Sidebilder
PDF
ePub
[merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors]

MAP OF WESTERN PORTION OF MARSHALL COUNTY SHOWING HOW DEATH AND DISEASE FOLLOW HOME CARE OF CONSUMPTIVES.

CHART SHOWING HOW INFECTION FOLLOWS
EXPOSURE TO CONSUMPTIVES IN THE FAMILY.

[merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small]

A TUBERCULOSIS SURVEY OF MCLEOD, SIBLEY AND CARVER

COUNTIES.

SEPTEMBER-DECEMBER, 1913.

By Mr. A. R. Blakey, Special Agent for Tuberculosis, State Board of Health.

This survey was undertaken at the request of the county commissioners of McLeod county after Dr. Bracken had discussed the proposition of a tuberculosis sanatorium with the commissioners.

The purpose of the survey was to obtain data for estimating the needs of the county. The law regarding the tax levy for a county sanatorium, is as follows: "In no case shall the amount of such a levy in any one year, exceed one mill on the dollar of the assessed valuation." The tax levy of one mill from McLeod county alone, would not raise a sum sufficient for a suitable sanatorium, therefore, a district sanatorium was considered, the sentiment in McLeod county being that the district should comprise McLeod, Sibley and Carver counties.

Accordingly, the survey of Sibley and Carver counties was undertaken after the work in McLeod county was completed. In making this survey, it seemed best to follow about the same plan as that adopted by Dr. Lampson in his tuberculosis survey of last year.

First To visit all the physicians in the counties in order to secure reports of cases of tuberculosis under their care. Then to attempt to discover additional cases through visits to families in which there had been deaths from tuberculosis within three years or where cases existed. All such families were visited except a few, for which the physicians gave reliable and complete data. Certain families in which cases were reported were not visited because the physicians believed that the reporting of the cases would be resented.

The survey of McLeod county required twenty days for the field work, since a bicycle was used in getting about. About ten days each, in Carver and Sibley counties were required, liveries being used in these counties.

The statistics of deaths and cases reported previous to or discovered during this survey in the three counties, are as follows:

[blocks in formation]
[blocks in formation]

In McLeod county, of the five cases reported during the thirty-two months preceding the survey; four are dead and one is in the state sanatorium. Seventeen cases are recorded as a result of the survey; thirteen being at home and four in sanatoria.

In Sibley county, of the fifteen cases reported during the thirty-two months preceding the survey; eight are dead, one has moved to another county and six are ill at home. Twenty-five additional cases are recorded

as a result of this survey.

In Carver County, of the six cases reported during the thirty-two months preceding the survey; two are dead, one has recovered, one has moved to another county and two are ill at home. Thirteen additional cases are recorded as a result of this survey.

Judging from the number of cases found in Sibley county, not more than one-half of the existing cases in Carver and McLeod counties are on record now. All three counties have practically the same number of deaths per annum and therefore, should have practically the same number of cases. It was known at the time that not all of the recognized cases were being referred for investigation.

There was a lack of co-operation on the part of certain physicians, probably due to their fear that the patients would resent having their illness reported. A few physicians seemed to think that they were not under obligations to report cases of tuberculosis and whatever information they chose to give was confidential and given merely as a personal favor. For instance, a physician in McLeod county stated that he had no cases under his care which he was sure were tuberculosis but that he had a suspicious case. With. in a few weeks this "suspicious" case died and the physician reported the death due to tuberculosis, duration, two or three years. Two physicians have reported deaths from tuberculosis in Carver county since the survey was made. These were not reported at the time of the survey, although, according to the death certificates both were chronic cases.

There was also a lack of co-operation on the part of members of families in which deaths from tuberculosis had occurred. This was shown by their refusal to follow the suggestion that they should go to the family physician and be examined. In fact, very few of the cases discovered in this survey were members of families in which death from tuberculosis occurred in the period, 1911-1913, inclusive. Some of the excuses made for refusal to go to the physician were: "No relation to party who died of tuberculosis"; "Party did not die of tuberculosis"; "We are all right now and do not want to be examined"; "Nothing can be done anyhow, so why find out if one has tuberculosis?"

The lack of co-operation and the attitude of the people show that an anti-tuberculosis educational campaign is urgently needed, especially in the smaller villages and rural districts. Wherever the tuberculosis exhibit had been, the people seemed to appreciate the object of the survey and were more willing to co-operate. The tuberculosis exhibit has never been in Carver county where the lack of co-operation amounted practically to active opposition to the work.

These three counties are called, in the U. S. Census, "Rural Counties," that is, none had a city or village with a population of 2,500 in 1910. According to the census of 1910, in McLeod county, there were 3,912 families living in 3,849 dwellings; in Sibley county, 3,105 families living in 3,078 dwellings and in Carver county 3,432 families living in 3;338 dwellings. Congestion of population, therefore, cannot account for the prevalence of tuberculosis in these counties.

At the first meeting of the county commissioners of these counties, following the completion of the survey, a report was made to each board of the results of the survey in the county. The need of the sanatorium was pointed out. The first one of these meetings was that of Sibley county. At the conclusion of the discussion, three of the five county commissioners seemed to favor the establishment of a district sanatorium.

However, all progress towards a tri-county sanatorium was blocked by the Carver county commissioners. It was almost impossible to secure a hearing before this board. The chairman said that whenever the board wanted information from the State Board of Health, it would be asked for. The representative of this county is one of the half-dozen in the legislature who voted against the county sanatorium bill when it became a law. He was present and showed his ignorance of the tuberculosis problem and his indifference to public welfare by urging the board not to consider any proposition toward the establishment of a county or district sanatorium.

In McLeod county, the matter was given favorable consideration. A delegation from Hutchinson, headed by the county superintendent of schools and Dr. Fred Sheppard, was present and urged the establishment of a sanatorium. Two Glencoe physicians were present and spoke favorably of the proposition. The writer reported that the Carver county commissioners had refused to consider the establishment of a sanatorium. Thereupon, the chairman of McLeod county commissioners requested him to consult the commissioners of Wright and Renville counties and ascertain if they would join with McLeod and Sibley counties to get a district sanatorium.

The following maps show very clearly the findings of this survey in the three counties and the need for a sanatorium. No Von Pirquet tests or physical examinations were attempted by the writer, who is not a physician, but the statements of the family physicians were used as a basis for the classification of the members of the family groups as "well" or "active cases."

[blocks in formation]
« ForrigeFortsett »