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As has already been said, immediate provision should be made for a corps of specialists to assist the chief medical officer in each of the special fields which are of vital importance in Indian health, namely, (1) Tuberculosis, (2) trachoma, (3) infant welfare and maternity, (4) venereal diseases, and (5) hospital management.
Immediate steps should be taken toward strengthening the personnel engaged in public health work-at schools and reservations, doctors, dentists, public health nurses, and home demonstration workers competent to attack the problems of diet. Both the number and the qualifications of these employees should be materially increased ; this will necessitate offering salaries comparable with those paid by other government agencies doing comparable work.
The number of supervising district medical directors should be increased by at least two, so that the distances and the amount of time spent in travel will be reduced and the amount of supervision of local medical employees will be increased.
Public health clinics, properly staffed and equipped, should be available to all Indians within a reasonable distance of their homes.
Medical examination of Indian children should be exceptionally complete and thorough for two reasons. Many of them are in subnormal health. In matters of health the government is to an extraordinary degree in loco parentis. In medical examination of white school children, the authorities can to a very considerable extent count on the parents and their family physicians for codperation and aid. The Indian families are generally not sufficiently advanced to give this aid, and even if capable are powerless in the case of children away at school. In dealing with Indian children the government must do the whole job until the Indians are much further advanced. The medical examination of the Indian children must therefore be of the highest standard.
As a vital measure in preventive medicine the Indian Service should take immediate steps to increase the quantity, quality, and variety of the diet of Indian children in boarding schools. For this purpose largely increased appropriations must be made. Money must be available for the purchase of milk, fruit, and vegetables until such time as a sufficient supply can be produced by the school farms and dairies.
Also as a measure in preventive medicine the existing over-crowding in boarding schools should be eliminated. As will be