MARCH, 1925
THE UNITED AMERICAN
Page Seventeen
Safeguarding the Health of Three Million People in One City
By Dr. HERMAN N. BUNDESEN, Health Commissioner of the City of Chicago
AVERAGE individual must have
T HE health
safeguards thrust upon
him. The reason for this is that when
one is well one does not think of disease.
It is only when one is sick that the
“whys and wherefores” of illness are
brought home to the individual. Sick
ness, or intimate contact with it, then,
is necessary before the average person
appreciates the safeguards that are
thrown around 'him daily.
It is very significant, however, that
today there is an awakening of what we
may term the “health conscience of a
community.” No .matter how well edu
cated, wideawake and careful an indi
vidual may be, 'he is unable alone to
protect his health or that of his family
from some of the most serious dangers
which threaten it. It makes no difference
how wealthy or influential a citizen may
be, he is utterly powerless adequately to
insure the purity of his own water sup
ply, or the proper disposal of sewage
or garbage, or the .purity of the milk
his children drink, or the wholesomeness
of the food on his table.
With the awakening of citizens to the
value of 'health conservation, health is
now the problem of every civilized
country. There was a time when people
were satisfied merely to be cured of
disease. Later they realized that an
ounce of prevention is worth a pound
of cure.- Today we go a step further.
Not only is it the function of the health
department to prevent disease, but to
find ways and -means of building up
the body, increasing the vigor and fos
tering the general welfare and happiness
of the community.
Some benefits
necessarily follow on a continued state
of good health. But the health officer
must not be satisfied with these. He
must always be one step ahead of his
generation. He 'has the great task of se
curing the co-operation of the children
of the rising generation in order to per
petuate 'his work, for they will control
the making and the enforcement of
the health laws of tomorrow. Universal
community hygiene and co-operative
health conservation, for all and by all,
is what the health officer hopes to attain.
The health officer is constantly fight
ing disease from within and without. In
a community as large as Chicago, made
up of varied elements and nationalities,
it is no easy task to keep disease from
developing within its confines. The
close proximity of three- million people
in a large and densely populated city
necessarily brings conditions of crowd
ing. An epidemic of contagious disease in
a crowded district, if unchecked, spreads
like a conflagration. Crowded habita
tions are a fruitful source for the spread
of contagion.
As a community protection, therefore,
quarantine in necessary. Quarantine con
sists of confining the patient or patients
within a certain prescribed area so as
to prevent the spread of contagion to
others.
Ordinarily, in the scheme of nature,
the individual is sacrificed for the
whole. In health matters, however, the
sick individual must be saved to prevent
the spread of disease to others. In
civilized communities we are our
brother’s keeper in matters of health
and disease. One who willfully breaks
quarantine while afflicted with a con
tagious disease breaks the fundamental
laws of health and becomes a virtual
murderer if others die as a result of his
law-breaking.
Eternal vigilance is the price of health
safety. The health officer must be con
stantly on’ the watch to prevent sick
persons from entering 'his territory and
becoming the starting point of an
epidemic. There is now an understands
ing between the health departments of
various cities and states regarding the
breaking of quarantine and escaping
from one city to another of those
affected with a contagious disease. The
co-operation of the railroads is a great
aid. in controlling the transportation of
contagion from place to place. But in
spite of precautions there are some who
elude the vigilance of the health authori
ties, enter the city and become a menace
to certain parts thereof.
Water and milk are two essentials to
life and health, -and unfortunately if
not watched may become -the carriers
of disease and death. Typhoid fever is
a water-born disease. Water contami
nated by sewage conveys typhoid -in
fection. In a large city like Chicago
the sewage problem is a difficult one. In
fact, it has not been completely
mastered here, nor can- the water supply
be made completely free from contami
nation, in view of the fact that there
are boats plying within the water
supply and bathing beaches and summer
colonies along neighboring shores.
Pending the attainment of the mille-
nium of an uncontaminated water sup
ply, the water of Chicago is treated with
chlorine gas to destroy the germs of
sewage. Weighed against occasional
slight unpleasantness of taste of the
water, is the fact that the chlorine treat
ment -has materially ' reduced typhoid
fever in -the city. Chicago’s water is
safe.
Milk also is brought from the outside
and delivered each day to the consumer
in the city. It is a .favorite culture
material for germ life and such deseases
as diphtheria, -scarlet fever, typhoid
fever and others are conveyed by it.
The source of the milk supply must
be constantly watched.
We know
where every ounce of milk comes from
and how it is handled and prepared for
the consumer. The children of Chicago
are being protected, as far as is human
ly possibly, from the death dealing
diseases spread by milk.
A carrier is an individual who has
recovered from a contagious disease,
but still harbors the germs of the in
fection and is capable of transmitting
it to others. The spread of typhoid
fever in a community often starts from
a carrier who, in some way, contami
nates water or food consumed in that
district. Typhoid carriers are 'guarded
against with great difficulty. In Chicago
every effort is made to locate them by
suitable laboratory tests and when
typhoid fever gets an unexplained start
in a locality, the health officer always
tries to trace a possible carrier.
Diphtheria also is a disease that is
spread more or less by carriers. In
Chicago no individual suffering from
diphtheria or who -has 'been in contact
with diphtheria is released until his
throat cultures give negative findings;
but even :so, there is still a too high
diphtheria incidence.
There -is no question of the efficiency
of vaccination as a preventive against
smallpox. In civilized countries where
there’ is -the least semblance of health
•law, smallpox -has been- reduced from
a death-dealing scourge -that once took
its toll of millions, to a disease of little
practical importance. A few sporadic
cases occur in the well-vaccinated com
munities and-, under these circumstances,
the disease is confined to the unvac
cinated.
Careful supervision of the health of
children has yielded results that more
than justify its existence. In fact, it
is today an essential measure of. health
protection. The examination of child
ren has done much toward reducing the
number of contagious diseases among
school children and has brought a re
duction in deaths of children.
Physical examinations are recognized
today as a necessary adjunct to the
school life of the child. By this means
physical defects and weaknesses are
brought to light, and proper correction
of these builds up resistance against the
diseases of childhood, lays the, founda
tions of good health in adult life, and
insures a longer life expectancy.
We have gone a step further than
this in the infant welfare stations.
Here the infants are watched from the
day of their birth, and results show a
materially lowered infant mortality rate.
These are but a few of the activities
of a health department. The community
is now ripe for -the proper sort of health
education and publicity. The general
public is becoming more and more in
terested in health matters, and, as I
said before, health propaganda is arous
ing not only a -health conscience, but a
health coneiousness. The general pub
lic -has began to realize -that there are
ways and means 'by which- it may stave
off the inevitable visit of the undertaker.
This is shown by an ever-increasing
demand for regular periodic health
examinations.
Industrial plants -also have learned
the value of well workmen. They know
too the tremendous -loss produced by
avoidable or preventable -sickness. They
■have done much toward safeguarding the
workman and even forcing good health
upon him. The newspapers 'are taking
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