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The C. Everett Koop Papers

Memorandum from Juan A. del Real, United States Department of Health and Human Services, Office of the Secretary to David Newhall [on Dr. C. Everett Koop's qualifications to be Surgeon General] pdf (276,683 Bytes) transcript of pdf
Memorandum from Juan A. del Real, United States Department of Health and Human Services, Office of the Secretary to David Newhall [on Dr. C. Everett Koop's qualifications to be Surgeon General]
Item is a photocopy.
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4 (276,683 Bytes)
1981-08-05 (August 5, 1981)
del Real, Juan A.
United States Department of Health and Human Services. Office of the Secretary
Newhall, David
This item is in the public domain. It may be used without permission.
Medical Subject Headings (MeSH):
Public Health
International Cooperation
Exhibit Category:
Biographical Information
Box Number: 5
Folder Number: 6
Unique Identifier:
Document Type:
Physical Condition:
Series: Sequential Files
SubSeries: July 1981
Folder: Confirmation as Surgeon General, 1981 Jul-Sep
5 Aug 1981
To: David Newhall
Chief of Staff
Samual Fromer for
From: Juan A. del Real
General Counsel
Subject: Dr. C. Everett Koop's Qualifications to be Surgeon General
This memorandum responds to your request for our views as to whether Dr. C. Everett Koop meets the qualifications set forth in recent amendments to the statutory requirements for the position of Surgeon General. As indicated below, we conclude that his experience and background in public health programs satisfy those requirements.
Section 204 of the Public Health Service Act, as amended by H.R. 3831, requires the Surgeon General to be appointed from individuals who "have specialized training or significant experience in public health programs." The following are some of the experiences of Dr. C. Everett Koop that would meet that requirement:
Indian Health Needs
Dr. Koop has organized programs to provide medical care to the Tarascan Indians in central Mexico. He established clinics, and trained staff to meet the basic health needs of this heretofore medically unserved tribe. He trained the staff to treat the Indians for a variety of common diseases including worms, diarrhea, and vitamin deficiencies. The training also included improved protein nutrition for children and the adoption of breast feeding by the women.
Dr. Koop provided significant advice to the Dominican Republic Ministry of Health during a serious epidemic of diarrhea in that country. As a result of that epidemic, there was an infant mortality rate of approximately 70 percent. Dr. Koop set up hydration stations, obtained materials from nearby countries, and arranged for doctors and nurses in the area to give intravenous infusions. The physicians that he mobilized at that time are still providing medical care to the underserved in the Dominican Republic.
When Dr. Koop entered the practice of pediatrics 35 years ago, cancer (other than leukemia) was not considered a public health problem for children. Through education programs and stumping the country, Dr. Koop raised the awareness of cancer as a childhood problem and improved techniques for treatment of cancer in children. Through the American Academy of Pediatrics, he established a registry of cancer in children. Now cancer is recognized as the number two killer of children and NIH has established a series of centers for treatment and research of children's cancer.
Infant Mortality
At the time Dr. Koop began surgery on the newborn in 1946, the survival rate of the newborn having major birth defects was in the neighborhood of five to ten percent. By teaching the concept of physiologic care for the newborn, establishing the first newborn intensive care unit, and leading a team effort in the improvement of anesthesia for infants, these rates have been reversed and it is now the mortality rate for infants with major defects that is in the five to ten percent range.
Radiation Exposure
Dr. Koop was among the first to recognize the radiation hazards associated with the x-ray machines that were used to fit childrens shoes. Through the American Academy of Pediatrics, he worked to regulate and eventually to eliminate the use of these machines.
Accident Prevention
Accidents are the chief killers of children. Again through the American Academy of Pediatrics, Dr. Koop was responsible for having the coloring and flavoring removed from corrosive substances that were used to clean ovens. This has greatly reduced the number of burns to children who thought these substances were candy.
Delivery of Care to the Underserved
Early in his career, Dr. Koop delivered babies at home in Harlem. For 30 years he has been deeply involved in providing primary care and consultative services to children in the black ghetto in Philadelphia.
The Childrens Hospital of Philadelphia, where Dr. Koop was Chief of Surgery, owned and operated the Philadelphia serum exchange where hyperimmune sera and serum globulin were manufactured. The Hospital also experimented with plasmaphoresis and manufactured blood typing sera for rare blood types.
During World War II Dr. Koop was surgical consultant to a hepatitis research unit. He worked with Joseph Stokes, who at that time was hepatitis consultant to the Army for Italy. Dr. Koop was the first to describe transmission of hepatitis virus across the placenta.
Reduction in Medical Costs -- Health Planning Activities
Dr. Koop pioneered with cooperative arrangements in Pennsylvania and New Jersey for the care of respirator-dependent children in their own homes, cutting the cost of that service from $600 a day to $50 a day.
Third World Medical School
At the request of the U.S. State Department, Dr. Koop went to Ghana to "sell" to Nkruma an American medical school for Accra. In spite of Russian and Czechoslovakian competition he did this and guided the staffing of the school until all Departments were turned over to Ghanians.
Fellowships for U.S. Medical Students in the Third World
With a grant from Dewitt Wallace of the Readers Digest Dr. Koop set up a fellowship program for U.S. medical students to have ten weeks to six months experience in small hospitals in third world countries. Seven hundred and fifty such students have been awarded fellowships by a committee which Dr. Koop chairs and some of the earlier grantees are now committing themselves to Public Health careers in the third world.
The above examples demonstrate that Dr. Koop has had significant experience in developing and carrying out public health programs. Each of the above experiences demonstrates not only his awareness of public health needs, but also his ability to bring research and its clinical application into use to devise effective solutions to public health problems.
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