By Robert L. Moore, MD, MPH, MBA, Chief Medical Officer
“The last time I looked in my textbook,
the specific therapy for malnutrition is food.”
-Dr. Jack Geiger
In December, 2020, Dr. H. Jack Geiger, founder of the first Community Health Centers in the United States, died on Monday at his home in Brooklyn at age 95.
In the 1960s, Dr. Geiger was a co-founder, with Dr. Count Gibson, of Community Health Centers in South Boston and in Mound Bayou, in the Mississippi Delta. They provided desperately needed health care but also food, sanitation, education, jobs, and social services — what Dr. Geiger called “a road out” of poverty. The centers inspired a national network of clinics that now number more than 1,300 and serve about 28 million low-income patients at more than 9,000 sites.
Dr. Geiger was a leading proponent of “social medicine,” the idea that doctors should use their expertise and moral authority not just to treat illness, but also to change the conditions that made people sick in the first place: poverty, hunger, discrimination, joblessness, and lack of education.
During his last year of medical school, he traveled to South Africa and worked with two physicians who were setting up a health center in an impoverished, disease-ridden region of the country called Pholela, which was then a Zulu reserve. A key to the center’s success was that local people — its own patients — worked there and helped run it.
For five months Dr. Geiger took care of patients, visiting thatch huts and cattle kraals, meeting traditional healers and seeing the huge improvements — pit latrines, vegetable gardens, children’s feeding programs — that the health center had brought to the region.
In the summer of 1964, he traveled to Mississippi to help care for the civil rights workers who were pouring into the Deep South to campaign for voting rights.
In Mississippi, he saw conditions much like those in South Africa: families living in shacks without clean drinking water, toilets or sewers; sky-high rates of malnutrition, illness, infant death and illiteracy; few or no opportunities for residents to better themselves and escape. He realized that he did not have to travel to Africa to find people in trouble.
Under President Lyndon B. Johnson, the war on poverty had begun and the Office of Economic Opportunity had been created to pay for projects to help the poor. Sponsored by Tufts University, and armed with grants from the opportunity office, Dr. Geiger, Dr. Gibson, Dr. John Hatch and others set up a health center in Mound Bayou, Miss., a poor, Black small town where most people were former cotton sharecroppers whose way of life had been wiped out by mechanization.
The clinic, which opened in 1967, treated the sick, but also used its grant money to dig wells and privies and set up a library, farm cooperative, office of education, high-school equivalency program and other social services.
The clinic “prescribed” food for families with malnourished children — to be purchased from Black-owned groceries — and the bills were paid out of the center’s pharmacy budget.
The governor complained, and a federal official was sent to Mound Bayou to scold Dr. Geiger for misusing pharmacy funds, which, the official said, were meant to cover drugs to treat disease.
“Yeah,” Dr. Geiger replied, “well, the last time I looked in my medical textbooks, they said the specific therapy for malnutrition was food.”
The official, he said, “shut up and went back to Washington.”
(Adapted from Dr. Geiger’s full Obituary in New York Times)