A Survey of Medical Inspection in the City Schools of California
- Author:
Emily Oothaut Lamb,
Stanford University, Cal. In a recent survey of the amount and kind of medical inspection in the public schools of twenty-nine of the larger cities and towns of California, the conditions shown were far from being ideal, yet demonstrate the fact that the superintendents and school boards are considering the matter seriously and that many of them are doing important work.
The cities considered by this survey run from 416,912 to 5,021 in population (Census of 1910). The following is the list of questions of the survey: 1. Have you medical inspection in your schools? 2. Is the work done under the Board of Education or the Board of Health?
Is the inspection done by a doctor? If more than one, number?
How much time does he give to the work?
What is his salary?
6. For what does he (or she) examine? (underline) Eye defects, ear defects, throat disorders, adenoids, enlarged tonsils, spinal curvature, malnutrition, nervous disorders, tuberculosis, contagious or infectious diseases. 7. Does each child have hearing tested annually? Vision? 8. Have you a medical clinic? 9. Do you employ school nurses? Number? 10. How much time does she (or they) give to the work? 11. What are her duties? What is her salary? 12. Have you a dental clinic? 13. How much time does the dentist give to the work? 14. What is his salary? Does any dentist give his time free? 15. After medical inspection, have you a “follow up” system? 16. Do the grade teachers do any examining of the children? 17. What is the character of their examinations? 18. Have you open-air schools? How many children are in the open-air schools? 19. Has each school a play-ground? How large is each? 20. Is a play-ground director employed? What is her salary? 21. Have you a physical director in the High School? 22. Do you use individual towels? 23. Have you drinking fountains? 24. Have you oiled floors? How often oiled?
Of the twenty-nine cities in the survey, sixteen have medical inspection and fifteen cities employ a doctor for this work; several cities employ more than one. Los Angeles has nine, four for full time and five for a half day. In the fifteen cities, twenty-one doctors are employed, at salaries ranging from $1200 to $2250. In all but two cities the Board of Education has charge of this inspection work; in the other two it is under the Board of Health. In nine cities the inspection is for the following defects: eye defects, ear defects, throat disorders, adenoids, enlarged tonsils, spinal curvature, malnutrition, nervous disorders, tuberculosis, contagious and infectious diseases. In the other cities the inspection is not quite so extensive. In twelve cities the vision of all children is tested annually, and in nine, the hearing. Five of the cities have a medical clinic. This is all important; the examination may be most carefully made, but if the parents are either too negligent or too poor to have anything done about their children’s defects, it is of little use to examine unless there is a clinic to take care of such cases.
In the cities not employing a doctor, seven employ a school nurse. In twenty-nine cities, sixteen employ one or more nurses, and the total number of nurses thus employed is forty-six. San Francisco has fourteen of these. In several places, the district nurses or the visiting nurses look after the school nursing. The school nurse is almost more necessary than the school doctor. She can get at the home better; can talk with, and persuade the mother to do something for the ailing child; can advise about diet, clothing, and home sanitation. Where a school doctor is employed, she can do the follow-up work and see that the doctor’s recommendations are carried out. The nurses’ salaries range from $540 to $1104 a year. The greatest deficiency in the system is in the matter of dental inspection and dental clinics. Only eleven cities regularly employ a dentist and of these only four dentists give full time to the work. In nine of the cities, dentists give their time free of charge, which is commendable but rather unsatisfactory in the long run. Only five of the cities have open-air schools. Yet in California there is little need for the expensive, pretentious school buildings; the weather conditions are such that a building of wood construction, of a very inexpensive type, is adequate and better in every respect. One of the advantages of such a type of building is the fact that it can be torn down after it has served its usefulness and be replaced by a new one embodying the most modern ideas of lighting and ventilation. When structures are erected which cost a half million dollars or perhaps a million dollars, then we are in duty bound to use them for many years whether they are suitable or not. The open-air school, together with the school lunch, might do much toward solving the problem of the ill health of the school children of California, and toward counteracting the effects of the closed up home. In a recent canvass made among the school children of one of the larger cities of Southern California, it was found that forty per cent of the children were in the habit of sleeping in rooms with more than one person and with the windows all closed at night: this was not in the poorer homes either. Easteners come to the California coast cities from the over-heated eastern homes and feel that the California houses are very cold; the nights are cold to them, they had expected summer heat the year round. The result is the closing up of houses at night.
Medical inspection is especially necessary in the California schools because of the problem of many families migrating to the Pacific coast every year who are physically unable to endure the rigors of the eastern winter. Many of these families come here because one or more of the members have tuberculosis or some other serious disease. Many families also come to California because of the poor health condition of the children, who may be anemic or tubercular.
The strongest argument for the open-air school is to watch a school being emptied at noon, in one of the well-to-do sections of almost any of our coast cities: there will be pale, thin, anemic looking children in the ranks; children who have plenty of food but perhaps not of the right kind; or who lack the power to assimilate it. This is truer of the southern part of the state than the northern part. Are we sufficiently guarding against this danger? Shall we allow tuberculosis to take a firm hold upon our population, when a small sum per capita, spent upon our school children, would almost eliminate such conditions altogether? Can we afford to take care of these people in our county hospitals, which for the most part are a disgrace to us, or would it be better to do preventive work in our public schools? It is only through the public schools that much can be done to alleviate this condition, and some few cities recognize that fact and are doing all in their power to deal with the situation intelligently and to remedy the faults of the home. In the poorer sections of our cities we have the Mexican element to consider, with their disregard of regular feeding and ofttimes their lack of food; their insanitary home conditions, where many sleep in the same hermetically closed room; and where bathing is little indulged in. Or we may have cities, such as San Francisco and Los Angeles, with a large foreign population to be dealt with; each nationality living in groups and as much in the manner of the life of their native lands as possible, universally with little air and in some cases the most inappropriate food. On the whole, the showing for these larger cities seems fairly good, but the record should be clearer. Our normal schools should have very thorough courses in Child Hygiene and in School Hygiene, so enthusiastically given that every prospective teacher would be ready to go out to fight for better sanitary conditions and for the physical welfare of the children under her care. Such a course would make the teacher better able to deal with the problem intelligently, from the standpoint of knowledge, no matter how small her school might be nor how isolated in the country. Our city school boards should be convinced of the necessity of medical inspection; that it is an economy not an extravagance. It is poor economy to hire experts to teach children who are not in physical condition to receive such instruction.
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