants with disabilities 
felt they were being shut out of an organization 
which was being run for, but not yet, with or by 
them. Senior Rehabilitation International staff, 
under the guidance of Norman Acton were able to 
hold the conference together, but clearly, some issues 
needed to be addressed. 

A decision was reached by some of the most 
adamant of disabled delegates that a separate, disability-
run forum was needed and that an organization 
should be established in order to 

88 HISTORY OF INTERNATIONAL REHABILITATION 


provide an international network of disabled 
people's organizations. Among the most influential 
and outspoken were Liam McGuire from 
Ireland, who wrote many of the declarations for 
the group, Ed Roberts, already well known for the 
Berkeley Center of Independent Living and Lex 
Friedan, a leading figure in the independent living 
movement from Texas, Eunice Fiorito, of the 
American Coalition of Citizens with Disabilities 
and Gini Laurie, editor of Rehabilitation Gazette. 
Also heavily involved were Henry Enns and Jim 
Dirkson, both from the newly established 
Canadian Coalition of Provincial Organizations of 
the Handicapped (COPOH); Ron Chandron Dudley 
from Singapore, and Bengt Lindquist from 
Sweden, who later became that country's Minister 
for Family Affairs. 

The splinter group framed a constitution and 
established a new international organization that 
would prove to be a workable entity, originally 
called the World Coalition of Disabled People and 
later Disabled Peoples' International. Despite ongoing 
contact between RI and the new group, it 
would be some time for many before the rifts that 
came to the surface in Winnipeg would diminish. 

Disabled Peoples' International 

With strong backing from groups in Sweden 
and Canada, Disabled Peoples' International was 
formed as a separate organization to act as the 
voice of people with disabilities and their organizations 
throughout the world. Eighteen months 
later, the First World Congress of Disabled 
People's International drew some 400 participants 
:o Singapore. Disabled Peoples' International has 

)ecome, over the past decade, an extremely effec


ive organization in its own right and now repre


;ents disabled people's groups at the United 

iations. With its primary base in Canada, it now 

peaks for thousands internationally and receives 

upport from several European governments, from 

'le Canadian International Development Agency 

nd from private contributions from around the 

orld. 

United States support for the U.S. affiliate of 

isabled Peoples' International, in this past 

cade, similar to support for all international dis


)ility issues, has been at a level far lower than 

at assumed by other industrialized nations. In 

ch case, internationally experienced Americans 

e supportive and active, but organizational, 

vernmental and foundation support is difficult 

locate. 

In 1991 Disability International USA was 
med officially with the involvement of apwimately 
15 of the leading disability rights ad


vocates and participated actively in the 1992 
World Congress of DPI in Vancouver. 

It has increasingly become a cross


roads of international research and 

discussion, and in a short time, a 

major presence in the world of inter


national disability and rehabilitation. 

World Institute on Disability 

Another significant organization run by 
people with disabilities was the World Institute on 
Disability, established by Ed Roberts, Judy 
Heumann and Joan Leon in 1983. The original 
seed money for the Institute was the MacArthur 
grant that Roberts had received, with future funding 
coming from private, state and federal granting 
agencies. From the outset, the Institute was 
intended to be an internationally-focused policy 
institute and think tank run by and for people 
with disabilities, which would address major issues 
such as independent living, attendant care 
and the demographics of disability. A central concern 
was not only to address research and policy 
issues that were of importance to the disabled 
population, but also to pursue these issues from 
the point of view of those who have disabilities. 

The Institute has grown and expanded over 
the years, and emphasis has been placed on an increasingly 
broad range of educational, vocational, 
social and legislative issues of direct relevance to 
individuals with disabilities. 

From the outset the Institute maintained an 
international focus, although much of its work is 
on issues of concern within the United States. It 
has increasingly become a crossroads of international 
research and discussion, and in a short 
time, a major presence in the world of international 
disability and rehabilitation. 

Additional Work by United States 
Based NGOs 

It is difficult to do more than list many of the 
additional international disability-related work 
done by United States based nongovernmental organizations. 
The recently issued GAO Report on 
"Assistance to Disabled Persons in Developing 
Countries," provides a solid comprehensive overview 
of current activities in the field. (GAO:1991). 
There were a number of projects, many bilateral 
in nature that might be noted. For example, the 
California-based Hesperian Foundation has run 

HISTORY OF INTERNATIONAL REI-IABILITATION 89 


Project PROJIMO, a rehabilitation project in rural 
Mexico, for many years, and the work has been 
disseminated further through a number of outstanding 
publications, including the recent book, 
Disabled Village Children. Research initiatives also 
continue to significant. For example, the Carroll 

Center for the Blind undertook an international 
review of aid and techniques for the blind in the 
early 1980s, with funding for the project being 
provided by NIDRR. 

Among the independent multilateral organization 
of note, Goodwill and Partners of the 
Americas have been, and continue to be, active. 
Goodwill Industries of America, Inc., has been active 
internationally for decades, supporting 
programs that encourage and develop vocational 
training and counseling. 

For example, with the coming of the 
1970s, the long tradition of activism 
within the deaf community that had 
been suppressed for decades began 
to revive, and a strong sense of community 
prevailed. 


Another example of an active multilateral 
American-based organization is the People-to-
People Program's Committee for the Handicapped. 
In 1956, President Eisenhower established the 
People-to-People Committees to promote private 
voluntary exchanges. Its Committee on the Handicapped, 
although not a government agency, has 
obtained funding from NIDRR to support much of 
its disability related voluntary activity. It has been 
particularly active in sponsoring numerous 
projects in special education, vocational rehabilitation 
resource center development and teacher, 
therapist and technician training. 

The private NGO, Partners of the Americas, 
has also actively supported direct service development 
projects to the very poor in Central and 
South America and the Caribbean basin. Established 
in 1966 and based in Washington, DC, it 
has long identified rehabilitation as a primary concern. 


Helen Keller International is an example of a 
disability-specific, U.S.-based organization that 
has been very active over the past several 
decades. Located in New York, it sponsors blindness 
prevention programs and service and technical 
aid programs to blind individuals around the 
globe. The recent international program begun at 
Perkins School by Larry Campbell (formerly of 
Helen Keller International), with funding through 

the Hilton Foundation, is an example of the innovative 
new disability research and training exchanges 
taking place. 

Some professional groups, such as the International 
Rehabilitation Medicine Association, 
promote the regular exchange of physicians and 
surgeons, as do a number of U.S.-based overseas 
health and child welfare groups, whose programs 
and projects serve some disabled individual (although 
many such programs do not specifically 
taret such individuals.) 

There have been other initiatives, often based 
on individuals with specific interests arid expertise. 
An example is The Healing Community, run 
by Harold Wilke, a minister in the United Church 
of Christ. Wilke had worked as a university 
chaplin and church minister before becoming a 
senior church administrator. Although Wilke, who 
was born without arms, had never considered 
himself limited by his own impairments, by the 
early 1970s the growing disability rights movement 
had begun to make him rethink many of his 
most basic assumptions about himself and the 
church. Wilke became increasingly concerned 
with the fact that individuals with disabilities 
were, too often, disenfranchised members of 
religious congregations. In 1975, Wilke left his administrative 
job to begin The Healing Community, 
an organization dedicated, in large part, to the 
task of convincing religious communities to accept 
and include people with disabilities in substantive 
ways. Over the past decade and a half, 
Wilke has lectured and advocated worldwide in an 
attempt to bring disability issues to their attention. 


Disability and Heritage 

While cross-disability cooperation is a 
hallmark of the era, it must also be noted that 
many groups of individuals with specific disabilities, 
also are using this period for further self-
awareness and development of a growing 
appreciation of their specific heritage. Numerous 
groups organized around distinct disabilities or 
combinations of disabilities and race, religion, 
sexual orientation and so forth, have come to the 
fore; the groups holding in common the attempt 
to foster a better informed constituency, with a 
pride and awareness of their particular circumstances. 


For example, with the coming of the 1970s, 
the long tradition of activism within the deaf community 
that had been suppressed for decades 
began to revive, and a strong sense of community 
prevailed. It was in those years as well that, for 
the first time, the concerns and needs of deaf 

90 I IISTORY OF INTERNATIONAL REHABILITATION 


JACK 11..CANNON 


Photographic essay on historic Gallaudet events. 

people and their preferred policies began to be included 
regularly in general discussions, programs 
and plans for all disabled persons. 

Times were changing. In an earlier time for 
example, deaf leaders, Mervin Garretson, President 
of the National Association of the Deaf, recalled 
attending rehabilitation conferences only to 
find that the understanding and appreciation of 
deafness and deaf culture were often slight. Once 
when Garretson attended a National Rehabilitation 
Association conference as the keynote speaker, 
he found communication with others after his 
speech was over difficult, and socializing impossible 
because at that time interpreters were only 
provided for formal presentations, and not for 
socialization or professional networking afterward. 

A proliferation of programs and courses in 
Sign Langauge and deaf history began to bring 
the world of deaf people to the attention of the 
hearing public, aable-bodied and disabled alike. 

In 1989, Gallaudet University in Washington 
exploded in a student-run strike after a hearing 
president had been selected over other well-
qualified deaf candidates. The deaf students 
closed down the campus, then marched on the 
Capital building, well aware that Congress was 

responsible for most of Gallaudet's funding. The 
American media paid close attention to the story, 
and the progress of the strike was followed by millions 
around the world. By the time it was over, 
Gallaudet not only had a new deaf President, I. 
King Jordan, but the world had had a crash 
course in Deaf Rights and disability advocacy. 

The strike at Gallaudet was followed that 
same summer by a major event, also at Gallaudet. 
A festival of deaf life was planned. Called Deaf 
Way, and organized by Mervin Garretson, the festival, 
despite its small budget, proved to be a 
major success. Over 6000 deaf individuals from 
around the globe attended the meeting, and 
events, lectures, seminars and entertainment 
provided a cross-pollination of ideas and interests 
for the global deaf community. Just as significantly, 
the number of private discussions and personal 
contacts begun during the festival have 
already born fruit, with individual and group exchanges 
and networks in full swing. 

Shifts in Policy and Focus 

Not only has work within the disability 
rights/rehabilitation community in the 1970s and 
1980s been more strongly cross-disciplinary and 
cross-disability than ever before, but input and 
ideas are now more truly international. Increasingly, 
those involved in disability work turn to the international 
marketplace of ideas and technology 
to design and anticipate directions for programs 
within the United States. U.S. leadership, particularly 
from within the disability community, is 
also represented on the international scene. 

Comparison between various national 
programs is on-going, with successful 
innovations and legislation being 
copied and modified from one country 
to the next. 

In the 19th and early 20th century, 
European ideas and techniques were imported 
with the assumption that programs and institutions 
already proven successful in Europe could 
be duplicated within the United States. The internationalism 
that has developed in the past two 
decades is of a substantially different order. Now, 
American scholars, administrators and advocates 
often work in conjunction with colleagues around 
the world to help develop innovative ideas, 
programs arid legislation. They then go on to implement 
these ideas at home, very often in a way 
that allows national programs to articulate with 

HISTORY OF INTERNATIONAL REHABILITATION 91 


and become a component of larger international 
schemes. Comparison between various national 
programs is on-going, with successful innovations 

and legislation being copied and modified from 
one country to the next. 

While new ideas and innovations within the 
field are a product of building on new and old 
ideas within the community itself, it is also important 
to note that the progress of the disability 
movement and the continual broadening of issues 
that have been undertaken are, in part, a reflection 
of a broader social and demographic consideration. 
The bulk of the disabled population, 
and particularly the disabled leadership today, 
was born during or influenced by the post-War 
baby boom generation. 

As these individuals have grown to adulthood, 
the issues with which they must deal, and 
which they have raised have logically matured. In 
the 1950s and 1960s, rehabilitation and special 
education were at the heart of much of the ongoing 
activity for disabled populations, with particular 
emphasis placed on early intervention, 
special education and child health and advocacy 
services. The generation's march into adolescence 
and young adulthood brought with it a concomitant 
emphasis on employment and training 
programs, group and independent living projects, 
and discussion of sexuality, marriage and parenthood. 
Social and economic equality took on increasing 
emphasis as these disabled people 
reached an age where they could demand the 
right to equal treatment and economic self-sufficiency. 
Currently, issues are expanding to include 
retirement and pension planning and 
geriatric services for disabled men and women. Already, 
the parents of mentally impaired children 
who were early involved in the special education 
movement through NARC and other grassroots organizations, 
are beginning to raise questions of 
guardianship as they reach old age, and their 
young children have become middle-aged adults. 
While the issues may change, the strong tradition 
of advocacy which has developed over the years 
continues. 

Among the most prominent of the issues 
within the disability community that have been 
fostered originally or come to some maturity with 
the United States over the past twenty years are 
the following: 

The Independent Living 
Movement 

A direct application of the disability rights 
model can be seen in movements towards independent 
living. Indeed many use the terms 'dis


ability rights' and 'independent living' interchangeably. 
The basic premise of independent living is 
that all people with disabilities have a right to a 
life as similar as possible to that of their non-disabled 
peers, including the right to grow up in a 
family or family-like groups, the right to an education, 
the right to atttain greater independence 
during adolescent and young adult years, the 
right to work, and to work in a field they have 
chosen for themselves, the right to establish their 
own family and their own personal relationships. 
(This approach advocated a reversal of the traditional 
institutional approach, where the primary 
concern was the convenience of caretaking personnel). 


The origin of the independent living 
movement in the USA can be traced 
back to the final years of the polio 
epidemics in the 1950s, when the 
"March of Dimes" began financing 
respirators, attendants and home services 
to enable persons to leave institutions 
and return home. 

The origin of the independent living movement 
in the USA can be traced back to the final 
years of the polio epidemics in the 1950s, when 
the "March of Dimes" began financing respirators, 
attendants and home services to enable persons 
to leave institutions and return home (Laurie 
1979). As the population of persons with recent 
cases of polio dropped and new vaccines made future 
polio epidemics unlikely, the prospect of 
maintaining large, expensive institutions for a 
relatively small number of patients proved prohibitively 
expensive. By returning the post-polio person 
home, significant savings could be 
experienced. An unanticipated byproduct of this 
was that disabled people and their families gained 
experience in achieving various elements of independence. 


The large numbers of children from the 
"baby boom" generation living at home despite 
their impairments from polio led to unanticipated 
results. A member of community service and 
physical rehabilitation organizations began to organize 
special programs—summer camps, youth 
groups, etc., to provide for this demographically 
significant population of children. For many physically 
impaired adolescents and young adults, 
these summer and vacation programs represented 
a unique opportunity to meet others with similar 
experiences, in a forum that was neither a school, 

92 I IISTORY OF INTERNATIONAL REHABILITATION 


nor a hospital. The initial insights gained and networks 
established among these children would 
prove to be early links in the disability networks 
that would deepen as they reach adulthood. 

Further impetus can be found rooted in 
several other significant social movements. As De-
Jong has underscored in a classic study, the Civil 
Rights movement, the consumer movement, the 
self-help movement, the demedicalization/selfcare 
movement and the deinstituionalization/normalization/
mainstreaming movement were all 
important precursors of the Independent Living 
Movement (DeJong 1983). 

Gini Laurie, herself a sister of a polio 
survivor, pioneered grassroots organizing. 


As early as 1956 the National Rehabilitation 
Association had passed a resolution in support of 
a forerunner of Independent Living. In 1957 an 
unsuccessful attempt were made to interest Congress 
in supporting some version of Independent 
Living. A similar bill failed in 1961 (5). While 
Federal support many not have been forthcoming, 
one of the first well documented examples of an 
actual Independent Living facility was initiated in 
the early 1960s at the University of Illinois, where 
four students with significant disabilities were 
moved from a nursing home to a modified house 
on campus. Success of the experiment led to an 
expanded program on that campus to facilitate 
living and college attendance by persons with 
severe physical impairments (DeJong 1983). 

Two early pioneers who deserve notes in 
these arenas were Mary Switzer and Gini Laurie. 
Mary Switzer, as noted earlier in this paper, working 
under the Vocational Rehabilitation Act of 
1954, shaped programs to provide direct services 
to those who once were considered too severely impaired 
for rehabilitative efforts. 

Gini Laurie, herself a sister of a polio survivor, 
pioneered grassroots organizing. She edited 
the influential newsletter, the Rehabilitation 
Gazette, the first widely distributed publication by 
and for severely disabled adults with polio. Working 
from her home, financing the publication herself, 
with all her time volunteered, Laurie worked 
to connect her readers with each other and with 
the wider world. She continually expanded the 
horizons of her readers, exhorting them to become 
informed users of attendant care, carrying information 
to them on the latest ideas, legislation and 
technologies. Each issue featured a number of 
profiles of readers with descriptions of where they 

went to school, what their careers and family life 
were like, what their primary concerns and individual 
opinions were. Unlike most disability related 
publications during those times, where such 
"human interest" stories were intended to be "inspirational", 
Laurie featured Gazette readers who 
were presented in a straightforward manner with 
candid discussions of the success and hardships 
they faced in living with a disability. A column 
where homebound individuals could answer requests 
for pen pals connected severely disabled individuals 
to each other, and the readership was 
truly international. One issue for example, had 
writers responding from France, Japan, the 
United States, Kenya and St. Helena in the South 
Atlantic. Contacts made through the column allowed 
increasing numbers of readers to compare 
notes, pass along ideas and strengthen interna


tional communication. 

Laurie tackled issues that were, for their 
time, truly revolutionary. These discussions were 
done in her matter-of-fact "this is your right" 
style, and were uncompromisingly activist in tone. 
Laurie for example, took great pride in having 
been among the very first to publicly raise the 
issue of disability and sexuality. She was also 
among the first to identify and discuss Post-Polio 
Syndrome. Her ability to identify this common 
problem long before the medical community did 
so, appears to have been the result of her ability 
to listen carefully to what her friends and readers 
told her and to respect them enough to accept the 
validity of the physical symptoms they were 
describing. 

By the time of Laurie's death in 1989, the 
Gazette reached 83 countries and new ideas 
about independent living was read by thousands. 
Many disabled adults began to resist institutionalization 
or life at home entirely dependent 
upon family members. Early ideas of separate 
rooms in modified nursing facilities, gave way to 
plans of cooperative living arrangements that allowed 
individuals the right to run their own 
households, while permitting them the latitude 
and flexibility to have privacy and independence. 

In 1972, The Center for Independent Living 
was incorporated in Berkeley, California, headed 
by Ed Roberts. Run as an independent center by 
disabled adults themselves, without the oversight 
or supervision of outside agencies, the Center 
soon attracted national and international interest. 
Phone calls and letters poured in from persons 
with disabilities around the globe. Organizations 
dedicated to disability issues watched with interest. 
Other Centers quickly followed in Houston, 
Columbus, and Aim Arbor. By 1985, the directory 

HISTORY OF INTERNATIONAL REHABILITATION 93 


William J, Bean, Ph Fred Fay. PhD, Director, Research. Tufts o Frio,den, New Options. (he Institut 
!LW' s Independent tg Proiecrs New Frig/anti Medical renter for Rehabilitation and I-iesecach 

Judy feu moan. Deputy Director, Center Ed Roberts, .Director, Dcpun-DivAd Williams n. Directon '-Office 

for Independent Liulug, Inc. ment of Rekihifitation of Independent Living 

Some of the Independent living leaders as "Young Turks" 


The above six candid photographs appeared in the 1979 issue of Rehabilitation Gazette, the international journal edited by the late Gini Laurie. 
Laurie was an early supporter of the international outreach of the independent living movement. Most of the six Americans are now leading figures 
in international disability programs. 

issued by the Independent Living Research Utiliza-The Independent Living movement was 

tion Project (ILRU 1985) listed 298 programs helped not only by legislation and technology, but 
through the U.S., with at least one active in every by demographic pressure. The baby boom genera-
state. tion who had absorbed the brunt of the polio 

epidemic were reaching adulthood in the 1960s 

New legislation began to address Inde-and 1970s. Medicine could now guarantee thempendent Living issues. The 1973 Rehabilitation longer and healthier lives; technology could allowAct authorized a study of the needs of severely them greater personal independence and in telinshandicapped people and other related measures. of sheer numbers, these individuals were able toIn 1978, this legislation was extended as sig-command more of a voice than ever before. In adnificant 
funding for Independent Living Centers dition, those who had survived spinal cord

was initiated. trauma and the newly-forming disabled Vietnam 

94 HISTORY OF INTERNATIONAL REHABILITATION 


In the early 1970s engineer 
Ralf Hotchkiss 
began researching his concept 
of a durable 
lightweight wheelchair that 
would function well in 
rough terrain, including 
that of developing 
countries. The Hotchkiss 

"Torbellino Chair" has 
gained support of many international 
groups and his 
work with disabled people 
in developing countries to 
enable local production of 
low cost chairs earned him 
a MacArthur "genius" grant 
in the late 1980s. 

veterans' groups greatly expanded these numbers 
and were very influential in lobbying efforts. 

Independent Living is part of a larger movement. 
"Mainstreaming," the inclusion of children 
with disabilities into regular classrooms rather 
than a 'separate (and supposedly) equal' system of 
education, is another manifestation of this, as is 
"normalization" and group homes for retarded 
adults. 

Accessibility is the concrete underpinning of 
this process. Although the terminology has 
changed over the years, discussion of "accessibility" 
has been a regular topic for decades at national 
and international levels. The United States 
has played an historic role in accessibility issues. 

The President's Committee on Employment of 
the Handicapped, stressing employment in the 
community, confronted this issue head on within 
a few months of its inception. Arranging for employment 
in a building where a wheelchair user 
could not go, or sending a deaf applicant to an office 
which relied on telephones, made little sense. 

The push for direct attention by the federal 
government to accessibility issues, particularly for 
the mobility impaired, however, seems in part to 
have be generated by an offhand remark made by 
President Eisenhower in 1953. Several of the 
senior experts interviewed for this study recalled 

that Eisenhower, officiating at one of the early annual 
meetings of the President's Committee on the 
Handicapped, took the stage to present an award 
to a young Marine lieutenant who used a wheelchair. 
The stage was inaccessible, and several 
members of the Marine Band had to be dispatched 
to the foot of the stage to help the man 
up, wheelchair and all. Eisenhower apparently 
saw the irony of the situation, for while the man 
was being brought to the stage, the President 
turned to the audience of experts and advocates 
and off-handedly remarked that, 'it was a pity 
that a man who had given so much to his 
country, couldn't wheel himself up here but has 
to be carried up here by his brothers-in-aims.' 

Government officials apparently scrambled. 
Although it would be years before legislation 
against architectural barriers was in place, within 
a short period of time the President's Committee 
and the Easter Seal Society had initiated discussions 
on accessibility, and legislation on both the 
state and national levels began to be passed. The 
United States Architectural Barriers Act of 1968 
was one of the earliest and best known legal 
models for accessibility. By the late 1970s accessibility 
legislation was being adopted around the 
world, prompted in part by the 1974 United Nations 
Experts Meeting on Barrier Free Design 
which resulted in guidelines distributed globally. 

HISTORY OF INTERNATIONAL REHABILITATION 95 


An important byproduct of the accessibility 
movement was the International Symbol of Access 
promoted by Rehabilitation International which 
was adopted in 1969 at the 11th World Congress 
in Dublin. A simple motif of a stick figure using a 
wheelchair to indicate barrier-free access, the introduction 
of the symbol made freely available 
and easy to copy, became widely used throughout 
the world. Simply put, the Symbol of Access was a 
graphic indication that the environment could be 
made hospitable to people of varying physical 
capabilities. This was a novel concept for the 
times. 

Although many disability activists felt the 
symbol should show the wheelchair user in motion 
(to symbolize independent movement), the 
Symbol of Access was of historic significance as 
perhaps the first graphic indication that disability 
issues and integration were becoming issues of 
concern to broader society. 

Legal Redefinitions and 
Provisions for Disability 

On both the national and international level, 
the past two decades have been unique in both 
the amount and the scope of progressive legislation 
submitted and passed on disability issues. 
The emphasis on legislation is, in part, a reflection 
of the shift from a charity and medical/
rehabilitation model to a civil rights 
conception of disability. Under the old model, 
protection of the rights of disabled individuals 
was not mandatory. The new civil rights model insists 
that equal protection under the law is an inalienable 
right of all disabled individuals as 
citizens, and that their ability to receive equal 
treatment in society can no longer be dependent 
on public opinion or good will. 

The United States, similar to other developed 
nations, had enacted some major pieces of legislation 
over the past 20 years, addressing equality in 
education, services and civil rights. Many of these 
ideas and concepts reflected work and legislation 
being done internationally. For example, the 
United Kingdom's Chronically Sick and Disabled 
Act of 1970, comprehensive legislation on disability, 
was called by some "the disabled's magna 
carta". It influenced (through consultations and 
conferences) the landmark United States 
Rehabilitation Act of 1973. 

Among the most significant bills enacted in 
the U.S. were: the Rehabilitation Act of 1973, 
which included truly revolutionary provisions for 
vocational, and rehabilitative services, the 1975 
Education for All Handicapped Children Act, and 
an important Developmental Disabilities Amend


ment. In 1978 the Protection and Advocacy Services 
legislation addressed the needs of mentally 
retarded children and others. Many of these laws 
addressed the need for better coordination of disability 
and rehabilitation services, requiring shifts 
of responsibility in government agencies. The high-
water mark however, is without doubt, the recently 
passed Americans with Disabilities Act, which 
mandates the most comprehensive and advanced 
legislation on disability in the world. 

National legislation both relies on and influences 
laws being proposed and enacted in 
other countries, and more than ever before, there 
is international dialogue between nations on disability 
and law. One of the earliest international 
conferences on disability-related legislation, was 
sponsored by Rehabilitation International and 
held in Rome in 1971. This Conference on Legislation 
Concerning the Disabled was followed by The 
Second Rehabilitation International Conference 
on Legislation Concerning the Disabled held in 
Manila in 1978. The "Manila Statement" advocated 
for legislation to establish national disability 
councils to coordinate the various departments 
dealing with disability. In Winnipeg, the RI 
Charter for the 80s advocated legal attention be 
directed toward social and civil rights. New laws 
reflecting the premise of equality as a right, were 
adopted in the 1970s and 1980s throughout 
Europe, and the countries of Asia, North and 
South America and Africa. 

These laws, in conjunction with United Nations 
resolutions and its World Plan of Action for 
the Decade of Disabled Persons are providing a 
new body of legislation used as reference points 
by many nations as attempts are made to establish 
civil rights and equal opportunities for disabled 
citizens. Society is gradually transforming 
the orientation of disability issues from a medical/
rehabilitation model to one emphasizing civil 
rights; legal systems have begun to reflect this 
and, in a feedback loop that augmented the social 
shift, have begun to lead the way. Actual implementation 
of new legislation does not always 
follow, but earnest attempts are being made in 
many nations. 

Shift from Western Medical 
Models: Culturally Appropriate 
Planning 

Both on a national and an international 
level, there has been a shift from relying on a largely 
medical/professional rehabilitation model 
with its unquestioning reliance on Western medical 
systems and technologies. The relinquishment 
of this medical model in part reflects the realiza


96 HISTORY OF INTERNATIONAL REHABILITATION 


tion that high-tech western medicine does not ad


dress all the social, economic and medical needs 

of millions of persons with disabilities in the 

Developing World. 

Until recently, Western professionals were 
considered, (at least by those in decision making 
capacities), the final arbiters of needs of people 
with disabilities and international aid was 
directed primarily towards the building of 
rehabilitation centers and projects, and the training 
and support of professional groups. In the 
Developing World, state-of-the-art hospitals, institutions 
and clinics frequently were the 
rehabilitation equivalent of enormous 
hydroelectric dams and highways through the 
jungles. While often effective in their own right, 
these programs were simply not reaching many 
who needed them most. Drastic, primary re-thinking 
of what was needed in the various cultures, 
designed by authentic representatives of those cultures 
was begun. 

A rethinking of some of the basic premises of 
rehabilitation medicine and special education was 
in order. Increasingly sophisticated medical and 

Two books by David Werner, Disabled Village Children and Where 

There Is No Doctor, have dramatically improved information dissemination 
about disability in developing countries. Werner, who is disabled, 
is based at the Hesperian Foundation in Palo Alto, California. 

technological services are not an option to many. 
Even the most basic of modern innovations and 
medical techniques is far too expensive to be readily 
availabe to the vast majority of people in the 
Developing World, where 80% of all people with 
disabilities now live. (Indeed, many are too expensive 
to be afforded by many in the United States). 
A new appraoch, known as Community Based 
Rehabilitation (CBR) was introduced at the 1969 
Meeting of Experts in Rehabilitation held at Killarney, 
Ireland by Rehabilitation International. Community 
Based Rehabilitation has received wide 
acceptance. Experts in Killarney asked two questions: 
What are the essential basic services?; and 
how can they most simply and economically be 
provided? The answer was to train persons with 
disabilities, family members and local health personnel 
in basic rehabilitation techniques that can 
make significant differences in an individual's 
ability to perform daily tasks. In essence, CBR is 
centered around the same policy of empowerment 
of the individual with a disability and his/her 
family found in the Disability Rights Movement, 
and is using grassroots approaches already 
proven effective in a number of international 
maternal/child health programs. It receives further 
support because much of the Third World 
cannot afford financially to build up the professional 
structures and accompanying buildings 
and organizations. The concept of low-cost Community 
Based Rehabilitation continues to be more 
fully developed by the World Health Organization 

and UNICEF. 

In 1989, a beginning was made to 

create a coordinating group for inter


national interests among the 

governmental and voluntary sectors. 

Cooperation within and between 
United States Based Groups 

Despite the fact that there has been a 
tremendous amount of activity within the United 
States over the past 20 years dealing with international 
rehabilitation and disability efforts, a working 
level of productive cooperation has yet to be 
established between many of the groups currently 
involved in the international arena. In the future, 
such cooperation may prove to be particularly advantageous. 


In 1989, a beginning was made to create a 
coordinating groups for international interests 
among the governmental and voluntary sectors. 
Called the United States Council for International 

HISTORY OF INTERNATIONAL REHABILITATION 97 


Clearly, the lesson to be learned from 

RIUSA concerning coordination efforts, 
is that all organizations and 

programs involved must reach agree


ment on priorities, goals and respon


sibilities before such a system goes 

into effect. 

• 

Rehabilitation, it does not yet have the full range 
of disability expertise represented, lacking primarily 
organizations directly representing people with 
disabilities and some of the government agencies 
involved in disability service provision. It is a 
beginning: it needs fuller support and a comprehensive 
internationally aware strategy to be 
successful. 

This is not the first attempt to gather 
together groups. A previous attempt was 
Rehabilitation International USA (RI USA), which 
functioned from 1971 to 1985. Based in New 
York, it was intended to serve as the United 
States' national liaison with Rehabilitation International. 
Organized initially by Norman Acton, RI 
USA received the strong support of Helen Wilshire 
Walsh, a very active volunteer with an on-going 
commitment to disability and rehabilitation activities, 
who chaired the group. Estelle Kessler, 
wife of Henry Kessler, also played a significant 
role in the working of RIUSA. 

RIUSA received some economic support from 
NIDRR and was intended to coordinate voluntary 
international activities, bringing together representatives 
from major national disability voluntary 
agencies and professionals in the field. It 
existed for over a decade and did sponsor a number 
of meetings and initiatives as well as some significant 
publications and a film library. 

RIUSA, however, appears to have lacked a 
strong mandate and individual groups, professional 
societies (such as the medical specialties, 
physical therapists and disability advocates), did 
not find a compelling reason to share their own 
sets of contacts and join forces with other groups 
from different professions and perspectives. 

Clearly, the lesson to be learned from RIUSA 
in coordination, is that all organizations and 
programs involved must reach an agreement on 
coordination of efforts and priorities before such a 
system goes into effect. The coordinating body 
must also offer some substantive servi, o these 
participating organizations that will ma heir 
participation worthwhile. Such a coopei,,,ive venture 
is certainly possible and much needed. 
Similar cooperative groups, such as the United 

98 HISTORY OF INTERNATIONAL REHABILITATION 

States Committee for UNICEF, for example, may 
provide good models of how such a system may effectively 
be organized. 

American Participation in 
United Nations Activities 

The maturation of thought and organization 
within the disabled community is also reflected in 
United Nations activities over the past two 
decades. Although various branches of the United 
Nations had directed some attention toward disability 
since the late 1940s, the definition of disability 
as unified area of concern has resulted in a 
growing attention to disability-related issues 
throughout the entire United Nations system. The 
receptivity of the United Nations to proclaim, first, 
an International Year of Disabled Persons (1981) 
and following that, the International Decade of the 
Disabled (1983-1992), was the logical culmination 
of a series of initiatives, directives and proclamations 
that had built up over the preceding decade. 

For example, as early as 1971, The Declaration 
of the Rights of Mentally Retarded Persons, 
patterned after the Declaration of Human Rights 
of 1948, (Resolution 2856) passed the General Assembly. 
The 1971 Declaration was followed by the 
Declaration on the Rights of Disabled Persons 
(Resolution 3447) adopted in 1975, and by a host 
of subsequent resolutions on behalf of specific disability 
groups and issues. 

Then, in the mid-1970s more intense activity 
began. The background to the International Year 
and the International Decade of Disabled Persons 
substantiates this growth. In 1952, the United 
Nations' Economic and Social Council had passed 
a resolution establishing the United Nations Disability 
Unit. This Unit had always been small but 
it served as a focal point for the international activities 
of many private voluntary organizations 
and was able to call upon United Nations funding 
to support some technical assistance programs. 

Within the United Nations system, "enabling 
resolutions" to sanction Units must be resubmitted 
for approval every 25 years. By 1976, the 
Disability Unit's resolution was soon to expire and 
at the request of the Unit's Director, Esko 
Kosunen, Noiman Acton, the Secretary General of 
Rehabilitation International, was asked to draft a 
new resolution for the re--approval of the Unit. 
This Acton did, expanding upon the ideas in the 
original enabling resolution to reflect the latest 
thinking in the disability field. Attention was no 
longer to be limited only to those with physical disabilities 
all disabled groups were included and the 
objectives of the Unit reflected the new and inclusive 
nature of the field. 


ISpecial projects for the International Year of Disabled Persons,

supported by the USA 

In 1981, James D. Wolfensohn, (left) then Treasurer of the Rockefeller Foundation, assembled 
an international group of experts on technical aids information services for a 
meeting at the Rockefeller Study Center in Bellagio, Italy. A particularly esteemed participant 
was Queen Silvia of Sweden (center) who is talking with Elizabeth Fanshaw, 
then Director of England's Disabled Living Foundation. RI and the World Rehabilitation 
Fund collaborated in the meeting, as did the U.S. government represented by Abledata, 
its computerized information bank on technical aids. The meeting established relationships 
and patterns of coordination among the European, Japanese and North American 
leaders in rehabilitation technology that have functioned well to this day. 

A special RI project for the IYDP was an international 
research study on the Economics of Disability. The 
study, commissioned by the United Nations, was carried 
out by Susan Hammerman, who worked closely 
with economist Monroe Berkowitz. Publication was 
supported by a grant from the U.S. National Institute 
for Disability and Rehabilitation Research. 

HISTORY OF INTERNATIONAL REHABILITATION 99 


In 1976, the United Nations General 
Assembly proclaimed 1981 as the International 
Year of Disabled Persons 
and called for a plan of action that 
would emphasize the abilities and 
potential contribution to society of disabled 
citizens. 

The Resolution itself was quickly passed by 
the Economic and Social Council. Soon thereafter, 
a United Nations' delegate from Libya who had experience 
in his own country with organizations 
working with blindness, suggested that the time 
might be right for an International Year of Disabled 
Persons to help focus attention on the 
whole realm of disability. 

In 1976, the United Nations General Assembly 
proclaimed 1981 as the International Year of 
Disabled Persons and called for a plan of action 
that would emphasize the abilities and potential 
contribution to society of disabled citizens. 

Early on, the United Nations recognized that 
a Year would not be enough time to accomplish 
much real change. The International Year of Disabled 
Persons was used therefore, as a period to 
identify some of the significant issues and concerns 
related to disability. The Year was then, 
with substantial support from the world disability 
community, followed by the International Decade 
of Disabled Persons, with the theme of "Full Participation 
and Equality." 

One of the most significant results of the 
IYDP was the founding of Disabled Peoples' International 
(DPI), the first international cross-disability 
organization. Founded with substantial 
material support of the United Nations, DPI has 
during the last decade joined the growing number 
of consumer-based international disability organizations, 
such as the World Blind Union, the 
World Federation of the Deaf and the International 
League for Societies for People with Mental 
Handicap. 

One of the most significant results of 

the IYDP was the founding of Dis


abled Peoples' International (DPI), the 

first international cross-disability or


ganization. 

U.S. support for these groups has been 
limited but shows steady growth. In 1991 the U.S. 
100 HISTORY OF INTERNATIONAL REHABILITATION 

branch of Disabled 
Peoples' 
International 
was founded 
and has begun 
to plan activities. 


Plan of 
Action 

The UN 
World 
Programme of 
Action Concerning 
Disabled 

Dr. Frank Bowe, noted author and researcher

Persons, was 

who is deaf, served 1979-1981 as a U.S. Rep-
adopted in resentative to the United Nations for its International 
Year of Disabled Persons Program.

1982 as a 

Dr. Bowe was the first director of the

global strategy 

American Coalition of Citizens with Dis-
to prevent dis-abilities, the first national cross-disability ad-
ability, vocacy organization. He remains active in 

international research, having recently col-

promote 

laborated with Japanese television manufacrehabilitation 
turers to assure long-range hardware 
and provide for accessibility for deaf and hard of hearing 

viewers. This research was carried out

full participa


through a fellowship awarded by the Internation 
and equal tional Exchange of Experts and Information in 
opportunity of Rehabilitation (IEEIR) Project under the direc


tion of Diane Woods.

disabled persons 
in social life. Emphasis was placed on disability 
leadership training and self-advocacy. 
Many countries utilized the International Year 
and the International Decade to initiate new 
projects and to coordinate both domestic 
programs and international initiatives in the disability 
field. Numerous meetings, conferences and 
exchanges helped strengthen international 
cooperative networks. 

Many countries utilized the International 
Year and the International 
Decade to initiate new projects and to 
coordinate both domestic programs 
and international initiatives in the disability 
field. 

The United Nations has taken a leading role 
in providing assistance to disability projects 
through the U.N. Center for Social Development 
and Humanitarian Affairs in Vienna, Austria. In 
addition, several United Nations agencies operate 
or support community-based programs, providing 
services such as rehabilitation, as a component of 
larger primary health care and vocational training 
efforts. 


n 


ri 


Ht 

Et id ow

6 

11:31 
ts.)

*la d 

n 

n 

Gallaudet College International Center on Deafness

A Group of 

Goodwill Industries International 
Helen Keller International

Organizations 

Partners of the Americas 
Rehabilitation International — 

University tenter for Internatinnal Rehabilitation 
World Rehabilitation FundGlobal Problems OfCounsel 
' habilitation international 

Working on the 

of Disabilit Natienal InOtute°f !iarodica !wed Research

Re 

A U.S. collaborative project for the International Year of Disabled Persons was a poster of many of the postage stamps issued for the Year around 
the world. Collaborating organizations were: Gallaudet College International Center on Deafness, Goodwill Industries International, Helen Keller International, 
Partners of the Americas, Rehabilitation International USA, the University Center for International Rehabilitation, the World Rehabilitation 
Fund, Rehabilitation International and the National Institute for Disability and Rehabiltiation Research. The stamps were from the private 
collection of Robert Ransom, then director of the international department of Goodwill Industries and now vocational rehabilitation specialist for the 
International Labor Organization in Geneva. 

HISTORY OF INTERNATIONAL REHABILITATION 101 


In 1979 the first meeting of the Advisory Committee for the International Year of Disabled Persons was held at UN Headquarters in New York. The 
USA was one of 23 countries represented on the Committee which drafted a program of approved activities for the Year. UN Photo by Y. Nagata. 


Among the most active are the World Health 
Organization and UNICEF. The United National 
Development Program, (UNDP) is the central funding 
agency and coordinator for technical assistance 
in the UN system. Since 1980, UNDP has 
funded some $25 million in projects related to disability 
and disability terminology. Also active 
within the United Nations system, has been the International 
Labor Organization (ILO), which has 
become involved in expanding vocational 
rehabilitation programs in many developing 
countries. Over $20 million dollars has been allocated 
by the ILO, riased through funding from the 
UNDP and donor nations, which currently support 
programs in several dozen countries. 

Independent of United Nations activities, but 
in response to the growing awareness of disability 
issues the United Nations' activity has engendered, 
a number of industrialized nations 
began to link international outreach programs in 
disability to other, on-going international aid and 
development projects. For example, each of the 
Scandinavian and the EEC countries as a bloc, 
have expanded their international disability 
programs significantly. Each has a specific 
mechanism for support and participation by the 
governmental and voluntary sectors, including organizations 
of disabled persons. 

The governments of Finland, Sweden and 
Norway have also instituted funds to support dis-
ability-related activities in conjunction with the International 
Year and the Decade. Finland, for 
example, provides some $700,000 per year to support 
the on-going administrative needs of the Dis


abled Persons Unit in Vienna. Sweden allocates 
some $10 million annually internationally to support 
programs for disabled persons and disability 
advocacy groups such as DPI. In England, the 
Overseas Development Authority coordinates international 
initiatives. 

There have been other activities as well, consolidated 
during the United Nations Decade.The 
Canadian government, through CIDA, has just allocated 
$5 million in funding for a Community-
Based Rehabilitation Center at Queens University 
in Ontario. Belgium provides support to programs 
in developing countries through a public agency, 
the National Fund. In the Netherlands, bilateral 
assistance includes disability specialists, technical 
aids and specialized treatment and rehabilitation 
of persons in Dutch facilities. Norway gives 
high priority to disability-related projects in its 
bilateral assistance programs and provides support 
for selected disability projects run by national 
NGOs, while Denmark, through its Danish 
International Development Agency, emphasizes 
projects that integrate disabled persons into the 
general social system. Japan has also initiated a 
major international aid program in disability/
rehabilitation through JICA, its international 
development agency. 

The reasons for involvement vary from 
country to country. Scandinavian countries have 
a history of social democracy, and strong liberal 
socialism as a political ideal. There is also some 
feeling that they are relatively small countries 
which share a sense of solidarity with other small, 
"nonaligned" nations. Former colonial powers, 

102 HISTORY OF INTERNATIONAL REHABILITATION 


such as Spain, France 
and the United Kingdom 
seem to maintain a feeling 
of some responsibility 
toward their former 
colonies. For example, 
Spain's leading organization 
of blind persons 
(ONCE) has as one of its 
declared purposes to 
strengthen organizations 
for the blind in Latin 
America. 

New legislation, 
proclamations and organizations 
have also 
proliferated in the 
Developing World, where 
the UN Decade has 
fostered a commitment to 
a disability agenda. As 
with any international 
movement, in both the Industrialized 
World and 
the Developing World, 
translating good intentions 
and model legisla-

Alf Morris, M.P. of England, the world's first Minister for the Disabled, confers with Norman Acton, then RI 
Secretary General, on initiatives for the International Year of Disabled Persons. Their collaboration with 
other delegates resulted in a strong focus of the IYDP on upgrading governmental commitment to legislation 
and elevating disability policy makers to more central roles in government. 

tion into action is a slower and often less impressive 
process than many would wish. Although 
countries have responded to United Nations initiatives 
to varying degrees depending on their 
priorities and available resources, much of what 
has been proposed or planned has not been implemented. 


New legislation, proclamations and organizations 
have also proliferated in 
the Developing World, where the UN 
Decade has fostered a commitment to 
a disability agenda. 

A mid-Decade review of the International 
Decade by the United Nations found only no more 
than a handful of coherent national plans had actually 
been enacted. Despite this, hundreds of 
programs, projects and legal redefinitions of disability 
rights around the world clearly illustrate 
that some strides have been made as a result of 
the United Nations' focused attention on disability 
issues. 

Unfortunately, the United States' role in the 
United Nations Year and Decade has been less active 
than most. The federal government provided 
some support for the International Year but has 

made negligible contributions to the Decade. In 
fact, while the United States promoted the idea of 
the United Nations Decade, it did so with the 
proviso that no United States funds be attached 
to the initiative, an unprecedented restriction on a 
major United Nations program, 

As an alternative, the State Department's 
Bureau of International Organization Affairs 
proposed several initiatives to be undertaken in 
conjunction with the World Program of Action and 
the Decade of Disabled Persons. The United 
States co-sponsored resolutions on disability and 
rehabilitation and supported the continuation of 
the Voluntary Trust Fund established during the 
International Year, and later extended to the 
decade. The United States' actual monetary contribution 
to this strongly supported voluntary 
trust fund, however, has been far less forthcoming 
than its vocal support. In 1983, the United 
States made a one-time voluntary contribution of 
$103,000 (from AID funds) to the United Nations 
Voluntary Fund for the Disabled. Since then, the 

A mid-Decade review of the Interna


tional Decade by the United Nations 

found only no more than a handful of 

coherent national plans had actually 

been enacted. 

HISTORY OF INTERNATIONAL REHABILITATION 103 


Unfortunately, the United States' role 
in the United Nations Year and 
Decade has been less active than 
most. 

United States has not contributed further to the 
fund, neither directly nor indirectly to the Dis


abled Persons Unit in Vienna. Almost half of this 
one-time contribution, given by the U.S. in 1983 
was spent in the United States, part going 
towards a $45,300 training grant for teachers of 
the deaf from the developing countries and part 
for computer work at Gallaudet (GAO:1991:25). 

-n01117-.7ftimn


Washington, April 6, 1977. Taking a vote outside the office of Secretary of Health, Education, and Welfare, Joseph A. Califano Jr. whether to 
remain. The group stayed for 28 hours to protest the delays in the implementation of the Civil Rights Act, known as Section 504. On May 7, 1977,
Secretary Califano signed the first implementation regulations. 
Source: No Apologies, p. 15. 


104 HISTORY OF INTERNATIONAL REHABILITATION 


Additional U.S. Leadership in International Disability Activities 

Below are shown other Americans who during the 1970s and 1980s came to prominence in interna


tional disability programs. 

Eunice Fiorito, New York City's first director of the Mayor's Office on Justin Dart, human rights advocate, is Chairman of the U.S. 
Disability, also became the Treasurer of Disabled People's Internation-President's Committee on Employment of Disabled Persons. He has 
al during the 1980s and is now helping to establish DPI's American long been a supporter of international projects and helped to found an 
branch. on-going Japan/USA exchange on disability issues. 

Dr. Fenmore Seton, a volunteer in the disability field for more than 50 Gwendolyn King is Commissioner of the U.S. Social Security Ad-
years, was an early influence on organizing U.S. efforts to suppport in-ministration. She has taken a leading role in the recent efforts to forge 

ternational disability programs and rose to become RI President in a new governmental/voluntary partnership in international disability ac


1988. He is a staunch advocate of the disability rights movement. tivities. 

HISTORY OF INTERNATIONAL REHABILITATION 105 


106 HISTORY OF INTERNATIONAL REHABILITATION 


Chapter IV: 
Recommendations for the Future 

Although this project was initially envisioned to be an historical study of international 
work undertaken by United States based individuals and organizations, merely 
reviewing past accomplishments seemed less important than learning lessons from the 
past that might help to set the agendas for future work. Each individual interviewed for 
this study has spent decades working closely with disability issues and has had a 
lifetime of experiences and insights into past, present and future problems and possibilities. 
For this reason, the interview for each participating individual in this study, 
concluded with a series of questions about what programs, policies and approaches, in 
their opinion worked well, which did not, and why they thought this was the case. Following 
this, each senior expert was asked to make recommendations for the future, 
based on their own experiences. These recommendations were further discussed during 
the Oral History Meeting in Washington in 1990, when these individuals were brought 
together to stimulate discussion of past programs and suggest avenues for future research, 
training and projects. The recommendations listed below are a synopsis of the 
ideas and suggestions raised by these experts. 

together; often they are not even aware of one

SECTION 1: Improved National 

another's existence.

Coordination of Efforts: 

The result is too often initiatives that are con-

Recommendation 1: Encourage 

fused and inconsistent, with efforts divided be-
Increased Cooperation Nationally tween often inadequately defined priorities,
Among All Groups Working on policies and programs. Such an uncoordinated ap-
Disability Issues: proach means that in a field where time, funding 

and experienced personnel are already limited, sig-

Background: 

nificant energy goes into the duplication of efforts 
It was the consensus of those interviewed for and under-utilization of experienced personnel. 
this study that presently there is no coordinated 

Recommendation:

response on the part of the United States government 
to disability research or training, and actual The senior experts taking part in this study 
programs and initiatives that touch the lives of have recommended a renewed commitment by 
disabled individuals internationally are scattered both federal and NGO groups to international dis-
among dozens of federal agencies. Moreover, most ability initiatives. Moreover, all felt that the collecof 
the experts interviewed noted that there is little tive impact of American efforts on disability 
coordination between the government and private internationally could be multiplied many times 
voluntary agencies, academic institutions, medi-over if there existed more communications becal 
facilities and disability advocacy groups which tween groups, and more collaboration between 
are involved in projects, large and small. Many are these groups and Federal programs. In a renewed 
involved in bilateral initiatives to assist projects in American effort, absolute agreement is not necesspecific 
countries. These are often excellent in sary, indeed, there will always be differences of 
themselves, but have only limited effect on nation-opinion and emphasis, however, there should be a 
al, regional and international planning. Additional-greater harmony of policy about the nature and 
ly, many non-governmental agencies are relative place of such concepts as independent 
themselves not in touch with each other. No over living, community based rehabilitation, the civil 
arching approach attempts to join these groups rights of disabled children and adults, appropriate 

HISTORY OF INTERNATIONAL REHABILITATION 107 


applications of technology, accessibility and other 

fundamental issues. 

For example, presently, it is not unusual to 
find projects that relate in some way to disability, 
sponsored by a U.S. government agency, a U.S. 
non-profit, a US academic institution and a U.S. 
religious entity, all working in the same area, with 
little or no communication/cooperation links 
among themselves in the country or at home, and 
all competing for priority. There should be no 
reason why two groups of rehabilitation workers 
from United States-based organizations, learn of 
each others existence when they begin to set up 
similar programs in the same remote region of 
Africa or Asia. (It has been suggested that a meeting 
to document our aid programs that touch 
upon issues related to disability to a single 
country, e.g. China, would make this situation 
quite clear). Those who have already worked overseas 
could save others who are planning to initiate 
new programs time and money by simply 
sharing their knowledge and experience, discussing 
their successes and failures. 

Recommendation 2: Improve 
Coordination Between 
Non-governmental Organizations: 

Background: 

It was suggested by many of the senior experts 
interviewed that coordination on a national 
scale is needed between organizations working on 
issues that relate internationally to disability. A 
central coordinating body or council that would 
serve as a clearinghouse, providing private voluntary 
groups with a central focus would foster a 
strong network which could concentrate on immediate 
international concerns and long-term policy 
development and analysis. 

Recommendation: 

It is recommended that a council should be 
organized that will serve as a hub of a network to 
bring together and promote better communication 
and cooperations between the many diverse 
groups working on related disability issues. Such 
a council, it was cautioned, would not, and indeed, 
should not, be asked to delineate a single 
national approach or policy. Rather, its strength 
would lie in the fact that: a) it would have the 
potential to serve as a clearing house for information 
from academic institutions, medical 
programs, private voluntary agencies and Federal 
government programs which target disability issues; 
and b) it could assist in the development of 
guidelines for U.S.-based international disability 
programs. 

U.S. postage stamp for the International Year of Disabled Persons 
Among the guidelines such a national coalition 
should foster, a number of those interviewed 
noted that U.S.-based international groups be encouraged 
to carry out with respect and sensitivity 
for local issues, beliefs and priorities. Where traditional 
beliefs and attitudes limit the rights of disabled 
individuals, the guide to appropriate actions 
can be found in the United Nations Declaration 
on the Rights of Disabled Persons. Wherever possible, 
programs should be undertaken in collaboration 
with governmental, academic or 
advocacy and self-help groups in the countries in 
which these programs are to be established. U.S.based 
programs must never assume that their 
ability to muster funding, technical expertise and 
resources supercedes local and national rights 
and concerns. It was also noted that such 
guidelines include a shared philosophy that all 
programs be not "for the disabled", but of persons 
with disabilities—including individuals with disabilities 
not simply as recipients of care, but also 
relying on disabled professionals and advocates in 
all phases of planning and implementation. 

The key concept here is better coordination of 
United States international efforts. In the past, 
there has been a reluctance to work towards attempting 
to coordinate efforts, because of "diversity". 
To rule coordination out because of 
"diversity" is to accept that the operational fragmentation 
which is characteristic of the United 
States voluntary system. The point is not to coordinate 
everything, but to find a level of coordination 
and cooperation that is acceptable to a 
sufficient number of institutions so that a start 
can be made. Functional coordination never 
comes unless and until the participants have the 
experience of working together. It is essential that 
a system be designed with which all participants 
are pleased enough, so that they can give it their 
support. The issue is initial design and a true 
commitment to make it work at the outset. It can 
be done. For example, the United States council of 

108 HISTORY OF INTERNATIONAL REHABILITATION 


UNICEF is a model that has worked well for U.S.based 
internationally-oriented child health 
programs. On the international level, the International 
Council on Disability, formerly the Council 
of World Organizations Interested in the Handicapped 
(CWOIH), has undertaken similar attempts 
at coordinating efforts within the United 
Nations system. Such ventures must be well 
thought out from the very beginning, but are 
workable. 

Most developed countries have a mechanism 
to involve their education, labor, social security, 
health, veterans and foreign ministries in support 
for their domestic disability council or office or disability 
minister, which also hold some responsibility 
for international outreach. (Some of these 
mechanisms were begun for the International 
Year of Disabled Persons and others evolved as 
disability issues rose to a more visible place on 
the national agenda). A similar collaborative council 
or coordinating body could be a focal point of 
on-going governmental/non-governmental information 
and collaboration. 

An organization that could serve as such a 
clearing house for information and resolve should 

To deny the
rights of any person is
to deny our own humanity 


An Affirmation of Human Rights 

With the belief that every person, 

regardless of disability, has certain 

fundamental human rights, the California

State Department of Rehabilitation and Health 

and Welfare Agency hereby make the following

corn ' rnents: 

V To independent living. 

VTo In al employment opportuniti 

VTo dev 

VTo guarad nsportation 

VTo provid ecessary supportive s v s for

independent and employment o n ty. 

V To end the ated education dren with 

disabilities an opriate

education. 

V To secure th ith 

to bear, raise 

V To guarant participate in

all aspects o al process. 

To promo dable, 

integrated a ccessible 

hou g 

International Year of Disabled Persons 

Maio C.3 Obledo rd V. 
Secretary ..ecter 
ii.anh and Vie:!:inz InannnY Di.panrnern. er Fiennb:t 

An International Year of Disabled Persons poster produced in California 
during 1981. 

be a permanent group. It should not be solely dependent 
on episodic grants, but rather be a 
grounded forum for regular review of international 
trends and dominant United States practices in 
key topical areas, with the ability to respond to 
specific requests. Currently, our ability, even to 
respond to foreign colleagues in a coordinated 
manner is fragmented. As an example, when a 
Minister on Disability from the United Kingdom 
visited in 1989, he wanted to meet his counterpart, 
discuss United States policy on rehabilitation 
technology, obtain expert opinion on the 
conductive education controversy now boiling over 
in his country, and see some independent living 
centers. He was making reasonable assumptions 
about an advanced country: there was a counterpart, 
and a policy and high level awareness of international 
issues. When the U.S.S.R. Foreign 
Affairs Minister arrived in Washington in 1989 requesting 
American assistance in rehabilitation, a 
high level interdisciplinary mechanism should 
have been ready to go in forward gear to facilitate 
contacts, provide introductions and to outline the 
possibilities, immediate and long range. 

Each year the number of foreign government 
officials, researchers, and representatives of voluntary 
organizations coming to see United States disability/
rehabilitation sites and consult with 
experts here in the United States increases. Currently, 
no individual organization or government 
agency coordinates this type of assistance. 

Not only was the need for more national coordination 
voiced, but also stressed was the fact 
that communication must be a strong component 
of such a coordinating body, and as part of that, a 
regular newsletter or published update must be issued 
to keep all members and groups equally and 
adequately informed of current issues and concerns. 
Historically, lines of communication within 
this field have been weak, with much infoimation 
passed along through informal channels, As the 
field grows and the number of groups and disciplines 
involved has increased, it has outgrown 
these earlier methods of communication and improved 
communications are now needed. 

As noted earlier in this Report, recently a national 
consortium of involved individuals and 
groups have come together to form The United 
States Council for International Rehabilitation. Its 
organizers hope that this Council will provide a 
national focus for groups working on disability internationally, 
and it has a real opportunity to establish 
a coherent national collaborative 
organization. If it proves to be successful, it may 
help to met the stated need for coordination. If it 
does not, the idea of such a council should not be 
abandoned, for the need still remains. 

HISTORY OF INTERNATIONAL REHABILITATION 109 


Recommendation 3: Improved 
Commitment from the Federal 
Government: One Agency Needed to 
Provided Central Focus 

Background: 

It was felt by the senior experts that progress 
in the United States role in disability internationally 
will not come about through good intentions 
only, nor from an non-governmental consortium 
alone. It was widely agreed by all members of the 
group that the government of the United States 
must broaden and deepen its actual support for 
commitment as well. The federal government 
must not only foster the international concerns of 
disability but must also put its own house in 
order, making national and international 
programs and policies throughout the Federal system 
reflect this renewed interest. 

Recommendation: 

It was suggested by all senior experts with experience 
working with federal programs that the 
United States government coordinate efforts on 
disability internationally, with one lead agency 
taking primary responsibility for advocacy and 
oversight, so that concerns about disability do not 
fall between the cracks. Such a lead agency and 
its administration must be high enough up the 
hierarchial pole to have clout, and its basic mandate 
to pursue and support international research 
and programming, must be broad enough to be 
applied to a variety of social, legal and medical 
situations. 

MTERNATI — A 

The international program in Vocational 
Rehabilitation under Mary Switzer provides a 
model of such a central focus. The program, even 
in its heyday, was relatively small. Because it 
could focus its attention and energies on disability 
issues throughout the federal system, it 
was impressively effective within the field of vocational 
rehabilitation. What is important is that 
such a program can act in two important 
capacities: 1) it can be a touchstone, a central 
clearing house for all those coming from outside 
the government, helping researchers, service 
providers and advocates find their way through 
the mass of bureaucracies, programs and grants 
available through United States government sources 
thus helping bring people and resources 
together and 2) it could be a watchdog within the 
government, ensuring that issues of concern to 
the disabled population are incorporated in all internationally-
focused government programs. 

Recommendation 4: Lead Federal 
Agency Addressing International 
Rehabilitation Issues Must Advocate 
for Disability Interests Throughout the 
Federally Funded International Aid 
System 

Background: 

For decades, the United States government 
has funded international aid and development 
programs throughout the world. Although a small 
proportion of this funding was given directly to 
disability-related programs, disabled citizens 

Samoa stamps for IYDP recognized 
various aspects of Franklin D. Roosevelt's 
life. 

110 HISTORY OF INTERNATIONAL REHABILITATION 


worldwide are equally affected by non-disability 
oriented programs that foster education, transportation, 
and economic development. Often these 
"non-disability" programs are designed without 
disabled individuals in mind, and many have in 
fact, had detrimental effects on the participation 
of individuals with disabilities in their societies. 

Recommendation: 

It is recommended by a number of the senior 
experts that the United States government make 
policies on disability mandated under existing 
federal law applicable through its own international 
programs. International aid and development 
projects, be they through AID, the Peace Corp, or 
any one of a number of other programs, must ensure 
that individuals with disabilities and disability 
groups are included in all phases of 
planning and will benefit by programs under consideration. 
As a nation, the U.S. must not continue 
to fund new schools that do not allow 
children with disabilities to attend, major construction 
projects that do not hire disabled 
workmen or new transportation systems that 
make no provision for travelers with disabilities 
throughout the developing world. (A model of 
such interagency attention to disability issues already 
exists on the national level in the form of 
The Architectural Barriers and Transportation 
Compliance Board, which has representation from 
all federal agencies, and which monitors compliance 
with and implementation of regulations in 
this area). 

Nor, it was felt, should these policies end 
with federal government funded international 
projects. As a major contributor to international 
organizations such as the World Bank and the International 
Monetary Fund, the U.S. has a right to 
insist that the same standards on disability be adhered 
to in programs supported through these organizations 
as well. United States based 
international philanthropic foundations which 
receive tax-free status, be they one of the major 
foundations, or one of the countless smaller ones, 
should also be made to toe the mark. United 
States based or owned companies expanding into 
international markets must also be encouraged by 
the government to meet the same accessibility 
and hiring standards for disabled citizens overseas, 
as our government now insists they do here 
at home. Our national policy on discrimination on 
the basis of race, religion and gender now are inherently 
part of all our extended activities in these 
areas overseas. There is no reason why disability 
related concerns should not be included in this 
list, particularly in light of the newly enacted 
Americans with Disabilities Act. 

There are precedents for such thorough 

reviews of policy. A generation ago, multimillion 
dollar American programs in international aid and 
development schemes rarely considered the impact 
that newly instituted programs would have 
on women in the societies in which they were to 
be enacted. Few provisions were made for hiring 
women, including them in training programs or 
ensuring that they had equal access to decision 
making. These things have changed. Making the 
inclusion of individuals with disabilities a pre-requisite 
for broader health, education and development 
programs can be undertaken in much the 
same way, if it becomes part of a national resolve 
to do so. 

While current government programming may 
be confusing, fortunately, the U.S. General Accounting 
Office has recently issued a review of the 
current state of international aid (governmental 
and non-governmental) in the disability/
rehabilitation field. The report, "Assistance 
of Disabled Persons in Developing Countries" 
(GAO:NS lAD-91:82), helps to clarify the current 
state of Federal involvement in international disability 
issues. 

This inventory and analyses of current 
programing from the General Accounting Office 
will, without doubt, assist United States-based organizations 
and government agencies to more 

IYDP poster produced by U.S. Department of Education 

HISTORY OF INTERNATIONAL REHABILITATION 111 


productively review and address disability issues. 
While the GAO investigation is a start, it is only a 
review of current activity. Concerned organizations 
and institutions must be prepared to 
develop strategies to address the needs identified 
with the report. 

Section 2: Training of Personnel 

For the past forty years, the United States 
has been a leader in research and education in 
the disability arena. Many of the senior experts in 
this study were leaders in these fields. Hence, it is 
not surprising that many recommendations 
generated in interviews and group discussions, 
touched upon issues of teaching, research and 
professional training. It was felt that if the United 
States, as a nation, is to have a renewed national 
commitment to disability internationally, it must 
ensure that those people who are graduated from 
our undergraduate and graduate schools are 
knowledgeable about the real issues and concerns 
of disability. 

In the developing world, medical, rehabilitative 
and sociocultural issues differ significantly 
from those in the industrialized world. American 
students interested in working abroad need more 
appropriate training and better and more appropriate 
training must be offered foreign students 
who come to the United States in the hope 
of returning home with professional training. 
Finally, the international exchange of ideas 
should be continued in the form of on-going 
dialogues, long after formal education has ceased. 

Recommendation 5: Training of United 
States Professionals for International 
Work Should Be Strengthened 

Background: 

Currently, channels to train young professionals 
for careers in the international disability 
field do not exist in the United States. Unlike the 
field of public health in which international health 
is now a recognized subdiscipline, or economics 
where in the past two decades international 
development has become an acknowledged 
specialty, people trained in the various medical, 
public policy and advocacy roles that deal with 
disability in the United States receive no training 
in working overseas. Often, little attention is ever 
paid to working in multicultural situations within 
the United States itself. The approaches, background 
knowledge and ability to innovate in the 
field—particularly in the developing world, where 
situations are often so markedly different from the 

United States, requires the better training of 
professionals interested in working outside of the 
United States. (It should also be noted that better 
training in a domestic policy track is also long 
overdue in many schools). 

Recommendation: 

It is recommended that academic institutions 
dedicated to disability—schools of rehabilitation, 
physical and occupational therapy, special education, 
programs in disability studies—should 
regularly offer courses on disability cross-culturally. 
Where possible, these course should be combined 
into a major in International Rehabilitation 
and Disability on both undergraduate and 
graduate school levels. This new curriculum need 
not necessitate the establishment of an entirely 
new faculty by allowing students to cross-register 
for classes in international health, and international 
development at the same university , or at a 
nearby university's school of public health, 
medicine, economics, or social science, students 
may receive a good training in rehabilitation while 
at the same time acquiring a real understanding 
of the potentials and constraints of working outside 
the United States. Often schools of rehabilitation, 
public health and international development 
exist on the same campus sometimes within sight 
of each other, but currently, there is rarely 
productive interchange between them. 

To advocate for the creation of training 
programs in international rehabilitation does not 
make up for the current lack of adequate education 
about disability for professionals who will be 
asked to make decisions that affect disabled individuals 
and populations. Another issue 
repeatedly raised by the senior experts interviewed 
was that currently, few professional training 
programs beyond those specifically designated 
as "about disability" even introduce the subject let 
alone explore it in depth. This is particularly unfortunate, 
for many individuals being trained in 
our nation's medical schools, schools of public 
health, and schools of allied health professions, 
as well as law and business schools, and schools 
of education and government, will encounter issues 
that directly relate to disability during the 
course of their careers. Furthermore, it was felt 
that emphasis should not only be placed on incorporating 
issues about disability in the basic curriculum 
of professional groups, but on fostering 
and encouraging involvement and leadership 
within these professional groups by individuals 
with disabilities themselves. 

It was recommended that a national forum of 
experts, coordinated by NGOs and educators, 
should develop guidelines and recommendations 

112 HISTORY OF INTERNATIONAL REHABILITATION 


for such educational endeavors. A national consortium 
discussed in Recommendation 2 might be an 
ideal coordinating body for such an endeavor, and 
to underscore the second part of this recommendation, 
particular attention must be focused on 
education of a wide variety of professionals in 
training about disability issues. 

Recommendation 6: Improvement in 
Training for Foreign Students 

Background: 

The experts concern with the training of students 
for international issues extended to the current 
training of foreign nationals who plan to 
return to their own countries. Currently, undergraduate 
and graduate programs in the various 
fields of special education, physical and occupational 
therapy and rehabilitation regularly accept 
and educate foreign students who intend to 
return home to teach and serve. 

Particularly in the case of those students 
coming from the developing world, it was felt that 
many of these programs are inadequate, for they 
rarely address the real issues that these students 
will face when they return home. Too often, such 
students spend a large amount of their brief and 
valuable time here in the United States memorizing 
the intricacies of American federal and state 
programs and policies, laws and learning about 
social concerns that are not of particular use in 
their home countries. This is a lost opportunity 
for many of these individuals, particularly those 
sent to the United States for graduate level training, 
are already on their way to becoming senior 
level professionals in government or health. It is 
they who will make the final decisions on the allocation 
of money and manpower for disability-related 
programs in health, education and 
development well into the 21st century. 

Recommendation: 

Academically challenging programs must be 
designed for foreign students in disability-related 
fields to introduce them to a body of knowledge of 
direct relevance to the countries and communities 
they seek to serve. Moreover, wherever possible, 
qualified foreign candidates with disabilities 
should be identified and encouraged. Again, 
public health and international development 
programs lead the way, having already established 
tracts for students who intend to work in 
regions outside the United States. These can serve 
as models. 

It is important to stress here that the senior 
experts are not suggesting that all foreign students 
be forced into these internationally-oriented 

programs. All feel that foreign students have the 
right to choose the training they think interesting 
and necessary. However, experience with many 
foreign students, particularly those from the 
developing world over the years, has convinced 
several of the senior experts that much valuable 
time and energy are being expended making these 
students master a body of infoiniation that proves 
to be virtually useless back home. Schools should 
not take a two-level approach to education, with 
lower standards or less complex tracts of study 
being designated for those who wish to serve in 
the developing world. Appropriate tracts of study 
if disabled populations in the developing world 
should, however, pay less attention to "high-tech" 
solutions, specific United States concerns with 
the roles of professionals in tertiary care facilities 
and complex social service networks. Rather, classes 
on epidemiology and nutrition, the organization 
and training of community based health 
workers and maternal/child health education 
programs may prove of more value. 

Finally, a multi-national and multi-cultural 
approach to exchanges is needed, with training in 
the United States linked to academic programs, 
facilities and disability oriented programs abroad. 

Scholarly research programs on disability issues 
need to be established jointly with other nations. 
There should be regular bi-lateral and 
multi-lateral exchange, with foreign students coming 
to the United States and United States students 
spending time overseas. Where possible, 
foreign students and the American colleagues 
should be encouraged to work jointly on projects 
so that they might learn from each other and establish 
links that will continue on into their 
professional careers. 

Recommendation 7: Advanced Level 
Training Needed 

Background: 

Another concern voiced by both educators 
and administrators interviewed for this history is 
that support for individuals involved in international 
work and research on disability should not 
be limited to the undergraduate/graduate school 
level. 

Recommendation: 

It was recommended that a system of regular 
exposure to and education about disability be 
developed and made available to a wide range of 
professionals who currently work with issues that 
relate to disability. On an academic and policy 
level, it is clear that many would benefit from a 

HISTORY OF INTERNATIONAL REHABILITATION 113 


more regular and comprehensive 
exchange of 
ideas throughout the 
field. These should include, 
but not be limited 
to: 

a) Research Funding: 
The United States 
government, as well as 
independent educational 
institutions should be encouraged 
to establish fellowships 
which would 
enable mature scholars, 
advocates and administrators 
to devote 
time and energy to issues 
that relate directly 
to disability. Such a system 
is already established 
in the United 
Kingdom and other Commonwealth 
nations, 
where Churchill Fellowships 
are available to 
study social policy issues 
abroad. One of the 
prominent social policy 
issues recognized by the 
Churchill Fellowship is 
in the area of disability 
research. 

b) Regular conferences 
for the open exchange 
of information 
and experiences are 
needed. It is urged that 
regular annual or bi-annual 
conference be established 
for disability 
issues to allow an ongoing, 
full and thoughtful 
exchange of ideas. 
Such an international 
think tank on disability 
could attract worldwide 
support and attention, 
and would prove invaluable 
to those currently 
working in the field. In an 

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BREAK DOWN THERaPar.) 

BkLAX VY4.E4

BREAK DOWN nEE74PRK-iT; 

A set of Australian IYDP posters also included FDR in its series on attitudinal barriers. 

those currently working on disability issues which

area which historically has suffered greatly from 

brings disability concerns into the non-profit

fragmentation and lack of communication, it is 

"mainstream." Public and private foundations and 

felt that such a regular exchange would prove 

many national and international funding groups

valuable to many. 

and institutions simply are not aware, nor conc)
There was also a consensus among many cerned with disability issues. Many groups, that 
that there should be advocacy on the part of annually donate millions of dollars to internation


114 HISTORY OF INTERNATIONAL REHABILITATION 


al endeavors, still believe that disability issues are 
wholly "medical" in nature, and fall outside the 
funding guidelines and missions statements of 
their particular organizations. These organizations 
need to be made familiar with the current 
state of disability initiatives and the educational, 
economic and civil rights issues that are involved. 

SECTION 3: International 
Cooperation: 
Recommendation 8: A System to 

Coordinate United States Efforts and 
International Issues Should Be 
Established: 

Background: 

It was felt by the senior experts that establishing 
a more coherent national effort and ensuring 
a better trained pool of professionals and 
advocates means little if a strong commitment is 
not also made towards true international cooperation. 
American national efforts should be in 
closer touch with bilateral, multi-lateral and 
United Nation efforts. 

Recommendation: 

Whatever alliance is formed within and between 
the federal government and private voluntary 
agencies, it is felt that some coordinating 
mechanism is needed to monitor and encourage 
United States participation and support for international 
instruments adopted to benefit disabled 
persons. For example, the UNESCO treaty to encourage 
duty-free importation of aids and articles 
to benefit disabled persons; the ILO Convention to 
raise standards of employment measures to 
benefit disabled persons; and the United Nations 
advocacy of Human Rights as applied to disabled 
persons, all deserve attention and support from 
the United States government, its various agencies 
and from United States based private voluntary 
organizations. 

A code of policies and practices that would 
be used in planning international assistance 
projects as well as in shaping the United States 
position on disability-related issues before the 
United Nations system, and other intergovernmental 
institutions should be included. A central information 
gathering/analyzing office, either 
established within the federal government (Recommendation 
3) or as a consortium outside the 
federal government (Recommendation 2), is 
needed to ascertain United States compliance and 
leadership and collaboration on these issues. An 

office within the government or outside it could be 
responsible for ensuring consistent application of 
international codes for all federal programs, which 
would need at least annual review to remain current 
in its applicability. Finally, the United States 
must take responsibility for more than responding 
to concepts from others. It should take the initiative 
to create policy and promote new ideas in the 
international sphere. 

Recommendation 9: Disability Issues 
Must be More Broadly Linked to 
Central Concerns of United States 
Foreign Policy: 

Background: 

Finally, all the senior scholars participating 
in this study recommended, in one form or 
another, that the Federal Government must 
broaden its basic mandate to serve disabled 
populations throughout the World. Prior commitments, 
it is felt, have not gone far enough. Even 
in the era of the large PL. 480 Program, funding 
for rehabilitation internationally was given on the 
condition that the rehabilitation community in the 
United States receive some new knowledge or techniques 
in return. Certainly, the administrators of 
these early programs are to be commended for 
realizing that the U.S. has much to learn from the 
rest of the world, and wherever possible such 
reciprocation of knowledge should be strongly encouraged 
and supported. However, a perhaps unanticipated 
by-product of such a knowledge 
exchange system was that those issues of concern 
to disabled populations in the developing world 
that were not of significant concern here in the 
United States, were given lower priority. The concept 
of direct rehabilitation-for-rehabilitation 
knowledge exchange works well when new 
prothesis devices from Poland or surgical techniques 
from Israel are at issue. 

The disability concerns and issues of many 
countries in the developing world, however are significantly 
different from those in the United 
States. For example, it is estimated that perhaps 
60% of all disability in the developing world today 
occurs as a result of severe malnutrition. It may 
be difficult, for example, to correlate reciprocal 
funding requests for the study of Vitamin A 
deficiency in Indonesia or Iodine Deficiency in 
Nepal, with rehabilitation priorities here in the 
United States. While American rehabilitation 
specialists often have knowledge that would be of 
benefit in such cases, they frequently have been 
hard pressed within current funding guidelines to 
obtain financing that would allow them to transfer 
this knowledge to other countries. 

HISTORY OF INTERNATIONAL REHABILITATION 115 


Recommendation: 

It is recommended that NGOs and federal offices 
work actively to promote disability issues as 
a significant concern in all United States government 
foreign policy initiatives. Realistically, 
federal government funding for foreign programs 
are often given with the expectation that benefits 
will also be derived for the United States. The correlation 
is not necessarily drawn on a one-to-one 
basis. For example, the United States government 
regularly funds child health programs, improved 
transportation systems or helps develop academic 
institutions in a foreign nation, in the belief that it 
is helping to build a better and more politically 
stable world for all. Disability can fall into this 
category. The Disability Rights Movement has effectively 
argued that individuals with disabilities 
are full members of society, not simply second-
class citizens. If this is the case, funding by the 
federal government for rehabilitation efforts in 
other countries must be seen as a contribution 
not simply to "needy" disabled individuals, but to 
all of society. The return for investing in disabled 
initiatives overseas is not simply better rehabilitation 
at home, it is a better world for all. 

Summary 

In conclusion, the senior scholars taking 
part in this historical study, and helping to 
generate these recommendations for the future, 
agree that as the United States moves into the 
21st century it is time to seek to reaffirm our ongoing 
commitment both as organizations and as a 
nation to disability issues world wide. More than 

International programs must be in


stituted in a spirit of cooperation, 

with respect and consideration for differing 
approaches, beliefs and con


cerns. 

words are required here. In a field where funding, 
expertise and technology are all in short supply, 
the duplication of efforts must be avoided. To that 
end there must first be organization and 
cooperate on a national level, with private voluntary 
agencies working in collaboration with inter-
nationally-oriented federal government programs, 
so that talents and energies are not squandered. 

With a century of rehabilitation experience, 
an extremely sophisticated medical system and an 
eloquent and active body of disability advocacy 
groups and individuals, there is certainly much to 
share. There is also much to learn. International 
programs must be instituted in a spirit of cooperation, 
with respect and consideration for differing 
approaches, beliefs and concerns. Where traditional 
beliefs prohibit the equal participation of men 
and women with disabilities in broader society, 
the United Nations Declaration of the Rights of 
Disabled Persons provides a good working definition 
for all. 

These recommendations are made with the 
best of hopes and expectations. Few countries are 
as rich as the United States in experience, expertise 
or technology. This country lacks neither in 
concern nor abilities. 

116 HISTORY OF INTERNATIONAL REHABILITATION 


Snapshots from the 1990meeting on the history of U.S. 
involvement in the international 
disability/rehabilitation field 

Meeting Co-Chairs Donald Galvin and Nora Groce 

There were moments of 
serious reflection and 

Meeting organizers: Judy Neumann, Mark Conly, Diane Woods, Barbara 
Duncan recollection. . . 


The Dybwads, Garrett and Boggs, Garrettson 

Wilson, Connor, Acton, Flax and Wilke 

HISTORY OF INTERNATIONAL REHABILITATION 117 


And some lighter moments as well, during the meeting and reception 
that followed. . . . 

Participants all told at least one joke. . 


At the reception Heumann and Dybwad take a point from Susan Parker, Associate 

Commissioner for Disability, Social Security Administration. In background is Evan 
Kemp, Chairman, Equal Opportunities Commission 

Lou Enoff of the Social Security Administration gets the 
scoop from McCahill. 

118 HISTORY OF INTERNATIONAL REHABILITATION 


Larry Campbell of the Perkins School takes notes. . . . 

LaRocca the raconteur. . . . 

Hammerman in a merry 
mood. . . . 

Warms screens old photos. . . . 

Galvin regales Woods 

and Conly checks out 
the bar.

Judge Leonard Suchanek and Eunice 
Fiorito confer. . . . 

HISTORY OF INTERNATIONAL REHABILITATION 119 


120 HISTORY OF INTERNATIONAL REHABILITATION 


Brief Biographies 

The biographies included in this section provide, at best, only the briefest of introductions 
to these "senior experts." The careers of the individuals featured here all deserve 
far more study, and without doubt, many of these people will be the subject of future 
biographies and historical reviews. 

The section is divided into two parts. The first section includes biographic information 
on four people who were not interviewed directly as part of this study: Bell Greve, 
Henry Kessler, Howard Rusk and Mary Switzer. Each of these people played key roles 
in the generation preceeding that in which most of the "senior experts" who took part in 
this study, functioned, and all played signcant role in defining the fields and fostering 
the careers of those people whose biographies appear in the second section of the 
Biographies. It would not be an exaggeration to state that the entire history and professional 
development of international, (and to a large extent, national) disability work in 
the United States would have been significantly different without their participation. 

Of the four, only Dr. Rusk was still living when this study was begun. Unfortunately, 
his health was precarious and he was unable to participate in the interview series. Instead, 
information on him was gleaned from his autobiography, A World To Care For, 
as well as from his writing and recollections of friends and families. 

Dr. Kessler had also written an autobiography, The Knife Is Not Enough, and a 
very interesting biography of Mary Switzer was recently published by Martha Walker, 
Beyond Bureaucracy. A biography of Bell Greve is currently in process. 

These publications in addition to interviews and written records have been used to 
assemble the following section. 

Interviews and written records also were used to assemble information for the following 
section, in which the current "distinguished elders" are featured. The information included 
here is a summary of the transcribed interviews done for this project and on file 
at the Rehabilitation International, World Rehabilitation Fund and World Institute on Disability 
archieves, as well as published and unpublished sources. The one exception to 
this is biographic information Virginia (Gini) Laurie. Laurie died shortly before this project 
was initiated—and in fact, as mentioned in the introduction, it was her death that 
prompted this project in the first place. Information on Laurie was assembled from written 
records and phone interviews with several of her closest associates. 

Section 1: "Ancestral figures": There are a number of figures who played prominent 
roles in international rehabilitation roles in the generation preceding that of most of the individuals 
who were interviewed as part of this history. Included below are short 
biographies of four of these people: Bell Greve, Henry Kessler, Howard Rusk and Mary 
Switzer, because it is important to have some understanding of who these people, in 
order to place more recent history in order. 

HISTORY OF INTERNATIONAL REHABILITATION 121 


with Bell Greve as Director it was one of the two

Bell Greve 

great rehabilitation centers, ranked on par with 
New York's Institute for the Crippled and Dis-

Bell Greve was born in Cleveland on January 

abled.

4, 1894, the daughter of Louis F. and Margaritha 
Greve. She graduated from Glenville High School Her international activities were as extensive 
and attended Hiram College intending to become as her regional and national work. She seems to 
a missionary. In 1916, she began as a volunteer have become active in the International Society 
at Hiram House, a neighborhood settlement house for the Welfare of Cripples at some point after her 
in Cleveland and this sparked her interest in a return from Easter Europe in 1924. Her internacareer 
in social service and rehabilitation. Soon tional perspective was probably invaluable to the 
after graduating from college Greve took a job as a early organizers of the Society, and she was soon 
relief worker for the city of Cleveland, while at the lecturing on behalf of the Society. One woman 

same time, began taking night classes 
at the Marshall Law School. She 
received her law degree from Baldwin-
Wallace College and passed the bar, although 
she never practiced law. 

In 1921, Greve left Cleveland to 
become the director of the Red Cross 
Child Health Center in Hodonin, 
Czechoslovakia, where she helped 
develop traveling public health clinics 
serving remote mountainous areas. 
She returned to Ohio in 1924 to become 
superintendent of the Division of 
Charities in the State Welfare Department, 
where she spent the next five 
years working to improve services to 
children. 

In 1929, at the beginning of the 
Depression, Greve took the job of 
Director of the Community Chest in 
Charleston, West Virginia and spend 
the next four years, in the depths of 
the Depression, trying to help deliver 
communities services to families in 
West Virginia. She returned to 
Cleveland in 1933 as executive 
secretary of the Association for the 
Crippled and Disabled, a position she 
was to hold for the next twenty years. 

During that period, the facility expanded 
and pioneered in the use of 
many new therapeutic advances in 
rehabilitative care. Under Bell's leadership 
the Center enlisted the support of 
every profession, discipline, agency 
and individual, public or private in 
fining and serving the handicapped. A 
consummate organizer, she was instrumental 
in establishing local chapters 
of the polio foundation, the heart 
society and the society for crippled 
children, all headquartered at the Center. 
By 1946, when it changed its name 
to the Cleveland Rehabilitation Center, 

of Miss Bell GREVE, Secretary 
to Comittee on International 
Development, Executive Secretary 
of the Cleveland Association 
for Crippled and Disabled, who 
went to Budapest to meet the 
local committee in the first days 
of the year 1936. With Budapest 
as her Headquarters, she visited 
about 15 countries in Northern 
Europe and the Balkan States 
returing several times to her 
Headquarters, thus insuring a 
close cooperation with the International 
Society. In the beginning 
of June she finally settled in 
Budapest to remain here through 
the entire Conference. We must 

Miss Bell Greve 

Executive Secretary. 

frankly admit that without her determination and her zeal with 
which she conducted her activity, the international preparative 
work would not have been achieved so smoothly. 

The determination of installing an exposition under Dr. 
GORTVA I's supervision, exhibiting all-kinds of handicap, in the 
Museum of Social Hygiene. had 
been of great importance. 

The delegates coming from 26 
different countries arrived mostly 
Sunday, June 28. Letters and 
telegrams from every part of the 
world 


— from the Governments of the Gold 
Coast, Australia, South African Union. 
Argentine, Brazil, Paraguay, Belgium. 
Rep. Dominicana, Rep. of Haiti, 
Government of India, Columbia, 
Zeeland, Peru. Venezuela. Poland, USSR. 
Switzerland, Philippine Commonwealth 
and Turkey, the Societies and 
Associations for the Care of Crippled 
Dr. GyOrgy Gortuuy

and Disabled in (he United States. 

Director. Museum of Social Hygiene.

from Guatemala, Oslo, Gliteborg, Stockholm, 
Berlin. Paris, Rio de Janeiro. 


Geneva, The Hague, Warsaw, Montreal, Leningrad, San .lose, stambul, 

Montevideo, Los Angeles, K(111111i(11, Mexico, Zurich, Roma, Amsterdam. 

Chiari, Bordeaux, Havana, Liverpool. Lyon, Manchester, etc. etc. -


This page of tributes from the Proceedings of RI's Third World Congress in Budapest in 
1936 provides some insight into Bell Greve's dedication to international work and the 
Budapest meetings which attracted delegates from 26 countries. 

122 HISTORY OF INTERNATIONAL REHABILITATION 


many years later that "... one time, Bell came up 
to Grand Rapids for a meeting of the Michigan 
Society. I can recall her very well. She was a 
woman with a large bosom and a high-pitched 
soprano voice, with a great deal of enthusiasm 
too, I might say... She, at the meeting in Grand 
Rapids, had said, "If we only had $500, we could 
start the work in Bulgaria." I always thought of 
that in later years and what a little bit of money 
the International was looking for to do a great 
deal. (Seton: 1988: 23) ." 

Greve was heavily involved in organizing the 
World Congresses in Budapest in 1936 and in 
London in 1939. She also traveled widely in those 
years and in 1937 was directly responsible along 
with Nelly Micrulocki, for fostering the Hellenic 
Society for Crippled Children in Greece. She became 
the Secretary General of the International 
Society for the Welfare of Cripples in 1939, and 
held that post until 1951. Throughout the War 
years, it was Greve, using her own resources, contacts, 
skill and money that effectively kept the International 
Society alive and in 1949, it was Greve 
who was instrumental in reviving the Society and 
deciding that it should be moved to New York. She 
even selected a former junior colleague, Donald 
Wilson, to take over as Secretary General. 

Her responsibilities in Cleveland and in running 
the International Society did not slow her actual 
overseas participation significantly. In 1941, 
Bell visited Greece as an advisor on rehabilitation 
of disabled war veterans. She returned in 1944 for 
10 months, on loan to the United Nations, 
(UNRRA) to establish rehabilitation programs for 
civilians with disabilities. After the close of the 
War, she spent time on the staff of the Near East 
Foundation in Alexandropol, Armenia, running an 
orphanage for 4500 orphaned children. Donald 
Wilson recalls Greve mentioning to him how she 
would ride up into the Armenian hills on horseback 
and herd stray children into the Center. She 
stayed in Armenia until the Soviet Union took 
over and ordered foreign relief workers out. 

She was also active through unofficial channels. 
Contacts in Europe, Latin America and Haiti 
kept her busy. For example, she organized a 
small, informal organization called "Friends of 
Haiti" to send donated food, clothes and 
medicine's to Sister Joan Margaret's St. Vincent 
School for Crippled Children. 

In 1953, Mayor Celebrezze appointed her 
Director of Health and Welfare for the City of 
Cleveland, a position that among other things, 
decreased (but did not eliminate) the amount of 
time she had available to devote to the Internation


al Society. 
Referred to frequently in the press as the 
"World Citizen of Cleveland," she became a close 
associate of Howard Rusk, Henry Kessler and 
many more. She seems to have boundless energy. 
Often at her work before dawn and she would 
work beyond midnight. Dr. Herman Flax recalls a 
quick visit he made anxious to see the Cleveland 
Rehabilitation Center, Bell Greve invited him to 
stop over quickly on his way home to Puerto Rico. 
The plane landed at night and Bell picked him up 
at the airport and whisked him to the Center. 
There she gave him a tour that lasted until the 
early morning hours, when she returned him to 
the airport to catch his flight. She went back to 
her office. She and Mary Switzer had a particularly 
close friendship, and Switzer flew to Cleveland 
several days before Greve's death to visit her in 
the hospital. 
Norman Acton recalled Greve as " a social 
worker of the old school, and one of the magnificent 
batch of women who first came to the 
scene in the early part of the century. Martha Elliot 
who was founder of the Children's Bureau, 
Francis Perkins, first woman Secretary of Labor 
there were about a dozen women in the 20's and 
30's who were very prominent. Bell was one of 
them." 
Greve died of cancer at the age of 59 in 1957. 

Henry H. Kessler, M.D. 

Henry Kessler was born to Rumanian Jewish 
immigrants in Newark, New Jersey in 1896. He 
won a scholarship to Cornell University, and 
gained admission to Cornell University's Medical 
School class of 1919. Kessler worked his way 
through medical school, helped by the people at 
The New Jersey State Department of Labor, who 
found him a job as a night telephone operator. Although 
he eventually replaced that job with a better 
paying night factory job, the temporary job he 
held at the State Department of Labor put him in 
contact with two individuals who would play an 
important role in his future career, Colonel Lewis 

T. Brayant, the Commissioner of the Board and 
Dr. Fred H. Albee, already a world renown orthopedic 
surgeon. 
After his internship at Newark City Hospital, 
arrangements were made for Kessler to continue 
his residency working with Dr. Albee. Working 
directly with Albee as his assistant, Kessler was 
also sent regularly to New York to study at the Institute 
for Crippled and Disabled. Albee, who had 
established United States Army Hospital No. 3 in 
Colonia, New Jersey during World War I was able 

HISTORY OF INTERNATIONAL REHABILITATION 123 


to convince the state of New Jersey 
that the rehabilitation work begun at 
the war-time hospital should be continued 
after hostilities ended. The 
state was thus the first in the nation 
to fund a rehabilitation clinic, proceeding 
the national Vocational Rehabilitation 
program by a year. Unlike the 
Federal program which was limited to 
vocational rehabilitation, the New Jersey 
program under the influential 
leadership of Albee was far more 
progressive, providing medical and 
rehabilitative care and vocational 
guidance. 

Kessler began as a staff physician 
under Albee in 1919 and became Medical 
Director of the program in 1923. 
His pioneering work in several orthopedic 
surgical techniques, particularly 
in cineplasty, the surgical 
technique which permits muscular 
control of artificial limbs, and his writings 
on surgical care of disabled 
patients brought him national and increasingly, 
international fame.A1though 
Kessler's reputation came from 
his medical expertise, it was his ability 
to see beyond the immediate medical 
issues that made him a leader in the 
rehabilitation field. He quickly became 
involved in the growing controversy 
over worker's compensation. 
Although Congress had passed the initial 
Vocational Rehabilitation Act for 
workers in 1920, it was still a heated topic. 
Kessler's advocacy was welcomed by his patients, 
although fellow physicians did not always greet 
him with equal enthusiasm. The president of the 
local county Medical Society at one point suggested 
that he should give up the "damn social 
nonsense" if he wanted to remain in the Society. 
Interest in the policy implications of rehabilitation 
lead to his returning to graduate school at Columbia 
part time, where he finished his doctorate in 
policy studies in 1934. 

Kessler had already established a growing 
reputation as an expert in orthopedic surgery and 
rehabilitation when, in 1928, he accompanied Dr. 
Fred Albee to Europe to attend a Congress in 
Budapest. It was Kessler's first trip overseas. It 
was Albee's eighteenth. Within a few years, 
Kessler also found himself traveling to Europe 
regularly to attend meetings, present lectures and 
discuss surgical and rehabilitative issues with colleagues. 
By the early 1930's he had become very 
involved with the International Society for the Wel-

Dr. Kessler, circa 1940. 

fare of Cripples, and Joined their Board of Directors. 


When World War II began, Kessler's own life 
change dramatically. A member of the Naval 
Reserves he was soon called up for active duty. According 
to his account in his autobiography The 
Knife is Not Enough, he was initially placed on 
board a ship in New York harbor giving physical 
exams to inductees. A well intentioned father of a 
former patient learned of Kessler's assignment 
and felt that a man with Kessler's skills was being 
underutilized. Intent on doing Kessler a favor, the 
parent spoke with a Congressman he knew. Soon 
Kessler found himself in the South Pacific doing 
frontline surgery. After some time, the Navy transferred 
him back to California to developed an innovative 
rehabilitation program for more than 
3,000 amputees at the US Naval Hospital at Mare 
Island, California. His work at Mare Island was innovative 
and very successful. 

Kessler returned to his private practice in 
1946, hoping to build on ideas he had developed 


124 HISTORY OF INTERNATIONAL REHABILITATION 


while in the Navy. The concept of 
rehabilitation however, had yet to 
reach the private practitioners and 
local hospital administrators. 
Kessler was troubled by the road 
blocks and red tape he quickly ran 
in to within the hospital system. He 
was further discouraged to learn 
that the state workman's compensation 
program for which he had campaigned 
for almost twenty five years, 
had been abandoned in his absence. 
Kessler decided that he wanted to 
design and run a medical program 
that reflected his own ideas. In 

1949, he opened his own clinic, The 
Kessler Institute for Rehabilitation, a 
non-profit, rehabilitation facility. It 
was, he stated, removed "from the 
red tape and other problems which 
invariably are associated with 
government control of such establishments." 
The clinic opened its 
doors in West Orange, New Jersey, 
twenty miles from New York City, 
with a small building and 5 patients 
all coal miners referred by the 
United Mine Workers Union. It 
would eventually grow into an institutions 
with dozens of staff members, 
serving thousands of patients 
and training rehabilitation professions 
from over thirty countries. 

Kessler's international activities 
resumed after the War as well. He 
regularly attended international conferences 
and meetings. As president 
of the International Society from 1948 to 1951, he 
was instrumental in supporting Bell Greve in her 
campaign to hire professional staff and move the 
Society from Ohio to New York. His international 
work soon expanded to include active participation 
in the new United Nations consultant system. 
He eventually served as a consultant in over thirty 
countries, and helped to establish rehabilitation 
centers in Yugoslavia, Indonesia, India, Greece, 
and the Philippines. He was also active as a consultant 
to the World Veteran's Federation. 

Kessler was by nature a modest man, highly 
respected by all who knew him. He would insist 
on paying his own way to all meetings a major 
help to fledgling organizations struggle to gain a 
foothold. Interested in the world around him, he 
not only wrote extensively for the surgical and 
rehabilitation fields, but also turned out books 
and articles on local New York history. Occasional-

Dr. Kessler and Norman Acton in 1969. 

ly, he combined his interests. For example, he 
had long been disturbed by two portraits of the 

early New York governor, Peter Stuyversant. One 
painting showed Stuyversant missing his right 
leg, the other his left leg. Kessler decided the subject 
worthy of a short lecture, and tracked down 

the fact that it was in fact the governor's right leg 

that had been amputated. By that time, however, 

Kessler had become so interested in the man that 

he eventually learned Dutch and gained access to 

the Dutch Royal Archives. In 1959, Kessler pub


lished a book, Peter Stuyvesant and His New York 

through Random House on the subject. 

Henry Kessler retired as Medical Director of 
the Kessler Institute in 1970, although he continued 
to maintain his office and serve as an international 
consultant for many years after that. 
Kessler's first wife, Jessie, was very supportive of 
his work in rehabilitation. After her death, he 
eventually remarried and his second wife, Estelle 

HISTORY OF INTERNATIONAL REHABILITATION 125 


Kessler, herself became an important figure in 
rehabilitation efforts in the United States, and 
was actively involved in international rehabilitation 
efforts as well. He died in 1978 at the age of 

81. Estelle Kessler continues to work in rehabilitation. 
Howard Rusk, M.D. 

Howard 
Rusk was born 
in Brookfield, 
Missouri in 
1901. He 
graduated from 
the University of 
Pennsylvania 
Medical School 
in 1926 and set 
up a solid internal 
medicine 
practice in St. 
Louis. Although 
older, married 
with four 
children and an 
established prac-

Dr. Rusk in 1957. tice, Rusk volunteered 
for duty 
immediately after Pearl Harbor, and joined the Air 
Force. He soon found himself Chief of Medical Ser


vices at Jefferson Barracks in Missouri. Working 
in the 1,000 bed Air Force hospital, Rusk was 
troubled by the number of patients who were no 

longer seriously ill, but not yet in shape to go 
back to active duty. He gradually began inventing 
projects to keep his patients busy, while productively 
utilizing their time, using the motto "out of 
bed and into action." For example, Rusk had 
models of enemy aircraft hooked to a pulley system 
on the ceiling which allowed them to be 
rotated daily. His men learned to recognize enemy 
aircraft while lying in their beds. Rusk was so 
pleased with the outcome of such projects, that in 
1942, he wrote up a page and half on his program 
to present at the Southern Medical Association 
meetings. On his way to the Meetings, he stopped 
briefly in Washington to give a copy of his paper 
to his Air Force superiors. Rusk's paper cross the 
desk of General David Grant, and Rusk was soon 
ordered to Washington to help initiate his program 
in all Air Force hospitals. Rusk later recalled 
the assignment as "the moment that changed his 
life." 

As the war years continued, Rusk was instrumental 
in making rehabilitation widely known 
throughout the Air Force medical system. He be


came increasingly knowledgeable about the field, 
and an eloquent spokesman on its behalf. He was, 
of course keenly aware that he was not the first 
person to be concerned with rehabilitation. Although 
the both physical therapy and vocational 
rehabilitation were known fields at the time, they 
were not well integrated into medical practice and 
most physicians were unaware of them. Those few 
who knew of them considered them as an afterthought, 
rather than an integral part of medical 
treatment. Rusk not only saw the medical, 
psychological and social importance of rehabilitation 
as a cornerstone for treating individuals who 
were disabled, he viewed these fields as important 
components from the outset of treatment. Unlike 
the few physicians involved with rehabilitation at 
the beginning of the war, Rusk was an internist, 
rather than a surgeon, and hence was in a unique 
position to think in holistic, rather than surgical 
terms about the population he served. 

Rusk established a solid reputation in 
Washington during the War, and at the close of 
hostilities, he remained on . He chaired the Health 
Resources Advisory Committee, reporting to the 
President on physician draft laws, and other 
health concerns. He was also instrumental in 
having rehabilitation extended to all branches of 
the armed services and establishing rehabilitation 
within the Veterans Administration. 

After this, Rusk's future was less assured. 
He was not anxious to return to his private practice 
in Missouri. Convinced that rehabilitation 
medicine was vitally important, he wanted to work 
in a program that would both deliver good quality 
rehabilitative medical care, and train others. However, 
rehabilitative medicine was not an established 
field, and there were no medical schools or 
large hospitals that were interested to setting up a 
new program in the still relatively unknown field. 
In his autobiography many years later, Rusk 
recalled that he found it exceptionally hard to interest 
colleagues in the "rehabilitation concept." 

Fortunately, Rusk was able to work out a collaboration 
with the New York University Medical 
School, aided in part by a small grant from the 
Baruch Committee. In early 1945, Rusk became 
Chair of the new Department of Physical Medicine 
and Rehabilitation. In March of 1949, Rusk was 
able to open his Institute, a 34 bed facility located 
on Thirty-Eighth Street in a former bath house. 
Even on its opening day, the facility was full, with 
almost all the beds filled with seriously disabled 
members of the United Mine Workers who had 
been sent north by the union for treatment. 

Rusk's New York facility grew quickly. Rusk 
was innovative and inspirational, and was also for


126 HISTORY OF INTERNATIONAL REHABILITATION 


tunate to have extremely competent and dedicated 
professionals on his staff, men such as the 
physician George Deaver and James Garrett, a 
leading innovator in rehabilitation counseling and 
psychology. The census at the Institute grew so 
rapidly, that Rusk and his staff were soon 
swamped by referrals. Work began on a new, 2 
million dollar permanent institute on Thirty-
fourth Street by late 1950, and new Institute 
opened in early 1951. 

In addition to his other abilities, Rusk proved 
to be a powerful writer and speaker, and would 
use any platform he could to "sell" the idea of 
rehabilitation to policy makers, members of the 
medical profession and to the general public. In 
1945, he began as a Medical Contributor to The 
New York Times, and for three decades produced 
a regular weekly column for the paper, frequently 
using it as a bully pulpit from which to sell the 
idea of rehabilitation. (Actually, much of the credit 
for Rusk's column and other papers must go to 
Eugene (Jack) Taylor, Rusk's right hand man, 
who in fact, did much of the actual writing for 
Rusk throughout his career). Rusk's campaign on 
behalf of rehabilitation soon bore fruit. In 1947, 
the field became formally recognized as a boarded 
field within established medicine. Known as the 
American Board of Physical Medicine and 
Rehabilitation, medical schools around the 
country began offering courses and residencies in 
the field. Central in much of the action, Rusk's Institute 
soon began attracting physicians from 
throughout the country who wanted to gain formal 
training in the new discipline. Quickly, its 
reputation spread, and soon, dozens of foreign students 
began to apply as well. 

By the late 1940's, Rusk had begun a new 
phase of his career, increasingly serving as an international 
expert in the field of rehabilitation 
medicine. In October, 1949, the government of 
Poland issued an invitation, through the United 
Nations for Rusk to come for a site visit. It was 
one of Rusk's earliest trips, and a very productive 
one, as he met Dr. Wiktor Degas. His translator 
on the trip was a young Polish administrator 
named Aleksander Hulek. 

Rusk's travels to Poland were soon followed 
by regular globe hopping expeditions, with Rusk 
serving as an expert to the United Nations, the US 
State Department, as well as responding to invitation 
by foreign governments and by colleagues 
and former students. Rusk's early ties with Mary 
Switzer proved particularly productive. Rusk had 
known Switzer during the War when they had 
both worked in Washington, and they held a 
mutual respect for one another that was to last 

Eugene "Jack" Taylor 

throughout their careers. Switzer relied on Rusk's 
insight and expertise in medical rehabilitation, 
and regularly called on him for foreign assignments, 
as well as for help and support with 
domestic rehabilitation issues. 

Rusk's international work also extended to 
his work with the International Society for the 
Welfare of Cripples. Rusk was an important figure 
in the International Society as it revived in 
New York during the late 1940s. By the early 
1950s, he had become heavily involved and in 
1954 began a term as President of the International 
Society that lasted until 1957. Rusk was well 
connected and an excellent fund raiser, and his 
contacts and reputation helped the renewing 
Society get back on its feet. For example, Rusk felt 
that the new Society should have more visibility 
on the New York non-profit scene, and he and 
Donald Wilson organized a regularly series of 
monthly cocktail parties to familiarize colleagues 
from other agencies and non-profits with their 
work. Rusk, whom Wilson recalls "could charm a 
bird out of a tree," managed to convince Maurice 
Pate, then Secretary General of UNICEF to come 
to one party a feat in itself, as Pate was apparently 
an extremely busy man. Always on the lookout 
for contributions, when Pate accidentally broke 
one of the Society's inexpensive wine glasses, 

HISTORY OF INTERNATIONAL REHABILITATION 127 


Rusk gently suggested a donation of 
money to the Society would help 
replace it. A $50 check for the broken 
glass soon arrived from Pate. 

In December, 1955, Rusk initiated 
the World Rehabilitation Fund as a 
component of the International Society, 
with the intention that the new fund 
would be responsible for the delivery of 
rapid and direct rehabilitative medical 
assistance and training the orthotics 
and prosthetics. Rusk gave credit to 
several people over the years for the initial 
idea, including the United States 
Ambassador to Thailand, William 
Donovan, who brought a group of 
people to Rusk's Institute to receiving 
training in the early 1950s, and to Mrs. 
Albert Lasker. The idea well might have 
been Rusk's own. Whatever its origins 
however, Rusk became intrigued by the 
idea of organizing a nonprofit 
rehabilitation agency to support training 
programs worldwide. Initial funding 
came from a $14,800 grant from Harry 
Lasky, and Rusk was soon campaigning 
for monies from leaders in society 

Dr. Rusk and Mrs. Alva Gimbel of the USA meet with Karl Montan of Sweden in Stock-

and industry. Each individual fellow-

holm in 1951. Karl Montan, Director of the Swedish Handicap Institute, was the foundership could be supported by a contribu-of the RI Commission on Technology and Accessibility (ICTA) which conducted the intertion 
of only $5,000, and the Fund soon national project resulting in the Symbol of Access. 

began to grow. 
The distinction between the Society and the 
Fund may have begun in 1955, but it was in 
1957, when Rusk's term as President of the International 
Society concluded that the two organizations 
formally split, although Rusk remained on 
the Society's board until 1959. It appears that 
Rusk simply incorporated the Fund under his 
own name, with the intention that it would function 
separately from the Society in future years. 
The split was not received well by the Society's 
Secretary General Donald Wilson, who appears to 
have learned of the incorporation somewhat after 
the fact. The exact circumstances remain cloudy, 
however, there was some tension, between at least 
certain members of the two organizations for 
some years after that. 
Rusk put most of his future energies into 
running the new World Rehabilitation Fund, and 
did a very good job at it. For the Fund's Board of 
Directors, Rusk assembled a truly distinguished 
group of internationally known figures such as 
Harry Truman, and Dr. Albert Schweitzer. The 
Funds Honorary Chairman was Herbert Hoover. 
An American based organization with programs in 
dozens of countries, the World Rehabilitation 
Fund estimates that over the years, it has trained 

professionals in 150 countries, including more 
than 6,000 specialists in prosthetics and orthotics 
techniques. Their work has eventually touched 
the lives of millions. 

Rusk continued his work at the Institute and 
at the World Rehabilitation Fund for many years 
to come. He traveled regularly and widely, including 
an important trip to newly opened China in 
the 1970s. He took great pride in his international 
contacts, and maintained a collection of dolls in 
traditional costume sent by colleagues and former 
students, which he showed with considerable 
pride. His Institute continued to grow, and over 
the years, trained more than a thousand 
physicians in various aspects of physical and 
rehabilitative medicine from 85 countries, more 
than 95% of whom returned to their own nations 
to practice and teach. Although in failing health, 
Rusk regularly came to his office at least a few 
days each week to within several months of his 
death. Rusk died in 1990. 

Mary Switzer 

Mary Switzer was born in Newton Falls, Massachusetts 
on February 16, 1900 to a family of 

128 HISTORY OF INTERNATIONAL REHABILITATION 


Mary Switzer, photograph courtesy Margaret Washington 

Irish Protestant descent. She and her sister Anastasia 
(Ann) were raised by relatives after their 
mother's death, and Mary was heavily influenced 
by an uncle who was committed to a number of 
Irish and social causes. She attended Radcliffe 
College and graduated in 1921. Her 48 year involvement 
with the federal government began shortly 
after her graduation, when she moved to 
Washington to begin a job as an assistant to the 
Secretary with the Minimum Wage Board. Intelligent, 
hard working and politically astute, she advanced 
to a position of junior economist within 
the Treasury Department. She also devoted time 
to causes outside of her job, serving for some time 
as executive secretary for the Women's International 
League for Peace and Freedom. Her first 
living situation in Washington also had later implications 
for her, for she boarded at The H Street 
Club, a respectable boarding house run by the 
American Association of University Women. The 
Club, in addition to having permanent boarders 
such as Switzer, also was used as a hotel by 
many professional women in Washington for short 
periods of time. It was through club activities and 
the club dinning room that Mary met many influential 
women of the day, including Tracy Copp, 
an administrator with the new Vocational 
Rehabilitation program established by Congress. 
Copp and Switzer would remain friends for the 

rest of their lives, and it was through Copp that 
Switzer began to learn about rehabilitation in the 
early 1920's thirty years before her career placed 
her in direct contact with the professional 
rehabilitation community. 

Switzer moved slowly up the ladder within 
the Treasury Department, and by 1934 was 
named assistant to the Assistant Secretary of the 
Treasury, among whose responsibilities was the 
supervision of the United States Public Health Service. 
In 1939, the Public Health Service Agency 
was transferred to the Federal Security AGency, 
the forerunner of the Department of Health, 
Education and Welfare, and Switzer was transferred 
with it. In the new agency, she became Assistant 
to the Administrator, and worked 
throughout the War years on medical and health 
manpower issues, including the difficult task of 
being the liaison between the government and the 
American Medical Association, two organization 
not known for their flexibility and willingness to 
cooperate. It was in the capacity that Mary Switzer 
first met Howard Rusk, with whom she would 
collaborate frequently in subsequent years. 

In late 1950, Switzer was named the Director 
of the Office of Vocational Rehabilitation within 
the Federal Security Agency. 

From the start, Switzer made sweeping changes, 
and vastly expanded and improved services. 
Soon Switzer's program began to get Congressional 
attention, for although a comparatively 
small program, it was designed to encourage self-
sufficiency. At a time when there was growing opposition 
to increased welfare and public 
assistance programs, Switzer's program was a 
shinning example of how relatively small amounts 
of money invested in people could be repaid many 
times over, with disabled adults being turned into 
'productive citizens' and 'taxpayers.' Part of 
Switzer's genius as an administrator was that she 
was insistent that good records be kept, thus enabling 
her to make a strong argument that her 
programs were effective. For example, one of her 
first decisions when she became Administrator 
was to undertake a study of the nation's rehabilitation 
needs, and she used this information 
repeatedly for future planning and fund raising. 

Switzer, in addition to being a good administrator, 
and a keen strategist, was also a very 
effective public speaker, and was particularly effective 
before Congressional committees and 
public audiences. Utterly dedicated to the benefits 
of the field of rehabilitation, smart and always 
well briefed in her subject, she was both eloquent 
and unshakable. The results were impressive. 
Howard Russell recalled that "if you sent Mary up 

HISTORY OF INTERNATIONAL REHABILITATION 129 


(before Congress), with a budget of 18 million, she 
came back with a budget of 36 million. That was 
one of the famous things, if you wanted more 
money, send Mary up to the Hill because she 
could get it." Within a period of fifteen years, support 
for the program increased almost fortyfold. 

Switzer was more than simply a good administrator, 
however. She also had a vision of 
where the field of rehabilitation should go, and 
over and above that, a vision of what she thought 
life should be like for Americans with disabilities. 
Having considerable discretion as to what she and 
her Office were able to fund, she supported 
programs that encouraged cross-disciplinary and 
cross-disability contacts; she initiated and supported 
funding programs for university training in 
many disability-related fields. She was among the 
first to clearly identify and support mental retardation 
issues as being a significant part of the disability 
agenda and not simply falling under the 
domain of education. Under her instruction, 
projects such as captioned films for the Deaf, and 
the American Theater for the Deaf received initial 
seed money; and early independent living agendas 
were fostered. She encouraged ties with many 
nonprofit agencies and organizations, often providing 
federal monies to foster their private programs 
and activities. 

Her first introduction to international 
rehabilitation was at the meeting of the International 
Society of the Rehabilitation of the Disabled 
in Sweden in 1951. She was impressed by the 
number of people who had traveled from all corners 
of the globe to participate, and felt that, as 
Rusk later phrased it, "here was the greatest opportunity 
to promote world understanding that 
would transcend race, creed, color, religion or 
political boundaries... she was a zealot with total 
dedication for the rest of her life." (Rusk: 1972) 

Switzer regularly attended international conferences 
from that time forward, and urged, (and 
funded) her staff members to do the same. She became 
active in many international arenas and 
even helped draft the constitution of the World 
Health Organization. She felt keenly that United 
States support of rehabilitation programs overseas 
were of critical importance, not only because 
they might be of benefit to disabled persons, but 
because them were excellent examples of 
democratic principals at work. America believed 
in the potential and capacity of each individual, 
she would argue, what better way to show it? It fit 
well with the tenor of the times, and throughout 
the height of the Cold War, Switzer, with strong 
backing from Rusk, would argue this before Congress. 
As discussed in the text, it was Switzer who 

Mary Switzer and Dr. Francis Bach of United Kingdom, 1957. 

130 HISTORY OF INTERNATIONAL REHABILITATION 


sheparaded the large federal support programs for 
international rehabilitation research and services 
through Congress, and it was under her direct supervision 
that the PL 480 program was initiated. 

Mary Switzer moved up higher up the federal 
ladder when the Office of Vocational Rehabilitation 
was reorganized within the Department of 
Health, Education and Welfare, and was renamed 
the Vocational Rehabilitation Service. Switzer was 
given the new title of Commissioner. In August 
1967, Switzer was appointed to the most senior 
position she would hold within the federal government, 
assuming responsibility for the new Social 
and Rehabilitation Service, an umbrella service 
composed of four different social service 
programs, income support programs for needy 
Americans, rehabilitative services for Americans 
with disabilities and specialized services for 
mothers and children, youths and the aged. All 
the programs in the agency were designed on 
rehabilitation principles. Switzer went from administering 
a budget of 300 million to one of $6 
billion overnight. 

In 1970, changes in the political hierarchy in 
Washington lead to the reassignment or "voluntary" 
early retirement of many senior administrators. 
Switzer was caught in the middle 
and although anxious to remain, she was forced 
to retire. She stepped down only to assume the office 
of Vice-President of the World Rehabilitation 
Fund's Washington office, which was opening in 
Washington. Unfortunately, within the year, Switzer 
was discovered to have an advanced form of 
cancer and died. 

Switzer is remembered today by her colleagues 
and many older members of the field, with 
an enormous amount of admiration and affection. 
As Howard Russell recalls "she stood out like a 
shining beacon, she overshadowed everybody 
else." Howard Rusk, a close friend and colleague 
till the very end, referred to her as "a magnificent 
lady" (1972:214). The entire international rehabilitation 
scene in the United States throughout 
the 1950s, 60s and 70s would have been greatly 
different had she not been a participant, and her 
influence continues to be felt today. 

HISTORY OF INTERNATIONAL REHABILITATION 131 


Norman Acton 

Norman Acton was born in Denver, Colorado, 
October 29, 1918. His mother died when Acton 
was quite young and his father, a traveling salesman 
originally working the mine country of 
Colorado, moved with his son from Denver to Kansas 
City to Des Moines and finally Chicago for 
work. Acton planned to become a newspaper man, 
and in 1935, entered the University of Illinois in 
Urbana to study journalism. He would have 
graduated in 1939, however at the beginning of 
his last semester he decided to attend Mardi Gras 
and took off for New Orleans. Once away from the 
college campus, Acton decided to take a year off 
before returning to finish his degree. He found a 
job in Chicago doing public relations and sales for 
a textile company. Then the war broke out. 

Norman Acton, circa 1965 

Acton entered the army in 1943, intending to 
be sent to the front lines. Instead he was assigned 
to what he recalls was "the softest job in the 
Army": editing a newspaper in Puerto Rico. He 
campaigned vigorously for a change of assignment 
and was finally sent to infantry officers' school at 
Fort Benning. From there he was sent to the 
South Pacific. Acton was in the Philippines by the 
end of the War, and was among the first troops to 
be sent to occupied Japan. Trained, in the course 

132 HISTORY OF INTERNATIONAL REHABILITATION 

The Next Generation: 

of various Army assignments, for military government, 
Acton was assigned to be the Chief of the 
Economics and Labor Section in Gi Fu Prefecture, 
Japan. Acton finished his stint in the Army, but 
elected to stay on in Japan for a time, working as 
a civilian employee of the military government. 

After several years, Acton returned to the 
United States to complete his education. He 
finished his undergraduate degree at the University 
of Illinois and had all but completed his 
master's degree in sociology at the same school 
when Donald Wilson, the new Secretary General 
of International Society for the Welfare of the Disabled 
invited him to come to New York. Wilson 
had recently joined the Society and had secured a 
small grant from the International Refugee Organization 
to help resettle disabled war refugees 
and their families in the United States. 

Acton and Wilson had met in the Army's 
military government training school and they had 
both been stationed in Japan, although in opposite 
ends of the country. Acton had no background 
in disability issues, but the job itself 
called for someone skilled in public relations, and 
Wilson thought Acton was just the man. In 1950, 
Acton moved to New York as Executive Director 
for the United States Committee for Resettlement 
of the Physically Disabled, with the additional 
responsibility of assisting in the day to day work 
of the International Society. Although Acton's position 
sounded formal, in fact the entire staff for the 

18 month project was a half-time secretary and 

himself. Throughout 1950 and 1951 Acton toured 

the country promoting refugee resettlement and 

was able to successfully placed some two hundred 

people. 

At the same time, Acton gradually assumed 
increasing responsibilities within the International 
Society itself. In 1951 he was given the formal 
title of Assistant Secretary General, and worked 
as a 'jack of all trades' within the small Society. 
He recalls that he was Wilson's "alter-ego," sitting 
in on events, conferences and meetings that 
Wilson's increasingly busy schedule did not permit 
him to attend. Acton's journalism background 
proved to be an advantage, as he was soon 
producing a much improved version of what was 


public relations and fund rais


ing arenas, overseeing a num


ber of very successful 

programs, including the 'Trick 

or Treat for UNICEF' Halloween 

fund raiser, remembered by a 

generation of American school 

children. In 1958, Acton moved 

to Paris to become Deputy 

Secretary General of the World 

Veterans Federation. By 1961, 

Acton had become Secretary 

General of that organization, 

and was active in developing 

and promoting policy that em


phasized economic develop


ment, human rights and 

rehabilitation topics that would 
soon become dominant issues 

in the disability field as well. 

In 1967, Donald Wilson 
called Acton in Paris to inform 
him that he would be leaving 
the International Society. Acton 

One of Norman Acton's major achievements was the creation of international campaigns that and Wilson had stayed in touchbrought disability issues to the attention of heads of state and government. Shown above are Dr. 

over the years, and Acton

the Hon. Harry S. Y. Fang, then President of RI, and Norman Acton presenting the Declaration of 

the Charter for the 80's to the Prime Minister of India Indira Gandhi. 

initially a short mimeographed newsletter, as well 
as other publications. 

Acton took primary responsibility for the 
Society's liaison with the United Nations and 
UNICEF, in the very years when the international 
body was beginning to voice an interest in disability 
issues. As a representative of the Society, 
he authored the first United Nations publication 
concerning disability in 1953. Concerned that the 
United Nations and its affiliated organizations 
would be besieged by large numbers of disability 
organizations with differing agendas, Acton was 
also instrumental in the founding of the Council 
of World Organizations Interested in the Handicapped 
in 1952, which represented the first 
forum for international cross-disability and cross-
disciplinary disability advocacy. The Council was 
a forum through which disability organizations 
could agree upon common goals, and then bring 
their shared concerns before the United Nations. 

In 1954, Acton was offered the Directorship 
of the United States Committee on UNICEF, and 
decided to leave the International Society in order 
to take it. His parting with the Society was a very 
amicable one, and he remained in close touch 
with his colleagues in the rehabilitation field 
through the coming years. While at the United 
States Committee on UNICEF, Acton worked in 

regularly attended the World 

Congresses of the International 
Society to keep abreast of the field and in touch 
with colleagues and friends. Now Wilson wanted 
to known whether Acton was interested in becoming 
the Society's next Secretary General. Acton 
told Wilson he was not interested. It was therefore 
with considerable surprise that Acton arrived at 
the opening reception of the 1967 World Congress 
of Rehabilitation International in Weisbadden, 
West Germany, to be inundated by colleagues offering 
their congratulations. He had been elected 
to the office before his arrival. Dr. Gudmund Harlem, 
the new President-Elect and an old and 
trusted colleague eventually talked Acton into 
taking over the post, which he would keep until 
his retirement in 1984. 

Acton's influence on the International Society 
was significant. Under his directorship, the 
Society was renamed Rehabilitation International. 
He, with the support of Gudmand Harlem, was insistent 
that Society policy be formulated by a 
more international representation, and distanced 
the Society from the relatively close ties it had 
maintained with the United States government 
during the 1950s. The scope of the organization 
widened to include more countries and more 
centers of activities. 

Concerned with the lack of accurate data in 
the field, Acton conceptualized and conducted the 

HISTORY OF INTERNATIONAL REHABILITATION 133 


first world-wide survey on the extent of disability 
internationally which produced the frequently referenced 
statistic that one in every ten persons 
world wide lives with some type of significant disabling 
condition. This was supplemented by a 
global survey of key issues in disability, undertaken 
in conjunction with the United Nations and 
the Council of World Organizations Interested in 
the Handicapped. This, in turn, led to path breaking 
expert meetings, conferences and publications 
on barrier free design, the social and economic 
consequences of investments in rehabilitation, on 
legislation concerning people with disabilities. and 
the international movement of equipment needed 
by people with disabilities. In addition he conceptualized 
the Rehabilitation International's Charter 
for the 80s, and, in conjunction with Susan Hammeinian, 
a study for UNICEF of the situation of 
disabled children which resulted in the adoption 
of the UNICEF Executive Board of a new strategy 
in this field. Acton guided Rehabilitation International 
through the decades when the very fields of 
rehabilitation and disability advocacy were being 
redefined by the Disability Rights and Independent 
Living movements, and he was instrumental 
in making Rehabilitation International 
far more responsive to the changing field. Acton 
also was instrumental in helping to design and 
oversee much of the activity that took place 
during the International Decade of the Disabled, 
and played a key role in drafting many of the most 
significant pieces of disability policy issues that 
were issues by the United Nations during the 
course of the decade. Although Acton formally 
retired in 1984, and now lives in Florida with his 
wife, he continues to be an active participant and 
consultant in disability affairs internationally. 

Irving Blumberg 

Irving Blumberg was born December 16, 
1906 in New York City. He received his bachelor's 
degree in social science from the City College of 
New York in 1928, and continued his studies with 
graduate courses at Columbia. Although by 
profession a printer with a business in New York 
City, Irving Blumberg has volunteered much of 
his free time for the last forty years, working on 
behalf of the mentally ill adult and child. 

Blumberg's interest in mental illness issues 
began early, prompted by his concern for his 
mother who suffered from a depressive illness. 
The social isolation and misunderstanding that 
she encountered and the toll it took, seemed to 
Blumberg far more severe than the actual mental 
illness itself, and he gradually became involved in 
advocacy issues. Long before mental illness be-

UP, AND AWAY WITH 


NCOA 


Irving Blumberg 

came a topic that was openly discussed, Irving 
Blumberg was in the fray, insisting not only that 
care and services be provided, but just as importantly, 
advocating for humane treatment and civil 
rights for the mentally ill. Moreover, Blumberg 
was in the forefront of advocates who emphasized 
that the mentally ill person must be considered 
and dealt with as a member of a family and a community, 
not simply as an isolated individual in 
need of specific services. Summing up many of 
the issues on which he has dealt for the last four 
decades, Blumberg told an international meeting 
in 1989, "we have accepted, with too little resistance, 
such dehumanizing and fatalistic terms as 
"recidivism," chronic schizophrenia," "chronic 
mental illness," "beds"—as a presumed measure 
of progress, "case management"—as if human 
being were "cases" and had to be "managed", and 
mental health "consumer"—as if the ill person 
was a shopper in a supermarket. He stressed an 

"equal partnership" of parents, relatives, advocates 
and those who are thus disabled. (Blumberg:
1989). 

Blumberg's most significant contribution lay 
in his talent for organizing groups and societies 
that served as a forum for issues of mental illness. 
He was instrumental in the founding of the 
International Committee Against Mental Illness. 
He played key roles in organizing the World 
Rehabilitation Association for the Psychosocially 
Disabled, and the World Federation for Mental 
Health, as well as a number of local and national 
groups within the United States, such as the National 
Alliance for the Mentally III. In collaboration 
with his colleague Nathan S. Kline, MD, Blumberg 

134 HISTORY OF INTERNATIONAL REHABILITATION 


organized and ran the first International Conference 
on Productive Participation Programs for 
the Mentally Ill in Helsinki Finland, in 1971 as 
well as a number of other national and international 
conferences on community care issues. He 
served for many years as the editor of The International 
Psychiatric Rehabilitation Newsletter. Blumberg 
also held an appointment as an assistant 
professor at the New York School of Psychiatry, 
teaching on public policy and community issues. 

In addition to his organizational work, he 
has served as a consultant to a wide variety of 
parent, consumer and citizen organizations, to 
legislative committees and to individual legislators 
on matters or public policy, funding programs 
and legislation in the field of mental health. On a 
national scene, Blumberg served on the 
President's Committee on Employment of the 
Handicapped, and as a delegate to meetings such 
as the White House Conference on the Handicapped 
and the President's Commission on Mental 
Health. 

In addition to his participation locally and nationally, 
for many years, Irving Blumberg was the 
individual who was called upon to represent mental 
health issues within the larger disability community. 
He, with a number of European 
colleagues, was a member of an informal group, 
who advocated for the inclusion of mental health 
issues on the World Health Organization agenda, 
and insisted that mental illness be included as a 
distinct category within the Decade of the Disabled. 
In 1989, Blumberg was instrumental in 
writing and passing The Declaration of Barcelona 
on the Rehabilitation and Human Rights of the 
Mentally IU at the World Rehabilitation Association 
for the Psychosocially Disabled, which clearly 
delineates a new direction in the treatment of 
those who have a mental illness, stressing the 
right to equal treatment, social support and civil 
rights within the larger community. Although 
retired from work, Blumberg continues to be an 
active advocate of mental health issues. He lives 
with his wife in Manhattan and continues to 
travel internationally on behalf of mental health 
groups. 

Elizabeth Monroe Boggs 

Elizabeth Monroe Boggs was born in 
Cleveland in 1915, and moved with her family to 
Rye, New York as a young child. She received her 
bachelor's degree from Freemont College in 1935, 
winning a scholarship that enabled her to study 
in Europe. She went to Cambridge University in 
1935 intending to stay briefly, but remained until 
1939, completing her doctorate in theoretical 

Dr. Boggs 

chemistry and mathematics just as war was 
breaking out in Europe. Despite anxious pleas 
from her parents to return home, Boggs, who was 
engaged in war related research would have 
stayed, save for the fact that England, flooded 
with refugees and fearing spies, barred foreigners 
from all work on war related projects. Boggs 
returned to the United States in December of 

1939 and reported to the research project at Cornell 
where she had been scheduled to begin the 
previous September. Her laboratory space had 
been given to a graduate student in her absence, 
and she soon found herself sharing lab space with 
Fitzhugh Boggs, her future husband. 

They were married in 1941, and the following 
year, moved to Cleveland to continue work on war 
related research. So top secret was some of their 
work, that Elizabeth found at times she could not 
mention the arrival of European colleagues to 
Fritz, for fear that he might guess what type of research 
was going on. (Elizabeth's division were 
helping to design the implosion device for the 
Atomic bomb). 

David, the Boggs' only child, was born in 
1945, several weeks after the close of the War. 
Healthy at birth, her baby ran an extremely high 
fever in the neonatal period and by ten days of 
age had suffered profound brain damage. Ironically, 
if he had been born only a few weeks earlier, it 
is probable that he would not have survived. The 
close of the war, however, allowed newly 

HISTORY OF INTERNATIONAL REHABILITATION 135 


developed antibiotics, previously reserved for 
military use, to be distributed to the civilian 
population. The Boggs' son was among the first to 
receive the new drugs, although not in time to 
prevent his permanent disability. 

The extent of David's injuries however, were 
not clear for some time, and they initially assumed 
that he would not have problems. A short 
time after the birth of their son, the Boggs moved 
to New Jersey where Fritz was scheduled to begin 
a job. Elizabeth planned to take a short break 
from work as she cared for their new baby and 
coped with the immediate post-War housing 
shortage. Months turned into years however, as it 
became increasingly apparent that David was not 
developing normally. Moreover, the answers the 
Boggs sought from physicians and educators 
seemed more and more unsatisfactory. In the late 
1940's virtually no programs existed for the care 
or education of retarded children, particularly 
those who had more severe forms of mental retardation, 
and parents, often fearing that they would 
be cut off from those few programs and professionals 
available, were reluctant to openly advocate 
on their children's behalf. 

Boggs, a well trained scientist, was keenly 
aware that the answers she was getting, were unsatisfactory 
and unfounded. She became increasingly 
active and aware. To better fit herself for the 
task, she returned to school while her son was 
still a toddler, to take classes in special education 
and social work administration. She began to help 
organize classes for her son and others in her own 
home and in locally available church basements 
and boy scout halls. She and her group were 
trying to provide education to over fifty retarded 
children, their ultimate goal being to get them 
registered at public schools. 

Her involvement locally lead quickly to her involvement 
nationally, and a growing interest and 
full time volunteer involvement in issues of legislation 
and public policy. She was one of the 
founders of the National Association of Retarded 
Children in 1950, and in 1958 became its first 
woman president. She served on its Governmental 
Affairs Committee from 1965 to 1979. 

She was a member of President Kennedy's 
Panel on Mental Retardation in 1961-62, of the 
National Child Health and Human Development 
Council (NIH) from 1967 to 1971, and of the 
President's Committee on Mental Retardation 
from 1975 to 1976. 

Boggs was a leading national and international 
figure within the world of mental retardation advocacy 
and research and a key liaison with others 
in the disability rights and independent living 

136 HISTORY OF INTERNATIONAL REHABILITATION 

movements. She regularly attended meetings, 
spoke at public forums and before Congress. 
Boggs was also instrumental in moving legislation 
forward for mentally retarded children and adults 
both in the United States and within the United 
Nation systems. Her early interest in education 
grew to include issues of independent living and 
group homes, the status and rights of adult mentally 
retarded men and women and to issues of 
guardianship for older mentally retarded individuals 
whose immediate family is no longer 
alive. 

In 1988, Boggs became the Acting Director of 
the Office of Prevention of Mental Retardation and 
Developmental Disabilities for the state of New 
Jersey. Her job was to coordinate public education 
campaigns and to promote expanded services 
and research. She took the temporary job only because 
she had fought for the position to be 
created and feared that it would be abolished 
before a suitable candidate could be found. Although 
the job lasted only briefly, it was notable 
for the fact that it was the first paid position 
Boggs had ever held in the disability field. 

Widowed in 1971, Boggs continues to live in 
New Jersey and remains active in both national 
and international arenas. Her son David resides a 
facility nearby. 

James Burress, Ph.D. 

James Burress was born in Virginia in 1913. 
At the age of two, he contracted polio, and was left 
with some degree of impairment in his left ail 

Dr. Burress in 1990 


and leg. His mother, a trained nurse, and his 
father, who was by profession, a bricklayer, made 
sure their son got what medical care was available 
at the time, and insisted that he lead a "normal" 
and active life. Burress recalls that as a child, he 
never paid attention to his impairments, and was 
very athletic as a youth, participating in football, 
basketball and track. 

His family moved to Ohio when James and 
his brother were still quite young, and that is 
where he grew up. He attended college in 
Greensborough, North Carolina; A and T State 
University, receiving his bachelor's degree in 
1937. After graduation, Burress worked for a 
year in the restaurant business to help pay his 
younger brother's way through college, and then 
returned to school himself, at the New York 
School of Social Work at Columbia University, 
where he received a master's degree. Although 
most of his studies were in social work, he did 
take an evening course in vocational guidance, 
which would stand him in good stead in the future. 


After graduation, Burress moved to 
Washington to begin work as a counselor in a 
private family agency. Although he worked at the 
agency for two years, he found it increasingly 
frustrating to try to help families by only talking 
to them about their troubles. At the same time, 
his work with the family agency regularly put him 
in contact with local vocational rehabilitation 
agencies, and he found himself particularly impressed 
by the concrete assistance these counselors 
could offer. He next joined the staff of the 
District of Columbia Rehabilitation Agency as a 
vocational rehabilitation counselor. Although the 
move reflected his own personal interests and expertise, 
the move also made him the first Afro-
American rehabilitation counselor in the United 
States, and he would take an active role in encouraging 
many other minority candidates to join 
the field in years to come. 

Burress had what he recalls as a "long and 
good" career with the District of Columbia 
Rehabilitation Agency. In the spring of 1951, however, 
Burress crossed paths with Mary Switzer, 
the newly appointed head of the Office of Vocational 
Rehabilitation, and his career shifted from a 
local to a national one. Switzer had taken over 
the Office of Vocational Rehabilitation several 
months earlier, and came to Burress' agency one 
day to find out exactly what vocational rehabilitation 
counselors did. As Burress recalls, Switzer already 
had a fair idea of what the field was like, 
but was particularly interested in speaking directly 
to a counselor who could give her an insider's 

view of the profession's strengths and weaknesses. 
Burress was the supervisor at the Agency 
when Switzer arrived, and he spent the afternoon 
sharing his ideas and insights with her. By 
November of the following year, Switzer had persuaded 
Burress to join her own staff . Burress 
would remain with Switzer's Office for twenty-five 
years, first working as a key staff member for Switzer, 
and then in 1959, becoming the Regional 
Commissioner for the Department of Vocational 
Rehabilitation for Denver. In addition to his work 
within government, Burress also became a 
prominent member of the field of vocation 
rehabilitation, severing a term as President of the 
National Rehabilitation Association in the early 

1960s. 

Burress' earliest international experience 
was as a participant at the First Pan-Pacific 
Regional Conference of what is today Rehabilitation 
International in Australia in 1961. Switzer encouraged 
a number of her senior staff people to 
attend, and Burress, along with Jim Garrett and 
others, flew to Australia for the event. The meeting 
was a very productive one for Buress, who had 
the opportunity to met a number of international 
colleagues. Burress was particularly interested in 
learning more about the state of rehabilitation 
and vocational counseling in the Developing 
World, and organized an informal discussion session 
while at the Australian conference. It was attended 
by a dozen colleagues from African and 
Asian nations. Struck by the lack of information 
and facilities available to many of his colleagues 
in the newly emerging nations, Burress volunteered 
to serve as the coordinator of an informal 
exchange network. Soon Burress was regularly circulating 
information and sending literature and 
reprints to dozens of colleagues through Africa 
and others in the Third World. 

Burress' ongoing interest in African nations 
and other Developing countries made him a valuable 
resource within the Switzer administration. 
Although assigned to Denver, Burress' expertise 
was regularly sought by those in Washington, and 
he was frequently sent overseas as a representation 
of the Office of Vocational Rehabilitation 
and through the United States government. His 
travels included several inspection tours of United 
States funded programs in India, as well as 
several multinational tours of rehabilitation 
programs in Africa. In addition to his own travels, 
Burress regularly hosted colleagues from abroad. 

In 1976, after 25 years with the Federal 
government, Burress retired. Almost immediately, 
William McCahill persuaded him to come to 
Washington to serve as the Executive Director for 

HISTORY OF INTERNATIONAL REHABILITATION 137 


the People-to-People Committee for the Handicapped, 
a job he held until his retirement. Among 
his other accomplishments while with People-to-
People, in 1980 Burress published a very informative 
guide, Developments in Services for 
Handicapped People in Africa: A Project Report. 

Burress now lives in the Washington, DC 
area and he remains active in the field of vocational 
rehabilitation, and as an expert on international 
rehabilitation issues. 

Francis Connor, Ed.D. 

Francis Connor was born in Brooklyn, New 
York in 1919, the oldest of four girls. Her father 
died when she was seven and her mother 
returned to work, taking a job in the New York 
State Reconstruction Home. The Home was a 
hospital where children with orthopedic disabilities 
would live, often for years, while they underwent 
medical procedures. As high school 
students, Fran and her sisters enjoyed accompanying 
their mother on weekends and holidays 
to help by entertaining the children. 

Connor earned her B.A. at St. Joseph's College 
in Brooklyn, New York in 
1940. Although interested in social 
sciences, Connor minored in 
education, with the expectation 
that she would eventually go 
into teaching. She worked briefly 
as a substitute teacher in the 
public school systems, and then 
in 1942, was able to find a job 
teaching disabled children at the 
hospital in which her mother 
had worked, by then renamed 
the New York State Rehabilitation 
Hospital. 

Connor decided to make 
teaching disabled children her 
career, but felt that there was 
much more she needed to learn 
and she began to take additional 
classes on the subject. One of 
the night classes she took at 
Hunter College was taught by 
Romaine Mackie, who had 
recently completed her doctorate 
at Columbia. One evening, 
when a hurricane discouraged 
the other students from attending, 
Connor had the opportunity 
to talk at length to Mackie. As 
Connor recalls, "I asked her if 
there was anything to this busi


ness of special education and working with handicapped 
children." Mackie, who would become a 
close colleague and friend, encouraged Francis to 
specialize in the field. Enrolling in the new and 
still small graduate program at Columbia, Connor 
continued to teach full-time while going to school. 
In 1948 Connor finished her master's degree, and 
in 1953 she received her doctorate. 

Her work at the New York State Rehabilitation 
Hospital continued, however, her interests 
began to expand beyond the bounds of the hospital 
world. She took an extra job on her lunch 
hours, working as a tutor for several children with 
cerebral palsy who lived at home. United Cerebral 
Palsy was just becoming organized, and the education 
of such children was a new idea. A group of 
parents asked Connor to leave the hospital and 
help them initiate a public school program for 
children with cerebral palsy. Connor took the job. 
Her first task was to simply set up an accessible 
physical plant for the new program. A school in 
Suffrin, New York was willing to donate the use of 
three science laboratories. She soon found herself 
with a group of volunteers, tearing down walls 
and building classrooms. (An unanticipated 

Susan Hammerman and Prof. Connor, 1990. 

138 HISTORY OF INTERNATIONAL REHABILITATION 


byproduct of the building campaign was that 
Francis met Leo Connor, one of the volunteers 
and a new local private school principal. They 
were married several years later). 

Although New York City had already established 
two or three classes for children with 
cerebral palsy, Connor's classes were among the 
very first of the public school programs in the 
country intended for seriously disabled and multiply 
handicapped children. While the program was 
not mainstreaming as it is known today, it was, at 
a time when few educators even acknowledged a 
responsibility for retarded children, very innovative. 
Connor herself, still a graduate student, 
recalls that at the time, she "did not realize how 
revolutionary" her program was. Rather she 
remembers being struck most by the fact that the 
potential of many of the children with whom she 
worked had been overlooked, and "how unjust it 
all was." 

The school brought her national attention. 
Nearing the completion of her doctorate, Connor 
eventually left her teaching position to being work 
on regional and national policy and research. She 
helped develop a training program in special 
education at the University of Georgia, and in collaboration 
with her fellow graduate student Ignacy 
Goldberg, became involved in a survey of 
services for mentally retarded students in New 
York. In addition, in 1954, Romaine Mackie, now 
at the Department of Education, began a major research 
project on the qualification of special 
education teacher, and hired Fran Connor as her 
assistant. At the same time, Connor began to 
teach part-time at Columbia, commuting weekly 
between New York and Washington. Her part time 
position at Columbia shifted to a full time professorship 
in 1958, and in 1962 she became Chair of 
the Department of Special Education, a position 
she would keep until her retirement. 

Involved in much of the on-going research in 
special education, Connor was in regular touch 
with most of the key national, and many of the 
prominent international supporters of special 
education. She became interested in issues of 
mental retardation in early childhood, and frequently 
working with her colleague Ignacy 
Goldberg, undertook research projects that established 
the benefits for special education among 
the very young, and developed special education 
curriculums for preschoolers who were retarded. 
As Connor recalls, she entered a field when more 
severely disabled children did not exist in terms of 
the law and established education, and found, 
within a decade, they had become a major center 
of attention. 

Francis Connor became involved in international 
work gradually. She had, from the outset of 
her career, held highly visible positions in innovative 
programs. Her work with Mackie enabled her 
to met a number of colleagues Mackie's office was 
part of a "grand tour." Individuals from all over 
the world would stop at Washington to visit Mary 
Switzer, and then go across town to meet with 
Mackie at the Department of Education. The 
foreign visitors would regularly invite Connor to 
come visit their own programs, and she began to 
correspond with many of them. Her position and 
research at Columbia brought her in contact with 
many more. 

Francis Connor regularly attended international 
meetings, and served as a consultant internationally. 
In 1962, for example, she and her 
husband undertook a long planed around the 
world trip that included visits to a number of different 
rehabilitation centers on behalf of the International 
Society for the Welfare of the Disabled. 
She often served as a consultant on special education 
for Howard Rusk. Leonard Mayo got her involved 
with consulting in South America. A 
constant concern of Connor's was the need for incorporating 
education into disabled child care 
programs. Children needed more than new medical 
innovations, she argued, they needed to be 
educated as well, and wherever possible, 
mainstreamed. 

Now retired, Connor divides her time between 
her home in New Jersey and Florida. She 
remains active in the field, and continues to guide 
students and colleagues. 

Gunnar and Rosemary Dybwad 

The Dybwads have had a career that spans 
fifty years of active participation in the fields of 
child welfare and mental retardation. Although 
often working together, both have made significant 
independent contributions to the field 
was well. 

The Dybwads met in Leipzig, Germany in 
1931. Rosemary had come to Germany as an exchange 
student following her graduation from 
Ohio's Western College for Women, (now part of 
Miami University), the previous year. A girl working 
in the foreign student exchange office invited a 
group of the new foreign students to her family's 
home for afternoon tea. The girl's brother, Gunnar, 
a student of law and political science at the 
University of Halle, happened to be home at the 
time, and Rosemary recalls he seemed very interesting, 
in part because he drove a motorcycle. 
Their relationship developed quickly, and 

HISTORY OF INTERNATIONAL REHABILITATION 139 


Rosemary was soon applying for a 

second year's studies in order to 

remain in Germany. 

Rosemary returned home in 
1933 and began work as a case 
worker with a local school department. 
Gunnar came to the United 
States in 1934 and he and 
Rosemary were married. 
Rosemary soon returned to Germany 
for a year to complete her 
doctorate at the University of Hamburg. 
The decision to return to Germany 
was a difficult one. The 
political situation had already 
begun to deteriorate, and Gunnar's 
family had money which was not 
allowed to be taken out of the 
country. They decided to invest the 
money in an education for his new 
bride and consequently used their 
savings to pay for her tuition. So difficult 
had the political situation become 
that Gunnary and Rosemary 
selected the University of Hamburg 
simply because it was closest to the 
border, should she have to flee the 
country in a hurry. 

Meanwhile, Gunnar began 
work in the United States. He had 
finished his degree in 1934 at the 
University of Halle, specializing in 
penial systems, having done research 
on prisons in Italy, Germany 
and England. In the United States 
he began similar work and in the 
late 1930s worked in institutions for 
juvenile delinquents in Indiana, New 
Jersey, and New York. While working 
in the New York area, Gunnar 
took additional course work at the 
New York School of Social Work, 
completing the program in 1939. The large number 
of juvenile delinquents who, upon closer examination, 
were mentally retarded, sparked 
Gunnar's interest in the field of mental retardation. 
When Rosemary returned to the United 
States, she also found work in women's prison 
systems, and continued to work until she her 
children were born. 

In 1943, Gunnar moved his family to 
Michigan, where he began work as the Director of 
Clinical Services at a Boys Training School while 
Rosemary began their family. Gunnar eventually 
became the Supervisor of the Child Welfare Program 
of the Michigan State Department of Social 
Welfare, regularly hosting visitors from other 

parts of the country and foreign nations who were 
interested in seeing their innovative programs in 
child welfare and child day care. 

In 1949, Gunnar returned to Germany briefly 
as a consultant with the United States Army, 
spending several months helping with social and 
child welfare issues in Occupied Geimany. From 
there, Gunnar moved his family back east to the 
New York area while he served as the Executive 
Director of the Child Study Association of America. 

Gunnar's shift to becoming the Executive 
Director of the National Association of Retarded 
Children (NARC) was rather serendipitous. The 
Board of NARC was meeting at the Gotham Hotel 

140 HISTORY OF INTERNATIONAL REHABILITATION 


in New York and had just finished interviewing 38 
candidates for the position of Executive Director. 
All candidates had been unsatisfactory, and the 
secretary taking notes raised Gunnar's name only 
because a fellow secretary already worked for him 
and thought highly of him. Elizabeth Boggs, a 
member of the Board already knew Gunnar, realized 
he was the perfect candidate and quickly approached 
him to apply for the position. Although 
new to the field of mental retardation, Dybwad 
had had extensive experience with families in 
stress, parent groups, voluntary organizations 
and governmental programs. Perhaps most importantly, 
his background as a lawyer allowed him to 
frame issues in legal terms, a new and affective approach 
to policy and advocacy on behalf of mental 
retardation. 

Gunnar assumed the Directorship in 1957. 
Some six months later, Gunnar asked Rosemary 
to come in to the office occasionally as a volunteer, 
for a large amount of foreign correspondence 
had accumulated, and there was no one with the 
time available to read and reply to inquiries and 
letters. Rosemary, whose children were getting old 
enough to take care of themselves at home, began 
to come in on a regular basis and to return correspondence. 
She was officially listed as the 
Secretary, International Activities Committee. 
Eventually she established a newsletter to keep 
many in touch. (By 1964, this Newsletter would 
reach readers in 70 countries). She and Gunnar 
were part of an ever growing network of parents 
and advocates brought together and kept in touch 
by the Dybwads. 

At the same time, the European Association 
of Retarded Children had begun to solidify and 
the International League was beginning to come 
together. Rosemary's correspondence and publications 
could not have been more timely, and in 
fact, often served as a bridge, tying together 
people, programs and associations worldwide. 
NARC early recognized the need for international 
organization, and tried to maintain informal ties. 
In 1959, the first step to an informal international 
organization of voluntary agencies was taken 
when three professional leaders of the movement 
from Holland, England and Germany met to plan 
a European League of Societies for the Mentally 
Handicapped , which was formed in 1960. The 
first Congress of the European League in 1961 
was attended by more than 400 people from 12 
European countries and 8 non-European nations. 
Gunnar Dybwad would eventually serve as President 
of this International League. 

In 1963, Gunnar retired from the National Association. 
Although he enjoyed his work, he felt 

strongly that seven years was enough, and that a 
regular shift in Directorship was important for 
any organization if it was to stay vital and responsive 
to its members. He and Rosemary were hardly 
interested in retiring from the field, however. 
They soon found themselves in Geneva, Gunnar 
the Director and Rosemary the co-Director of the 
Mental Retardation Project through the Union of 
Child Welfare. The Union of Child Welfare funded 
the Dybwads for a three year project, their assignment 
being to travel from one country to another 
fostering parent involvement and advocacy in 
mental retardation issues. Between 1964 to 1967, 
Gunnar and Rosemary traveled to 34 different 
countries—some several times—to encourage 
grassroots organizing among parents with mentally 
retarded children. 

In 1967, their time with the Union of Child 
Welfare almost finished, the Dybwads were invited 
to come to Brandeis University, where Gunnar became 
a Professor of Human Development in the 
Florence Heller Graduate School. Gunnar continued 
his extensive activities, serving as a consultant 
to a large number of organizations such 
as the US Public Health Service, U.S. Office of 
Education, the Social and Rehabilitation Service 
Administration, the President's Committee on 
Mental REtardation and numerous state and 
governmental agencies. In addition, he has been 
instrumental in advocating legal and political solutions 
to discriminatory and bias against the mentally 
retarded. 

The Dybwads maintain an extremely busy 
schedule. Gunnar not only continues to work and 
teach at Brandeis, but he also commutes on a 
weekly basis in order to teach students at 
Syracuse University. Rosemary continues to write, 
and in 1989 published a revised version of her International 
Directory, a fundamental resource and 
who's who for those working in mental retardation 
internationally. Together they continue to be at 
the very center of the international exchange network 
for mental retardation and broader disability 
issues. They have managed to develop an international 
network based on personal acquaintance 
and mutual concerns. The Dybwads live in 
Wellsley, Massachusetts. 

Herman J. (Jake) Flax, M.D. 

Jake Flax was born in Richmond, Virginia, 
March 31, 1917. His father was a wholesale 
grocer, and Flax initially planned to be a high 
school science teacher. He graduated from the 
University of Richmond with a major in physical 
chemistry in 1936, and at the suggestion of his 

HISTORY OF INTERNATIONAL REHABILITATION 141 


college chemistry professor decided to enter medical 
school and specialize in surgery. He received 
his MD degree from the University of Virginia in 

1940. He completed his internship in Richmond, 
regularly commuting between Virginia and New 
York where his classmate and future wife, 
Josephine Guarch, was completing her internship. 
The separation was difficult for them both. 
Surgical interns were paid very little and Flax was 
so impoverished that he could only afford to travel 

to New York to see his fiance when he was able to 

sell blood, and the local bloodbank insisted on a 
waiting period between donations. At the end of 
their internship year, Flax married Josephine and 
they returned to her home in Puerto Rico to complete 
their residencies. Flax began a general surgical 
residency at a municipal hospital with the 

expectation that he would soon be called into the 
armed services, however the local need for a surgeon 
was so great that he was never called to ac


tive service. 

At the end of four years, Flax went to work 
for the State Insurance fund, an organization very 
similar to a workman's compensation fund. His 
job was to travel to clinics throughout the island 
examining workmen. The job provided Flax with 
his first introduction to physical medicine, which 
in the late 1940s was only beginning to become 
recognized as a medical specialty. Flax and the administrators 
for whom he worked were very enthusiastic 
about the new field and in 1945, they 
invited Dr. Harold Storms of the Canadian 
Rehabilitation Center, to Puerto Rico to help them 
organize a regional rehabilitation facility. The 
rehabilitation facility was at first small and its 
resources limited. Its dispensary was located on 
the roof of a warehouse, and the staff assisting 
Flax was composed of several women trained in 
physical or occupational therapy. 

Dr. Harold Storm invited Flax to Canada for 
further training, and Flax spent several months in 
1947 at the Workman's Rehabilitation Center in 
Toronto. He then spent several months in Chicago 
working with cerebral palsy patients. The experience 
helped solidify his interest in rehabilitation; 
Flax recalls that he began to think of himself 
as an expert in the new rehabilitation medicine. 

Although Flax learned a great deal while 
working with Dr. Storm, the program in Toronto 
had no organized residency. Only Howard Rusk in 
New York had initiated this and so Flax spent 
several months with Rusk in the spring of 1947. 
He then went on to further his training at the 
University of Pennsylvania, where he spent a year 
working on a M.A. in Physical Sciences before 
returning to Puerto Rico. Needing an additional 

142 1 IISTORY OF INTERNATIONAL REHABILITATION 

Herman "Jake" Flax 

six months of training to pass the newly instituted 
American Board Physical Medicine Board 
exams, he returned again to the Rusk institute in 

1951 to become one of its early Fellows. 

During these years, Flax continued his work 
in Puerto Rico. By 1949, he had organized a program 
in physical medicine and rehabilitative services 
for the State Insurance Fund, and in 1950 
Flax and his colleagues felt the program at the 
State Insurance Fund was so advanced they 
decided to hold their first Institute on Physical 
Medicine and Rehabilitation. The Institute drew a 
number of leading figures in the field, including 
Howard Rusk, Henry Kessler, Bell Greve, Dr. 
Storms, and representatives from the Department 
of Health, the Depai Lucent of Education, the 
Department of Labor and the Veteran's Administration; 
contacts that would continue 
throughout Flax's long career. Although the 
speakers were from throughout North America, 
the audience was largely Puerto Rican. A following 
significant meeting in 1956 brought physicians 
from throughout the Caribbean region. 

By 1951 changes in State Insurance Fund 
prompted Flax to join the Veterans Administration. 
Eventually he became Chief of the Rehabilitation 
Medicine Service, at the San Juan VA 
Medical Center and Professor of Physical Medicine 


and Rehabilitation at the University of Puerto 
Rico. Funding through the Department of Vocational 
Rehabilitation and the National Polio Foundation 
expanded the programs for training 
residents and physical therapists, and allowed 
Flax to organize a residency program at his hospital 
in 1957. While the residency was intended for 
doctors from Puerto Rico, by the early 1960s, a 
growing number of physicians from throughout 
Latin America attended, making Flax's program 
one of the principal centers of training in physical 
and rehabilitation medicine for Latin America. 
Within his own field, Flax has held many national 
offices, including President of the American Congress 
of Rehabilitation Medicine, 1970-71 and 
President of the Rehabilitation Medicine Association 
in 1982. He has published extensively in 
physical medicine and rehabilitation. 

In addition to developing the first regional 
academic training program, Flax has been involved 
in international work throughout his 
career. In addition to attending many meetings 
and conferences, teaching students from 
throughout Latin America and perusing his own 
research, Flax has also played a significant role in 
helping rehabilitation efforts in the Caribbean 
region. For example, Bell Greve, whom Flax first 
met during the Institute he organized in 1950, 
asked Flax to provide medical assistance for Sister 
Joan Margaret's work in Haiti. Beginning in 1951 
and for many years to follow, Flax would fly to 
Haiti several times a month to see children at 
Sister Joan Margaret's St. Vincent's School for 
Crippled Children. 

Flax continues to work at the University and 
in his position with the VA administration. In addition 
to his other interests, Flax is a poet, and 
several volumes of his poetry have been printed. 

William Gallagher, Ph.D. 

William Gallagher was born in Maynard Massachusetts 
in 1938. His father was a factory 
worker, his mother a homemaker, and Gallagher 
recalls that he was a healthy, active child living 
with his parents and two older sisters. His life 
changed dramatically however in his sophomore 
year of high school, when he awoke one morning 
to find himself suddenly blind. He was rushed to 
the Massachusetts Eye and Ear Infirmary, but the 
physicians could do nothing, and his sight would 
never return. For some time, he "hung around at 
home," but eventually returned to his studies. He 
began his undergraduate career at Boston College, 
which at the time had a close liaison with 
what is now the Carroll Rehabilitation Center in 

William Gallagher 

Newton, Massachusetts. Boston College had a 
profound effect on Gallagher, particularly the 
teaching of Father Tom Carroll, who was in the 
Religion Department. From Boston College, he 
went on to graduate work at Boston University 
and then to teach at Holy Cross. In 1960, he went 
to teach in Pittsburgh, but returned to the east 
coast in 1965 to become Director of Rehabilitation 
at the Lighthouse for the Blind in New York. After 
seven years working at the Lighthouse, Gallagher 
went on to join the American Foundation for the 
Blind in 1972, and became its Executive Director 
in 1980. In addition to his work with the 
American Foundation, Gallagher also holds many 
prominent positions within other organizations, 

such a chair of the North American section of the 
World Blind Union. 

Gallagher's international work in the field of 
blindness has been extensive; he has traveled 
widely in Europe, Asia, the Near East and the 
Pacific. His contacts with people on the international 
scene began early, through his early association 
with Father Carroll who came to this 
country in 1950. Father Carroll hosted a large 
number of foreign visitors involved in blindness research, 
and Gallagher met many of them during 
the time he was at Boston College. 

HISTORY OF INTERNATIONAL REHABILITATION 143 


The blind world has always been separate, 
and in many ways, leaders in the international 
rehabilitation field. Gallagher worked with Switzer, 
Rusk, and others within the larger rehabilitation 
field as well as with many of the international 
leaders in blindness work such as Sir John Wilson 
on IMPACT. He fondly recalls a dinner in with 
Howard Russell, the highlight of which came at 
the end, when Russell went into a long tirade 
about how "he could do just about anything with 
his hooks, open a door, eat with a knife and fork, 
drive a car," but he confided to Gallagher, "just 
about the only thing he could not do, was pick up 
a check off the table." Gallagher, not missing a 
beat, calmly smiled at Russell and said "what 
table?" (Neither man recalls who finally paid for 
the meal). 

Gallagher continues to be Executive Director 
of the American Foundation of the Blind. He and 
his wife reside in the New York area. 

Mervin Garrettson, Ph.D. 

Mervin Garrettson was born in Sheridan, 
Wyoming in 1925, the son of a cattle rancher. His 
mother had been the local rural school teacher 
before marrying his father, a man who had already 
been twice widowed. Although Mervin was 
the only one of his mother's three children to survive 
childhood, the family was a large one, with 
eight children by his father's previous marriages. 
Garrettson recalls his early childhood as a 
pleasant one, however at the age of five, he lost 
his hearing to spinal meningitis, and his life became 
significantly different. 

Despite his hearing loss, his parents were 
anxious for him to attend school. His first year in 
elementary school was spent at the local rural 
schoolhouse where no provision was made for his 
recent hearing loss. He learned very little that 
year, and his parents, already convinced that he 
was a bright child, realized that something else 
would have to be done. His mother began searching 
for programs throughout the area that might 
take him and the following year, at the age of six, 
he was placed at the Colorado School for the Deaf, 
where he would remain through high school. 

Hundreds of miles away from home and family, 
existence for the children at the school was 
made all the more difficult by the fact that signing 
was not allowed, although some finger spelling 
was permitted. Garrettson quickly learned 
fingerspelling from a friend, but would not learn 
sign langauge until he was eleven years old. It 
was at Colorado that his interest in advocacy 
began. He found his hearing teacher's insistence 

Dr. Garrettson 

on the use of spoken language and lip reading for 
all occasions indefensible. He developed an appreciation 
for American Sign Language and joined 
National Association of the Deaf (NAD), as a student 
member. 

Garrettson graduated from the Colorado 
school in 1942, and spent a year at the 
preparatory school at Gallaudet. From there he 
continued on to Gallaudet College, taking a number 
of English and mathematics courses. He 
majored in library science and graduated in 1947. 
In addition to his undergraduate studies, during 
his college years in Washington, Garrettson also 
came in close contact with many leading national 
deaf figures. He continued to be very active in the 
National Association of the Deaf. 

Although by training an archivist, 
Garrettson's first job after graduation was at the 
Maryland School for the Deaf, where he taught algebra 
and social studies. After two years in 
Maryland, Garrettson and his new wife returned 
to the west, where he began a master's degree at 
the University of Wyoming. His plan was to earn a 
graduate degree in English, and then return to 
Gallaudet to teach. However when a position on 

144 HISTORY OF INTERNATIONAL REHABILITATION 


the Gallaudet faculty opened, it went to a more 
senior scholar, and Garrettson decided to look for 
employment elsewhere. 

He soon found at job teaching at the Montana 
School for the Deaf. Initially, he was the only 
deaf teacher on the faculty. When the principal 
was fired, Garrettson was hired to replace him, becoming 
the twelfth principal of the institution, 
and the first who was deaf. The Montana School 
was both fairly isolated and progressive, which allowed 
Garrettson the chance to make innovative 
changes in the institution, changes that would 
not appear at most other deaf institutions for 
decades. For example, under Garretson's direction, 
sign language was officially introduced for 
use throughout the institution. 

In 1962, Garrettson left Montana to return to 
Gallaudet where he taught as a professor in the 
Education Department, while working on his doctorate 
at the University of Maryland. Garretson 
remained at Gallaudet until 1967, when he left 
his teaching position to become the Executive 
Director of the Council of Organizations Serving 
the Deaf, continuing on in that position until 
1970. In 1970, he returned to Gallaudet to undertake 
a job which he remembers as a "real challenge", 
Principal of the Experimental High School, 
an open school offering education to children from 
a wide range of different backgrounds and educational 
levels. He remained Principal for five years 
and then moved on to become the Assistant Dean 
of the Pre-College Program and then Assistant to 
the President at Gallaudet for 10 more years. 

During his years at Gallaudet, Garrettson 
also became increasingly involved in deaf advocacy 
issues both nationally and internationally. 
He served as a board member of the American 
Federation of the Deaf, and attended the World 
Congress in 1967 for the first time, as an official 
representative of the United States. He was a 
member of international exchanges and host to 
many colleagues who came to Washington from 
overseas. In 1989, Garrettson ran the largest international 
festival on deafness ever held—The 
Deaf Way. Working with a small budget of only 
$150,000, Garrettson organized a festival highlighting 
deaf culture, art and advocacy that drew 
6,000 participants from all over the globe. 

While Mervin Garrettson has been at the very 
center of activity and advocacy within the deaf 
community for decades, it is an indication of the 
historic divisions within the disability community 
that contacts between his organizations and the 
rehabilitation community have been, so use his 
own words, "thin." Garrettson's initial contact 
with Mary Switzer and the Office of Vocational 

Rehabilitation began while he was the principal of 
the Montana School. He recalls that it was Boyce 
Williams who was actually instrumental in introducing 
deaf concerns into the realm of rehabilitation, 
a crucial point being the shift from an earlier 
insistence on oralism, to a growing appreciation of 
sign language. Mary Switzer understood a number 
of concerns of the deaf community, and 
among other important issues, began to provide 
funding for conferences, meetings and programs, 
as well as for such experiments as film captioning. 
It was through her backing that a "number of 
seeds" were planted that led to future successful 
projects. 

Despite Switzer's interest in the deaf world, 
contact with hearing rehabilitation professionals 
and advocates from other disability groups continued 
to be difficult. Lack of knowledge and understanding 
about sign langauge was at the heart 
of much of the problem. Garrettson for example, 
recalled that in 1969, he was invited to be the 
keynote speaker at the National Rehabilitation Association 
meetings. After his talk however, with no 
interpreter provided for him, the langauge barrier 
blocked his ability to discuss ideas or socialize 
with other conference participants. 

In reflecting on his life, he notes the many 
major changes he has seen in the deaf world. 
Deafness has been redefined as a culture, not just 
a disability; and both the United States and the 
United Nations have endorsed sign as a legitimate 
option of deaf peoples. Despite several decades of 
revolutionary advances in policy, legislation and 
public awareness however, Garrettson still sees a 
significant gap in understanding and interchange 
between those in the deaf world and many in the 
international rehabilitation communities. 

James Garrett, Ed.D. 

James Garrett was born in New York City, 
March 31, 1916. His father worked as an accountant, 
and his mother regularly worked as well, in 
addition to being a homemaker. At several 
months of age, Garrett contracted polio and was 
for a time completely paralyzed. He spent time in 
the Beekman Street Hospital in New York, and 
would have some impairment of his arm for the 
rest of his life. 

Garrett did well in school, graduating from 
Regis High School in New York in 1934. The first 
person in his family to attend college, he entered 
Fordum University, studying the classics and 
philosophy and graduated in 1937. He continued 
on to the Fordham Graduate School, receiving an 
MA in educational methods in 1939. From there 

HISTORY OF INTERNATIONAL REHABILITATION 145 


he went on to New York University specializing in 
clinical psychology in the School of Education, 
and received his Ed.D in 1941. 

Initially, Garrett found work at New York 
University teaching introductory psychology courses, 
and it was through his university colleagues 
that he began to met people associated with the 
New York based Institute for the Crippled and Disabled. 
In 1942, Garrett was invited to join the 
Institute's staff, as Assistant Educational Director, 
working on a program for vocational evaluations, 
guidance and advising. 

In 1944, Garrett took a new job, as Chief of 
Special Rehabilitation Procedures, within the 
Veteran's Administration, overseeing its first 
guidance center. Garrett's New York based program 
served the severely disabled veteran, a new 
concern of the Veteran's Administration. His 
pioneering work brought him to the attention of 
many in the field of rehabilitation both within the 
New York area, and nationally, including individuals 
such as Howard Rusk and Henry 
Kessler. 

Garrett's strong 
background in 
rehabilitation and 
solid reputation as a 
competent administrator, 
made him 
the logical choice to 
serve as the Chief of 
Psychosocial and Vocational 
Services at 
Howard Rusk's new Institute 
for Physical 
and Rehabilitation 
Medicine in New York. 
Rusk invited Garrett 
to join his staff, and 
Garrett served there 
from its beginning in 
1948. Garrett found 
himself in charge of almost 
every aspect of 
rehabilitation at the Institute, 
except the 
medical issues which 
fell under Rusk's 
domain. His program 
was modeled in part, 
on the program he had 
overseen at the Institute 
of Crippled and 
Disabled, but it was 
revolutionary in that it 

psychological and social service components a 
reflection of Garrett's own ideas and innovations. 
Although Garrett always identified himself as a 
service provider and not a consumer, many of the 
ideas and innovations in his new program may 
have reflected his own insights as both a professional 
and a person who was himself disabled. 

The program grew tremendously in a very 
short space of time, in part aided by a staff that 
was exceptionally well trained, and soon began to 
help define the profession of rehabilitation counseling. 
Garrett not only oversaw the program at 
the Rusk Institute, but during these years, also 
held a joint appoint through the Institute as an 
Assistant Professor of Clinical Psychology at New 
York University College of Medicine. He published 
regularly, and his books and articles became used 
widely. 

In 1951, Garrett left New York to become the 
Associate Commissioner of Research and Training 
at the Office of Vocational Rehabilitation in 
Washington under its new director Mary Switzer. 
Switzer needed someone to take responsibility for 

incorporated 

Dr. and Mrs. Garrett and Dr. Fenmore Seton in the early 1980s. 

146 I-IISTORY OF INTERNATIONAL REHABILITATION 


the professional side of rehabilitation and Garrett 
was taken on as her key staff assistant. Thus 
began Garrett's 34 year career with federal government. 


Garrett worked exceptionally well with Mary 
Switzer, and they proved to be a highly effective 
collaborative team. Switzer's broad interests and 
ready enthusiasms were tempered by Garrett's 
more systematic approach and his ability to frame 
issues in terms of research and training priorities. 
Between them, they generated programs and 
policies that were able to be put into action. 

One of Garretts primary responsibilities was 
to oversee the actual functioning of the PL 480 
program. Garrett was responsible for ensuring 
that funds were administered properly and for 
visiting projects in the field to evaluate their 
progress. He and his senior aid Joseph LaRocca 
would divide the world up each year, each man 
selecting the dozen or more countries to which he 
would travel in the next twelve month period. In 
addition, Garret helped to develop an impressive 
network of experts in every country, and strongly 
emphasized 'participatory planning' for all PL 480 
projects—adamant that people already working in 
the areas and on the subjects, be included in all 
planning. His insistence that groups involved with 
each PL 480 project develop five year plans for research 
and training fostered clearer thinking on 
goals and priorities for many participants in the 
project. 

When Mary Switzer retired in 1971, James 
Garrett took over responsibility for her program. 
He found however, that by the beginning of the 
second Nixon Administration in the early 1970s, 
appointments within a number of the federal agencies 
with which he had to work, had become increasingly 
political. A number of the new people 
knew little about rehabilitation or disability in 
general, and were even less interested in thinking 
or planning in international terms. 

Increasingly frustrated working within the 
federal system, in 1978, Garrett was retired from 
his Federal position and became Executive Vice 
President, of the World Rehabilitation Fund. He 
was responsible for the creation, development and 
implementation of many rehabilitation activities, 
and he under his leadership, the World Rehabilitation 
Fund developed closer ties to US AID and 
other federal agencies. He was instrumental in establishing 
the World Rehabilitation Fund Regional 
Training Centers in Prosthetics and Orthotics. 
Centers were located in nations such as Taiwan, 
India and Brazil, and they offered training in the 
prosthetics and orthotics to health personnel from 
countries throughout these regions. In addition, 

Garrett worked to develop physical therapy and 
occupational therapy training programs to reach 
those in the developing world. Garrett at the same 
time, was also responsible for the development 
and implementation of the International Exchange 
of Experience and Information in 
Rehabilitation, a project funded by the National Institute 
on Disability and Rehabilitation Research. 
In addition to all his other work, Garrett also established 
strong ties and served as a mentor to 
many junior colleagues and helped to foster the 
careers of several leading individuals within the 
disability rights and independent living movements. 


Garrett remained active in the international 
rehabilitation arena throughout the years, despite 
declining health in the last of years of his life. He 
died in 1991. 

Ignacy Goldberg, Ed.D. 

Ignacy Goldberg was born in Warsaw, Poland 
on March 6, 1916 and entered the University of 
Warsaw in 1934. Intending to qualify as a high 
school teacher of English as a second language, 
he went immediately on after his undergraduate 
years, completing his Master's degree two years 
later. Goldberg graduated in June of 1940, as 
rumors of war swept Poland. Eligible for being 
drafted into the Polish army, Goldberg was unable 
to leave the country, and remained through the initial 
German invasion. Several months before the 
closing of the Warsaw ghetto, he fled the country 
using forged papers and traveled through an underground 
network of contacts to enlist in the 
overseas Polish army in Vienna. He and a small 
group of comrades managed to evade capture by 
the gestapo and made their way to British Palestine 
where they were trained by the British in 
desert warfare. The Poles, fighting alongside the 
British, were stationed in North Africa. 

In 1941, during the siege of Tobruk in Libya, 
Goldberg was severely wounded, loosing his right 
arm and much of the mobility in his right leg. The 
next four years were spent in hospitals, first in 
Egypt and after El Alamein, in the British Army 
Hospital in Durban, South Africa. His own injuries 
provided him with his first exposure to 
rehabilitation although Goldberg recalls that it 
was not an organized field at the time, but rather 
a combination of small amounts what today 
would be considered physical therapy, occupational 
therapy and common sense delivered on a 
"catch as catch can" basis. 

While undergoing treatment in South Africa, 
Goldberg met his future wife, Diana Solarsh, a 

HISTORY OF INTERNATIONAL REHABILITATION 147 


volunteer on his hospital ward. Diana was already 
involved with disability issues. She worked as a 
Girl Guide leader, having organized a troop in a 
home for disabled children in Johannesburg. She 
was particularly interested in camping and outdoor 
activity programs for disabled children. Her 
interest and experience with disability would help 
influence his own. 

Married in 1948, Goldberg and his wife considered 
moving to the United States, however, the 
waiting list for obtaining United States visas made 
the possibility of immigrating highly unlikely. 
However, Diana's interest in organizing some kind 
of outdoor camping program for children with disabilities 
and their families in South Africa lead 
Goldberg and his wife to choose to come to the 
United States for their honeymoon. Their plan to 
was find out more about such activities in the 
United States, (they had assumed there were 
many active programs here), and then to return 
home. 

Once in the United States, however, they 
decided to try to remain in this country, and they 
began to contact anyone they thought might be 
able to give them some guidance. By chance, 
Goldberg knew Bruce Greenbaum, a fellow Pole, 
who had immigrated with his family shortly before 
the start of the War. Greenbaum was now a 
physician in New York working as one of the first 
Rusk fellows. It was Greenbaum who actually suggested 
that Goldberg go into a field of rehabilitation. 
As Goldberg recalls, at that suggestion "a 
light went on," and many of his experiences and 
interests began to fall into place. 

Greenbaum's idea was seconded by another 
friend who recommended that Goldberg apply to 
Teacher's College at Columbia University, which 
had begun a small program on the education of 
disabled children in the new Department of Special 
Education. Goldberg was immediately accepted 
into a master's program, and later 
extended his stay by enrolling in the doctoral program. 
The Department was then very small there 
were only two full time students, and only a handful 
of part time students. Goldberg received his 
doctorate in 1952. 

Although Goldberg had concentrated more 
on physical than on mental retardation during his 
studies at Columbia, his first job after completing 
his degree was as principal of the Muscatatuck 
State School for the Mentally Retarded in Indiana. 
His three years at Muscatatuck fostered a growing 
interest in mental retardation. Through meetings 
and his writings, Goldberg quickly came in contact 
with the small but active group of state and 
national leaders in the new field of mental retarda


tion advocacy. Goldberg's interest in advocacy 
and his writings on the retarded child and family 
made him a natural choice for a one year survey 
contemplated by the National Association of 
Retarded Children in 1956-57. The National Association 
under the guidance of Elizabeth Boggs 
and George DiMichael, had received a $16,000 
grant from American Legion Child Welfare Committee 
to undertake a national survey of the needs 
of retarded children and their families. Goldberg 
was hired as the educational consultant. He was 
to travel around the country (hosted by local 
families, to keep costs down), meeting with as 
many interested parties as possible parents, 
school officials, colleagues, and educators. His 
mission was to serve as a consultant to parent 
run schools which were springing up, as well as 
to function as an advocate, trying to convince 
people wherever possible, that public schools had 
a responsibility to mentally retarded children. 

The United States had only a handful of individuals 
with doctorates in Special Education at 
that time, and virtually none were willing to work 
in collaboration with parent advocacy groups. 
(Goldberg recalls that a colleague tried to discourage 
him from taking the NARC appointment, 
telling him "you're committing professional 
suicide" when the advise was ignored). Requests 
for Goldberg to visit, however, poured in from 
parent groups and Goldberg "barnstormed" the 
country, visiting well over 50 places in 30 states 
during the year. He found a highly decentralized 
system, with programs varying greatly from city to 
city. He also found for the families, issues of concern 
ranged far beyond special education. 
Goldberg's work provided much basic information 
and many questions upon which NARC would 
build. 

At end of his year with NARC, Goldberg was 
invited to join the Department of Special Education 
at Teacher's College, Columbia. He was to 
work as the Assistant Director of the Mental Retardation 
Project, one of the first efforts to study the 
potentials of retarded children. He remained on 
grants for several years before receiving a regular 
faculty appointment. His research and writings, 
often done in collaboration with his friend and colleague 
Francis Connor, were important contributions 
to the field. In addition to his other work, 
Goldberg became interested in what he described 
as comparative special education—special education 
in a cross-cultural context. He began to work 
increasingly in the international arena, attending 
meetings, and serving as a consultant in a number 
of countries, in addition to receiving a constant 
flow of international visitors and students at 
Columbia. 

148 HISTORY OF INTERNATIONAL REHABILITATION 


Now a professor Emeritus, Goldberg lives in 
Florida, but continues to be active in both the national 
and international arena. 

Joseph LaRocca 

Joseph LaRocca's interest in international 
work started early. Intending to become an engineer, 
LaRocca landed a summer job as a clerk in 
an engineering firm in his home town of Pontiac, 
Michigan that sent him to Brazil for a summer. 
He continued his interest in the sciences at Cornell, 
from which he graduated in 1930 with a 
major in Chemistry. Although he was fortunate 
enough to find work as a research chemist, he 
lost the job several years later, as the Depression 
deepened. Returning to the School of Social Work 
and Public Administration at what today is Case 
Western Reserve, he graduate in 1932 and began 
work with the WPA on schools and hospitals in Atlanta. 


It was in Atlanta 
that 
LaRocca's first 
contact with the 
field of rehabilitation 
began. Attending 
a dinner one 
evening, LaRocca 
struck up a conversation 
with an 
employee of the 
Georgia Rehabilitation 
Agency who 
complained that it 
was impossible to 
find employment 
for disabled people 
through the WPA. 
LaRocca was interested 
and soon 

Joseph LaRocca had helped 
develop a small 
but successful 

program to train individuals with disability for a 
variety of jobs, such as store workers and check 
out clerks. 

Shortly thereafter LaRocca left Georgia to 
work on a WPA hookworm eradication program in 
Florida, but he was soon back, this time working 
for the new Social Security Administration. After 
opening the first Social Security office in Athens, 
Georgia, LaRocca was transferred to Washington, 
where he traveled widely, responsible for assisting 
states to bring their laws in line with the new 
federal Social Security system. In addition La-

Rocca worked with the forerunner of the Office of 
Vocational Rehabilitation, responsible for helping 
to make the vocational rehabilitation legislation 
permanent. 

LaRocca's work in the Social Security Administration 
was cut short by World War II, which 
LaRocca spent in the Navy. Although all federal 
employees were assured of resuming their old 
positions with the Social Security Administration 
after the War, LaRocca's return to his pre-War job 
was complicated by the fact that his old job had 
been abolished. The State Department however, 
needed people with administrative experience, 
and LaRocca was transferred them for the duration, 
and from there segunded to help organize 
the administrative service of the new United Nations. 
His work with he United Nations lasted for 
about a year, and he then returned to the State 
Department where he was sent to Greece with the 
Marshall Plan. 

In 1947, LaRocca began work with the Office 
of Vocational Rehabilitation under Michael Shortly, 
responsible for opening a regional office in New 
York. From New York, LaRocca went to 
Washington to work as an assistant to Dobblestein, 
the principal planner. By 1950, however, La-
Rocca had returned to the State Department, and 
was sent by them to Egypt for three years to help 
set up a social security program there. He 
returned in 1953 and again joined the Office of 
Vocational Rehabilitation, now under the leadership 
of Mary Switzer, whom he had known since 
she had worked for McNutt at the Federal 
Security Agency. LaRocca's experience with legislation 
helped as he worked on the 1954 landmark 
legislation for rehabilitation. 

With the passage of PL 480, LaRocca's extensive 
overseas expertise was put into play. Working 
under Garrett, LaRocca helped organize PL 480. 
Although still small by international standards, 
PL 480 was the first large chunk of money available 
for international work in the rehabilitation 
community. Between them, Joe LaRocca and Jim 
Garrett split the world each year, deciding who 
should go to which countries to oversee American 
funded projects through the PL 480 program. He, 
along with Martin McCavitt and Joseph Traub, 
oversaw PL 480 projects throughout the 1960s 
and 1970s, which was instrumental in the founding 
of rehabilitation centers in India, Pakistan, Israel 
and Yugoslavia. 

Feeling the lack of systematic overviews of 
disability issues, LaRocca undertook one of the 
first and most extensive surveys done up until 
that point on the condition of individuals with disabilities 
internationally. The survey was circulated 

HISTORY OF INTERNATIONAL REHABILITATION 149 


to the cultural attachees at all 
American embassies, asking them to 
collect the information from local ministers 
of health and universities. The 
summarized findings can be found in 
the publication Rehabilitation of the 
Disabled in 31 Countries in 1954, 
and followed by an updated version 

Rehabilitation of the Disabled in 51 

Countries, in 1960. 

In 1965, Joseph LaRocca left the 
federal government, his position on 
PL 480 being taken over by Joseph 
Traub. LaRocca went to George 
Washington University, where he 
taught until 1972. In that year, he 
joined the Child Development Center 
at the Department of Medicine at 
Georgetown University, and from 
there he joined the Urban Institute, a 
research consortium working on issues 
of transportation for disabled 
consumers. In addition, LaRocca 
served as an international consultant, 
frequently volunteering his time 
to projects he found particularly 
worthwhile, such as the famine relief 
efforts for Bangladesh. In addition, 
he served as an administrator for the 
World Rehabilitation Fund's training 
project in Cyprus, helping to bring 
physical rehabilitation to Lebanese 
civilians injured in the civil war. 

Most recently, LaRocca has 
directed the rehabilitation program allocated 
by the Senate Foreign Relations Committee 
in 1987, aimed at assisting and provide prosthetics 
and orthodicts for civilians injured in war 
torn countries such as Laos, Mozambique and 
Uganda. Although a small, $5 million dollars program,
it is one of the few on-going international 
rehabilitation efforts currently funded by the 
federal government. 

Virginia Grace (Gini) Laurie 

In a sense, Gini Laurie's life was influenced 
by disability issues even before she was born in 
St. Louis in 1913. She was the oldest of a "second 
batch" of children. A year before her birth, all four 
of her parents' young children had been stricken 
by polio. Exposure to the disease possibly came 
from their father, a surgeon who had been caring 
for polio patients. Within a few days, two girls, Virginia 
and Grace were dead, a son was severely disabled 
and the only surviving girl, mildly impaired. 

Gini Laurie 

Virginia Grace, named for her two dead sisters, 
was born the following year and two younger siblings 
would follow. 

Virginia grew up in a progressive household 
and was devoted to her older brother, who died 
shortly after college graduation from complications 
related to his disability. She attended Randolph 
Macon Women's College in Virginia, 
majoring in biology and Latin. Although interested 
in medicine, the conventions of the day dictated 
that women should not become physicians and instead 
she married Joseph Scott Laurie 3rd at the 
age of 25. Joseph Laurie and his wife eventually 
moved to Cleveland where he pursued his career 
as a research chemist, and she settled down to 
the life of a housewife. 

In 1949, the polio epidemic struck Cleveland 
and Ginni became a Red Cross volunteer at the 
Toomey Pavilion, a polio center under the direction 
of Dr. J. Toomey. Always energetic, Ginni 

150 HISTORY OF INTERNATIONAL REHABILITATION 


devoted increasing amounts of her time to the 
Center. She focused her attention on working 
directly with polio survivors, organizing entertainment 
and running programs for them. As an extension 
of these activities, in 1958, Laurie took 
over the editorship of The Toumi Gazette, a small 
annual in-house newsletter that kept patients in 
touch with activities in the Center and with those 
fellow patients who had returned home. Over 
time, the newsletter was renamed The Toumi 
Junior, and then The Toumi J.. Eventually its 
name was changed again to The Rehabilitation 

Gazette. 

At first, issues of the publication would appear 
sporadically. Laurie, as she would until the 
end of her life, ran the entire operation from her 
home and did all the work on a completely voluntary 
basis. Initially, The Toumi Gazette was little 
different from dozens of other in-house newsletters 
that were published by polio rehabilitation 
facilities. Most of these publications ceased as 
years passed, funding decreased and the institutions 
closed. Laud however, realized that many 
polio survivors still needed the Gazette, and on 
her own continued publishing the paper, putting 
increasing emphasis on self-help tips, advocacy issues 
and relevant social, economic and legislative 
news items. Ginni's editorship of The Gazette was 
distinguished by her skill as a visionary. In an era 
that was still largely medically-centered, she felt 
strongly that individuals with disabilities should 
be informed consumers and armed her readers 
with specific information about medical issues 
and technical aids, attendant care and pending 
legislation. Her work helped pave the way for the 
Disability Rights and the Independent Living 
Movement. 

She supplemented the annual, or occasionally, 
the bi-annual issues of the Gazette with 
voluminous correspondence, writing regularly to 
individuals all over the country. Although the circulation 
of The Rehabilitation Gazette never exceeded 
10-12,000, the copies circulated far more 
widely as it was read and re-read by many. For 
many years it was one of the very few, and certainly 
the best known, of any national consumer 
driven journal on physical disability. Although the 
Gazette was to continue to be Laurie's best known 
publication she also established several other 
newsletters including International Ventilator 
User's Network and Polio News Network for more 
specific audiences. 

Polio issues were not Laurie's only concern. 
Although her early work had been with largely 
ventilator dependent individuals, she saw clearly 
that the issues they faced were shared by many 

other children and adults with disabilities. In an 
era where the disability community was divided 
into "camps" based on specific impairments, she 
was one of the earliest and most eloquent voices 
supporting cross-disability cooperation. Furthermore, 
she was very vocal in urging experienced individuals 
to share their insights and expertise 
with others. For example, her newsletter always 
included feature articles on adults with disabilities. 
Unlike most publications of that era, 
there was little attention to inspirational stories or 
biographies of super achievers. Individuals with 
disabilities in all walks of life, many of whom held 
"normal" jobs teachers, insurance agents, college 
students and so forth, were featured. Columns on 
travel, housing, books reviews and other relevant 
information rounded out the newsletter. A correspondence 
column included letters from readers 
all over the Americas, Europe, Asia and beyond 
one early issue featured letters from readers in 
Japan, Germany, Brazil and from a woman on the 
island of St. Helena in the South Atlantic. The exchanges 
the newsletter fostered among readers in 
many nations provided a very early international 
forum for disability activists. Laurie's goal was to 
develop an educated and informed readership, 
and she felt that this awareness was a pre-requisite 
for all future movement in the field. In later 
years, Judy Raymond Fischer, who helped Laurie 
edit The Gazette for twenty years, recalled that 
Laurie had little patience with independent living 
centers which had few books lining the walls— 
Laurie keenly felt it was the responsibility of individuals 
and groups with disabilities to keep 

informed about the world around them. 

Laurie's respect for the opinions and insights 
of disabled readers and colleagues may have been 
based on her own experiences growing up with 
disabled individuals as friends and family members 
rather than "patients." Whatever her initial 
experiences, having no children of her own, her 
readers and the hundreds with whom she corresponded 
came to be her family. Laurie never 
compromised her insistence on consumer advocacy. 
She took great pride in the fact that, in 
the late 1960's, she was one of the very first to 
raise the topic of sex and sexuality and disability. 
She was also one of the very first to listen closely 
to the complaints of older adults who had had 
polio, realize a common pattern of experiences 
and from that, identified what is now called Post-
polio Syndrome as a real physical entity and 
source of future concern. 

The Rehabilitation Gazette brought Gini Laud 
first national and then international attention. At 
the time of her death, it reached over 83 countries 
and was read by thousands. In addition to her 

HISTORY OF INTERNATIONAL REHABILITATION 151 


publication of The Gazette and the voluminous 
correspondence which she carried on until her 
death, Gini Lauri also played an important 'behind 
the scenes' role in the disability rights movement, 
as a senior statesperson, generally staying 
above the fray and upon occasion quietly mediating 
disputes. Gini returned to St. Louis in 1971 
and was widowed in 1985. She died of cancer at 
the age of 76 in 1989. The Rehabilitation Gazette 
renamed The Gazette International continues to be 
published in St. Louis. 

Romaine Pryor Mackie 

Romaine Pryor was born in Darbyville, Ohio 
in 1898, the daughter of a Methodist minister. 
Graduating from the local high school, she 
received her BA from Ohio Wesleyan University 
and taught high school English in Columbus for 
several years. She then took at job with the Board 
of Education in Columbus, working with children 
who were having difficulty in the school system. 
She recalls that she "always had an interest in the 
child that couldn't get along very well," and she 
functioned as a case worker for the school district 
working with children and their families who were 
having difficulties. She was particularly drawn to 
children with physical and intellectual impairments. 


The school district, recognizing her ability, 
soon made her the principal of the Third Street 
School, the public school in Cleveland responsible 
for educating "crippled children." Mackie was principal 
at Third Street for four years, and while 
there, completed her master's degree, again in 
English, at Ohio State University. Feeling that 
she wanted to gain more expertise in the field of 
educating disabled children, she asked for a leave 
of absence from the Cleveland schools so that she 
could go to Columbia University and work on her 
doctorate. (She never in fact, returned). 

Mackie left for New York in 1933 after being 
accepted at Columbia. She intended to study 
guidance, but the registrar at Columbia discouraged 
her. The registrar, recognizing Mackie's 
already extensive experience, convinced her that 
she was already in the best field for working with 
disabled children and instead guided her to the 
new Department of Special Education just opening 
at the Teacher's College. 

Mackie was among the very first Special 
Education students at Columbia. Having worked 
as an educator before coming to the University, 
she soon found herself relied on by faculty, as 
well as students, for practical expertise in the 
field. She was quickly enlisted to help teach at 
Columbia and began teaching part time at Hunter 

College as well. (While at Hunter, she met and 
married fellow educator Frank Mackie in 1938. Although 
she had relatively few students, she 
remained close with many of them, and one of her 
night school students at Hunter, Francis Connor, 
would remain a close colleague for the rest of 
their careers. 

Mackie completed her doctorate in 1942, and 
was hired by the State Board of Education of 
California to help establish special education 
programs throughout the state. It was a job she 
loved, but funding ran out, and she and her husband 
relocated again at the end of the year, this 
time going to Washington where Mackie would 
spend the rest of her career working for the 
Department of Education. Mackie's background 
was very unique for the 1940s there were few experienced 
educators who also had completed their 
doctorates in special education, and Mackie was 
able to accomplish many significant projects 
through the Department of Education because of 
her broad understanding of the field. Early on, 
she undertook the first comprehensive survey of 
special education teachers in all fields, including 
teachers of blind and deaf children, as well as 
those who worked with physically impaired 
children. Under her aegis, she was also able to 
fund a number of research projects throughout 
the country that allowed a far more detailed understanding 
of the nature and benefits of special 
education. Several years after her arrival, she was 
joined across town by Mary Switzer at the Office 
of Vocational Rehabilitation. While Mackie 
covered education, Switzer's programs began by 
addressing the needs of physically disabled individuals. 
While there was some overlap in what 
was covered, there was cooperation between the 
two administrators and the two offices, and a visit 
to Washington for many in the rehabilitation field 
included stops at Switzer's office and at Mackie. 

Early on in her career in Washington, Mackie 
also took the lead in becoming involved in international 
issues in special education. She convinced 
her superiors that the Department of Education 
should be represented at many international conferences, 
and regularly volunteered to be the representative 
who would attend. She herself traces 
her interest in international issues to her early 
career in Ohio. Working in education in the 1920s 
in Ohio, she recalls, "you couldn't help being 
aware of international rehabilitation" because of 
the work of Edgar Allen and his International 
Society for the Welfare of Cripples in Elyria. According 
to Mackie, Allen's work and ideas were 
pervasive in Ohio, and the result was that many 
educators in Ohio were keenly aware of the latest 
international ideas in education and legislation. 

152 HISTORY OF INTERNATIONAL REHABILITATION 


In Ohio, "You felt like you were on the cutting 
edge," she recalls. 

Mackie's interest in international aspects of 
special education made her an important resource 
in the area, and Mackie regularly attended conferences, 
served on committees and worked as a 
consultant to individual and groups in the United 
States interested in special education overseas. 
She also was a key contact person, and often 
helped put people in touch with each other, and 
with the latest research in the field. 

Mackie's career at the Department of Education 
lasted until her retirement. Never one to 
remain idle however, Mackie still continues to 
work in the education field, now volunteering 
several days a week to work at the State Directors 
of Special Education office in Washington. 

Col. William P. McCahill 

William McCahill was born 
June 29, 1916 in Marshalltown, 
Iowa, and graduated from Marquette 
University in 1938. He 
stayed on at Marquette to earn a 
master's degree in journalism, 
finishing in 1940. After graduation, 
he joined the Associated Press as a 
night editor in Milwaukee in 1940, 
intending to work his way up in 
the newspaper business. 

World War II changed his 
plans. In 1941, soon after Pearl 
Harbor, he enlisted in the Marine 
Corps, serving for five years as 
public relations officer for Admiral 
Nimitz, the Commander-in-Chief of 
the Pacific Fleet, as well as a number 
of other assignments 
throughout the Pacific Theater. He 
left the service in 1946 as a Major, 
although he continued in the 
Marine Reserve until 1971, when 
he retired with the rank of Colonel. 
His long-term affiliation with the 
Marine's is reflected in his writings. 
He authored the definitive history 
of Marine Corps Reserves as 
well as authoring two books on 
Marine experiences during the 
War. (First to Fight, McKay 1943 
and Hit the Beach, Wise, 1947). 

Shortly after World War II, he 
was a staff executive with the 


of establishing state and local committees on 
employment of the handicapped. This work eventually 
lead to the formation of the President's Committee 
on the Employment of the Physically 
Handicapped, initially inspired by the work of 
General Graves B. Erskine and Paul Strachan 
with whom he worked closely. 

Because of his experience in journalism and 
administration, in 1947, McCahill was given the 
responsibility by Truman for pulling the Committee 
together and making it functional. Under his 
direction, the President's Committee rose from a 
staff of one (himself), to a staff of 39. McCahill 
was to serve as Executive Secretary of the 
President's Committee from it's inception to his 
retirement in 1973, twenty-seven years later. The 
Committee has addressed the need for expanding 
job opportunities for Americans with disabilities, 
for eliminating architectural and transportation 
barriers, in promoting jobs and in educating the 
public. In the course of his assignment, McCahill 

etraining and Reemployment Ad-McCahill receives a Dr. Henry H. Kessler Award in 1980 for his dedication to international 
programs. Presenting the award is Mrs. Estelle Kessler, whose generosity has made the

ninistration which began the work 

Kessler Award an on-going memorial to her late husband. 

HISTORY OF INTERNATIONAL REHABILITATION 153 


lectured, wrote and consulted 
regularly both nationally and internationally, 
and sat on a number 
of significant committees and 
boards of directors. He was particularly 
active in RIUSA and 
worked hard to try to pull 
together the various organizations 
and programs with which 
the national committee worked. 

McCahill retired from the 
President's Committee in 1973 to 
join the National Association of 
Retarded Citizens as the Director 
of Governmental Affairs and 
served in that position for a year 
and a half. He then became the 
Executive Director of the Industry 
Labor Council of the 
White House Conference on 
Handicapped Individuals during 
its formative period, from 1976 
to 1977. In addition to his work 
on the President's Committee, 
McCahill chaired the National Advisory 
Committee on Scouting for 
the Handicapped, and serves as 
Chairman Emeritus of the People-
to-People Committee for the 
Handicapped. He is also an Executive 
Board member for the 
United State's Catholic 
Conference's National Advisory 
Committee on Ministry with the 
Handicapped, and has served on 
the National Advisory Council of 
Goodwill Industries of America 
and the National Easter Seal Society. Known for 
his enthusiasm and his administrative skill, Mc-
Cahill remains very active in both national and international 
rehabilitation issues. 

Harold John Russell 

Harold Russell was born in Nova Scotia in 
1914. His father died when Harold was only four 
and him mother took her three young children 
with her to Cambridge, Massachusetts while she 
studied nursing. The family remained in the 
United States where Russell attended local public 
schools, graduating in 1933. Although he had 
hoped to go to MIT to become an aeronautical engineer, 
the Depression put an end to such plans, 
and he instead found work as a meat cutter in a 
local food store. He enlisted in the army soon after 
Pearl Harbor. Eager to get into the action, Russell 
volunteered for the paratroopers and received fur-

Harold Russell 

ther training in demolition and explosives so he 
could serve in parachute demolition squad. One of 
the first through the program, however, Russell 
was asked to stay on to train others, despite his 
repeated requests to be sent to the front. He 
gained the rank of sergeant, and was finally able 
to convince his superiors to transfer him to a combat 
outfit at Camp MacKall, North Carolina, 
which was soon to be sent overseas. Ironically, he 
never got there. During a training exercise in 
June of 1944, an explosive charge went off in his 
hands. Russell suffered severe wounds, the most 
significant of which was the loss of both hands. 

His injuries were so severe that he was quickly 
transferred to the Walter Reed Army Medical 
Center, where he was placed on a floor with other 
amputees. Russell recalls that he was, at first, 
overwhelmed. He had had no virtually no exposure 
to disabled people or issues - he knew no 
one who had lost a limb. Nor was the program 

154 HISTORY OF INTERNATIONAL REHABILITATION 


then in place at Walter Reed of any particular 
help. The ideas of clinicians such as Rusk and 
Kessler had yet to affect treatment even at such 
major army hospitals. Writing in The Best Years 
of My Life many years later Russell recalled that 
"For a disabled veteran in 1944, 'rehabilitation' 
was not a realistic prospect. For all I knew, I was 
better off dead." 

One day, however, Russell was shown a 
short documentary film entitled Meet McGonegal, 
about Charlie McGonegal, a World War I bilateral 
amputee who had gone to work in real estate. Although 
the film itself ran less then ten minutes, 
and featured Mcgonegal doing such mundane 
tasks as shaving, dressing and driving to work, 
Russell recalls that "I watched the movie in awe," 
and had it replayed repeatedly. When McGonegal 
himself came by a few weeks later, Russell and he 
quickly became fast friends. 

While Russell felt the short documentary on 
McGonegal was outstanding; the Ai iny believed 
the World War I film was too outdated. They 
wanted to make a new training film for recently 
disabled soldiers, with more attention paid to social 
and psychological issues. Despite having no 
acting experience, Russell, the only bilateral amputee 
in the hospital at the time, was asked to 
'star' in the film. The resulting film, Diary of a Sergeant 
took only a few weeks to shoot, and as far 
as Russell was concerned, was an interesting interlude 
before he returned home to Cambridge to 
begin his studies at Boston University in business 
administration. 

Soon after film's release, however, the army 
decided to use the training film in War Bond Rallies. 
Russell, wanting to do what he could to help 
out, continued to work for the Army between 
semesters at school, attending War Bond rallies 
around the country at which the film was to be 
shown and making short speeches afterwards. In 
1945, during the last War Bond Rally funds were 
specifically designated for "rehabilitation" of 
veterans, with 'rehabilitation' actually part of the 
title. 

Unbeknownst to Russell, the filmmaker 
Samuel Goldwyn was working on a script entitled 
Glory for Me, to be directed by William Wyler. The 
film which was renamed Best Years of Our Lives, 
had begun casting. However, one leading character 
proved exceptionally difficult to fill; 'Homer 
Parish', a character described as "a spastic 
sailor." By chance, William Wyler happened to attend 
a War Bond rally where Diary of a Sergeant 
was shown. Wyler was struck by the fact that the 
sergeant portrayed seemed to be going through 
many of the same adjustments to civilian life as 

the film's disabled character. Wyler got a copy of 
Diary of a Sergeant and went to find Samuel 
Goldwyn. Russell meanwhile, had finished his last 
War Bond rally and had gone back to Cambridge, 
where he was running a boys' program at a local 
YMCA and beginning his undergraduate degree at 
Boston University. He was at his desk at the "Y" 
one Friday night when he received a phone call 
from Goldwyn's secretary. Believing it a joke, he 
promptly hung up. It took her persistence to convince 
him to meet with her and consider the part. 
He agreed to work on the film, in part, because he 
believe he could introduce issues of concern to disabled 
veterans to the American public. 

Filmed in 1946, the film was an immediate 
success, winning nine Oscars in 1947, including 
that of best picture. Russell had been nominated 
for best supporting actor, but was considered a 
long shot. To ensure that he receive some official 
recognition, The Academy set up a special Oscar 
for him, for "bringing aid and comfort to disabled 
veterans through the medium of motion pictures." 
When he also was voted best supporting actor, 
Russell became the only person in the history of 
film making to take home two Oscars for the same 
part. It has been estimated that the film itself has 
been seen in 35 countries by 60 million people. 
(Its release on videotape and selection as one of 
the ten best American films by the Library of Congress 
insures that it will eventually be seen by 
again as large an audience). 

In early 1947 Russell toured the country to 
help promote the film as it opened in one city and 
then another. In Washington, a reception for the 
film was held at the White House on behalf of a 
charity organization. President Truman was there 
and struck up a conversation with Russell. As 
Russell recalls "here was the President of the 
United States and I was a beat up Army sergeant— 
I couldn't believe it. And he was telling me about 
the plan that he had to set up a committee, called 
at that time the President's Committee on the 
Employment of the Physically Handicapped..." 
Truman asked Russell to join the committee, and 
he immediately agreed. It was his introduction to 
the field of rehabilitation—he knew no one else in 
field. 

Russell joined the President's Committee on 
National Employ the Physically Handicapped 
Week in 1947. Soon, others such as Senator 
Hubert Humphrey, began to ask his advice on 
legislation for returning veterans. Russell took an 
active role in the workings of the Committee, and 
in 1962, President Kennedy appointed Russell 
Vice Chairman of the President's Committee. In 
1964, President Johnson appointed him Chair-

HISTORY OF INTERNATIONAL REHABILITATION 155 


man, a voluntary position he held for the next 25 
years. His commitment to disabled causes and disabled 
veteran's issues extended to his other work 
as well. In 1948, Russell became involved with 
American Veterans of World War 11, (AMVETS), a 
group that paid particular attention to rehabilitation 
issues and programs for disabled veterans. 
He served for a time as National Commander of 
AMVETS, and through AMVETS became involved 
with the World Veterans Federation. 

Russell, one of the best known and most 
visible of disabled Americans for many decades 
has given freely of his time and energy to a number 
of disability and veteran causes. In addition to 
his film work, he has authored several books on 
his experiences. His first, Victory in My Hands, 
was a best seller, published in 54 countries, and 
was one of the earliest books to bring the issues 
of disability and rehabilitation to the attention of 
millions. In addition to his volunteer work with 
disability and veteran's issues Russell also supported 
his family by running his own small insurance 
company in Massachusetts. Although he 
is not a professional actor, he had appeared in 
several films in the past few years, and is considering 
more acting work in the future. Russell is 
now retired, and he and his wife live on Cape Cod. 

Henry Viscardi, Jr. 

Henry (Hank) Viscardi was born in New York 
City in 1912. Born without legs, he spend most of 
his very early 
childhood at a 
charity hospital 
undergoing a 
series of operations 
that would 
eventually allow 
him to wear 
padded boots 
over his stumps, 
although he also 
made make use 
of wheelchairs 
and modified 
skate boards. He 
returned home at 
the age of six, 
and eventually 
moved to Long Island, 
where he 
lived with his 
parents and 
sisters. Viscardi 
was an excellent 

Depression made his ability to stay in school increasingly 
difficult however, and he eventually 
had to drop out of college at the end of his junior 
year for lack of money. He attended law school at 
night while helping to support his family by doing 
tax work. When he was 27 years of age, his local 
family doctor encouraged him to try to learn to 
use artificial legs, and Viscardi took a leave of absence 
from work, and eventually mastered the arduous 
task of walking noinially with two artificial 
legs. 

Although Viscardi was exempt from the draft, 
he volunteered for work with the Red Cross at the 
beginning of the War. Convinced that his own experience 
with prosthetics would make him the 
right person to teach new amputees how to walk, 
Viscardi requested the Red Cross put him to work 
at the Walter Reed Army Medical Center, where 
the most severely injured men in the aimy were 
treated. Viscardi was an outstanding teacher. He 
was adamant that his men work to regain skills 
that they had lost, they often thought were 
beyond them. At the same time, he was a tireless 
advocate on behalf of his men, feeling strongly 
that they were receiving less than adequate 
rehabilitative care, shoddy prosthetic devices and 
little or no counseling. Viscardi's untiring insistence 
that the men he worked with were entitled 
to everything the army could provide, (including 
his run in with the top army brass described in 
the text), created some movement within the 
Hospital. Viscardi's lack of patience with paper-

student, but the Dr. and Mrs. Viscardi visit a vocational workshop in Bombay. 

156 HISTORY OF INTERNATIONAL REHABILITATION 


work however, got him in every deeper trouble 
with his superiors in the Red Cross. It was not 
that Viscardi refused to do paperwork. Rather, as 
Viscardi later recalled, all his time and energy 
went to teaching individuals how to walk. Taking 
hours and days off to turn in the proper reports 
and fill out required forms seemed to him 
preposterous. It seemed less preposterous to the 
Red Cross however, who, after repeated warnings, 
dismissed Viscardi from their ranks. Viscardi, 
giving an indication of future determined behavior, 
felt that the men he worked with were relying 
on him, and would not be so easily dismissed. 
For many months until the War drew to a close, 
people strolling the ground of the Walter Reed 
Army Medical Center were treated to the sight of 
amputee veterans sneaking away into the bushes 
to meet Viscardi for walking and driving lessons. 

At the end of the War, Viscardi returned to 
New York, where he married and quickly became 
a very successful businessman. In 1949, Viscardi 
was contacted by Orin Lehman, a member of the 
prominent New York banking and brokerage family. 
Lehman had himself lost a leg in the War, and 
was concerned about unemployment among 
returning disabled veterans. Lehman invited Viscardi 
and an handful of other prominent business 
leaders to join him on a committee which called itself 
Just One Break (JOB). The committee met 
twice a month, interviewed disabled veterans and 
then, using their connections, tried to line up jobs 
for as many as they could. 

Although JOB was quite successful for a 
small committee, and eventually placed several 
thousand individuals, Viscardi felt that there was 
more yet to do. He was specifically concerned 
about those veterans and civilians who were too 
severely disabled to find work in the competitive 
job market. Viscardi felt that if no one else was 
willing to hire these people, he would. Unfortunately, 
he did not own a company. Undeterred 
by such minor considerations however, in the 
summer of 1952, Viscardi borrowed $8,000, 
rented an unoccupied garage in West Hempstead, 
Long Island and declared himself president of 
Abilities, Inc., a non-profit industrial and clerical 
work center. The only other employee was the 
plant manager Arthus Niernberg, who was 
paraplegic. Viscardi assigned Neirnberg the 
responsibility of locating furniture and beginning 
to interview employees, while he himself began to 
visit local executives and line up assembly line 
piece work for his new business. By September, 
the first assembly line opened with a crew of five. 
Within two years, Abilities had 160 employees and 
a backlog of work. Its growth has been constant 
since that time, and over the years, has employed 

thousands of men and women with severe disabilities. 


Viscardi's success with Abilities came about 
not only because of his own belief in the project, 
but also because he was an eloquent speaker and 
writer, who had the gift of selling his ideas. He 
refused to argue that people with disabilities 
needed exceptional treatment, insisting instead 
that all they wanted was a job which would 
enable them to support themselves. He regularly 
addressed business meetings, educators and 
policy makers. He wrote eight well received books, 
including his autobiography, A Man's Stature, 
which was translated into over 30 languages. In 
addition he published shorter articles about his 
own experiences and the work of his center in 
newspapers and widely distributed magazines 
such as The Reader's Digest, which had an international 
readership of millions. He became a 
prominent figure on the national rehabilitation 
scene with close ties to Bernard Baruch and 
Eleanor Roosevelt. (Roosevelt became a close family 
friend, and attended the baptism of all four of 
the Viscardi's children). Mary Switzer frequently 
worked with Viscardi, and regularly asked him to 
send a copy of one of his books to prominent 
people whom she though should know more 
about the rehabilitation field. 

Viscardi became a regular figure at both national 
and international rehabilitation meetings. 
He chaired the 1977 White House Conference on 
the Handicapped, submitting recommendations to 
Congress and the President on legislation affecting 
disabled children and adults. He also serves 
an a consultant in the international arena, and 
has been a consultant as well to ever every 
American President since Roosevelt on disability 
matters. 

Over the years, the scope of activities overseen 
by Abilities, Inc. has expanded as well, the 
organization eventually changing its formal title to 
the Human Resources Center, which includes 
employment, educational, research, rehabilitative 
and social services resources for adults and later 
children with disabilities in the Long Island 
region. Some 40 Abilities in 37 countries have 
been established using Viscardi's center model. 
Its influence has been felt worldwide, as it has 
helped to alter the employment practices of many 
major national and international firms. 

Helen Payne Wilshire Walsh 

Helen Payne was born in Cincinnati, Ohio in 
1898. Her father was a prominent insurance executive 
and her mother, a homemaker, took an ac-

HISTORY OF INTERNATIONAL REHABILITATION 157 


Helen Walsh presents a RIUSA Volunteer of the Year Award to First Lady Patricia Nixon in 1970. 

Live role in civic affairs. She insisted that her two 
sons and only daughter also volunteer part of 
their time and energies to community efforts, and 
Helen Walsh recalls that even as a teenager, it 
was expected that she spend her Saturday mornings 
working with underprivileged children. She 
attended Miss Kendrick's School and then studied 
piano at the Cincinnati Conservatory of Music. 

She married Joseph Wilshire and moved to 
Greenwich, Connecticut in 1923, where she continued 
her involvement in community affairs 
while her husband worked his way up the corporate 
ladder. The Wilshires' also shared a sense 
of adventure. For example, they both took time 
out of their busy schedules to perform professionally 
in a circus troop. Her husband, fifteen 
years older than herself, became the Chairman of 
the Board of Standard Brands when still in his 
early forties, and Helen Wilshire soon found herself 
active in local affairs and local Republican 
politics. In 1938, the Connecticut Republican 
Party tried to recruit Helen to run for Congress. 

By that time, however, her life had changed 
dramatically. Her husband Joseph had taken a 
bad spill from a horse, and his spine had been 
seriously damaged. Over the course of several 
years, his condition grew increasingly worse, and 
he eventually used a wheelchair, and experienced 
almost constant discomfort. Helen, anxious to 
help him and intent on finding out as much as 
she could on the current state of research in the 
field, read everything she could find on spinal in


jury, neurology and 
chronic disability. 

Already interested 
in medicine through her 
readings, a news report 
on the use of plants in 
medicine sparked her interest 
and Helen became 
very interested in the 
subject. She went 
regularly to the Brooklyn 
Botanical Gardens to 
learn more and she also 
began to give public 
speeches on the current 
value and future medical 
potential of plants, arguing 
that much more research 
needed to be done 
in the field. She spoke to 
women's groups, as part 
of public lecture series, 
to university audiences, 
and at one point, in front 
of the National Academy 

of Sciences. Her interest in plants became known 
to her friends in Greenwich and one, Mrs. 
Gimble, suggested that she would like to arrange 
a lunch meeting between Helen Walsh and a particularly 
good friend of hers, Howard Rusk. Thus 
began a long and productive collaboration. 

Rusk invited Helen to become a volunteer in 
his new Institute in New York City. Widowed 
shortly before she met with Rusk in 1951, she 
began to work regularly at the Rusk Institute in 
1952 starting out as an auxiliary worker in the 
gift shop. She was soon working four days a week 
at the Institute, running the auxiliary, fund raising 
and coordinating special projects. Rusk relied 
on Helen Walsh as a problem solver in a wide 
number of areas, and Helen covered many areas 
of the hospital in one capacity or another. Helen 
continued her volunteer activities at the Institute 
even after her remarriage to William J. Walsh. 

Through her work at the Institute, Walsh 
was appointed an Associate trustee of the New 
York University Medical Center, and was also invited 
to join the President's Committee on the 
Employment of the Handicapped. 

It was through Rusk that Walsh became involved 
in international activities as well. Rusk became 
President of the International Society for the 
Welfare of Cripples in 1954, and remained President 
until 1957. He invited Helen to join the 
Board of the Society, and Helen began to regularly 
attend World Congresses and regional meetings. 

158 HISTORY OF INTERNATIONAL REHABILITATION 


-

Helen Walsh, third from right, with some members of the U.S. delegation to RI's Thirteenth World Congress in 1976 in Israel. Left to right are: Fen-
more Seton, Jack Taylor, Phyllis Seton, Ellis Reida, Ethel Hausman, George Welch, Elly Skinner, Helen Walsh, Earl Cunard and William Walsh. 

At Rusk's invitation, Walsh also became very active 
in the World Rehabilitation Fund when it was 
formed in 1955. 

In 1971, Helen became Chair of Rehabilitation 
International USA, (RI USA), a committee 
which sought to raise money to support 
Rehabilitation International through fund raising 
among American based rehabilitation organizations. 
She took the position with the understanding 
that it would last only six months, but 
her "temporary" position continued for 12 years. 

Helen Walsh continues to be actively involved 
in Rehabilitation International, as well as serving 
on a number of community and state committees 
and with the Republican party. She lives in Greenwich, 
Connecticut. 

Dorothy Warms 

Dorothy Warms was born in New York in 
1912, the youngest of 4 children. Her father 
owned a garage, and her mother was a 
homemaker. She graduated from Hunter College 
High School and then attended Barnard as a Ger


man and psychology major graduating in 1934. 
Her first job as a research assistant at Yale lasted 
only six months. Homesick she returned to the 
Bronx where she took at job at the Home Relief 
Bureau doing case work for families severely affected 
by the Depression. She enjoyed her job and 
kept it after her marriage in 1937, while her husband 
began to build his legal practice. Warms 
continued to work at the Home Relief Bureau 
more or less regularly for the next seven years, 
but then gave up the job after the birth of her first 
child and stayed home to raise her children. 

In 1954 Warms' husband became ill and was 
unable to work for some time. To support her 
family Warms "brushed up" on her short hand 
and went to find a job. She soon found a 
secretarial job in the Social Welfare Department of 
the National Council of Churches. To this day, 
Warms' prides herself on the fact that "I must 
have been the worst secretary in New York City." 
Her boss agreed and told her "you'll never make a 
living at this." Fortunately, he thought she had 
great potential in other areas and shifted her to 
the position of an administrative assistant instead. 
Wat ins worked for the National Council of 

HISTORY OF INTERNATIONAL REI-IABILITATION 159 


Churches for 
four years, 
taking courses 
part time at the 
New York School 
of Social Work 
at Columbia 
University to better 
qualify her 
for the job. (Her 
progress 
through the 
graduate school 
was not rapid, 
she finally completed 
all her

Dorothy Warms, 1990 

course work and 
received her Certified 
Social Worker certification in 1965). 

While Warms enjoyed her work at the National 
Council, it eventually became apparent that to 
become a higher level administrator in the organization, 
one had to be an ordained minister an 
option not open to women in the 1950s. A member 
on the Board of the Social Welfare Department, 
Gunnar Dywbad, urged her to come work 
for him at his new position at the Association for 
Retarded Citizens, but Warms was not at that 
time interested in the offer. Instead, she went to 
an employment agency who informed her that 

"they had this opening at this international organization 
and I went to see Don Wilson." Warms 
had never heard of the organization for which she 
was interviewing, The International Society for the 
Welfare of Cripples. She also recalls that at the 
time she "knew absolutely nothing about 
rehabilitation." 

She joined the International Society (now 
Rehabilitation International) in 1958, and was immediately 
put to work on the planning of their upcoming 
World Congress in New York. In addition, 
she was given a number of other projects and assignments, 
as well as the responsibility of keeping 
up much of the correspondence and helping to 
host visiting dignitaries. She was soon working 
"eight in the morning to eight at night," and her 
husband would call her at work and ask plaintively 
if she "was ever coming home?" 

Dorothy Warms quickly became an integral 
part of the rehabilitation scene and a key player 
in organizing conferences, collaborative efforts 
and networking. She worked closely with Donald 
Wilson and then became acting Secretary General 
for a year after Wilson left to join the Leonard 
Wood Memorial Fund, keeping the Society active 
while Acton completed his work with the World 
Veterans Federation and moved to New York. 
(There had been some inquiry made as to whether 
Warms herself would be interested in becoming 
Secretary General, but she turned down the sug


gestion, as her family commit


ments made the extensive travel 

and long hours that went with 

the job difficult to undertake). 

Dorothy Warms genius was 
in identifying talent and encouraging 
others. She rarely 
took credit for the work done, 
choosing instead to remain largely 
behind the scenes and work 
out of the limelight. She nonetheless 
was an extremely strong 
voice within the rehabilitation 
community, and instrumental in 
ensuring that new and innovative 
ideas were included in the 
international agenda. For example, 
Waims was a strong 
proponent of including mental 
retardation issues and parent advocacy 
in general rehabilitation 
issues. She was involved and 
supportive of early disability 

rights issues. She retired from

A 'time capsule" of Rehabilitation International: left to right, Donald Wilson, former Secretary 

Rehabilitation International in

General; Barbara Duncan, Assistant Secretary General; Susan Hammerman, current Secretary 
General; Dorothy Warms, former Deputy Secretary General; and Norman Acton, former Secretary 1972, after 13 years with the or-
General. ganization, moving across town 

160 HISTORY OF INTERNATIONAL REHABILITATION 


to work with United Cerebral Palsy. Now widowed, 
she remains active in the field of rehabilitation 
and continues to work part time for United 

Cerebral Palsy. 

Harold Wilke 

Dr. Wilke 

chores, do well in school and take 

Harold 

Wilke was 

born on a 

small farm in 

Missouri in 

1918, the 

second of 

three boys. 

Born without 

arms, his 

parents quick


ly came to ac


cept the 

situation, and 

insisted that 

Harold con


sider himself 

and be treated 

by others, as 

any other 

child. He was 

expected to 

help with farm 
part in com


munity events, the only difference between him


self and other being that he used his feet in place 

of hands for anything that needed to be manipu


lated. Initially excluded from 

the local school because the 

teacher thought he would 

prove too much of a distraction 

to the other children, Wilke's 

father was able to locate a one-

room school in the country 

that would accept him. As 

Wilke recalls, actually getting 

to school was often more chal


lenging than the work that had 

to be done once there. His long 

walk to school was enlivened 

by a walk through the woods, a 
run through a pasture with a 

bull prowling around and fording 
three streams. While the 
local school may have refused 
him entrance, he early became 
deeply attached to his church 

which was fully accepting and 
allowed him to participate free-

Although his family refused to pity him or 
give him special treatment, they keenly sought information 
on his condition and even traveled to 
Chicago with their young son to meet Kittie 
Smith, a woman who had lost her arms in a fire 
as a child. Smith also used her feet with great dexterity, 
and Wilke's parent's were enormously encouraged 
by her ability to take care of herself. 
They came increasingly to expect that their son 
would grow up to be an independent and self-supporting 
adult. 

Wilke decided to become a minister while 
still in high school. Very active in his church and 
in church youth groups, his decision was greatly 
aided by two ministers he encountered early on. 
Both strongly advised him not to go into the ministry 
because of his disability. Used to being accepted 
and treated as an equal in his small 
community, their advice not only made Wilke 
more determined than ever to enter the ministry, 
but also helped him think carefully and critically 
about why he wanted it. 

He received his BA from the University of Missouri 
and his B.D. from the Union Theological 
Seminary in New York, and pursued graduate 
work at the University of Chicago. While the initial 
resistance to his disability may have been a driving 
issue to Wilke before his studies, his disability 
would not be a central issue in his own professional 
career for the ensuring decades, although 
he would regularly serve as a volunteer to help 
"disabled people". He was ordained a minister in 
the United Church of Christ, and returned to his 

ly. Dr. Wilke consulting with Kuwaiti disability leaders Munira Al-Muttawa and Munira Al-Gatami in London, 
1986. 

HISTORY OF INTERNATIONAL REHABILITATION 161 


alma mater to work as pastor at the University 
Chapel at the University of Missouri. It was in Missouri 
that he married Margaret Vigars. They were 
to have five sons. 

Wilke spent the War years as a Chaplain of 
an army hospital in Boston, and at while in the 
Boston area, completed a Masters Degree at the 
Andover Newton Theological Seminary. His career 
as chaplain continued, as he moved to Topeka 
Kansas to serve as chaplain at the local Veterans 
Administration Hospital. While in Topeka, Wilke 
also was on the faculty of the Menninger School of 
Psychology, working closely with Dr. William C. 
Menninger himself and serving as a chaplain in 
his clinic. 

From Topeka, Wilke and his family moved to 
the Chicago suburb of Crystal Lake, where he became 
an active and respected local minister, while 
at the same time working on his doctorate 
through the University of Chicago. A popular minister 
and good administrator, Wilke was invited by 
his colleagues at the United Church of Christ's national 
headquarters in New York to join their staff, 
and for the next twenty years, Wilke headed their 
Council for Church and Ministry, a program that 
dealt with recruitment, education and placement 
issues for the nine thousand ministers of the 
denomination, as well as retirement and insurance 
issues. 

In the 1970's, Wilke began to reevaluate his 
own life and his career. The social unrest and the 
Viet Nam War made Wilke think critically about 
justice and equality within society. He was 
surprised to realize that he himself had been leading 
a divided life for some years. Later he would 
tell a New York Times reporter "I kept saying that 
my responsibilities had nothing to do with my 
armlessness, that my handicap was irrelevant 
and of course it was. But at the same time, I was 
spending most of my weekends and vacations as a 
volunteer with handicapped people. I was living 
two kinds of life." 

In 1975, Wilke resigned from his executive 
position to devote all his energies to a group he 
helped to establish. Including church leaders, 
professors and rehabilitation personnel, "The Healing 
Community" addressed issues of social justice 
and equity, and took as its central mission the 
need for the religious community to accept disabled 
individuals and those alienated by society, 
such as Vietnam veterans, the homeless, those 
with drug addiction and others. Wilke was named 
founding Director, and took as his personal mission 
the need to convince religious organizations 
to open their doors to disabled members not only 
to make their facilities accessible, but to ensure 

that disabled congregants were included in the 
central activities of the church. 

The Healing Community, now 15 years old, 
continues to address problems of those alienated 
by modern society and social institutions. Wilke 
continues his work with the Community and has 
preached to over a thousand congregations both 
in the United States and in fifty-five other 
countries around the world. He has recently 
moved to California, but commutes to New York 
regularly to maintain ties with Union Theological 
Seminary. He sits on dozens of national and international 
boards of directors for religious and lay 
organizations. In addition to his other activities, 
he has written extensively both on his own experiences 
as an individual with a disability, and 
on theological and philosophical issues and concerns 
of daily living. 

Donald Von Stein Wilson 

Donald Wilson was born in Kansas City in 
1909. He earned his undergraduate degree in 
political science from Muskingum College in Ohio 
in 1931, his LL.D from Western Reserve University 
in Cleveland in 1934, and was admitted to the 
bar that same year. In 1937 he also completed a 
masters degree at the School of Social Services Administration 
at the University of Chicago. 

Wilson began his career in social work at the 
Boys Club at Hiram House, a large settlement 
house in Cleveland. From 1932 to 1934 he 
worked as a case worker for the Ohio Relief Administration 
of Cuyahoga County and first worked 
in the field of rehabilitation in 1935, when he became 
a case worker for the Association for the 
Crippled and Disabled in Cleveland. (His work 
with both the Relief Administration and the Association 
for Crippled and Disabled were overseen 
by the same individual who served as part-time 
Director of the first, and Executive Secretary of 
the second during those very years Bell Greve. It 
was an association that would be significant to 
Wilson in later years). 

In 1937, Wilson took a position as Lecturer 
in the Graduate School of Social Welfare at 
Louisiana State University in Baton Rouge. He 
taught at the school until the start of the War, 
also working concurrently on policy and legislation 
for the Louisiana Department of Public Welfare. 
Wilson remained in Louisiana until 1942, 
when he joined the Army and received special 
training in military government and civil affairs. 
In 1946, Wilson was named Chief of the Public 
Welfare Branch of the Military Government section, 
with the Eighth Army in Yokohama, Japan. 

162 HISTORY OF INTERNATIONAL REHABILITATION 


Donald Wilson, 1951, RI Secretary General 

tion, with the Eighth Army in Yokohama, Japan. 
The following year he became the Social Welfare 
Officer, in the Public Health and Welfare Section 
on General MacArthur's staff in Tokyo. Working 
from his base in Tokyo for the next year, he was 

instrumental in establishing the first school of social 
work in Japan and in designing and running 
training programs for persons with governmental 
and voluntary social welfare. 

Wilson returned to the United States in 
1948, and took an appointment as Dean of the 
School of Applied Social Sciences at Western R-
Eserve University. His position as Dean lasted 
only a year. In 1949, his former boss, Bell Greve 
urged Wilson to come to New York to take over the 
reigns of the new International Society for the Welfare 
of Cripples. Appointed in 1949, he brought 
his previous 20 years of experience as a social 
and rehab worker in Ohio, Illinois, Louisiana and 
Japan. 

Wilson was Secretary General of the International 
Society for the Welfare of Cripples from 
1949 until 1966, and was largely responsible for 
its early growth and development. In 1949, the 
number of nations who were members of the or


ganization was only 12. Increasingly the number 
of participating countries became a priority for 
Wilson and by the time he departed in 1966, sixty-
three nations maintained membership. Although 
much of Wilson's activity is already covered in the 
historical section of this book, a brief review of 
some of his major accomplishments would include 
the fact that he helped foster close ties between 
the International Society and the UNited 
Nations, (and allied organizations such as 
UNICEF and WHO) and with other leading international 
health and advocacy organizations. He was 
instrumental in reviving the World Congresses, 
beginning with the first one in Stockholm in 
1951, and cleverly arranged for many of the meetings 
to dovetail with other larger international 
society meetings, so that attendance would increase. 
He also began the practice of holding 
regional conferences to enable better communications 
within nearby geographical areas, and most 
of these meetings met with considerable success. 

After eighteen years with the International 
Society, Wilson was ready to move on. He 
resigned as Secretary General in 1966 to take the 
position of President of the Leonard Wood 
Memorial for the Eradication of Leprosy, a post he 
kept until 1970. In 1970 he became the Deputy 
National Executive Director, of Goodwill Industries 
of America and remained there until his 
retirement in 1973. Wilson now lives in a suburb 
of Washington, DC and continues to remain active, 
sitting on a number of boards, and advisory 
groups. 

Donald Wilson, 1975 

HISTORY OF INTERNATIONAL REHABILITATION 163 


About the Author 

Nora Ellen Groce is a medical anthropologist currently teaching and working 
on research at the Yale University School of Public Health. 

In the disability field she is probably best known for her 1985 book, Everyone 
Here Spoke Sign Language on the subject of hereditary deafness on Martha's 
Vineyard. The book traces the impact of a high incidence of deafness on an isolated 
New England community and is one of the few studies of a community where disability 
was "normal." Television and radio specials on the book were carried by National 
Public Radio and WGBH-Boston in the USA, by the BBC in England and on 
the Australian Broadcasting Service. A commercial film of the book is in development. 


Ms. Groce is a founding member of the Society for Disability Studies and 
regularly serves as a guest editor for cross-cultural issues of its periodical, Disability 
Studies Quarterly. 

During the 1980s her academic appointments included teaching in the 
anthropology departments of Harvard University, Bowdoin College and Brown 
University. Other books and monographs by Groce include The Town Fool: Mental 
Retardation in a Small-Scale Society (1986, Wenner-Gren Foundation, New York) 
and The Prevalence of World Hunger: Current Methodologies for Assessing the Extent 
of Hunger in the Developing World (1988, Brown University). 

As a consultant, she has worked with the World Health Organization, the Boston 
Children's Hospital, the National Endowment for the Arts, Rehabilitation International, 
the Smithsonian Institution—Folklife Division and Harvard University's 
Committee on Disability Affairs. 

She is an active member of the following professional organizations: the 
American Anthropological Association, the Society for Medical Anthropology, and 
the American Folklore Society. 

Her education includes: Post-Doctoral Fellow, Harvard Medical School, 1986; 
Ph.D., in Medical and Socio-Cultural Anthropology, Brown University, 1983; M.A. 
in Cultural and Medical Anthropology, Folklore, Brown University, 1976; and B.A. 
in Anthropology, University of Michigan, Ann Arbor, 1974. 

She resides in Essex, Connecticut with her husband, son and daughter. 

164 I IISTORY OF INTERNATIONAL REHABILITATION 


1 The organization that is today known as 
Rehabilitation International has had a long list of 
people involved and four formal name changes. 
The following list of people, Congresses and formal 
names of the organization is intended to provide 
a brief chronological outline for the reader: 

A) Founded 

1922 Edgar F. Allen, Founding President 
1929 Paul H. King, U.S.A. 
1942 Dr. Juan Farill, Mexico 

Bell Greve, first Secretary General 
1948 Dr. Henry Kessler, U.S.A. 
Donald V. Wilson, Secretary General 
1951 Konrad Persson, Sweden 
1954 Dr. Howard Rusk, U.S.A. 
1957 Sir Kenneth Coles, Australia 
1960 Hall H. Popham, Canada 
1963 Dr. C.W. de Ruijter, Netherlands. 
1966 Dr. Gudmund Harlem, Norway 
Norman Acton, Secretary General (1967) 
1969 Jean Regniers, Belgium 
1972 Prof. Kurt-Alphons Jochheim, Federal 
Republic of Germany 

1976 Kenneth Jenkins, Australia 
1980 Dr. Harry S.Y. Fang, Hong Kong 
1984 Dkfm. Otto Geiecker, Austria 

Susan Hammerman, Secretary General 
1988 Fenmore Seton, United States 

B) Titles of the organization that is now 
named Rehabilitation International: 

1922 International Society for Crippled Children 
1939 International Society for the Welfare of 
Cripples 
1960 International Society for Rehabilitation of 
the Disabled 
1972 Rehabilitation International 

C) World Congresses sponsored by Rehabilitation 
International 

1929 First World Congress, Geneva, Switzerland 

Footnotes 

1931 Second World Congress, the Hague, 
Netherlands 
1936 Third World Congress, Budapest, Hungary 
1939 Fourth World Congress, London, England 
1951 Fifth World Congress, Stockholm, Sweden 
1954 Sixth World Congress, the Hague, Netherlands 
1957 Seventh World Congress, London, England 
1960 Eighth World Congress, New York, U.S.A. 
1963 Ninth World Congress, Copenhagen, Denmark 
1966 Tenth World Congress, Wiesbaden, Federal 
Republic of Germany 
1969 Eleventh World Congress, Dublin, Ireland 
1972 Twelfth World Congress, Sydney, Australia 
1976 Thirteenth World Congress, Tel Aviv, Israel 
1980 Fourteenth World Congress, Winnipeg, 
Canada 
1984 Fifteenth World Congress, Lisbon, Portugal 
1988 Sixteenth World Congress, Tokyo, Japan 
1992 Seventeenth World Congress, Nairobi, 
Kenya 

2 A number of leading figures in international 
rehabilitation can be traced to Ohio and many 
were affiliated with the Case Western Reserve 
University's School of Social Work. Among others, 
the following individuals later involved in international 
rehabilitation activities were active in Ohio 
in the 1920s and 1930s: Edgar Allen, Bell Greve, 
Leonard Mayo, Romaine Mackie and Donald Wilson. 
James Burress, who was disabled from infancy, 
grew to adulthood in Ohio during these years, 
and received services for disabled children established 
in part by some of these people. Virginia 
(Gini) Laurie would not come to Ohio until the 

1940s, but her work began and was carried out in 
Cleveland for three decades. Romaine Mackie, 
later to serve as the international expert in special 
education in the Federal Government's Department 
of Education, worked in Ohio in the late 
1920s and recalled that you "couldn't help being 
interested in international issues if you worked in 

HISTORY OF INTERNATIONAL REHABILITATION 165 


Ohio, the influence from Elyria was so pervasive." 
3 I am indebted to Gunnar Dybwad for information 
about the significance of tenBroek's work. 
4 Interviews from five members of the 
President's Panel on Mental Retardation were 
gathered after President Kennedy's death. The 
transcribed interviews, which included descriptions 
of these foreign study visits, as well as the 
national workings of the Panel, are on deposit at 

the John F. Kennedy Library in Boston, Massachusetts. 


5 Representative Carl Elliott of Alabama, 
Chairman of the Special Education Sub-Committee 
and Labor introduced H.R. 69-81 which was 
designed to provide Federal funds to states for the 
development of independent living services. A 
similar bill, introduced in 1961, also failed. (Dybwad: 
1989) 

166 HISTORY OF INTERNATIONAL REHABILITATION