American Women's Hospitals Service and an Appalachian Mountain family

The American Women’s Hospitals (AWH) was founded by women physicians in 1918 to provide medical care to the people of war-torn France during World War I. AWH subsequently established hospitals in other parts of Europe and Western Asia, continuing to provide medical care to devastated populations after the wars and conflicts had officially ended. In the 1930s, the AWH established itself in the rural, mountainous, Southern Highlands of the United States, in a region known today as Appalachia. Even before the Depression, Appalachia was a relatively impoverished region, and was geographically isolated with few roads or means of transportation in or out of the area. The economic crisis of the Great Depression only increased the severity of the region’s existing poverty and lack of quality education and healthcare. The AWH established a mobile health clinic, and launched a wide-ranging/multi-faceted public health and health education program to combat the region’s rampant health problems, which included malnutrition-related diseases (such as Pellagra) and highly contagious and potentially fatal diseases such as typhoid, tuberculosis, and diphtheria.

This photo reveals some aspects of the impoverished circumstances of Appalachian residents: the children are not wearing shoes; both children and the woman are wearing old, battered clothing, likely hand-sewn from sacks or other fabric; they are all very thin. Their appearance is in stark contrast to the AWH doctor.