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Karel Raška (17 November 1909 – 21 November 1987) born in the South Bohemian town Strašín, in what is now Czech Republic. He was a physician and epidemiologist, who headed the successful international effort during the 1960s to eradicate smallpox. Raska was a Director of the WHO Division of Communicable Disease Control since 1963. His new concept of eliminating the disease was adopted by the WHO in 1967 and eventually led to the eradication of smallpox in 1977.[1] Raška was also a strong promoter of the concept of disease surveillance, which was adopted by WHO in 1968 and has since become a standard practice in epidemiology.[2]
D.A. Henderson commented:
“Dr Raška’s studies in the epidemiology of hepatitis in Czechoslovakia were known to and respected by all epidemiologists concerned with this major infectious disease problem. No other country or area in the world has documented so thoroughly its experience with hepatitis. The surveillance programme in the United States was cut with a different fabric. Its construction for a variety of reasons differs from that of Czechoslovakia. Comparisons of data have to be interpreted cautiously”.
In those days, Czech studies were far superior and extensive than those in the USA. And Raška had a major influence on them.[3] Raska received the Edward Jenner Medal awarded by the Royal Society of Medicine.
The recognition by the Royal Society of Medicine and WHO notwithstanding, Raska faced a tough deal back home. Walter Holland, describes the following about Raska in the Central European Journal of Public Health:
"Raška lived in challenging times. Czechoslovakia became an independent republic in 1918, after the First World War. Thus his early years were spent in a country beginning to establish its identity in the face of great uncertainty and turmoil. This culminated with invasion by Germany, Poland and Hungary of the borderlands in 1938 and full occupation by Hitler’s Germany in 1939. The war years were not pleasant for any Czech, and he participated in resistance activities. His involvement in the control of an epidemic typhus outbreak in Terezin is particularly poignant.
For the rest of his life, he worked under the communist regime. This was the time of the Cold War between East and West. There were major differences in policies and paranoia about contacts of individuals from the East with those in the West, particularly the United States and the United Kingdom. Those from Russian dominated regimes who had contacts in the West were viewed with some suspicion in their own country. Persons from the East were also treated with reserve by the West. Every WHO office had an individual from an Eastern country responsible for reporting on the behaviour and contacts of his Eastern colleagues. Only those considered “reliable” were allowed, to a small degree, to collaborate with individuals from the West. Those who did so, showed remarkable courage.
Raška was a good example of a scientist who had the courage to appreciate that medical science had no boundaries and could only advance through collaboration; infectious agents have no ideological principles and do not recognise state boundaries. He suffered the consequences of this behaviour, when he returned to Czechoslovakia, after his service with WHO in the early 1970s. It is particularly unfortunate that his enormous achievements in the control of infectious disease over a long period were not acknowledged in his own country and many of his former colleagues and pupils abandoned him and his achievements." [3]
And he is not the only one. Look what Vladimir Zikmund writes in the same journal:
"Raška publicly criticized the invasion both at home and abroad and after he returned permanently to Czechoslovakia, he was completely deprived of all positions in public health by the Minister of Health, Prokopec. Raška became an exile in his own country for the rest of his life. It is a pity that Karel Raška was barred from educating medical students and future generations of epidemiologists. His lectures had been informative because he stated concrete cases of fighting infectious diseases. Raška was also not allowed to publish at home. The main hygienist during the period in question wrote a letter to the editor of journal Vesmír that Raška’s scientific capacity had declined and that there was no reason to publish his work. Even citing his work was discouraged. Unfortunately, some authors respected this banishment of Raška all too much." [2]
Fortunately, this politically orchestrated isolation that tried to make the world forget about this public health hero, failed. Raska was a founding member of the International Epidemiological Association (IEA), and key members considered his contribution:
".....inestimable. He brought to the IEA, the views of a highly experienced Infectious Disease Epidemiologist working in Eastern Europe. His support for the Association, from his part of the world, demonstrated that the aims and objectives of the Association could transcend boundaries and Ideologies."
Raska was greatly appreciated by many leaders in public health, among which was Alexander Langmuir. In his "Appreciation of Raska", that was published in the International Journal of Epidemiology the year after his death, Langmuir writes:
"From our first meeting we related warmly to each other. Behind a somewhat stiff, even brusque exterior, my first impression was a warm personality, great enthusiasm for scientific ideas, and a mission to achieve. He deeply believed that the principles of what he termed epidemiological surveillance should be applied worldwide."
D.A. Henderson, director of the active phase of the smallpox eradication program, added:
"Karel made two further important contributions to epidemiology. The first was his enormously successful efforts as a professor, to recruit and to train young Czech physicians in the subject. It was apparent to all of us that of the countries of Europe, Czechoslovakia was one of the strongest in epidemiology and contributed a number of first-rate epidemiologists to WHO programmes. Almost all of these were trained by Karel.
The second was regarding the smallpox eradication: he [Karel] played an important role [....] without which the programme could not have succeeded"
In his article in 1988, Henderson summarized his view on Raska's contribution to smallpox eradication as follows:
“Raška played an important role in gaining acceptance of a number of vital administrative and policy matters without which the program could not have succeeded”.
Imagine how many lives are saved each year, as a legacy of Raska's efforts: the World Health Organization estimates that in 1967 still 15 million people contracted the disease and that two million died in that year. [4]
Karel Raska is one of the people, we owe a debt of gratitude. So let's celebrate his birthday on 17 November.