The COVID-19 pandemic has immersed us all in the science of public health, but do you know of these five pioneering doctors who fought for action on public health and won?

When COVID-19 emerged, chief medical officers and epidemiologists became household names overnight.

Faced with a health emergency, science and communication are essential to protect the nation. Clear and accessible expertise and information can save lives - and history has shown that the opposite can be deadly.

While public health figures such as Dr. Edward Jenner and Dr. John Snow have gone down in history, there are some unsung names whose work saved many thousands of lives.

 

1. The original ‘CMO’

 

Born in Liverpool in 1805, Dr. William Henry Duncan was a doctor at the Liverpool Royal Infirmary for many years and saw how the poor, cramped and dirty living conditions common in the city caused disease and suffering. At the time, the mortality rate in Liverpool was one of the worst in the country, with the population quickly increasing.

In 1842, he submitted evidence to the Poor Law Commission showing these links. His research - and his lectures and published pamphlets - pushed the Town Council to pass the Liverpool Sanitary Act in 1846.

As a result, Dr. Duncan was appointed Liverpool’s Medical Officer of Health, the first such role in the UK. Alongside sanitary inspector Thomas Fresh and civil engineer James Newlands, he helped to bring in revolutionary reforms - including building over 140 miles of sewers and drains nearly 20 years before Joseph Bazalgette introduced these in London.

Throughout his life Dr. Duncan struggled against the idea that disease and moral character were linked: many people believed that illness was an individual failing rather than a result of social poverty and a poor environment. However, his work proved this idea wrong and, before his death in 1863, caused the mortality rate in Liverpool to drop from 36 per 1,000 to 28 per 1,000 in 1860, and inspired the formation of public health departments across Britain.

 

2. The first Native American doctor

Born in 1865 on the Omaha Reservation in Nebraska, Dr. Susan La Flesche Picotte did not have an easy path to medicine. As a girl, she saw a Native American woman die after a white doctor refused to come to the reservation to treat her. The incident inspired Dr. La Flesche to study medicine, and when she graduated first in her class in 1889 she became one of the first Native Americans to earn a medical degree.

She returned to work on the Omaha Reservation, becoming the sole doctor responsible for over 1,200 people. Despite often working 20-hour days, she went on speaking tours and worked to educate her community about public health issues and preventative medicine.

Dr. La Flesche’s work on public health issues included fighting against widespread alcoholism on the reservation, promoting school hygiene and food sanitation, and fighting to stop the spread of tuberculosis - a disease that killed her husband in 1905.

She spent her life fighting for better public education about health issues and became chair of the state health committee of the Nebraska Federation of Women's Clubs in the 1900s. She led fundraising campaigns which led to the building of a hospital on the reservation in 1913, which functioned as the Dr. Susan La Flesche Picotte Memorial Hospital until 1940.

 

3. The health inspector who found Typhoid Mary

 

Dr. Sara Josephine Baker, born in New York in 1873, decided to become a doctor after she lost both her father and brother to typhoid as a child. After graduating from medical school in 1898, she moved to work as a health inspector on Manhattan’s Lower East Side, where conditions were so bad that it was often dubbed the “suicide ward”.

Dr. Baker found that many of her colleagues were not bothering to report or treat the people who were living in these slums. She stated that: “The health department reeked of negligence and stale tobacco and slacking.” However, her determination meant that she was quickly promoted to Assistant to the Commissioner of Health.

In this role, Dr Baker began working on many important projects, from leading a smallpox vaccination programme to becoming director of the new Bureau of Child Hygiene, where she introduced programmes into East Side slums that lead to 1,200 fewer cases of infant mortality in a single year.

However, her most famous role was as one of the doctors who identified and tracked down Mary Mallon in 1907 and 1915 - a cook who is more commonly remembered as ‘Typhoid Mary’. This well-publicized case led to a frenzy of public health reforms, which Dr. Baker used to promote her innovative ideas.

She later gained a doctorate in public health and became the first woman to serve on the League of Nations’ Health Committee in 1922. When she retired in 1923, New York had the lowest infant mortality of any US city due to her work.

 

4. A Glaswegian women’s health pioneer

 

In the interwar years, sexually transmitted diseases ran rife in many impoverished communities in the UK. Dr. Nora Wattie worked for over 30 years to try to alleviate the suffering of women and children in Glasgow - both before and after the establishment of the NHS.

After studying medicine at Aberdeen University and public health at Cambridge University in the early 1920s, Dr. Wattie was appointed Venereal Diseases Officer in Glasgow from 1929. She worked to combat stigmatisation of STIs, publishing medical research and speaking to medical and non-medical audiences about the subject.

After being appointed Principal Medical Officer for Maternity and Child Welfare in 1934, she convinced the Glasgow City Corporation to invest in women’s health clinics in the poorest areas of Glasgow. This improved maternal care and led to her being part of the 1944 British Government’s Scientific Advisory Committee on Infant Mortality. The immunisation campaigns that she led also almost completely eliminated diphtheria in Glasgow within a few years.

Wattie used innovative techniques throughout her career - including contact tracing, campaigning for availability of menstrual products and encouraging sex education. After the establishment of the NHS, she advised on antenatal services and in 1961 she was elected President of the Society of Medical Officers of Health before receiving an OBE in 1964.

 

5. A controversial US Surgeon General

 

Born in rural Alabama in 1933, Dr. Jocelyn Elders did not visit a doctor until she was 15 years old. After joining the army, she became the first person in her family to go to college and was the only woman to graduate from the University of Arkansas Medical School in 1960.

Though she specialised in paediatric endocrinology, Elders became an advocate for sex education - at the time, 20% of children born in Arkansas were a result of teenage pregnancy. As a result of her work, then-Governor Bill Clinton appointed Elders as the Director of the Arkansas Department of Health, making her the first African-American woman in that position.

Under her guidance, Arkansas saw a 24% rise in infant immunisation rates and a 10-fold increase in early childhood screenings. However, her work on sex education and contraceptive availability in public schools, as well as her promotion of public awareness of HIV, led to increasing political attacks.

This continued in 1993, when Clinton nominated Elders to the post of US Surgeon General. In this role she raised public awareness on tobacco related-disease, alcohol and drug abuse, AIDS, and continued her advocacy for sex education. Her calls for reform drew fire and she was asked to resign in late 1994, but has continued campaigning and lecturing on public health issues, even after retiring from medicine in 1999.