Page:LewisMeriam-TheProblemOfIndianAdministration.djvu/278

established for this almost superhuman effort and skill have resulted on the whole in an untrained personnel.^[1]

Much may be said to the credit of these workers, although a few have been uninterested and perfunctory. In many instances, they have been most self-sacrificing and within the limits of their understanding have done everything in their power to render a service to the Indians. One field matron was encountered who had a real grasp of her duties. She had had about three years of nursing training and experience and was rendering a service worthy of special commendation. Regardless of the conscientiousness and long hours of toil of many of these workers, constructive work resulting from their endeavors is rarely found. They should not be blamed for lacking qualifications which were not required by the government when they entered the service. The present administration is to be commended for its decision to abandon the long established policy of using this type of worker and to substitute for them trained public health nurses. The change cannot be effected too rapidly. The investment in this service has been a great loss when compared with what might have been accomplished had the same amount been expended for trained personnel.

Medical Supplies. The drug supplies on the shelves of practically all reservation dispensaries and hospitals are of a doubtful character, and are far in excess of the present needs.

Much of this stock is of a perishable nature, long since deteriorated, and of uncommon drugs, seldom if ever used. At Zuni, for example, ten pints of fluid extract of ergot were found, enough to supply the entire service.

This situation is due chiefly to the policy of purchasing supplies in advance, the unsystematic method of ordering, and the shipping of army surplus supplies without an order from the agency.

The estimates for the purchase of such supplies are made in November for the fiscal year beginning the following July. With the possible exception of the more staple supplies, such as cathartics and cod liver oil, the tendency has been to overload with certain perishable drugs. At the time of the visit from the survey staff some agency physicians did not understand that they were allowed