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UNITED STATO ERICA
API: 5 39
Children's Bureau, Department of Labor---
Senior Surgeon; and L. M. Rogers, Surgeon..
SANITATION (SANITARY CONTROL). By Charles T. Wright, Passed
Assistant Sanitary Engineer; and L. M. Fisher, Sanitary Engineer----
REPORT OF A SURVEY OF THE HEALTH DEPARTMENT AND OTHER HEALTH AGENCIES IN THE DISTRICT OF COLUMBIA?
By ROBERT OLESEN, Assistant Surgeon General, United States Public Health
Service, and collaborators
SUMMARY OF RECOMMENDATIONS
The recommendations in this report are presented in two summarized sections: A, those of an outstanding character, involving in some instances, considerable expenditures, and B, the more detailed suggestions, many of an adminstrative type, for the improvement of the several activities of the health department.
A. Principal Recommendations
1. Provide a separate building of appropriate design and adequate size for housing the various overcrowded and scattered activities of the health department. 2. Build four units of hospital beds as follows:
(a) Pediatrics, 100 beds, Gallinger hospital;
(d) Tuberculosis, 150 beds, Freedmen's hospital.
4. Provide additional personnel, living quarters, service facilities, and supplies for operation of new hospital units.
5. Decentralize the work of the health department by providing a total of three health centers, coordinating the activities with the local medical schools. 6. (a) Provide trained, full-time directors for each of the following activities :
1 Without the very helpful information received from the official health agency and the numerous voluntary organizations operating in this field, it would have been impossible to secure a clear conception of the local health and hospital situations. That necded data were always freely and cordially forthcoming will account for such interest and value as this report may have for its readers.
7. Make available 110 additional public health nurses. 8. Employ eight additional trained sanitary inspectors.
9. Especially intensify the efforts for the control of syphilis, tuberculosis, cancer, pneumonia, and diphtheria, and for reduction of maternal and infant mortality.
B. Detailed Recommendations for Each Activity Cancer:
Establish a cancer-control section in the health department.
Provide a physician, expert in cancer diagnosis and treatment, to direct the efforts at cancer control.
Establish a tumor clinic at Gallinger Hospital.
Educate medical profession and lay public in prevention, early recognition, and early treatment of cancer.
Communicable disease control:
Provide more suitable office space, with private room for director.
Improve office and field procedures connected with control of acute communicable diseases.
Establish venereal-disease work in a new and separate section.
When practicable, encourage dental care from private professional sources.
Employ full-time dental supervisor to coordinate all activities designed for the benefit of school children.
Provide decent quarters for this activity.
Utilize the facilities of the bureau for instruction in all phases of public health.
Food inspection (milk and food control):
Adopt the Public Health Service standard milk ordinance.
Apply the frozen desserts and restaurant ordinances shortly to be released by the Public Health Service.
Promote an educational campaign for the consumption of the highest grade of milk.
Provide additional and more suitable quarters.
Within next 6 years add two additional technicians in serology and one each in chemical and bacteriological laboratories, in view of continued increase of work.
Maternal, infant, and preschool child health services :
Create a committee representing the health department, hospitals, med
ical schools, medical societies, nursing agencies, and social agencies to coordinate all medical, nursing, and social-work programs in the
field of maternal, infant, and child health. Consider carefully the social and economic aspects of the problem in
expanding the program. B. Specific recommendations
Provide adequate office space for the bureau of maternal and child
health. Develop a plan for more active interbureau coordination of services
related to maternal and child health. Develop a demonstration center in which the suggestions in the
report may be put into immediate effect. Provide for a well-rounded program conforming with modern public
health practice and coordinate the activities of the bureau of
hygiene, and crippled children's program.
hygiene, and health education. C. Detailed recommendations, by activity. (Presented in special text, p. 145.) Mental hygiene:
Enact a new lunacy law.
Change commitment laws to allow voluntary patients, certified patients, and nondelinquent mental defectives to go directly to St. Elizabeths Hospital for treatment.
Use the Gallinger Hospital wards only for emergency admissions.
Establish principle of sufficiency of examination by qualified psychiatrist and physician for information of court.
Furnish clerical assistance to Board of Public Welfare for deportation activities.
Establish a bureau of mental hygiene in health department. Marshal public and private forces in community for amelioration of adverse mental situations. Nursing (public health):
Provide 110 additional public health nurses.
Work out a completely generalized nursing service in a selected district of the city.
Conserve nursing time. Pneumonia control:
Increase the appropriation for purchase of antipneumonococcus sera and make the sera more generally available.