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Coöperation with Other Organizations. Various national and local health agencies have asked permission of the Bureau to carry out on Indian reservations certain activities in their particular fields. The permission has been granted. The private agency has been permitted to send workers to the reservation and a degree of courtesy has been assured them by Indian Service employees. Their studies were made with a certain amount of independence. In the case of public health nursing, where the most constructive results could be obtained only by a close coöperation with the reservation employees, it was found that the relationships were often strained, even to the breaking point, as the work progressed, although they had been cordial at the outset. This was due to the fact that the outside workers had no definite responsibility to the Indian Service. With salaries that were much in advance of those paid within legislative limits by the Indian Service and training of a more specialized character than that of the reservation employees a definite clash in personalities resulted.

The most serious fault, however, lies in the fact that generally the work attempted by these workers was not done with any idea of its ultimate incorporation into the Indian medical service. If this idea was ever advanced, it was theoretical, because, by and large, this goal has not materialized. In practice, most of these endeavors have vanished as abruptly as they started, leaving little that was constructive.

The Office of Indian Affairs has also failed to assume leadership in these matters, largely because it has not had a trained personnel in close contact with, and able to evaluate, the activities of these private agencies. It has seldom taken the initiative and requested service from outside agencies, and therefore has not assumed responsibility in such endeavors. One exception to this is found in the Red Cross Survey of 1924. The Indian Office requested the American Red Cross to make a survey to determine the public health nursing needs on certain Indian reservations. A study was made and a report with recommendations submitted. As a result, the Office has attempted to carry out some of these recommendacoöperattions, although in a limited way, due largely to the lack of funds with which to bring about the changes suggested. It may be said in passing that the findings of the Red Cross report correspond