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were more keenly interested and alert. It would be well to state in passing that during a recent five-year period, 49 per cent of the deaths which occurred on this reservation were of children under three years of age.
Although it was not possible to secure similar figures on other reservations visited, it was found that a considerable number of births were being conducted in the hospitals. Reference will be made to them under the section dealing with hospitals.
The proportionate number of deliveries in homes on other reservations could not be secured because the physicians did not keep an accurate record of such work. The fact that they signed the birth certificate was not evidence that they attended the case at the time of delivery.
The Indians’ demands for a physician at child-birth are clearly increasing, especially on those reservations where a definite effort is made to induce the Indian to request such attention and the physician remains long enough to become acquainted with his clientele. It is believed that considerably more Indian women would accept the services of physicians if their interest were solicited and adequate facilities made available.
Despite the many adverse criticisms which it has been necessary to make as the result of this first hand study of the medical field service, it is nevertheless true that a marked change for the better has been inaugurated since its reorganization. The conditions found are known and regretted, but the Indian Service can do little to overcome them until it can raise the standards for its medical personnel to the level of personnel in other medical services of the government. To achieve this it will have to establish a salary scale comparable with those in the other services.
Contract Physicians. There are sixty-one positions for contract physicians, thirteen of which are vacant. The officers have resorted to the contract service plan for three reasons: Inability to secure full-time service; the belief that the medical needs on certain jurisdictions did not require full-time service; and because, in several jurisdictions, the authorities had requested a contract in preference to a full-time service in the light of past experience. In general, this type of personnel has been only a make-shift.