Appalachian Figures Series – The Story of Peggy McDowell Curlin of Harlan, Kentucky
Peggy McDowell Curlin’s life began in the mountains of eastern Kentucky and reached into some of the most important international conversations about women’s health, family planning, and development in the late twentieth century. She was born in Harlan, Kentucky, in 1940, and later became known far beyond Appalachia as a leader in international women’s health.
In her own oral history, recorded for the Sophia Smith Collection at Smith College in 2003, Curlin began her story by placing herself clearly in Harlan. She remembered being born in Appalachia, in a place already known to outsiders through the phrase “Bloody Harlan.” That phrase came from the labor wars and union conflicts that shaped the county during the 1930s and early 1940s. Curlin did not treat that history as a distant label. It was part of the atmosphere around her childhood, part of the world she had inherited.
Her maiden name was McDowell. She grew up as an only child, but not in a small household. She described a shared family home with grandparents, parents, an aunt, and a cousin. In that crowded house, she later said, privacy meant having her own bed. The memory says something about Harlan in the Depression and wartime years. Families combined homes, labor, childcare, and resources. Children grew up surrounded by older generations, family obligation, and stories about work.
Coal was part of that background. Curlin remembered that her grandfather came to the area as a carpenter and worked around the deep mines, building and overseeing tipples, the structures that helped move coal from the mountain to sorting and loading. He later supervised work in the mines. Her grandmother, energetic and active in women’s organizations, believed education could help the family move beyond mine work. That belief in education, service, and organized action helped shape the world Peggy McDowell Curlin came from.
From Centre College to Public Health
Curlin graduated from Centre College in Danville, Kentucky, in 1962. Centre later honored both Peggy McDowell Curlin and her husband, George Tams Curlin, as Distinguished Alumni Award recipients in 1996. In 2002, the college also awarded her an honorary degree during commencement, recognizing her work in international family planning and women’s health.
Her marriage to George Curlin became part of the path that carried her into public health work. George Curlin was a physician connected with the United States Public Health Service, and his assignments brought the family into contact with major international health crises. Peggy Curlin did not begin as a famous institutional leader. Her later work grew out of practical experiences, friendships, and repeated encounters with women whose needs were not being met by existing systems.
That pattern matters. Curlin’s work was not simply policy work from a desk in Washington. It was shaped by what she saw in homes, clinics, relief efforts, and crowded urban neighborhoods. Her Harlan upbringing had already taught her that social problems were not abstract. They lived inside households, shaped who worked, who studied, who stayed poor, who had choices, and who did not.
Bangladesh and a Crisis in the Home
The turning point in Curlin’s public life came in Bangladesh. She and her husband had been connected to public health work there, and in the 1970s she became involved in relief and health efforts in a country marked by disaster, poverty, and enormous need. In her oral history, she recalled experiences after the 1970 cyclone and later work after returning to Bangladesh in the 1970s.
In 1974, during a smallpox epidemic, Curlin saw a problem that exposed the limits of a public health system built without women in mind. Government vaccinators were men. In many Muslim households, men who were not relatives could not enter freely or touch women. That meant many women and children were not being vaccinated. A program existed, but it could not reach the people most at risk.
Curlin and Mustari Khan, a Bangladeshi woman who became her close colleague, responded by organizing teams of female volunteers. These women could enter homes, speak with women directly, and provide vaccinations in spaces that male workers could not reach. It was a practical solution to an immediate crisis, but it also revealed something larger. When female volunteers entered homes, women often pulled them aside and asked about family planning. Curlin later remembered the question as direct and urgent: “Sister, can you tell us how not to have babies?”
The answer was not as simple as telling women to go to a clinic. Many of the women could not easily leave home. Some lived far from clinics. Some were restricted by custom, poverty, or family structure. A health service that expected women to come to it was failing women who needed the service most.
Curlin’s response was to turn the model around. If women could not reach the clinic, trained women could bring information and services to them.
Concerned Women for Family Development
Out of that work came Concerned Women, later known as Concerned Women for Family Development. Curlin co-founded the organization in Bangladesh with Mustari Khan and others. Its early work focused on family planning, vaccination, and direct contact with poor women in Dhaka. The idea was not only to deliver services, but to train women to become trusted health workers in their own communities.
The program began with volunteers and simple tools. Curlin remembered using buttons and visible identifiers so that women workers had a recognized role on the street and in the home. In a city where women’s public movement could be limited, that visible role mattered. It gave workers legitimacy. It helped families understand why they were there. It allowed women to talk to women about subjects that were difficult, private, and often urgent.
The work grew beyond family planning alone. Concerned Women for Family Development became connected with women’s empowerment, education, income-generating work, reproductive health, and later AIDS-related programming. Its strength came from the same principle that shaped its founding: women closest to the problem had to be part of the solution.
Curlin eventually returned to the United States, but she believed the organization could continue without her. In her oral history, she said her role had been to help build the organization, secure funding, and prepare it to carry on. The women in Bangladesh did carry it on. That fact became one of the clearest measures of her success.
CEDPA and Women-Centered Development
After returning to Washington, Curlin joined the Centre for Development and Population Activities, known as CEDPA, in 1978. She later became its president, serving from 1989 until her retirement in 2003.
CEDPA’s work focused on training, leadership, population, development, and reproductive health. Under Curlin’s leadership, it became closely associated with the idea that women should not be treated only as recipients of aid. They should be trained as leaders, managers, advocates, and decision makers. That approach connected directly to what Curlin had learned in Bangladesh.
Her philosophy was practical. She had seen that a program designed without women could miss women entirely. She had also seen that women, when trained and trusted, could build systems that reached deep into communities. CEDPA’s training programs reflected that lesson. They emphasized management, budgeting, proposal writing, supervision, advocacy, and the ability of women-led organizations to build local capacity.
Curlin’s own words from her oral history show how deeply field experience shaped her leadership. She respected people working close to the ground and wanted authority moved closer to those offices and communities. She resisted the idea that experts should simply drop into a country, provide brief technical assistance, and leave without understanding the place. The work, in her view, had to be built with the people who would carry it forward.
Cairo and the International Stage
By the 1990s, Curlin was part of international debates over population, reproductive health, women’s rights, and development. She was involved in the 1994 United Nations International Conference on Population and Development in Cairo, a major event that helped shift global population policy toward a more women-centered framework.
Curlin’s oral history places her in the work around Cairo and its difficult negotiations. She described lobbying, long days, late nights, and arguments over language concerning adolescent health, reproductive health, sexual health, and the role of women and girls in development. She also spoke about helping bring attention to the “girl child,” a phrase used in international policy discussions to address the needs of girls as a distinct group.
The Cairo conference mattered because it moved the conversation beyond population targets alone. It connected population policy to women’s health, education, rights, and decision making. Curlin did not claim that CEDPA alone caused that change. She understood it as the work of many groups, many women, and many advocates. But she and CEDPA were part of the movement that helped push the discussion in that direction.
Her public role continued after Cairo. In 1999, United Nations press records identified Peggy Curlin as president of CEDPA during public discussions about support for the United Nations Population Fund. Policy reports from the same period also quoted her on international family-planning debates and the global gag rule. These sources show her as a public voice in contested policy discussions, not merely an administrator behind an organization.
A Kentucky Woman in a Global Story
Peggy McDowell Curlin’s life does not fit neatly into a single regional category. She was a Harlan County native, a Centre College graduate, a public health advocate, a co-founder of a women’s organization in Bangladesh, a CEDPA president, and a participant in international policy debates. Her work crossed local, national, and global boundaries.
Still, the Harlan part of her story should not be treated as incidental. In her own telling, she began with Harlan. She described a coal-country childhood, a crowded household, women who worked and organized, and a grandmother who believed education was a way forward. Those themes followed her, even when the setting changed from eastern Kentucky to Dhaka or Washington.
Her career was built around a simple but powerful observation. Systems often fail people when they are designed without them. In Bangladesh, women were being missed by vaccination and family-planning programs because the system could not enter their homes. Curlin helped build a different model by organizing women to reach women. At CEDPA, she carried that lesson into leadership training and international development.
Peggy McDowell Curlin died in 2005 at the age of sixty-five. The Washington Post remembered her as a women’s health advocate who led international initiatives, co-founded Concerned Women for Family Development, and served as president of CEDPA. For Harlan County, her story adds another kind of Appalachian history. It is not only a story of coal, labor, mountains, or migration. It is the story of a woman from Harlan whose life’s work reached women in homes and communities far across the world.
Sources & Further Reading
Curlin, Peggy. Interview by Deborah McFarlane. Transcript of audio recording, May 13 and 15, 2003. Population and Reproductive Health Oral History Project, Sophia Smith Collection, Smith College. https://www.smith.edu/libraries/libs/ssc/prh/transcripts/curlin-trans.pdf
Smith College Libraries. “Population and Reproductive Health Oral History Project: Narrators.” Sophia Smith Collection, Smith College. https://www.smith.edu/libraries/libs/ssc/prh/prh-narrators.html
Centre College. “Distinguished Alumni Award Past Recipients.” Centre College, 2025. https://www.centre.edu/documents/da-past-winners-2025
Centre College. “Centre graduates largest class ever, Katherine Lacy and Henry McEuen win valedictorian prizes.” Centre College News Release, May 28, 2002. https://ccirc.contentdm.oclc.org/digital/api/collection/comarchives/id/3139/download
Sullivan, Patricia. “Peggy Curlin.” The Washington Post, September 28, 2005. https://www.washingtonpost.com/archive/local/2005/09/29/peggy-curlin/af91d5d2-b177-459f-b2f3-46212a30b205/
“Peggy Curlin Obituary.” The Washington Post, September 2005, republished by Legacy.com. https://www.legacy.com/us/obituaries/washingtonpost/name/peggy-curlin-obituary?id=5541716
Mann, Judy. “Seeing the Need, Making the Change.” The Washington Post, May 26, 1994. https://www.washingtonpost.com/archive/local/1994/05/27/seeing-the-need-making-the-change/5f2af000-8a44-4e58-a295-a96cd6da87b3/
Boustany, Nora. “Building Women’s Rights, House by House, in Bangladesh.” The Washington Post, June 6, 2002. https://www.washingtonpost.com/archive/politics/2002/06/07/building-womens-rights-house-by-house-in-bangladesh/f34ad6a1-efa8-4b05-8a0b-5aa673f20ea3/
United Nations. “United Nations Population Fund Welcomes Support from United States Senate to Restore Funding.” Press Release POP/725, May 5, 1999. https://press.un.org/en/1999/19990505.pop725.html
United Nations. “Press Conference by United States Delegation to Special Session on Population.” July 2, 1999. https://press.un.org/en/1999/19990702.uspop.brf.html
United States Department of State. “Fact Sheet: U.S. Delegation, Biographical Profiles.” 1997-2001 State Department Archive. https://1997-2001.state.gov/global/prm/fs_delegate-bios.html
Guttmacher Institute. “Proponents Say Women’s Health, Core American Values at Stake in Global Gag Rule Debate.” Guttmacher Report on Public Policy 3, no. 2, April 2000. https://www.guttmacher.org/sites/default/files/article_files/gr030205.pdf
CEDPA. Project Design for Program Managers. Washington, D.C.: Centre for Development and Population Activities, 1994. https://sswm.info/sites/default/files/reference_attachments/CEDPA%201994%20Project%20Design%20for%20Program%20Managers.pdf
CEDPA. Training Works! What You Need to Know about Managing, Designing, Delivering, and Evaluating Group-Based Training. Washington, D.C.: Centre for Development and Population Activities, 1995. https://www.ircwash.org/sites/default/files/CEDPA-1995-Training.pdf
CEDPA. Cairo, Beijing and Beyond: A Handbook on Advocacy for Women Leaders. Washington, D.C.: Centre for Development and Population Activities, 1995. https://www.mewc.org/images/stories/documents/Cedpa_CairoBeijingAndBeyond_1995.pdf
Curlin, Peggy. “Population Policy since Cairo: Women on the Move.” Paper presented at the Population Association of America Annual Meeting, Chicago, April 1-3, 1998. https://www.africabib.org/rec.php?RID=W00071399
Curlin, Peggy, and Anne Tinker. “Women’s Health.” Infectious Disease Clinics of North America 9, no. 2, 1995. https://doi.org/10.1016/S0891-5520(20)30664-4
Curlin, Peggy, and Anne Tinker. “Women’s Health.” ScienceDirect PDF. https://www.sciencedirect.com/science/article/pii/S0891552020306644/pdf
Koblinsky, Marge, Judith Timyan, and Jill Gay, eds. The Health of Women: A Global Perspective. Boulder, CO: Westview Press, 1993. https://books.google.com/books/about/The_Health_Of_Women.html?id=r2oVAQAAIAAJ
Stanford University Libraries. “The Health of Women: A Global Perspective.” SearchWorks Catalog. https://searchworks.stanford.edu/view/2503736
World Bank. India’s Family Welfare Program: Toward a Reproductive and Child Health Approach. Washington, D.C.: World Bank, 1995. https://documents1.worldbank.org/curated/en/973031468750032073/pdf/multi0page.pdf
Kentucky Oral History Commission. “Interview with Cloyd D. McDowell, April 22, 1989.” Appalachia: Coal Operators Oral History Project. https://kentuckyoralhistory.org/ark:/16417/xt78930nvp3t
Kentucky Oral History Commission. “Appalachia: Coal Operators Oral History Project.” https://kentuckyoralhistory.org/ark:/16417/xt7gms3k0n5n
United States Federal Communications Commission. FCC Reports, Second Series, Volume 37, September 15, 1972 to November 24, 1972. Washington, D.C.: Federal Communications Commission, 1974. https://digital.library.unt.edu/ark:/67531/metadc306591/m1/818/
Georgia State University Library Digital Collections. “Local Coal Operators Associations.” Southern Labor Archives. https://digitalcollections.library.gsu.edu/digital/api/collection/mhross/id/44625/download
Artley, Meg. “Peggy Curlin.” Crazy Spaces Between. https://crazyspacesbetween.com/tag/peggy-curlin/
Author Note: Peggy McDowell Curlin’s story is a reminder that Appalachian history does not always stay within the mountains. Her life began in Harlan, but her work carried lessons about women, family, health, and opportunity into communities across the world.