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man. This may seem absurd, but it is evidence of the gradual breaking down of the old undesirable custom. In such instances the white doctor has an opportunity to render service that he would not have if he held aloof.

Lack of knowledge of the Indian’s language is frequently a barrier to appropriate medical service. Notwithstanding the spread of schools, many older people do not speak or understand English. Usually the only means of communication between health officers and the non-English speaking Indians is through interpreters, a method not satisfactory for many reasons.

Another real difficulty in health work is due to the past activities of the Indian medical service. In some instances the physician has been little better than the Indian medicine man, and the Indians have been forced to doubt his ability and interest. Today, however, a number of physicians with ability and a genuine interest for the Indians are winning their confidence and respect. Had there been more of these in the years past a far better situation would exist now. The type of hospital and the manner of its administration have kept away many a case in need of care. Within the past few years more and more Indians are going to hospitals off the reservation, where they learn to appreciate and expect a higher type of service than can generally be found in their government hospitals.

Clashes in personality and lack of sympathy for Indian ideas and feeling have not been confined to the medical personnel. These unfortunate attitudes have existed also among some agency employees, and have added to the difficulties encountered in inducing the Indians to accept the white man’s methods.

The isolation of Indians from convenient transportation centers causes many difficulties in rendering the necessary services. Many places, miles from highways, have barely a wagon track leading to them. Some are beyond rivers or creeks that are impassable at times. Rains or snow may very quickly wash out or render useless a trail that was passable a few hours previously. One has only to attempt these trips to understand fully the difficulties faced daily by field health employees during some seasons.

The mode of transportation of employees has shifted from horse and wagon to motor car, and, not infrequently, on some reservations, back to the horse again. The appropriation allowed for purchasing new equipment is very small, thus necessitating the use of