Andrija Štampar
© F. Memedović Dr. Andrija Štampar was one of Croatia's pioneering medical figures
© F. Memedović

Andrija Štampar: Croatia's pioneer of 20th century public health

The Croatian doctor whose proposals shaped today's World Health Organisation.

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For a small country, Croatia has had a disproportionately large impact on global advancement, a perpetual influence that includes much more than Nikola Tesla's genius, the invention of the parachute, fingerprinting technique and the development of the torpedo.

One of the current highly-prized strings Croatia holds to its bow is its healthcare industry, boasting some of Europe's leading physicians and facilities. But, this is no new development. Thanks to the work of Andrija Štampar, Croatia has been setting standards and world initiatives in health for 100 years.

Born in 1888 in Brodski Drenovac, Andrija Štampar's career saw him travel from this small village in Slavonia, eastern Croatia, to become one of the most important and defining figures of world healthcare and illness prevention.

In 1906 Štampar finished high school in Vinkovci and, a brilliant student from the off, he left Slavonia to study medicine, graduating from the University of Vienna Medical School in 1911. His first position was at Karlovac city hospital, but within a year he had been called back to Slavonia to act as district health officer of Nova Gradiška in 1913. Some of his earliest published works were issued while he was working in the city; not only did he write for his peers in the journal of the Croatian Medical Association, but he also produced pamphlets for the people of the locale, called 'Public Health Library'. These pamphlets informed the people about the latest knowledge of health and illness prevention.

This dialogue with the general public would continue throughout his career, with Štampar displaying a desire and no small amount of skill to organise public health. In 1918 he was appointed as health adviser to the Croatian Commission for Social Welfare and in 1919 became the head of the Department of Public Health in Belgrade, where he began building a network of more than 250 hygienic institutions.

Coming into conflict with the Serbian royal regime, he departed from the Yugoslavian Ministry of Public Health in 1930. But, such was his international reputation that he immediately walked into a position at the Health Organization of the League of Nations. There, he contributed to the writing of a constitution which would be adopted by its successor, the World Health Organisation (WHO). Also while in this position he began lecturing on public health across the world, visiting China, many European countries and being invited to speak at America's premier universities like Yale and Harvard, where he also became a professor.

Having already founded the School of Public Health in Zagreb in 1927 (using his connections at the Rockerfeller Foundation to acquire the funds for the school's brand new building), Štampar was elected as the Dean of the Medical School in Zagreb for the first time in 1940, where he set about reforming the training of physicians.

His work was cut short by the fascist Ustaša regime who arrested him. Štampar was imprisoned until the end of the Second World War. Upon his liberation by the Russian army, he began his work afresh, returning to his position as professor at Zagreb's Medical School and also, in 1945, becoming Rector of Zagreb University. Just one year later, at the International Health Conference in New York, proposals for the formation of the WHO were finally accepted, based on the constitution Štampar had helped construct. Štampar was unanimously elected as the first President of the Assembly.

Štampar's own proposals changed the face of public healthcare across the globe. His initial proposals for the WHO are the basis for what they use today when faced with public health crises, epidemics and pandemics. His research and principles still define the ethics and structure of the work the WHO does.

These principles drew on every aspect of his experience working as a doctor in the region. They stated that health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, that a physician should not be financially dependent on a patient, that healthcare should be equally available to all, irrespective of an ability to pay for it and that a physician's place should be both educational and within the heart of a community. They also stated that a physician's responsibilities to public health outweigh their responsibility to obey the law of the land, demonstrating the loyalty he had for society and explaining his imprisonments.

More so than ever before, in today's cross-border co-operation and response to the Coronavirus pandemic, we can see the framework invented by Štampar still in place and holding strong. For his innovative and altruistic work, Andrija Štampar is today commemorated across the globe and will surely be for a long time to come.

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