Page:LewisMeriam-TheProblemOfIndianAdministration.djvu/254

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Health
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In addition to the full time services already granted by the Public Health Service, the Chief Medical Director has been privileged to call on any one of the six Public Health Service surgeons, stationed at various points in the United States, and this action has frequently been taken.

In like manner, a very commendable service is being rendered by sanitary engineers and other specialized field personnel of the Public Health Service. Several water supply and sewage disposal systems at Indian schools and reservations have been studied. Detailed reports with recommendations for their improvement have been submitted and action is being taken to apply the necessary remedies. The water situation in the Cherokee country of North Carolina was recently appraised at a cost of only eight dollars to the Indian Service.

The duties of the full-time district directors are of an investigational and advisory nature. They do not include the exercise of authority over the internal affairs of schools, hospitals, sanatoria, and agencies or disciplinary powers over their personnel. Such matters are handled by the Washington office.

Their duties in general are as follows:

  1. Inspection of Indian schools, hospitals, sanatoria, and agency health activities.
  2. Study and reporting on standardization of methods and facilities, including personnel.
  3. Coordination of the Indian Service medical and sanitary activities by means of conferences with service officers in the district.
  4. On instructions from the Washington office, investigations and adjustments of controversies.
  5. Reports on matters affecting the Indian medical service and public health policies.
  6. Promotion of cordial relations with state and local sanitary authorities, and other public health organizations.

Perusal of the duties outlined above shows that the district director is required to cover a wide field of activities. To perform these duties fully would require a very intensive study and analysis of each unit of the Indian Service visited. Each district comprises an Indian population of approximately 62,000. If this population were concentrated in one state or fraction thereof the problem

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