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Sanitation of Camp Sherman Extra-Can

tonment Zone, Chillicothe, Ohio

By D. E. Robinson, Surgeon, United States Public Health Service

W

ITH the opening of the tect the citizens of the extra-can

numerous army canton- tonment zone from the unusual

ments throughout the dangers to which they were exUnited States, there arose sanitary posed by reason of the establishand health problems of great ment of a cantonment in their magnitude, for never before in our midst. history have so many large bodies City, state and national health of men been suddenly brought to- authorities, working in harmony gether from all walks of life and, with each other and with the milias it were, thrust upon civil com- tary authorities, have striven to munities. The nearby towns maintain sanitary and health conrapidly increased in population, ditions in the region surrounding often to more than twice their the cantonment up the highest posnormal size, and new villages sible standard. sprang up almost over night. The The United States Public Health great influx of strangers taxed the Service at the request of the difhousing accommodations to the ut- ferent state and city authorities most and through the congestion has detailed medical officers to resulting, the danger of introduc- most of these zones, in either an tion of contagious diseases was advisory or an administrative caenormously increased. Not only pacity, with a view both to aiding were the soldiers likely to bring the local health authorities in meetinfection to the camp, but the ing the emergency conditions and large force of laborers required also to developing a health organfor construction work and other ization of the highest order to restrangers incident to the camp main after the emergency shall were an even greater menace to have ceased to exist. the health of the community. On The direction of sanitation the other hand the potential dan- around Ohio's great cantonment ger to the men of the new army (Camp Sherman) was turned over from impure water and food sup- to the United States Public Health plies or other bad sanitary condi- Service by the state, October 27, tions in the zone around the camp

1917. At this time the state auwas very great.

thorities had developed a health These dangers were early rec- organization and, with the aid of ognized by the sanitary authori- the American National Red Cross, ties throughout the country and which had contributed a sanitary prompt measures were instituted unit, had sanitary measures well to protect the soldiers from acquiring infection from sources The present health organization without the camp and also to pro- consists of: two commissioned

under way.

a

medical officers, one acting assis- to use water from private and pubtant surgeon and one scientific as- lic wells and cisterns. Many of sistant detailed from the United these, because of insufficient safeStates Public Health Service; the guards against contamination from Chillicothe board of health with a

privy vaults and from surface polpart-time health officer and

lution, have become badly infected. sanitary officer; an American Red

A large number have been exCross sanitary unit composed of amined bacteriologically and this one bacteriologist, two sanitary in- work will be continued as rapidly as spectors, four public health nurses.

possible. Of the public and semiand one clerk. A bacteriological public wells and cisterns thus far laboratory equipped by the state tested 54.5 percent have been found and maintained by the Red Cross infected with B. coli and conis an invaluable aid in the work. demned. Of the purely private

The city was found to have an wells 18.1 percent show contaminaexcellent sanitary code but some tion. Two cases of typhoid fever revising was needed. Amend- in one family undoubtedly resulted ments have been made requiring : from the use of water from a well (a) that all privy vaults shall be in close proximity to a defective screened against flies, (b) that all privy vault. This well showed a wells shall be adequately protected high degree of pollution. against pollution and that both public and private wells when

Milk found polluted may be condemned

Nearly all the milk used in Chilliby the sanitary authorities, (c)

cothe is furnished by six large that manure shall be kept in tightly distributing firms

distributing firms which receive constructed bins and removal ef

their milk supply from about 100 fected twice weekly from Marchi

producers. Thirty-five per cent of to November 1, (d) that all food

the milk is furnished by one comhandlers or workers in dairies shall be subject to medical ex

pany which pasteurizes the milk

before distribution. Frequent amination and protective inocula

bacteriological examination is made tion against typhoid fever at the

of all milk and the dairy farms are discretion of the board of health.

inspected and scored. In only one

instance has the bacterial count and Water Supply

sediment test shown impure milk, The city water supply is pure and by process of elimination this and abundant, coming from deep trouble was traced to one particuwells which are adequately pro- lar dairy farm and found to be tected against contamination, and due to improper methods used in the reservoir is admirably located, milking. By insistence upon the well constructed to prevent pollu- proper precautions being employed tion from surface drainage and this milk quickly conformed to carefully policed. Repeated bac- the required standard. With the teriological examinations have advent of

weather still shown total absence of B. coli. greater care will be necessary in Notwithstanding this

this adequate order to make sure that the proper supply of pure water, a large num- standard of purity is being mainber of the citizens have preferred tained.

warm

Hotels and Restaurants produce a certificate of health, One of the most difficult and at

those who know they can not pass

do not apply. the same time most important of the problems of extra-cantonment

The barber shops are also resanitation is the regulation of eat

quired to conform strictly to the ing places. There are about sixty regulations prescribed in the city of these in the zone around Camp sanitary code as are the ice cream Sherman, a large proportion of

and soda water establishments. which have sprung up since the

Frequent inspections, scoring and opening of the camp. Unless these

issuance of approved certificates places are kept under strict super

being the means employed for this vision not only the sanitary but

purpose. Military guards for the also the moral conditions would

prevention of patronage by soldiers

have at times been necessary to fall to a low plane. Every effort is being made to keep these places produce the desired results in resup to the standard required by the

taurants and barber shops. sanitary code. All have been fur

Disposal of Garbage and Night nished with copies of sanitary

Soil regulations and frequent inspec

The collection and disposal of tions and ratings are made.

garbage has heretofore been one of In conjunction with the military

the functions of the Health Deauthorities the following plan has

partment. Four men with horsebeen put in force: To all eating

drawn carts collect the garbage places which fulfill the sanitary re

from residences twice weekly, and quirements a certificate of approval three times a

three times a week from is issued, which must be posted in

taurants and hotels. The garbage a conspicuous place, and instruc

is dumped a short distance beyond tions have been given all soldiers to

the city limits. The defects of this eat in no place which does not

method are readily apparent and possess this approval certificate.

steps have been taken either to have To obtain one of these certificates

the removal of garbage turned over a restaurant must not only reach

to the Service Director or an inthe usual standards of cleanliness

creased allotment of funds to the but all employes handling food des

Board of Health in order that tined for public consumption must

motor garbage wagons can be purhave been examined by officers of

chased and the garbage taken a the United States Public Health

sufficient distance from the city Service and found free from com

and burned. municable diseases. For the examination of female employes, a

A sanitary survey of the city in female physician has been ap

regard to privy vaults has been

completed and shows the followpointed. Not many cases of com

ing:
municable diseases have been found
but this in all probability is due to

Total number of houses in
the city

3,810 the fact that many so afflicted have

Number of houses connected left their places of employment with sewer

1,803 when notified that a physical ex- Number of houses with privamination would be required, and

ies only

2,007

Number of houses with both now that all those seeking employ

sewer connection and privment in restaurants are required to ies

621

res

About one-third of the houses aid in controlling diphtheria as unconnected with sewers could be swabs are taken from all suspicious connected if the owner chose to do looking throats among school chilso but the remainder are not acces- dren and contacts, and a few carsible to a sanitary sewer.

Orders riers have thereby been found, have been issued to the property quarantined and treated until they owners to clean, fill and abandon ceased to be carriers. The inspecprivy vaults and make sewer con- tion of school children is performed nections where this is possible. by nurses of the Social Welfare Those having sewer connections League employed by the board of already and still retaining the old education for this purpose aided privy vaults are ordered to clean, in cases of threatened epidemic by fill and abandon these vaults. the Red Cross nurses. Those not accessible to sewers who Smallpox appeared the latter have insanitary vaults are ordered part of October but was held in to clean existing vaults and replace check by isolation of patients and

cement water-tight vaults. isolation and vaccination of conThese orders are being complied tacts. An order was also issued with as rapidly as the weather con- requiring vaccination of all school ditions permit

children who had not been recently

successfully vaccinated. Nearly Contagious Diseases

400 children were vaccinated un

der this order. A few isolated The lack of hospital facilities renders the control of contagious

cases have occurred in the city and diseases a difficult matter, as when

country districts since, but at no one of these diseases appears in

time has an epidemic threatened.

The total number of cases in Ross a family, strict isolation in the home is often not maintained, and

County including Chillicothe since

October 27 is eleven. A circular other members of the household

letter has been addressed to all are very liable to be attacked. All

physicians urging upon them the cases are visited by a medical offi

importance of reporting every case cer for the purpose of confirming

of chickenpox in view of the difdiagnosis and collection of epi

ficulty often experienced in difdemiological data. The houses

ferentiating this disease from mild are placarded and contacts isolated

smallpox. for the period of incubation. Fre

Eight cases of typhoid fever quent visits are made by the nurses

have been reported, three of which who give instruction in prophylaxis

were in one family and two in anand report other suspicious illness

other among other members of the against this disease has been urged

Prophylactic inoculation family or contacts and in emer

and offered free to all but this ofgencies give bedside care.

fer has not been taken advantage An unusual number of cases of of. However it may later be remeasles and German measles have quired of all handlers of food and occurred, but scarlet fever and workers in dairies. diphtheria have been kept well within bounds, and only two cases

Venereal Diseases of cerebro-spinal meningitis have The control of venereal diseases been reported. The American Red is of prime importance in extraCross laboratory has been of great cantonment work both as regards

the effectiveness of military organi- schools in the five-mile zone zations and the serious after-effects around the camp and these are these diseases entail.

visited and inspected by a medical With a view to lessening these officer and a nurse. The hygienic evils a venereal clinic has been and sanitary conditions of the opened, where carriers of venereal schools and physical condition of diseases among the civil popula- the pupils are noted and steps tion will be given free treatment taken to improve them when deand hospitalized if necessary until

fective. they cease to be a menace to so- The most serious condition thus ciety. Physicians will be supplied far noted has been an almost total with salvarsan and other venereal lack of protection against smallremedies without cost for use in pox, not more than one-tenth of their private practice under pre- the pupils ever having been vacscribed regulations and serological cinated against this disease. and bacteriological tests will be Measures will be taken to produce made upon request.

as far as possible a smallpox-im

mune population in the extra-canFlies and Mosquitoes tonment zone. Camp Sherman is fortunate in

Notification of Diseases being located in a malaria-free region, making the fight against It goes without saying that the mosquitoes of minor importance. first essential in disease control is As yet no anopheles have been an accurate knowledge of the exfound but careful search will be istence of disease. To secure this, made for the larvae of this genus all the physicians of the county with the advent of spring. A have been furnished notification constant and strenuous warfare cards and franked envelopes and against flies will be necessary, requested to report every case of careful attention being given to communicable disease occurring in the eradication of breeding places their practice, and they have cosuch as manure piles, garbage, etc. operated very heartily in this Manure will be required to be work. Daily interchange of inkept in tightly constructed bins formation as to the occurrence of raised one foot from the ground communicable disease within and and removal effected twice a week. without the camp is maintained be

tween the army medical authorities Rural

and the Public Health Service. The character of the population The board of health of Chilliand the sanitary conditions in the cothe has measured up to the rerural districts are much above the quirements of the altered condiaverage for country districts, but tions in a most commendable manefforts will be directed toward im- ner and has at all times given its proving conditions when necessary

undivided support to any in regard to surface privies and health measure which has been recwater supplies unprotected from ommended for adoption. pollution. All cases of contagious disease are visited and quarantined

Editor's Note: Dr. Robinson's article for the required time.

was prepared about February 1, and all

statistical information contained must There are twenty-five rural

be considered as of that date.

new

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