- [Hilla] I've had people say to "When did you decide you wanted to be a doctor?"

But remember, that wasn't presen That was a long time ago when there weren't many women do - [Child] This is the mama, these are the children, and this is the doctor.

- [Hilla] So when we played pape my papa in the family would always be the doctor.

So I just kinda grew up hoping someday I could be a doctor.

- [Narrator] At age 19, Hilla Sh was one of three women enrolled at the Medical College of Charleston in 1922.

Her brother predicted she'd be married before years end, but social conventions often discount the power of the inborn desire.

Hilla Sheriff always honored her deepest longings.

In doing so, she an indelible legacy to mothers and children.

Graduating with her medical degree in 1926, Hilla trained further as a medic and resident in pediatrics.

In 1929, she returned to her native South Carolina and opened a private practice in pediatrics in Spartanburg at the Andrews Building, Number But the Great Depression had beg and people were in terrible need - Many of those farm homes did not have privies, for instan And they didn't have wells, which meant that they had to bri from long distances, maybe sprin And very often, those springs were not well protected from surface water and contamina - [Narrator] Malaria, diptheria and smallpox, hookworm, whooping cough, and syphilis afflicted the masse as public health funds suffered Tuberculosis cases and the maternal and infant mortality rates shot up, the highest since 1915.

The underclasses, white male workers and Black tenant farmers, suffered most.

- In almost every category you e Blacks fared much worse than the average white in the state and mill workers fared worse than the average of the white po who were not in the mills.

- [Narrator] In 1931, Hilla received a timely proposal from the American Women's Hospitals or AWH.

A medical corps organized during World War I, the AWH wanted to provide general health services in the Southern Appalachians.

They also hoped to wipe out pell a disease caused by poor diet.

- Their chief menu was cornbread and fat back.

And if they get ahold of some mo put some of that on there.

And lots of times, they would steal the molasses that they had to give to mules a their medicine in which it was black strap molasses.

- [Narrator] To lead the assault on pellagra, the AHH asked Dr. Sheriff to be the medical director, a position that launched her lifelong calling in public health.

- And so they said, "What would you like to do for Spartanburg County?"

And I said, well, there's no nee to have a lot of knowledge about immunizations, about anything unless it gets to the people.

- [Narrator] In response, the AWH provided a mobile health a large trailer with seating for hitched to a Model A Ford.

Traveling under the slogan, carrying health to the country, Dr. Sheriff and her team, a nurse, sanitarian, and dietici taught the mountain families about the dreaded disease.

- I would tell them how pellagra affected the body and it was lack of food.

It was not the corn products, but they didn't have, instead of cotton up to the door they could plant collards, and they could have a cow, and feed the cow what the people didn't eat.

- It's sometimes called the disease of the four Ds.

And if I can remember this right it's diarrhea was a symptom.

Dermatitis, there was a characteristic skin eruption.

Dementia, most of them lost thei and actually ended up their last in mental institutions, many of And then death was sort of the crowning blow.

- [Narrator] For the childbearin especially one afflicted with pe the services of the AWH healthmobile were vital.

- Women tended to have it worse because they needed more nutritional sustenance because of their giving birth to and that sort of thing.

And they tended, I think, also to give up their food to the other members of the fami the valuable foods.

And so they suffered worse.

- We taught childcare.

We even cooked.

They even cooked oatmeal and put raisins in it 'cause raisins had iron in it and we'd serve.

They'd say, "We don't eat that, we eat grits."

But they just, you know, they just lapped it up.

- [Narrator] The pellagra epidem was soon checked in Spartanburg From 1931 to 1935, reported cases dropped from 527 to only 35.

Another resounding success was the AWH maternity shelter that Dr. Sheriff helped to organ in Greenville County in 1932.

Prenatal patients and mothers wi often hitchhiked or walked to receive the good care at no c By 1933, Dr. Sheriff was named D of the Spartanburg County Health Department, continuing the AWH work until 19 Prenatal, well baby, preschool, tuberculosis, and immunization clinics were held throughout the county.

In the mill villages, help houses and little mothers classes were organized.

At the end of 1936, Dr. Sheriff left the state to earn a Masters in Public Health at Harvard University.

She had been awarded one of only four Rockefeller scholarships offered nationwide.

At that time in South Carolina, of the 38,282 live births, 295 mothers died in childbirth and 2,429 infants died in their first year of life.

This was one third higher than the national average.

- And there was a feeling with mill workers like with Blacks that you can't do much for 'em anyway.

I mean, the people are so stupid or so backward that whatever you teach 'em or provide 'em, they'll just waste it.

In other words, you can't teach mill working women to use birth control just like you can't teach Black women to do this.

- [Narrator] On her return to South Carolina, Dr. Sheriff began a maternal health project funded by the Mill Bank Memorial Foundation.

- And it was real sad to see a family of little children and the mother gone, and the father left to fend for 'em and so forth.

And I thought, well, mercy day, maybe those little children at home might've had a mama if she hadn't gotten pregnant for the 19th time, maybe.

- [Narrator] 1,000 women learned to use the diaphragm and spermicide jelly, launching one of the first birth or child spacing clinics in the Catherine Greene, a public healt who worked with Dr. Sheriff in S recalled one woman who always complimented her on the clinic.

- Oh, I could just listen to you talk all day long because I enjoy your classes so much on family planning and the advantages of spacing your children so that you can give your other children the advantages that you would want them to have - [Narrator] Dr. Sheriff soon applied for a grant from the U.S. Children's Bureau to expand the program statewide.

Then, the call came from Washing - And he said, "Hilla, you've got family planning in th You've got contraceptive clinics and so forth and so on."

And said, "You can't do that," said, "There are people up here that are opposed to that and we might not be able to get (indistinct)," said, "I don't like you writing And I said, well, I'll tell you.

Do you believe in post post partum examinations of a person?

And he said, "Oh yes, I'm an obstetrician."

I said, "Well, you're gonna have post partum examinations, but you're not restricting me on what I can tell 'em they can And he said, "No, I can."

I said, "Well, I can tell you no the overcoat's gonna be there, whether you see it or not."

- [Narrator] Like the traveling salesman who hid the cost of his overcoat in an expense ac Dr. Sheriff advised her caller, family planning's going to be th whether you see it or not.

We'll call them postpartum clini And when the mother comes in after the baby's born, we'll give her contraceptive adv Sure enough, the statewide clinics were funded.

Change was now sweeping through public healthcare.

Under President Roosevelt's new the Social Security Act of 1935 was passed.

This major reform tool infused n into maternal and child health and crippled children's services money desperately needed in such states as South Carolina.

As the State Board of Health rebuilt the services, the new director of the Maternal and Child Health and crippled children's or MCH d took full advantage of both appr and special project funds.

- And the federal money allowed her to make the difference.

If there'd been racial attitudes that had caused kind of a break on delivering of the services, that didn't matter anymore 'cause those programs were earmarked for things, that it had to be spent on VD and child maternity care.

And if you have a woman like Hilla in to use the money, it doesn't even matter if maybe some of the officialdom are still racist, the job gets done.

- [Narrator] When Dr. Sheriff became the MCH Director in 1941, a mother in childbirth still had a greater chance of dying in South Carolina than in any other state in the u Hilla's first priority was to save mothers and babies.

- And if you did it on a scale of how high tech was she, it would look pretty primitive, to be quite frank.

But it wasn't primitive in that instead of looking for the fanciest kind of procedures that could be done on a few privileged elite women and children, her purpose was to provide a lev of prenatal care particularly that would be accessible, available to the entire mass of the population.

And that's a very different kind - [Narrator] To meet this goal, Dr. Sheriff built an interdisciplinary team.

A nutritionist, social worker, and a health educator were hired to work with the nurse midwives and public health nurses.

In turn, this team worked with the granny midwives who attended at home births.

In 1940, over 1,800 midwives delivered some 41% of the babies born in the state.

To be licensed under the State Board of Health, the midwives were required to attend a two week long midwife institute every four yea While some officials saw the mid as a troublesome problem, Dr. Sheriff didn't see it that w - [Hilla] You just can't make an and say nobody's gonna have home deliveries, it'll all be hospital.

That was not practical.

There wasn't money enough in the state to do that.

And the midwives had a big place and a great influence on their maternal health.

- [Narrator] The midwife institutes were held in at Penn Community Center on St. Helena's Island near Beau One of the head instructors was Maude Callen.

A registered nurse who came to Berkeley County in 1924, Ms. Maude was specially trained to teach midwives.

She often reviewed the material to make sure everyone understood like the time she asked Rose Pre what she learned that day.

- And I said, you know, we have rules and regulations that midwives should go by.

She said, yeah, and I want to te There's one I'll never forget.

And everybody started looking at She said, "When a midwife go on or go to attend to people, I tell you, she must wash her hands from the end of her fingernails up to your elbow with soap and water that's clean.

And another thing, after she done wash her hands and her arms with the water, she must put 'em in some water, warm water, and scandalize them."

You know what she meant?

Sterilize 'em.

She says, scandalize 'em.

And then that was the half of th for that afternoon.

- [Narrator] Guest instructors also came to the institutes.

Julia Brunson, the state nutrition consultant for 26 year regularly talked on the importance of a balanced diet.

- I remember in particular, some of the people thought, well, some of these foods weren' good for expected mothers.

Certain things, they weren't supposed to eat.

One of them had the idea they weren't supposed to eat eggs.

Well, that was a wonderful source of protein and other nutrients, which some of the patients had in their backyards, you know?

(upbeat choral singing) (rhythmic clapping) - [Narrator] Clearly, the institute's work was rewarding.

Like Dr. Sheriff herself, her staff also knew you how to make hard work fun.

The nurse midwife Rosa Clark is a good example.

Starting in 1942, Ms. Clark provided a complete maternity service in the Tamassee area of Oconee C Willie Mac, the World War II Jeep she drove, announced her arrival at her patient's isolated homes.

Her family roundups were an annu where checkups and shots were te by juice and Fig Newtons.

Then there was Miss Maude's celebrated Life Magazine article published in 1951.

Readers were so moved, they donated $27,000 to build a much needed health clinic in Berkeley County.

By keeping careful records of statewide progress between 1936 and 1945, Dr. Sheriff confirmed a 50% redu in the maternal death rate.

The infant death rate had also d from 81.8 to 48.6 per 1,000 birt Prematurity continued to be the primary cause of infant deat but she had started to tackle that problem too.

- There's a human tendency, you anything you can't explain or ch you can call it the will of God.

So she had to advance the idea that the many things you can cha like the premature babies.

Well, I said some of 'em are just born too soon and don't have enough to live on The Lord will take 'em back.

- [Narrator] Dr. Sheriff wouldn't accept that.

Beginning in 1941, health officers like Dr. Preston public health nurses, and social were sent to Cornell University for training in premature infant care.

A system transporting the baby from home to hospital was also d - She had babies that were at hi that needed to be transported.

And there was no talk about regionalization and ambulance arrangements, et cetera, in those days.

So she concocted a little box, both lighted and warmed by light that had a steady temperature, climate control environment that gave some security in getti from where they were in the fiel into what she had developed as specialized nursery centers in some of the major cities in South Carolina.

- [Narrator] The first premature baby nursery was located at Columbia Hospital where the administrator was asked to provide one room separate from the sick babies.

Expenses would be paid under Dr. Sheriff's grant.

- Well, one day, I walked in to see how things were getting a and went up to here.

I saw four babies in this nurser Well, I looked at one of 'em and I could almost tell it had a low bar pneumonia from the door.

And I saw another one.

I thought, geez, that looks like a sick baby and that's certainly an immature So I said to the nurse, "What's the matter with that bab Oh, it has the pneumonia.

And what's the matter with that It has diarrhea.

- And she saw out of her understanding of infectious dise that this was a very bad thing to be doing, and she took steps to correct it And she informed the hospital administrator that the division of nurseries to accommodate these separate ba was something that he had a responsibility for, or, and I can hear the words resounding down those halls, he would be responsible for the deaths of those babies.

- [Narrator] From then on, the premature babies had their own nursery.

And the forerunner of today's neonatal intensive care unit was established.

Conviction often drove Dr. Sheri to find creative solutions like the Tuberculosis Obstetrica the first high risk pregnancy program in the state.

The problem crystallized when Dr. Sheriff heard the story of the pregnant war bride with tuberculosis.

- And one of the nurses out in one of the counties came to me by one day and she sa "Dr. Sheriff, I've found the most pathetic thing in this county.

This war bride, she had worked in an ammunition factory in England and she had married this young boy from South Carolina.

And he came back, I'm sure, with and maybe family with no money."

And the nurse found her in a blacksmith shop behind a store.

The blacksmith shop had been aba He had taken up abode there for and she was very pregnant.

And the nurse told me that there was a dirt floor.

I know that her tuberculosis must have been enhanced to the n by living under those conditions And I said, (indistinct) the cen - [Narrator] But both the sanato and the hospital turned the woma so Dr. Sheriff wrote another gra - And they had contracts with various doctors and they would send the patients to state park for their prenatal care and gene which many of 'em needed.

And then had a contract with some of the obstetricians to deliver them when the time ca - And the little baby was never put out (indistinct).

But it was placed in an appropri by family members who would love or by sometimes foster home pare until such a time it was able to for this mother on a permanent s whatever happened.

- [Narrator] Dr. Sheriff continually sensitized medical practitioners to the needs of women and children.

At her urging, a Maternal Mortality Committee was formed in 1948 in cooperation with the South Carolina Medical Association.

- The physicians around the stat that there was a nucleus of peop that were absolutely embarrassed by the number of maternal deaths We recognized that we were indee probably most of the larger counties were so rural, they had limited access to the s And we were trying to come up with some plan, if you will, to prevent or provide better access to the system.

- [Narrator] By the 1950s and '6 public health needs were shiftin Drugs all but eliminated contagious diseases, including polio.

Accidents emerged as the leading cause of disability and death of children under 15.

Accident prevention then became a major activity of Dr Sheriff's division, but the MCH division's scope was never limited to one problem Vision screening, migrant workers, high risk pregnancies, mental retardation, school nurse PKU testing, and child abuse.

- It seems to be the habit of th to pick the little ones up by the legs and fling them.

- [Narrator] These two warranted attention.

And as usual, Dr. Sheriff took a And by 1965, Dr. Sheriff no long had to offer contraceptive advic under the guise of postpartum cl Family planning became an offici expanding to all 46 counties by That was the year after Dr. Sher was promoted to Deputy Commissio of the Department of Health and Environmental Control.

In this position, she met one of her greatest political challenges, the reorganization of the 46 individual county health departm into 15 public districts.

- There were many legislators who were very opposed to this co because most legislators in this that see their counties as certainly their domains.

And they had no intention of sharing anything, certainly not the health department with somebody else.

- But it took a lot of persuasion sometimes to make these men understand that they didn't have the final say about their county if it was going on a district le - [Narrator] In three years, Dr. an early advocate of comprehensive healthcare deliver had accomplished the bulk of her The public health districts appropriately remain a part of her legacy.

- So of course, my first respons was mothers and children, but that's the foundation of our civilization, mothers and children.

I was interested in everything that affected them, their lives.

It was not only that prevent dea but we wanted to make this world a better place for them to be and to come, and a safer, safer place for the - [Narrator] Her days in Spartanburg proved that more would be accomplished, more lives of mothers and childr if high standards and cooperation were stressed instead of mediocrity and compet - The old timers now still talk about Hilla, 'cause again, she was unique.

I mean there were no other femal involved in those high level positions essentially.

And there was nobody with quite Hilla's both push and finesse at the same time.

I mean, she could get herself into the middle of anything, and not be obnoxious, and not be too obvious, but Hilla was in there making her mark, and contributing, and speaking up for the state, and for public health, and for mothers and children.

(soft orchestral music) - [Narrator] By 1974, the maternal death rate had dropped to 2.1 deaths per 1,000 births, and the infant rate to 27.8.

That year after 43 years in publ Dr. Sheriff retired.

Though she married, Hilla never had children, but she is always fond of saying "I was everyone's mama, all the children of the state."

- And I've always had a feeling that if I could do something for that would be helpful, that would be my aim in life.

In fact, there's no need to be h if we can't help our fellow man.

There's no need to be here if we can't make the world a little bit better because we assisted.

(soft orchestral music)