Clarence Gamble - Pathfinder Fund

Pathfinder Fund

Clarence would do whatever was most effective at the time with relatively small investments. In addition to paying the salaries of visiting nurses and health workers to staff the clinics and office workers to manage offices, he paid for and distributed print materials: posters in native languages, comic-book-style pamphlets, flyers, reprints of scientific articles, booklets and books, and contraception manuals. He provided anatomical models of the human pelvis, purchased film strips and movies, and supported their production.

Clarence defied the conventionally held views of the role of women at that time and decided to take advantage of the adroit management and diplomatic social skills that he had observed older women often possessed, exactly the skills that were needed to introduce such a potentially controversial topic as birth control into a community. As he had in the 1930s, when he was engaging field workers to open clinics in the United States, Clarence chose women in their fifties to be his envoys. Margaret Roots was a widow with three grown children, touring the world with friends, when Clarence met her in India in 1953. She worked first in Sri Lanka, then in Indonesia, India, Thailand, and Korea. Edith Gates had been working for the YWCA and similar organizations internationally for 30 years when Clarence met her in Hawaii in 1954 and asked her to go to Africa and South America.

Clarence and his fieldworkers adapted written materials and tailored their social interactions to local culture. In Puerto Rico, mothers were happy to have a visiting nurse come into their homes. In Hong Kong, this was not acceptable. In Sri Lanka, in 1954, a woman did not walk the streets alone; Margaret Roots made sure that another woman accompanied her when she went out or when she visited a male authority.

Always, Clarence advocated simple methods, insisting that the people should decide for themselves the number of children they wanted and offering family planning methods that could be used without intensive medical supervision. However, he also provided the diaphragm and jelly when it was appropriate or requested.

He understood that "favorable public opinion regarding family planning takes years to develop" and so he worked for the long term; if his fieldworkers could not open a birth control clinic within a year or two, they could leave behind a committee that might do so in the future.

In 1957, at the suggestion of his attorney son-in-law, Lionel Epstein, husband of his oldest child, Sally, the ongoing philanthropic activity of Clarence Gamble was incorporated into The Pathfinder Fund. In 1991, The Pathfinder Fund was renamed Pathfinder International.

In a typical report from 1959, The Pathfinder Fund listed its activities and expenditures: the fund was paying the salary of a nurse in Mombasa; a nurse in Burma; a nurse in Maadi, Egypt; supplemental salaries for nurses in Taiwan; part-time salary for secretary of the Associazione Italiana Per L'Educazione Demografica; salaries for three workers in Colombo, Sri Lanka; salaries for persons working for the family planning associations of Thailand and Bangladesh, both under supervision of Mrs. Roots; consultation fee for Dr. Luigi DeMarchi, (who, with his wife Maria Luisa DeMarchi, were crusaders for the legalization of birth control in Roman Catholic Italy); salary for a nurse in Hong Kong, who worked in an area of "hillside shacks beyond the ends of roads," occupied by refugees; and in August, supplementary payments of approximately $5 per month were allowed for nurses in Taiwan because the nurses must live in the village "where they were exposed to snakes, barking dogs, and sleeping behind doors with no locks." The Margaret Sanger Research Bureau was funded for a study of foam tablets, the salary of an intern, half the salary of the head of their research program, and general expenses. Miscellaneous grants were made to Princeton, PPFA, and local community groups.

In 1960, Edna McKinnon, an attorney, a widow, and an "older woman" joined Pathfinder. In the 1930s, Edna had been opening clinics throughout the South as field representative for Margaret Sanger's Research Bureau and had worked for Clarence when he was field director of that organization. Edna became a Gamble fieldworker in Malaya, Indonesia, and, briefly, with great difficulty, in Saudi Arabia. Margaret Roots, Edith Gates, and Edna McKinnon were long-term fieldworkers for Pathfinder. They loved their work and were deeply loyal to Clarence. As Edna McKinnon later explained,

"Clarence always worked on the basis that he was no more important than anyone else.... You could always be sure that if we were really in a bind, he'd come down and help you get out. It didn't mean that he was there all the time, but I can't emphasize enough how much the correspondence made me feel that we were having careful direction. But I will say this, that sometimes I'd have anywhere from six letters a day… When I later worked with PPFA, when Clarence wasn't as closely connected, I didn't feel that security. I don't know what it is. It's a psychological something that he gave to each of his workers that was priceless.... He was interested in every detail. There wasn't anything that was too much or too detailed for him to be interested in."

At the time, The Pathfinder Fund was also covering the salaries of staff in the home offices in Boston, salaries and expenses of John Gordon and Yoshio Koya, of fieldworkers Margaret Roots, Edith Gates, and after 1960, Edna McKinnon. Beginning in 1962, expenses were covered for volunteer fieldworkers Charles and Bernadine Zukoski. Upon retirement from a successful banking career, Charles Zukoski and his wife, Bernadine, devoted themselves to The Pathfinder Fund, working in the States and overseas, accomplishing much in Turkey, Iran. and Ethiopia. Others, including fieldworkers Ruth Martin and Sarah Lewis, who worked for shorter periods, were supported, as were individuals on scholarship to Harvard School of Public Health.

After incorporation of The Pathfinder Fund in 1957, Clarence took fewer and shorter world trips. With his own organization and a team of fieldworkers in place, administrative duties increased, but he was still able to explore his many innovative ideas related to increasing access to contraception. For example, he considered hiring writers to place stories that mentioned birth control in pulp magazines. With his Public Progress Program, which encouraged personal letters to the media, he managed to get the taboo subject of birth control into such popular magazines as Colliers and Reader’s Digest.

In the 1950s and early 1960s, Clarence and his fieldworkers visited 60 countries in Africa, Asia, and South America. From these visits, family planning associations and clinics emerged in at least 30 countries, while groundwork was laid in others.

And just as The Pathfinder Fund was being incorporated, Gregory Pincus set up his first clinical trial of the first contraceptive pill in Puerto Rico. Clarence drew on his contacts from the 1930s in Puerto Rico, when he had rescued Puerto Rico’s birth control program. At that time, the Franklin D. Roosevelt administration had eliminated federal support for a thriving chain of clinics due to pressure from Catholic bishops, and Clarence had provided the support to keep them going. Two decades later, Clarence organized additional trials of the Pill with Dr. Adaline Satterthwaite at the Ryder Memorial Hospital in Humacao, and in 1961, Dr. Satterthwaite began testing the intrauterine device (IUD) as well.

Though Clarence supported trials of the pill, he regarded it as impractical because of its daily dose requirement and relatively high cost. The IUD was both practical and low cost, requiring one-time insertion of an inexpensive piece of plastic. Dr. Satterthwaite quickly demonstrated its safety, and Clarence began mailing out the plastic loops. The office space that he rented above Sparrs Drug Store, adjacent to Harvard Medical School, became a distribution center for IUDs. In Korea, where as many as 2,000 babies were abandoned yearly in the Seoul streets, the government welcomed this new method of practical birth control. By October 1962, Clarence had sent almost 3,000 loops to Korea.

Predictably, he ran up against the Population Council, who wanted complete control of IUD trials and distribution. Clarence countered by opening his own manufacturing plant in Hong Kong. By 1964, David Burleson had been brought in to supervise Pathfinder's worldwide IUD project, and Clarence was receiving reports on the IUD from 72 doctors in 32 countries. At the time of his death in 1966, The Pathfinder Fund was delivering IUDs to 504 doctors in 74 countries.

Despite sharp disagreements, Clarence continued to attempt to work with the Population Council, PPFA, and IPPF. The clinics and family planning associations that Clarence funded and his fieldworkers opened were all encouraged to become members of PPFA or IPPF, and, indeed, most did.

When Dr. Koya wanted to include Clarence as co-author of the Three Village Study, acknowledging the many design suggestions he had contributed, Clarence told him not to. The modesty was characteristic of him. He held true to the words of his mother, Mary: "Results are what count, not position. Why care who's given the credit?"