Page:LewisMeriam-TheProblemOfIndianAdministration.djvu/320

offset by the stuffy vitiated air the patient must breathe while taking the treatment.

The sewage disposal plants operated in connection with many of these institutions are inadequate. Steps are now being taken to determine the efficiency of such facilities by Public Health Service sanitarians.

The medical superintendents of all these sanatoria are provided with a residence. In some instances the quarters are quite acceptable as is the case at Sac and Fox, Talihina, and Fort Lapwai. In others, notably Navajo and Laguna, the quarters are inferior. The housing facilities for other employees are generally poor. Space is provided either in the institution or in poorly equipped quarters outside. Those housed in the institution must use bed space that is needed by patients.

Fixed equipment, such as sanitary facilities, is frequently inadequate, both in number and in arrangement. In converted schools and buildings, Shawnee, for example, this equipment may be found entirely in the basement, a most unfortunate location when many patients are semi-bedfast. The bathing facilities provided are often showers instead of tubs. The abandoned school converted to serve as a sanatorium with the least possible re-arrangement, is almost invariably an inefficient institution.

The same unwise economy and lack of understanding of sanatorium requirements are reflected in the movable equipment. Sanatorium employees often complain that Indian children refuse to remain in bed, a refusal which is readily explainable when some of the beds are found to have sagging springs and lumpy mattresses. Bad beds are not universal but they are found too frequently. This condition is due in the main to the poor quality of equipment salvaged from other buildings, and the low grade of new equipment bought in the past. The Indian Office reports that from this time on, all such equipment will be purchased on specifications meeting the standards of other federal sanatoria. Properly treated, the tuberculosis case is required to spend longer periods in bed than the general hospital case, and the least the sanatorium can offer is a comfortable bed that will be conducive to the rest and relaxation the patient needs.

Other equipment, such as kitchen utensils, dishes, and food conveyors, is limited. Some of the sanatorium superintendents are