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- Child welfare and hygiene have been neglected. Scientific
effort is made in prenatal and preschool work only in a few instances. The school child has had the most cursory of physical
examinations and wholly inadequate correction of defects. This
statement is borne out by the reported prevalence of tuberculosis
among children in the schools and by the epidemic of acute infectious diseases that spread almost unchecked. Adequate facilities
for isolation are lacking.
The teaching of health education in boarding schools has to a great extent been rendered ineffective by two factors: the inability of teachers untrained in this subject to handle it effectively, and the negative practices in the every day life of the child in school. As examples may be cited, stressing in formal instruction the drinking of milk, but at the same time not providing it, and advocating regular bathing and yet making only limited provision for it.
- Provision for potable water supplies and for adequate sewage
disposal arrangements have been neglected. In only a few places
has a concerted effort been made to meet these needs. Many years
ago, a sewage disposal plant was installed for the Warm Springs
Indians at Pala, California. Equipment was provided and installed
in the agency quarters, but never in the Indians’ homes, and the
surplus equipment has long since been moved off the reservation.
In boarding schools where this matter should be of the first importance from an educational standpoint, a poorly functioning
system is sometimes found.
At some jurisdictions reports have been made for years of a contaminated water supply, yet corrective steps have been taken but slowly. The first really broad and systematic effort to change this situation has been made during the present year through surveys of water and sewage disposal systems by the Public Health Service.
- Inadequate provision has been made for coöperation with. other organizations, federal, state, and philanthropic.
These eight points cited appear abundantly to justify the conclusion that as a rule the medical work of the Indian Service has been curative or even palliative rather than educational and preventive.
The important matters of coöperation with other agencies and adequate statistics and records require further discussion.