A Freedom Fighter Packs for Washington : Health: Children who have children constitute America’s newest slave class, says Bill Clinton’s surgeon-general designate, adding: It must stop.

Some of Dr. M. Joycelyn Elders’ detractors have called her a mass murderer and “director of the Arkansas holocaust.”

The nation’s new surgeon general-designate, however, is more than willing to fight back.

She has called fundamentalists opposed to abortion “very religious non-Christians,” accused them of operating from a “slave-master mentality” and once branded two of their leaders “mean, ugly and evil.”

Favoring the dispensing of contraceptives in public schools, and unabashedly pro-abortion rights and pro-sex education, Elders epitomizes the sea change in Washington.

She may well turn out to be the most controversial physician yet to wear the surgeon general’s gold-braided uniform. And the most influential in at least two decades.

Unlike recent predecessors, Elders will hold the concurrent post of assistant secretary of health for health policy, overseeing the federal offices of population affairs, adolescent health, women’s health, minority health, and health promotion and disease prevention.

That’s more power than any surgeon general has wielded since 1969, when President Nixon gutted the post of most responsibility, leaving it primarily a bully pulpit. Pending Senate confirmation, Elders will take over the jobs in June, when Dr. Antonia Novello, a Bush appointee, steps down.

“The first thing I can do is try to make sure every child born in America is a planned, wanted child,” says Elders, 59.

She argues that unintended pregnancy, especially among teen-agers, is the root of nearly every other major social problem. Nine of 10 prison inmates are children of teen-age mothers, she notes, and pregnancy is the leading reason that adolescent girls drop out of school.

The public assistance tab for teen mothers and their children came to $26 billion in 1991, up from $19.3 billion four years earlier. Single, unemployed with no job skills and on welfare, children who have children constitute America’s newest slave class, she says:

“We do the sorriest job of any country in the world providing family planning. We’re always running around hollering and screaming about abortion--and abortion is not the issue. The issue is providing family planning services for all women who need them. Right now, the rich have them, but we don’t care about the poor.”

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Elders, a Methodist mother of two who favors demure blouses and conservative suits, works from her large corner office atop the sprawling, five-story complex housing the Arkansas Department of Health, which she heads.

While some appointees, wary of jinxing a nomination, have traditionally kept low profiles, Elders has not.

Why does she call those opposed to abortion “slave masters?”

“If Medicaid does not pay for abortions, does not pay for family planning, but pays for prenatal care and delivery, that’s saying: ‘I’ll pay for you to have another good, healthy slave, but I won’t pay for you to use your brain and make choices for yourself,’ ” she explains.

Her voice, combining Maya Angelou’s timbre and enunciation with the Rev. Jesse Jackson’s evangelism and fervor, soars on each “pay”:

“It’s a way to keep people poor, ignorant and enslaved. And if you are poor and ignorant, you are a slave.”

What about calling people “non-Christians?”

Elders used the phrase in 1991 in reference to people whipping up opposition to school health clinics by spreading false rumors the clinics would perform abortions. Offended Christian conservatives in the Arkansas General Assembly demanded an apology. Elders complied in a contrite March 27, 1991, letter to lawmakers, but she still says it.

“It’s non-Christian to deny health care to our children,” she says. “Most of our society believes a baby is God’s just punishment for fornication. Their attitude is, ‘I’m not going to invest in this baby growing up healthy, educated, motivated and with hope. I’m going to keep using him to grind in that punishment for you.’

“I don’t think we are good enough to sit on God’s judgment seat and make those kinds of decisions for other people.

“I don’t feel that we know enough. And I certainly don’t feel that we love enough.”

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Last year, Elders took her message to 34 states where she addressed more than 60 groups, from a contraceptive technology conference in Anaheim to a Kansas school nurses meeting in Wichita.

“I’ve been on the same platform with her,” says James S. Todd, executive vice president of the American Medical Assn. in Chicago. “She has an evangelical delivery that is very captivating and very effective.”

Says David L. Rickard, research analyst for Arkansas Advocates for Children and Families in Little Rock: “I’ve heard that her brother, who is a Methodist minister in town, won’t speak when she’s on the program. She’s the better preacher.”

Even Jerry Cox, sponsor of Arkansas’s successful 1988 right-to-life amendment and one of the men Elders once called “mean, ugly and evil,” admires her formidable oratorical skills.

“To be honest with you, I think she’s very well suited for the (surgeon general) job,” he says.

Other opponents aren’t always so gracious.

Last year, the Westark Christian Action Council demanded the county prosecutor charge her with violating the state’s right-to-life amendment because she had spoken at a rally to celebrate the 19th anniversary of Roe vs. Wade.

When an investigation cleared Elders of any crime, the group filed a civil suit demanding a special prosecutor be appointed. A circuit court judge denied the petition, but Westark has appealed to the Arkansas Supreme Court.

Elders hopes the debate can move beyond abortion: “If I could ever get people to understand the difference between preventing pregnancy and performing abortion, then I’d be home free,” she says. “I’ve never known a woman to need an abortion who’s not pregnant.”

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Elders was born Minnie Joycelyn Jones in 1933 to a teen-age mother and sharecropper father in Schaal, a rural town of fewer than 100 people in southwestern Arkansas. Seven more children followed.

“All we knew was work,” recalls her brother, the Rev. Chester Jones, pastor of Hunter United Methodist Church in Little Rock.

Even the youngest took turns feeding chickens and hogs, milking cows, hauling water the quarter-mile from the well to the house and working in the cotton fields. Any money the family made went to pay rent on the land.

To earn cash for such extras as Christmas presents, Elders’ mother, Haller, took several of the children on the back of a flatbed truck to Arizona in the summer, where they picked cotton as migrant workers.

“Coming out of that climate, you did not have the role models where people had gone to college, and there was not a lot of time for sitting around reading about how other people lived,” Chester Jones recalls. “Remember, you’re still talking about a coal-oil lamp. There were separate schools, separate bathrooms. You ate in the back.

“But every so often a person will just kind of catch a vision in the midst of all the grief. Joycelyn always knew she was going to college.”

At age 15, Elders won a full-tuition scholarship to Philander Smith College, an all-black, church-supported liberal arts school 100 miles away in Little Rock. To pay for her transportation, her brothers and sisters did chores for neighbors. And she scrubbed bathrooms in the college dormitory.

Her sights on the G.I. Bill, Elders joined the Army after graduation, and enrolled in medical school at the University of Arkansas in Little Rock after her 1956 discharge. She was one of three black students and the only woman.

She became a pediatric endocrinologist and tenured professor of medicine at the university, landed several large research grants and became recognized as a regional expert on adolescent diabetics.

Elders and her husband, Oliver, a high school basketball coach, also raised two sons. And Elders found time to serve on the boards of several community organizations.

In 1987, then-Gov. Clinton appointed her health department director--the first woman and the first black to hold the job.

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While supporters see her as principled and courageous, Elders’ opponents view her as an intolerant zealot.

“She recognizes no sincerity on the part of people on the other side of the issue,” says Douglas Johnson, executive director of the National Right to Life Committee.

Predicts Marilyn Simmons, Arkansas state director of Family, Life, America, God (FLAG), an anti-abortion group based in Little Rock: “If she offends people at the state level, I expect there would be more of the same at the national level.”

Elders’ defenders acknowledge tact is not her strength, but don’t view that as a shortcoming.

“Why not tell the truth the way you see it? That’s what the other side does. And then people have a rather clear-cut choice, don’t they?” says Dr. Betty Lowe, president-elect of the American Academy of Pediatrics and a longtime Elders friend.

“I think we’ve been real nice to these people for a long time,” says Nancy Liebbe, executive director of Planned Parenthood of Greater Arkansas and another admirer. “It’s time someone speaks out.”

As surgeon general, Elders intends to do just that--on a variety of health issues.

Her top priorities, she says, will be working within the Clinton Administration to make sure all Americans have access to basic preventive health care.

To ensure children get that care, Elders advocates putting a health clinic in every public school. Nurse practitioners at such clinics could administer immunizations, treat sore throats and sprained ankles, perform sports and job physicals, and make sure seriously ill or troubled students get help.

She argues that junior high and high school students should also be able to receive counseling about sex at the clinics and contraceptives should be available.

Despite expected opposition, Elders says she has no plans to tone down her rhetoric as she pursues these goals:

“President Clinton knows what I’m about, and he knows I’m not going to change. They’ve held our children hostage for 12 years. We need to reverse that, and I plan to use every resource I’ve got to do that.”