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-The Project Gutenberg EBook of A Working Plan for Colored Antituberculosis
-Leagues, by C. P. Wertenbaker
-
-This eBook is for the use of anyone anywhere in the United States and
-most other parts of the world at no cost and with almost no restrictions
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-www.gutenberg.org.  If you are not located in the United States, you'll
-have to check the laws of the country where you are located before using
-this ebook.
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-Title: A Working Plan for Colored Antituberculosis Leagues
-
-Author: C. P. Wertenbaker
-
-Release Date: May 13, 2020 [EBook #62116]
-
-Language: English
-
-Character set encoding: UTF-8
-
-*** START OF THIS PROJECT GUTENBERG EBOOK COLORED ANTITUBERCULOSIS LEAGUES ***
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-Produced by hekula03 and the Online Distributed Proofreading
-Team at https://www.pgdp.net (This book was produced from
-images made available by the HathiTrust Digital Library.)
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-                           TREASURY DEPARTMENT
-     Public Health and Marine-Hospital Service of the United States
-
-                       A WORKING PLAN FOR COLORED
-                        ANTITUBERCULOSIS LEAGUES
-
-                                   BY
-
-                            C. P. WERTENBAKER
-
-                _Surgeon, United States Public Health and
-                        Marine-Hospital Service_
-
-                             [Illustration]
-
-                               WASHINGTON
-                       GOVERNMENT PRINTING OFFICE
-                                  1909
-
-
-
-
-A WORKING PLAN FOR COLORED ANTITUBERCULOSIS LEAGUES.
-
-Reprint No. 39, from the Public Health Reports, Vol. XXIV, No. 36,
-September 3, 1909.
-
-By C. P. WERTENBAKER, Surgeon, United States Public Health and
-Marine-Hospital Service.
-
-
-There was published in the Public Health Reports of May 28, 1909, Volume
-XXIV, No. 22, a plan for the organization of colored antituberculosis
-leagues, which contemplated the organization of a league in each State,
-with a branch in every colored church.
-
-Experience has shown that after such leagues are formed difficulty
-arises in getting to work in an effective way, because the work is
-new in character and those engaged in it have had but little, if any,
-experience. It is to meet this difficulty and supply a practical guide
-for the work of the leagues that this is written.
-
-
-ORGANIZATION OF A STATE LEAGUE.
-
-The object of the state league is to organize the church leagues, to
-bind them together and render more effective their work. The caring for
-patients and work of a similar character are properly the function of the
-church leagues.
-
-There need be but little ceremony in organizing a state league. A few
-leading colored men and women, preferably from different parts of the
-State, but not necessarily so, meet and proceed to organize the state
-league.
-
-The constitution and by-laws for state leagues should be adopted,
-followed by the election of a president, a secretary, and a treasurer.
-
-It is desirable that the constitution and by-laws recommended in “The
-Plan” be adopted in all essential particulars, so that there will be
-uniformity in organization and work. They have been adopted in all
-the States that have organized thus far, and it is believed future
-organizations should also adopt them.
-
-The president then appoints a committee, the president and secretary
-being members of it, to select a vice-president for each county in the
-State. (The plan contemplates that there shall be a vice-president for
-each county, whose duty it is to organize a branch league in each colored
-church in the county.)
-
-The selection of the county vice-presidents should be made with a good
-deal of care. Suitable persons who will actively carry on the work should
-be chosen for these positions. The vice-presidents should be authorized
-to appoint one or more representatives in each community to help them
-organize the leagues in the churches and arouse interest in the work.
-
-It can not be impressed too strongly on the vice-presidents that the
-success of the church leagues in their districts will depend upon the
-amount of attention given the work. The organization of a branch league
-in a church is merely the starting point; the real work is done after the
-organization is completed.
-
-The president and secretary of the state league should call for regular
-reports from the county vice-presidents, showing the number of church
-leagues in their respective counties and a statement of the work done in
-each.
-
-If any of the church leagues are not prospering, the president or the
-secretary of the state league should visit or write to them and learn
-what is the trouble, and give needed advice and encouragement. Officers
-of the state league should consult frequently and freely with their state
-board of health and enlist its sympathy and aid in their work. The closer
-the leagues keep in touch with the health authorities the better will be
-the results obtained. Both the state and local health officers will be
-glad to give their best efforts to help along this work. They are in a
-position to do a great deal to assist both state and church leagues, and
-the leagues should work in harmony with them.
-
-
-CHURCH BRANCH LEAGUES.
-
-_Organization._—In order that the members of the church in which it is
-proposed to organize the branch league may understand thoroughly the
-objects of the league, the minister or other competent person should
-explain clearly the purpose of the league and what it is expected to
-accomplish. He should inform them that relatively many more colored
-people die of consumption than white people; that very few colored
-people get well of the disease, partly because they do not know how to
-take care of themselves and partly because many neglect to do so; and
-that the object of the league is to teach the well how to preserve their
-health and prevent their contracting consumption and other diseases, and
-the sick how to regain their health. If too poor to take the necessary
-treatment, it is the purpose of the league to help its members to do so.
-
-After the foregoing has been thoroughly explained, the church branch of
-the state league should be formed by the adoption of the constitution and
-by-laws given for church leagues in the plan of organization published
-in the Public Health Reports of May 28, 1909. After this has been done,
-the officers required by the by-laws should be elected.
-
-The secretary then takes the name and address of each of the members,
-and as soon as a member has paid his dues he is given the certificate
-of membership, properly filled out, and signed by the president and
-secretary of the church league.
-
-The certificate of membership given to each person joining the league has
-printed on it information and instructions which, if followed, will tend
-to protect the individual from consumption.
-
-An attempt has been made to make the certificate large and attractive,
-and it is expected that the members will value it to such an extent that
-they will frame and hang it in a prominent place in the home, where it
-can be frequently seen, and that the sanitary maxims that it contains
-will be learned and followed.
-
-In organizing the church league it is well to have a number of the
-certificates on hand to supply the members as soon as they pay their
-dues. The form of the certificate will be found in the plan of
-organization for these leagues. The certificate can be printed at a local
-printing office, but if this is not practicable, or it is preferred to
-buy them, very handsome certificates printed in black and red, with a
-large red seal, and the name of the state and church branch league, can
-be bought for about 6 cents each, by the hundred.
-
-The amount of the annual dues to be paid by each member can be changed by
-each league to suit the necessities of the community. The dues should be
-so small that no one will be kept out of the league by not being able to
-pay them. However, as the dues will be the chief source of revenue with
-which the league expects to do its work, they should not be made smaller
-than is actually necessary.
-
-The money paid into the league as dues goes to form a fund that is
-disbursed by the church league collecting it to help those of its
-members who contract consumption. How much this help will be will depend
-upon the amount of money the league has at its disposal and the needs
-of the individual. But whether this help is much or little the having
-the certificate of membership and belonging to the league will give
-information that will teach one to protect himself and his family from
-disease. This means less sickness, consequently less loss of time from
-work, therefore more money, more comforts, and more happiness for all
-concerned.
-
-The vice-presidents and organizers should see that the four standing
-committees required by the by-laws of the church leagues are promptly
-appointed and that they understand their duties.
-
-As the work of each church league will at first consist largely of
-educating its members as to the cause of tuberculosis and the way to
-live to keep from getting it, the committees, and especially the ones
-having charge of “sick,” “sanitation;” and “information” should be
-especially active. They should learn all that is possible about their
-respective subjects so that they can teach the other members.
-
-In joining the church league one also becomes a member of the State
-Colored Antituberculosis League. Members of the state league and church
-branch leagues wear a button showing their connection with the leagues.
-
-_Membership._—Membership in the church leagues should not be confined to
-the members of the church organizing the league. As a rule it is better
-that the members of each church join their own church league, but if for
-any reason their church has no league there should be no objection to
-their joining the league of some other church. Those who are not members
-of any church should also be allowed to join the league.
-
-_Details of the work of a church league._—As soon as the church league
-is organized the president should appoint the four standing committees
-required by the by-laws to serve for one year, viz: “Finance,”
-“Information,” “Sick,” and “Sanitation.” The details of the work to be
-done may then be considered. One of the first of these is to ascertain
-how many of the members have or are suspected of having tuberculosis.
-This duty devolves upon the committee on the sick, which should get from
-the secretary a list of the members, giving the name and address of each.
-This list should be gone over and every member carefully considered. It
-is probable that the greater number of the members are personally known
-to the committee, and thus it can be told at once whether they are sick
-or well.
-
-The committee is not expected to decide whether these members have
-tuberculosis. Their duty is to make out the list of the sick and ailing.
-The physician will decide the nature of the sickness.
-
-It is desirable to find cases of consumption in the earliest stages, for
-these may be cured, and if all members who are not strong and healthy are
-examined by the physician it is possible that cases of early consumption
-will be found.
-
-Each ailing member should be visited by some of the committee and more
-careful inquiry made as to the nature of the trouble and the member urged
-to go to a physician or a dispensary for examination. This is especially
-true if the member has been losing flesh, or has had a cough for some
-time, or has throat trouble, or is sickly and frail. If upon examination
-the physician finds that the member has consumption, the patient should
-get a certificate stating that fact. The physician will also tell the
-patient what treatment is necessary.
-
-The certificate will be presented to the committee by the patient, and
-the committee will make more careful inquiry into the condition of
-the patient, the treatment considered necessary by the physician, the
-patient’s means, the number of people he has depending upon him, etc., so
-that the facts may be presented to the executive board in accordance with
-the requirements of Article VII of the by-laws.
-
-The list of the sick should be most carefully guarded and no one allowed
-to see it but the officers of the league and the health officers. This
-knowledge should be regarded as a sacred confidence that should not be
-divulged except to the persons mentioned above, as many might object to
-having it known that they have tuberculosis.
-
-Under no circumstances should the list be allowed to fall into the hands
-of “patent medicine” concerns which might urge their nostrums on the
-patients, much to their annoyance and also to their detriment, if they
-become induced to take the “patent medicines.”
-
-The measures necessary for the treatment of a patient who has
-tuberculosis must be determined by the physician, but it is the duty of
-the executive board to decide how much and what kind of help the league
-can give the patient in carrying out this treatment.
-
-It is not proposed to discuss here the question of treatment in a
-sanatorium which is the ideal way of handling all cases of tuberculosis,
-for in a sanatorium the sick cease to be a menace to the community and
-can be under supervision and treatment all the time. Unfortunately, at
-present sanatoria are not available for the great mass of the people; and
-even if they were, many would be unable to go to them.
-
-There is a class of patients who have to depend upon their daily labor
-for the support of themselves and their families. If they stop work,
-their support is cut off. For such as these treatment in a sanatorium
-is out of the question, and any treatment they can get must be given
-in their homes and frequently while they are working. To this class
-belong the great majority of the negroes; therefore the work of the
-church leagues must be directed to such help as can be given under these
-circumstances. What is necessary in each case will depend upon the
-condition of the patient, the stage of the disease, and the financial
-circumstances of the individual.
-
-For the purposes of the league, consumptives may be divided into three
-classes:
-
-First. The patients who are in the earlier stages of the disease and are
-able to go about their work while taking treatment.
-
-Second. Cases in which it is necessary to stop work and remain quiet if
-they are to get well.
-
-Third. Cases in which the disease has progressed so far that it is
-hopeless to attempt a cure, but for which much can be done to make the
-patients comfortable and prevent them from scattering the germs of the
-disease.
-
-As stated above, what is necessary in each case will depend upon the
-condition of the patient and his surroundings. Much also depends upon the
-means the league has at its disposal to help the individual. Most church
-leagues find that they have very little money; therefore the help given
-must be limited. However, there are certain things that can be done even
-by the poorest leagues.
-
-Information as to the way in which the disease is spread; the means to
-prevent it; what is necessary to get well if one has it, etc., is all
-printed on the certificate. When the member gets the certificate and has
-learned all that is printed on it, the first step has been taken in the
-education of the individual in regard to tuberculosis, so it should be
-the aim of the officers of the leagues to get the certificates in the
-hands of the members.
-
-The officers of the league can see that the instructions on the
-certificate are understood and carried out. Many individuals are careless
-and must be constantly watched to see that they do not neglect important
-precautions. Probably the most difficult thing the league will have to do
-will be to induce its members to keep their windows open and let fresh
-air and sunlight into their rooms.
-
-The officers and committees of the league should urge the members to
-keep the windows of their rooms open, especially at night, and to avoid
-overcrowding their sleeping rooms. Whenever a dark room or closed window
-which should be open is found, the danger should be pointed out, and the
-member urged to correct it.
-
-The practice of sleeping with the head and face covered is so deeply
-rooted in the negro race that it seems almost hopeless to attempt to
-eradicate it in the present generation. It is a most pernicious habit.
-The dangers of the practice should be pointed out, and the members urged
-to abandon it. Children should not be allowed to contract the habit.
-
-The careless spitting of consumptives in their homes is a practice
-dangerous to others. The careless at times spit on the floor, the
-walls, the hearth of the open fire, or on the stove if one is used. The
-sputum of the consumptive dries and is carried into the air as dust.
-This is drawn into the lungs when one breathes. The dangers of this
-should be emphasized, and the proper way to dispose of sputum shown. The
-consumptive should catch all of his sputum and burn it. There are cheap
-cups made of paper that can be had at small cost, and these should be
-used to spit in, and when they are full they should be burned. The better
-cups have covers to them, so that the flies can not get at the sputum.
-While consumption is a dangerous disease, the careful consumptive is not
-dangerous to live with. The careless consumptive, however, is dangerous
-to live with and a menace to those around him.
-
-The minister and the officers of the leagues should consult frequently
-with the health officer of their community. Working together they can
-accomplish much more than by working alone.
-
-The minister and officers of the league can teach their people to be
-careful and not produce unsanitary conditions, and the health officer can
-remedy conditions that the people can not correct. The leagues should
-urge the members to beautify their homes, no matter how humble they may
-be. If the home is made more attractive, interest in it will grow, and
-an improvement in the sanitary conditions will naturally follow. Teach
-the members to have grass and flowers in their yards. See that there
-is no dirt, trash, or litter scattered about; that the loose paling
-of the fence is nailed on, and the sagging gate has a new hinge. Pull
-the dirty rags from the broken window pane and burn them. Let them put
-their bed-clothing out in the sun occasionally, and sweep the dust from
-under the bed and furniture. Open the window and door and let air and
-sunlight into the rooms. All of these things tend to improve the sanitary
-conditions, which means health and happiness.
-
-Members should be taught that remedies advertised as cures for
-consumption are not to be relied upon, and that the only known way to get
-well is to live in the open air as much as possible, both day and night,
-and to eat nourishing food at regular intervals. The consumptive when
-possible should go to a physician or a dispensary and follow exactly the
-instructions given.
-
-Aside from the help that can be given the individual consumptive, which
-will be discussed later on, there is much that the leagues can do by
-concerted action to improve the conditions under which the negro lives.
-Probably one of the most important factors in the spread of tuberculosis,
-aside from his habits, is the manner in which the negro is housed. The
-negro as a rule is a renter. The houses that he can rent are usually
-located in the poorest and most unhealthy part of the city. They are
-often poorly constructed, badly lighted and ventilated, and frequently in
-bad repair. The rooms are usually small and dark, having but one window,
-and the top sash is seldom arranged to be lowered. Many houses are built
-on poorly drained ground, and water stands under them after each rain,
-making the rooms damp and cold. These houses are seldom provided with
-bathing arrangements or water-closets, thus necessitating the use of
-privies, or the back alleys, with all the dangers attendant upon such
-conditions. For such houses, or more frequently for one or two rooms in
-such a house, the negro pays proportionately more rent than the white
-race does for better houses in the same community, either because better
-accommodations are not available, or because he can not, or will not,
-pay for better. The family, usually consisting of father, mother, and
-several children, and often friends or relatives, all live, eat, and
-sleep in these two or three rooms, frequently with the windows and doors
-tightly closed, and in winter a stove going at full blast.
-
-In the negro section of the city the streets are usually either badly
-paved or not paved at all. The sidewalks are either in bad repair or
-missing. The streets are badly lighted at night, garbage cans are not
-emptied regularly, and the scavenger service is poor.
-
-“There is a reason for these things,” say the landlords, the municipal
-authorities, and others who have dealings with the negro. The landlord
-says: “Negroes are destructive; they pull down, but they never improve
-property. A house rented to negroes will depreciate from 25 to 50 per
-cent in a year. If you put in plumbing they break it, they deface the
-walls, they tear off the shutters and the doors, they break and burn the
-fences. It is useless to give them good houses as they neither appreciate
-them nor take care of them.”
-
-The municipal authorities say that negroes make no effort to keep their
-surroundings clean and sanitary. They throw things into the street, choke
-the plumbing, drains, and sewers with old rags, trash, and dirt, and make
-no effort to help the authorities keep things in order; therefore it is
-useless to try to help them until they learn to help themselves. They say
-that there are exceptions to these statements, but that they are true so
-far as the great mass of the negroes is concerned. Reference is made to
-the subject here to draw attention to the fact that the leagues can do
-much to change these conditions, thereby bettering the condition of the
-race.
-
-If the things that are said about the negro by the landlords, the
-municipal authorities, and others are true, then it is necessary for
-the negro to change these conditions before there can be hope for much
-betterment. If they are not true, steps should be taken to convince the
-landlords, municipal authorities, and others that they are false.
-
-It is in this way that the leagues, though aimed at tuberculosis, may be
-the means of bettering the conditions along many lines. If the negro can
-demonstrate that he is not destructive, and that he can and does take
-care of the house in which he lives; if he will keep his surroundings
-neat and clean; if he shows that he is clean and sanitary in his
-practices, and that he feels his responsibility as a citizen by trying
-to keep up the sanitary conditions and the appearances of his home and
-his city, he will find that many of his troubles will disappear. If a
-landlord finds that his property is being cared for by his negro tenant,
-the yard, fences, etc., being kept in order, the rent promptly paid, and
-tenant is desirable, he will be only too glad to keep him, and to make
-such alterations in his house as he may desire. If it is demonstrated to
-the municipal authorities that the negro is as careful of his section
-of the city as the whites, his wants will receive consideration. The
-educated negroes succeed in getting surroundings that are far better than
-those of the average because they have learned to appreciate the above
-facts, and have put them into practice.
-
-When the leagues have taught their members that it is not healthy to live
-in dark, damp rooms, with bad sanitary surroundings, and have educated
-them to the point where they will refuse to live under such conditions,
-then the landlords will build proper houses for them. The leagues working
-in conjunction with the health officer can get the city authorities to
-so frame the building ordinances that only sanitary dwellings will be
-erected in the city.
-
-_What a church league can do for the individual consumptive._—In addition
-to supplying the members of the league with information in regard to
-tuberculosis and sanitation, which is the work of the committees, and
-trying to induce the members to follow the instructions given them, there
-are other things that the league can do for the individual consumptive.
-
-The chief difficulty that will be encountered by the leagues is the
-lack of money to help their sick members. It is hoped, however, that as
-the league demonstrates its value to the community more money will be
-available, and the work of helping the sick members can be extended.
-This work contemplates the “class method” of treating patients at their
-homes, the establishment of dispensaries, and ultimately sanatoria and
-“tuberculosis farms,” where a patient can earn a living by working on the
-farm and at the same time be under medical supervision. It is realized
-that these things are for the future, but it is well to keep them in mind
-as one of the ultimate aims of the leagues.
-
-Now let us consider what can be done for the members who have
-consumption. The league should buy a number of the paper spit cups
-mentioned above, and distribute them to their consumptive members,
-and urge their use. These cups are cheap and therefore can be burned
-after being used. If every consumptive can be induced to use these cups
-and then burn them much will be done toward stopping the spread of
-consumption.
-
-Whenever a case of consumption is discovered the officers of the league
-should apply to the health officer to disinfect the rooms occupied by the
-consumptive, in order to protect the other people in the house from the
-disease. Then if the consumptive is careful he is not likely to reinfect
-them. Also when a consumptive dies the health officer should be asked to
-disinfect the rooms.
-
-Consumptives should spend most of their time out of doors, and if
-possible should sleep on a porch, or in a shed, or tent. All one needs is
-something to protect against the weather and keep off the rain and snow,
-but let in a great deal of fresh air. Patients live out of doors all
-winter in the north, with the thermometer below zero, and many have been
-cured of consumption in this way, including negroes. The league may help
-to provide the shack, shed, or tent, or it may furnish sleeping bags,
-blankets, etc., and in this way help the patient.
-
-If the patient is very poor it may be that the league can see that he
-gets proper food which he might not otherwise have. The committees of the
-league will doubtless find many other means for helping the patient at
-small expense. The minister in making his pastoral calls can be of the
-greatest help both to the patient and to the community by seeing that the
-patient is properly carrying out his instructions, and that he has the
-proper facilities for doing so.
-
-_Dispensary._—As soon as the church league is formed, some physician
-should be designated who will examine all members referred to him, to
-decide if they have consumption. Usually there will be found one or more
-physicians who are members of the league, who will probably act in this
-capacity. If practicable a tuberculosis dispensary might be established
-at some convenient point, possibly in one of the rooms in the church,
-where the physicians could be found on certain days at stated hours,
-say, twice a week. Here they could see the consumptives, and examine and
-advise them as to the treatment necessary. They could also examine other
-members referred to them to decide whether they had consumption or not.
-Records of the dispensary work should be kept.
-
-It is not practicable at this time to go more minutely into the details
-of the work of these leagues, which are now in their formative stage.
-
-The writer will be glad to lend any aid in his power to any state or
-church league that may desire it, and all persons who are interested in
-this movement are invited to write to him, expressing any views they may
-have for the advancement of the work. He will be glad to have any aid,
-advice, or criticisms that may be offered.
-
-
-
-
-
-End of the Project Gutenberg EBook of A Working Plan for Colored
-Antituberculosis Leagues, by C. P. Wertenbaker
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