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nmsfOff crLSfta sryvprrCj
!The Hygienic
paigh Conducted in
New York by Dr. S.
! Josephine Baker, Who
Has Reduced theMor-
tality Rolls by 1 200
-.Year
7 l 'tdllLY speaking, a baby must be
- saved before it is born if infant mor
tality is to be reduced to a minimum.
' UpHl1 principle a woman has been work
in gin New'' York for several years, wth the
result that, from- January i to November I,
"Tp, there were 1324 fewer deaths of
babies under one year than there had been for
the same period of iqio.
This year, by the way, the record is 300
? under the mortality of iqii, for the first six
months.
' ' Preventive measures will, therefore,
heme saved somewhere around 3000 little
tives'm two years if the present ratio is main
tained. Jll this has been accomplished through
tha organization of a division of child hy-
'gicne of the department of health, at the
': jieadof which is Dr. S. Josephine Baker, who
has engaged in a campaign of life saving with
2viMuch precision, as great a regard for
- thoroughness and efficiency of organization,
4 Wt would be exhibited by a general in the field.
(The bureau of which she is at the. head
U the first "established under municipal con
trol to deal with the supervision of the health
pf ' children from birth to the legal working
' and the system she has developed is
entirely tier own. 11 ucgms mc cuutu-
tioitlhrotkrrByrd,oncraThild h
. '
scure tt.
---v ist perhaps, in accordance with the
trend of the times that, as men heretofore
"JiaTOfl taken the lead in destroying life, a
tooman should now take the lead in saving it.
B
Y VIRTUE of her position, which makes her the
guardian of the health of all the children of the
greatest city of the country, end Involves the
responsibility for the expenditure of more than
"tialf a million dollars yearly. Doctor Baker easily takes
'; Crsrt place in the work of human reclamation. The first
- cl her sex to be trusted with a position of such lmpor-
tance, she has done much to prove that the feminine
'rtand has long been needed in this branch of civic work.
' And it is notable that her nuccess In New York has been
i' followed by the organization of a similar department by
the national government, with Miss Julia C. Lathrop as
' the bead.
In Doctor Baker's case, promotion came as the re
,,ward of efficiency, demonstrated while a medical lnspec
tor in the department of health. Still quite a young
"Woman, she is thoroughly feminine, light of hair and eye
and soft of voice. Judging from her personality, one
l might say that much of her success has come from a
' broad and deep sympathy with those she has aided.
.Perhaps the most striking measure Doctor Bakr
', 'adopted was the supervision, by competent nurses and
i fthyslclans, of babies born In districts where they were
, Jiot likely to receive efficient care.
"We cannot hope to cover the entire city," said
; n Joctor Baker, recently, "so we naturally concentrate
our efforts on those sections where the mortality is
''greatest in the congested districts of the boroughs
of Manhattan and Brooklyn, and In some sections of
' '-J-ong Island, principally.
4 -u - WORKS FROM BIRTH REPORTS
K "The birth reports are consulted every day, and
,', stnurse is sent to any home In which there is a pos
sibility that assistance may be needed. Last year
, from My 1 to September 15, there were 16,987 babies
"tinder the supervision of these district nurses, with
; the result that there were only 237 deaths, or a mor
' juilty of 1.4 per cent."
Naturally, as this system has proved so eminently
J aatlsfactoryMit is beln continued this year, with an
IncreafS from 1S7 to 263 In the nurning staff. In order
that a grealer-ipmount of work may be done.
Even this, however, is scarcely more than a tem
i'torry measure In a general plan of campaign which
' Doctor Baker Is perfecting. "In order to attain the
Vest results," she says, "It Is necessary to go still
further back. We must prepare women for mother
THE OREGON SUNDAY JOURNAL', PORTL'AND, SUNDAY HORNING, JULY 11. 1813
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Gam- rmi 'lr mdMW
ill k ? v. . j-.it: . v 1 1111 s .,,' ,v,'.i'.v, .v. ,.; . w ' - -v
hood; we must educate them to the observance ot
hyglenlo laws.
"If we could secure cleanliness and yentllatlon In
all homes, the necessity for the greater part of our
work Would be obviated. Contagious diseases, for In
stance, start to Increase In the fall, when people begin
to close their windows, and reach their maximum
during the coldest months, when fresh air Is almost
entirely excluded from many dwellings. In the
Bprlng, when the windows begin to open, there is a
corresponding decrease, and during the summer
months, when windows, almost universally, are open,
the number of contagious diseases Is extremely small.
"In order that women generally shall be brought
to appreciate how necessary It is to nurse their chil
dren themselves, and to obey simple hyglenlo laws,
we greatly elaborated our educational work last year
by holding conferences with mothers on recreation
piers, In playgrounds, vacation centers and at the
offices of charity organization societies. A physician
and a trained nurse gave lectures and demonstrations,
and tli is work has been continued, also, during the
winter, with gratifying success.
"Along the same lines, but going still further back
for motherhood
ganlzatlons and an enrollment of 17,0u0. L
We have
ith 2U or
ganizations ana an enrollment oi i,vv. wtiiuca uu
the care of babies have been given In the public schools
to girls over 12, and thsy have served. to stimulate in
terest in the leagues.
"I have great faith In what may be accomplished
through these leagues, because we can never reduce
Infant mortality to a minimum until all mothers are
thoroughly educated and prepared for their duties."
So far there have been given Just a few of the dis
tinctive lines upon which Doctor Baker and her sev
eral hundreds of doctors, nurses end other' assistants
have been working. Hut, as she herself has pointed
out In a recent paper, no one line of endeavor will
obviate the evils of a complex situation, "in stating
what I believe to be the principles Involved In the
reduction o Infant mortality," she wrote, "I shall go
back of the more concrete forms and mention rather
those broad forces which must be studied and applied
to the fullest extent before we can dellnltely and
permanently lower the death rate.
"rlrst and foremost, we need public opinion, trie
awakening of civic consciousness, to view clearly the
paradoxical situation of increasing our population by
immigration while allowing our native born to die;
stimulation of the people to demand that all clvlo
forces shall be so adjusted and. eo-orilinatd that the
babies may be allowed to live. Instead of forced Into
illness and doomed. to death."
The specific principles upon which Doctor Baker
has been working, as given In the same artlcW, are
as follows:
1. Thf ntudy of the problem of the lnlltutlon baby.
During thl year up to October 1. 42 per cent of all
death of babies under 1 year In tha burouih of Man
hattan have occuried In Institution, tho foundling bablei
furtilnhlriK the greater proportion
J. a supply pf milk note tut infant feedlnir at a prlco
within the reach of the majority of our people. Th
relative value of raw and paateurlied milk fur infant
feeding st ill eeemi an open queatlun. Puiillcatlon cannot
take tha place of purity, but the matter la economic,
and purity seem beyond our reach at the price we can
pay.
I. The broadening of courses In pediatric In our medi
cal colle(fe. no that they may assume the importance
lhat 1 their due and assuru lo every physician a thor
ough knowledge ot infant hyKlene and care-
4. The lntereit and attention of social student and
workers and of philanthropists. In meeting Individual
family needs and adjusting economlo conditions.
6. Instruction of each mother, first In the necessity
of nursing her baby, and, if that la impossible, then in
the proper substitute feeding, and how ehe may tak
advantage of and apply the ssential methods of hygi
enic baby care. '
6. A right understanding; of the Immediate cause
of infant mortality.
All of these principle have bea applied In part, with
results that are worthy of attention. In the thirty-year
period from 1880 to 1910 the change In the Infant death
rate In New York, city have been as In the accompanying
table.
Deaths of Children I'nder t Year of Age for the Years
1880 sad 1910, With Bates per 1000 Infants Living
at That Age
10
Kate
per
1000
li.ll
62.74
43 70
47.57
, -1910
Hate Per cent
pel reduction
Death 1000 In rat
7S 4.67 7
4.807 89. 71 37
,2!2 27. 'JO 88
6.629 45.CS
Death
Contagious dlaeaaa. . "4
I'larrlx-al dls-ases . . . l,fD5
Respiratory disease. 1.32
Congenital debility.. 1,434
Total, all onuses. . 8,
Wfien a reduction
16.215 133 9 54
than 50 per cent Is
of
more
i
mad In the death rate, as the above table shows, lt
Indicates, first, that the problem of child Saving is In
a fair way of solution; and secondly, it calls up the
question of cost, which Is always of great weight with
municipalities when any humanitarian project is
under consideration. In this case, the cost cannot be
considered prohibitive, amounting to about 60 cents
per month each for the more than 16,000 babies. A
physician was assigned to every two or three nurses,
and held dally consultations with them. All babies
were visited at least once in ten days, and those who
needed attention were seen oftener. The 111 and deli
cate children were' under the direct supervision of urn
physicians, and a case record of each was kept at
the headquarters of the division.
For the extension of the work. Doctor Baker has
planned a campaign of educational publicity, for the
general public as well as for Individual mothers.
Next she alms, more completely, to eliminate the
deaths from congenital causes. A third of the mor
tality, the above table, shows, is due almost entirely
to prenatal Influences, which have been little affected
by the preventive measures already taken. Women
who thus need special care she would have place them
selves under the supervision of physicians a month ,
before and a month after the birth of their children,
thus saving a considerable portion of the third of the
entire deaths which now occur within the first few
weeks of Infant life.
In the article before quoted, Doctor Baker specific
ally states her plans, as follows!
(a) Proper education and control of mldwlvsa. who,
in this city, care for mora than 40 per cent of the birth.
b) Classes for and supervision of pregnant women,
using all mean to provide them with essential Instruction
sad the mean of applying it.
(c) A form of insurance whtoh will provide a stated
11 1 m 1r Mru miKiwnummii V - mi inn '- - r"J III II SsMUMWias
Dollar, Divorces
and SotChmper
D
OLLAR divorces ! Reno papers, please copy.
Out-rate separations, marked down
severances of matrimony, bargain sales of
single bliss what a wonderful lot of in
ducements might be offered to mismated tourists if
Nevada could appropriate some of the African
statutes! For instance, the women of the Ingalwa
tribe who are tired of their husbands have the
Reno women backed off the map. They do not
have to worry for six months, a year or two years,
held in an onerous marital leash until a judge
condescends to 6ign a decree. Instead, they simply
nag and nag their husbands until they induce the
irate gentlemen to give them a good beating. Once
T
HE Arabs and the Moors probably hold tha
divorce record. In Sudan there are Arab men
who have been married forty or fifty tiroes
within ten years. The female of the soecles
cannot boast of such record. The best they are usually
able to do is twenty matches In a decade. This Is
because the customs and conventionalities decree that
a divorcee shall wait three whole months before
becoming a blushing bride again, while her former
husband can remarry the day he Is freed if he so
desires. It would Indeed be a great scandal for his
discarded wife to startle Sudanese society by belnB so
previous. But after her period of grass widowhood
has expired, she can go and do it again without
fear of criticism.
In the Barbary states a wife can get a divorce it
she finds that hubby had another sweetheart before
he wooed her. That Is her only salvation if she tires
of her better half, unless she can prove that he has
beaten her without sufficient provocation, or that he
had- not. given her- proper food, . clothing- or shelter..
And this Is pretty hard for her to do. for the Judge
might agree with the husband that she deserved the
beating and that the food and clothing that he gave
her were good enough for her.
On the other hand. It is the easiest thing in the
world for an Arab of the same region to cast aside
V
1 i j
Yurscvy m?3fxt?j77Pj7tPtefi7-
payment tor women for a period of at least one month
before and one month after confinement, thus obviating;
the necessity for physical labor on their part durltaaj this
time.
(d) The co-operation of phllanthropto forces, relief
agencies and social workers to provide proper food, hy
glenlo surroundings and freedom from anxiety for the
mother during the prenatal period of the child' life.
The Socialist will say that the crux of this whol
matter Is the living wage for the wage-earner of the
family. To a great extent I agree with him. Such a
solution would lighten our labors, but we should still have
to consider the vast and vexed question of the Illegitimate
child.
The problem of the mid wives, as indicated above,
Is, in Doctor Baker's opinion, one of the greatest with
which she has to contend. Proper supervision, such
as Is now practiced, will, she relieves, do much. But
nothing will take th place of efficient education, such
as Is now insisted upon.
In August of last year the first municipal school
for mldwlves was established in New York by Dr.
John Winters Brannan, president of Bellevue and
Allied Hospitals of New York, and of this much Is
expected. Eight classes are receiving Instruction in
courses of six months, during which time all pupils
live In the building which has been devoted to the
work. Not only are the women taught the essentials
of their calling, but are Instructed in general nursing,
the preparation of meals, and the like.
"while the midwife Is Indeed a problem to be
'reckoned with," says Doctor Baker, "she may be an
agency tor Rood, as well a for evil. In the first place,
she not only does a physician's work, but often at
tends to the household as well. Furthermore, her ad
vice on the observance of the rules of hygiene will often
be followed when a doctor's will not Usually she speaks
the language of the women she attends. She Is looked
a drop of blood flows, it is all off. Rack to mother
goes the wife, taking with her a good share of the
marriage offerings, and becomes a divorcee with
out any more ado.
Nor are these African women the only ones
who don't have to hie themselves to Reno when
they merely want to get rid of their husbands.
Yet everywhere one :rule holds pretty good in the
divorce records it's the young women who are
willing to take another chance. The middle-aged
ones are usually satisfied with the meal tickets
they have, and glad enough when they can hold
on to them. Particularly is this so in Tunis,
where any man with $1.20 can get his freedom any
time he wants it.
nia wife in favor of anothsr. And then the first one
cannot remarry, unless she returns to him the money
that he paid when he bought her. It she loses her
good looks or is untidy In her dress, or if he grows
tired of her for some reason or another, all he has
to do Is to say, "Woman, get thee hence; take thy
goods and go." And go she must. Divorce courts or
fees do not have to be contended with.
In and about Tunis It Is a different story. For
there one will find a. divorce court, where the men
can get rid of their wives for the grand total sum of
$1.20. And the women seldom have any say in the
matter, it being estimated that nine divorces out of
every ten applied for are granted.
There Is a wonderful scene In this majestic hall of
Justice In Tunis, presenting a picture which may some
day win a prize for some enefgetio and ambitious
artist In this hall, the principal furnishings of which
are beautiful eastern rugs and draperies, there Is a
striking contrast In the appearances presented by tha
gray-bearded Judges in green robes and gold turbans,
-the husbands also- in -turbans,-tke lawyer -in -tar
booshes and the wives, closely veiled and hooded,
herded like so many sheep behind an Iron gitlL. These
latter take no part in the proceedings, leaving their
Interests in the hands of an advocate.
After the Judge gives his decision, which is gen
erally In favor of tha husband, and on or the other
i II
f
I
X 1 mt- M.'.v..v.fc'. III!
1
np to and respected, where a, pbraicUn mlflit t r
raxded u n Interloper.
"Borne ot the ' mldwlve hare alreadr been most
helpfnl In Interesting 'women In the claes we hare
been conduotlnr for motnera, and their ugefulaeaa
slonc tnls line might be Indefinitely extended."
At present, no woman oan practice m a midwife
In New York unless she has a certificate from the
division of child hygiene, and these must be Issued
very year. Certificates are issued, also, after proper
Inspection, to wet nurses, who take children from Inn
etltutlons and foundling homes. During the year 1910,
these places was abnormally nigh. On the island of
Manhattan, 43 per cent of all the deaths under 1 year
of age were in these institutions. Consequently the
plan of hoarding them in private homes) was adopted.
Last year Certificates were granted to 4010 foster
mothers, and the homes were visited frequently, the
relnspeotlons. to insure proper care of the Infants,
totaling 29,283.
This, with practically altf the work bo far -outlined,
is above and apart from that ordinarily -undertaken
by municipalities. Yet what may be termed the
routine methods for safeguarding children, have- not
by any means been neglected.
For Instance, last year Doctor Baker obtained .an
appropriation of $40,000 for tlx establishment of fif
teen municipal milk stations, to supplement the sixty
four maintained by various charities. Eo successful
were they that this year the number kept up by the
city was increased to fifty-five. By the does of last
year 7802 babies had been enrolled since the opening
of the stations, among which there had.-ienelghly,
deaths.
WORK OF INSPECTION
The. day -nurseries, ot which thrre.are ninety-two,
were regularly inspected by agents of the division o8
child hygiene. The work they do Is not unlike that
accomplished in many other cities, and they were re
ported in excellent condition.
In addition to all these -varied-branches) of aottrtty
is the Inspection of school children, which, irT Itself,
is a tremendous work In a municipality of the slza of
Greater New York. As a result of the examination Isx
the schools, 265,165 visits were made by Inspectors and
purses to the homea of children, with a result thai
Dr. Baker waa able to report that 88 per-3eatf,all
the defects discovered had been treated.
Of a total of the 65,160 children who received.
tentlon, only 27,164 attended dispensaries and hospV
tale, the remainder being attended by private physU
clans. Free clinics, however, are always at tha dla
posal of such children as need them.
The total of the children examine was230,24af
whom 16,S8 were found with defects, thougU of
these latter only 76,857 had defects other than of tha
teeth. Physical examinations were held, as well, on
boys who desired to take part In athletics, in order
that those with weak hearts should not b allowed, to
engage in sports which might permanently Injur
them.
In this connection p la Interesting to not that
Doctor Baker does not'favor compulsory, treatment for
school children.
"In the first place." she says, "the responsibility
for deciding on the welfare of their offspring should
never ba taken a.wav from narnt. Am inn am tkt
Is a free country, I do not believe It would be In ac
cordance with our form of government to assume
such inquisitorial powers. Again, I do not believe that
rn.edlcal science has yet reached a point where It la
competent to sentence a ch'ld to an operation. When
more than 80 per cent of the defects we discover ara
treated voluntarily, what mora can we expect7 Cer
tainly there is no reason, so far as I can see, for
resorting to severer measures. By all means let the
parents decide, because It is only through the o
operatlon of the parents that we caivhope to-o-eduo
the ills of childhood."
is discontented, all he or she does is to walk aoxoaa
the hall and lay the matter before another Judge. Hla
decision is final. Even then It does not take moro
than an hour for the case to be settled, and the cost
la never more than $1.20, often Jl or less.
In Morocco, marriages are lightly made and lightly
broken. It is not unusual for the people to talk of all
the husbands and wives that they had before they
were 30 years old. But then the young folks hav no
opportunity to get acquainted before their marriage,
so It Is more or less natural that, after the novelty oJ4
the first few months hag passed, many marital storms
result Besides, the Moroccans take great delight la
marriage festivities and are never disposed to dis
courage matrimony. However, the man who marries,
divorcee must curtail these ceremonies, which la a
hard blow.
TWIXT TWO CEREMONIES
Trial marriages are often the thing in Abyssinia,
for there a broad distinction is placed between tha
religious and the civil ceremony. The latter Is a
solemn tie. and cannot be broken'. If u. man is doubt
ful, he selects the civil ceremony, which is hardly con
sidered binding. Very few venture to undergo tha
religious ceremony first.
Getting a divorce from a flowered husband might
sound like a riddle, but thl is don among tha
Kadava Kumbls trlbeswomen. For a girl to marry la
India for the tlrst time a man who has not great
wealth, if she belongs to a hltjh caste or class Is con
sidered a crime; but, as in many other places, 'wealthy
men cannot be found every day, so to settle the mat
ter the girl Is married to a bunoh of flowers and she
divorces herself by throwing her beautiful' bouquet
in a well or hiding it somewhere, that it won't ba
easily found. Then it is easier for her to contract a
marriage, and she will hot have to remain an old maid
the rest off her days. Other girls of this same tribe
marry men who already have helpmates, with the
understanding that they will divorce them. Then
cheaper ceremonies are performed without tha
expense and fuss that must accompany first mar-
riages.
In South Africa the men also have the advantage
over the wives, that they have In many cases bought
for pigs and goats. The Bushmen, for Instance can
divorce their wives at their pleasure, but the" dis
carded one cannot marry. If she should take a fancy
to another,her former lord and mustor can challenge
- him to a duel, and ah humbly follows th eonenemr. -
The Bushmen still observp an ancient custom that
, a man must not look his bride in the face, but must
visit her in the dark. In other tribes, especially
Among the Hottentots, the Fiji Islanders and the Cir
cassians, it Is almost considered a. crime for a man
to b seen with his wife.