Page:LewisMeriam-TheProblemOfIndianAdministration.djvu/222

This brief introduction gives in summary the outstanding findings of the survey without pausing to present the supporting evidence. The evidence and a more detailed discussion will be found in the following pages where specific detailed recommendations are also made. The broad general recommendation is obvious. Appropriations should be made greatly to strengthen all the medical work of the Service, especially that which relates to prevention of disease. Certain specific broad recommendations should be here enumerated for emphasis:

1. The personnel in health work for the Indians should be materially strengthened both in respect to numbers and qualifications.
2. An adequate public health program should be inaugurated, with special emphasis on prevention. This program should emphasize: (a) Reaching the Indians in their homes through public health nurses, home demonstration agents, and social workers in an effort to change the home conditions that are responsible for disease, (b) establishing regular clinics for the benefit of Indians whose health is in the least doubtful so that diseases or susceptibility to disease may be discovered early and treated, (c) providing adequate hospital and sanatorium facilities so that those who cannot be cared for in their homes will receive proper care and will not be a menace to members of their families, and (d) establishing an adequate system of medical reports, records, and statistics so that all concerned in the administration and control of medical activities may have definite facts to use as a basis for analyzing problems, measuring results, and determining policies.
3. The whole régime at the Indian boarding schools should be revised to make them institutions for developing health. This revision should include: (a) A marked increase in quantity, quality and variety of food for all children, (b) a marked reduction in overcrowding, (c) a thorough physical examination of all school children at least once a year and oftener if the child has any defects, (d) a material reduction of the working day for all children below normal if not for all children, (e) a much greater effort to prevent the spread of contagious and infectious diseases, and (f) more thorough training in the care of the person and prevention of diseases.