STATEMENT OF KEVIN M. CAHILL, M.D., PROFESSOR AND CHAIRMAN OF TROPICAL MEDICINE, THE ROYAL COLLEGE OF SURGEONS IN IRELAND, AND DIRECTOR OF THE TROPICAL DISEASE CENTER, NEW YORK

Mr. Chairman, Members of the House Foreign Affairs Subcommittee on Europe, I appear before you this morning not to document further discrimination on brutality or bigotry or conflict or meanness or torture or religious hatred. For several days you have heard the sordid tale told, ad nauseum, of the gulf that currently separates the communities of Northern Ireland, and the Irish people living on either side of an anachronistic border.

I do not come before you merely to enunciate the stark facts of medicine in Ireland, though some of those will be presented. Rather, my testimony will emphasize the positive, cooperative efforts that have occurred and are occurring and will occur in the field of medicine in Ireland, and I put forth the thesis that the generosity of spirit and the joint efforts in this humane endeavor will win out when all the bitterness and hatred have spent themselves, and that out of the rubble and chaos that is today the North of Ireland some day reconciliation must come between Catholic and Protestant, between North and South, between Ireland and England, and when it comes it will begin by building on these common grounds that are understandable and acceptable to all sides. Common interests and shared objectives are central to diplomatic practice. Although there are undoubtedly many bridges between Catholic and Protestant, North and South, Ireland and England I can speak only of medicine, for that is my area of competency and interest.

My involvement in medical affairs in Ireland is both professional and formal, and my affection for and knowledge of that beautiful land is the result of genetic and educational factors. I am the President of the New York Celtic Medical Society, the oldest and largest American-Irish medical society in this country. I am also the only American who is honoured at the present time in holding a full Professorship and Chairman of a department in an Irish Medical School. I commute between New York and Dublin a half dozen times per year and number among my friends teachers in all medical circles in that land. I have just returned from a series of meetings in Ireland, and discussed the current strife with the Minister of Health, with the heads of Irish medical associations and societies, with the Deans of Medical Schools, North and South, with practicing physicians and academicians in the North as well as in the Republic, with politicians and journalists, with the Catholic and Protestant Primate Archbishops of Ireland and, despite the understandable accentuation in these hearings on the horrors that have occurred in the North of Ireland in recent years, and the understandable concern and repulsion that these evoke I suggest that one must balance that picture with a presentation stressing the cooperative efforts that not only are occurring, but it seems to me, offer hope for the eventual solution. My views are shared by almost all the responsible physicians with whom I have met during the past years in Ireland.

There have been allegations that a few physicians in the current conflict have been delinquent in their duties, or have actually participated in maltreatment of internees and prisoners; if indeed this has occurred, it is despicable, and these men ought to be condemned. Such actions are condemned, unequivocally, by every Irish physician-North and South-to whom I spoke, and assuredly such actions are not reflective of the spirit of medicine in Ireland today. It would be wrong to accentuate that miniscule percentage just as it would be wrong to conclude that every surgeon leaves forceps behind in the abdomen, even though it is the latter case that will become a cause celebre and reach the newspapers. Without doubt, medical life in the North today is forced from a coherent plan to care for the health of the community to one programmed for the next disaster. Ambulance and emergency services are overwhelmed preparing for and tending to the wounded. Regrettably, the scars of conflict are growing ever more obvious

and ominous as life continues under constant siege. Possibly the psychological damage to the children of Belfast who are growing up in a city enmeshed with barbed wire and sandbags, and patrolled by machine gunners is even greater than the more readily seen lacerations and bruises inflicted by rubber bullets or flying glass. The development of new medical programs and research, and the ability of our profession to serve the sick of the community is stunted by the prolongation of armed conflict.

Another physician might, with ample justification, approach the task of discussing the medical scene in Ireland for this Committee by dwelling on the impact of poverty and violence in the North on the physical health of the populace, or by detailing the psychic injuries inflicted by prolonged and degrading unemployment, or by the constant fear of indiscriminate bombings, or by the ever present threats scrawled on every wall and reflected in the innocent children's games today. People often forget that the oft-quoted number of those killed does not take account of the much larger group that have been maimed, some permanently, and of the medical impact on families when a breadwinner is removed in an area where a marginal economy, to say the least, is the rule. Detailed studies by psychiatrists and specialists in social medicine will some day document this terrible toll. I should like to present an equally valid, and remarkable presentation regarding the current medical cooperation in Ireland.

There are five medical schools in the Republic of Ireland and one medical school in Ulster. There is a free interchange of physicians from North to South with common medical licensure, and in the academic sphere there has always been and continues to be a steady flow of external examiners and lecturers among the six institutions. On the application for Queens Medical School in Belfast, there is no line noting the religion of the applicant, but if one can judge from the secondary schools from which the students graduated, approximately 33 percent of the student body are Catholic, a percentage roughly equivalent to the general population of the area. The mean and contemptible discrimination that has been detailed in other activities and businesses does not occur in medical schools.

Although there does appear to have been discrimination in the appointment of higher consultant and administrative positions in the health sphere by the Govern ment of Northern Ireland, this too is changing and is not reflected in the average practice of medicine.

There are no significant differences in the general vital statistics between Ulster and the Republic of Ireland. Life expectancy tables, birth rates, death rates, infant mortality, perinatal mortality, infectious and cardiovascular disease figures are all quite similar. This cold, statistical comparability is, far more importantly, reflected in human terms.

It should be of interest to this Committee to know that there is a constant and extensive medical exchange between the North of Ireland and the Republic, Within the past week a medical organization of specialists in internal medicine, the Corrigan Club, held their annual meeting in Belfast, and one of the largest numbers of physicians ever from the Republic travelled to meet and discuss and communicate with their colleagues in the North as an overt effort to demonstrate and indeed strengthen the bridge that medicine provides. It should be of interest to this Committee to know that the Royal College of Surgeons in Ireland, an undergraduate as well as a graduate medical facility in Dublin, has extensive interchange of members between the Republic and the North. In their Faculty of Anaesthetists, for example, 57 of the total of 159 fellows are from the North of Ireland; in the Faculty of Dentistry 25 out of 64 are from the North of Ireland, in the Faculty of Radiology 16 out of 36 are from the North of Ireland and that percentage exists in its other divisions. In fact, the College of Surgeons in Dublin is the most international medical school in the western world with students from 32 nations. Political borders and barriers wane in this universal effort for the health of all men of all colors and creeds.

It should be of interest to know that last year the Irish Medical Association held a joint meeting with the Ulster Branch of the British Medical Association in Drogheda, again as an overt act of cooperation. The Royal Academy of Medicine in Dublin not only has joint membership but frequent meetings North and South. The Medical Benevolent Fund assists needy physicians and their families in Ulster as well as the Republic. At the time of the recent marches in Newry, there was joint planning by doctors and hospitals on both sides of the border, and a political line on a map did not deter the Knights of Malta ambulance servicesfrom North and the Republic-from their heroic duties in Derry, Belfast and other troubled areas in recent months. The Irish Orthopaedic and Ophthalmological and

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Otolaryngological and travelling surgical societies have joint membership and constant communications and cooperation. I contend that these efforts are not accidental. They are purposeful examples of intellectual leaders in a humane endeavour to maintain a common ground and a bridge, for someday surely these common grounds will become essential in the eventual healing of the wounds of Ireland.

Possibly one of the most dramatic examples of cooperation and generosity of spirit in recent years has been the decision of the Mater Hospital in Belfast and the North of Ireland Health Service to formally integrate their activities. For 24 years this Catholic hospital worked outside of the government health system, and I believe that it is highly significant that during the period where so many other forms of communications were deteriorating or had become non-existent, that men of wisdom and charity chose a time of terrible strife and division to reach a hand out to one another and join their assets for the welfare of all people in Ulster. It is that type of constructive decision that can set the example for other disciplines. In the January 1972 issue of Modern Medicine in Ireland, the leading editorial stated:

When the chaos of the killings and torturings, and the bitter fears and recriminations have ceased and we are lead by Justice and Sanity to cooperate in some new kind of social and political entente, Health Services will continue to dominate the community scene. It is essential therefore that the goodwill, common mutual help and common cultural traditions of medicine developed in all parts of our two islands through many decades should continue to prevail. Doctors will be required to assist in healing not only the physical and emotional wounds of individual casualties, but also in the rehabilitation of a very sick society." The author, a past President of the Irish Medical Association, also notes that: In the present days of foreboding and confrontations the attitudes and actions of many Irish men and women will be determined by the accident at birth and the ancestral emotions resulting therefrom. Few in their hearts can feel truly neutral. Herein lies the challenge to the medical profession. Doctors in their private work and in their public image, individually and collectively, are called upon to manifest the traditional neutrality of their calling in times of conflict.

Those of us of Irish extraction do not want to avoid the obvious or evade the problems, nor should neutrality be misinterpreted in the above author's words as cowardice. It is a positive neutrality, willing to continue to be involved and serve the Irish who must and someday will again live as brothers. It is a neutrality that calls for generosity of spirit to Čatholic as well as Protestant, to unionist as well as nationalist; it is a neutrality that hopes to preserve and strengthen this crucial bridge between factions.

During the past six months I have had the privilege of testifying before some of the members of this Sub-Committee on a Bill, also introduced by Congressman Carey, that embodies the concept that medicine is an untapped resource for international goodwill, and a vehicle for communication between peoples and nations. In Ireland today, that very concept is a reality and that thesis, it seems to me, offers an example for hope and for reconciliation. I do not pretend that it is the only bridge or the only hope, nor that in itself, it can solve the terrible problems of which you have heard so much. But without any doubt it is a solid, substantial, meaningful area of common ground, and particularly in recent months the discipline of medicine has clearly shown that it contains men of wisdom and goodness who are making open and obvious efforts to cooperate during times of stress, and those working within this sphere are fully cognizant that they are indeed opening and maintaining corridors through which peace must eventually come.

America is surely hesitant to become involved once again in an apparently insoluble overseas conflict. As you yourself, Mr. Chairman, stated in the New York Times, and I quote:

Our purpose is not in intervention but concerned inquiry, not moral paralysis but a genuine commitment to those rights which bind all citizens in a world community.

A number of months ago in this very room, I testified that "I believe that the American people, despite the normal human desires to retrench and devote the majority of our resources to the major problems that face America within its own shores recognize that there can be no retreat from our position as the prime

international country in the western world." I do not believe that the American people question whether we ought to be abroad but how. I contend that we as a nation and surely those of us whose ancestors came from Ireland, and particularly those of us who have a commitment to that lovely land-must concern ourselves with the terrible events in the North. My view, however, is that that concern must also be directed towards emphasizing those common grounds that we can support towards reconciliation, for certainly further violence and bloodshed cannot be the ultimate answer.

I believe that my theme-different though it may be from the dramatic statements that you have heard-can provide not only an example of cooperation and generosity that should be emulated, but offers one of the rational islands in a sea of irrationality on which America might positively concern itself in a manner acceptable to all sides.

I do not wish to have this view of generosity of spirit and emphasis on common grounds and bridges of communication between factions to be misinterpreted as opposing the rightful expressions of dismay by the preceding witnesses. But if the purpose of these Congressional hearings is to bring attention to the current strife in Ireland then certainly it cannot be purely negative in its content, and certainly there must be an expression of hope. I trust that the efforts of physicians in Ireland today to maintain the contacts on which eventual peace will be built is not dismissed as romantic or simplistic or idealistic, but rather will be seen as similar to the lonely, courageous and poetic stand of Thomas MacDonagh, one of the Irish poet-patriots who was executed in 1916, who stated:

By his songs new souls shall thrill

The loud harp dumb

And his deed the echoes fill

When the dawn is come

The dawn will come to Ireland and the deeds in medicine that I have detailed for you may well set the tune for the songs that shall thrill Irish harps in generations to come.

Gentlemen, I thank you for the privilege of appearing before you and as with so many other Irishmen express my gratitude for your interest.

STATEMENT BY JEREMIAH J. O. CALLAGHAN, JERSEY CITY, N.J.

I am a native of Ireland, a former captain in the United States Army, during World War Two, I am a past national president of the Ancient Order of Hibernians America and Canada, a practicing attorney of New Jersey, and a judge of the ersey City Municipal Court.

I am deeply interested as an American in the Carey Resolution, and he Ribicoff-Kennedy resolution on the situation in Northern Ireland, being ne of the members of the American Committee for Ulster Justice that met with he Senators and the Congressman in Washington in October, urging the introuction of the resolution. I believe that the vast majority of decent Americans re intensely disgusted with the English policy in Northern Ireland, which has esulted in the internment without trial, the complete denial of civil rights, holesale discrimination in allocation of housing, opportunities for employment, nd the proven torture of political prisoners. America has done a lot for the Irish, nd the Irish have contributed a lot to America.

At a time when the good offices, the blood and treasure of our country have een and are being expended in behalf of many of the oppressed peoples of the world, I believe that the Irish in America, supported by a legion of other Americans sk very little when they ask that the aforesaid resolutions be approved for onsideration by both Houses of Congress.

The resolutions do not ask for troops, or money, but only for an expression by he Congress of the United States that it believes that such oppression is unjust nd unfair, and should be remedied.

I do believe that such an expression of concern would have a great effect on the English Government, which has received such great support from our country two economic depressions.

Please believe that this is a matter of great moment, and will determine the political preferment of a great number of our citizens in large measure. Practical olitics being what it is, it goes without saying that we will be impressed by those Congress who treat our request fairly, and we will feel the opposite to those who dicate to us that they care little for our conviction in this grave matter.

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