Mr. DIMOND. There was an infantry post at Fort Lister, about 3 miles east, and there was a small post hospital, but no Indian hospital. There has never been a hospital at Valdez. So far as maintenance of the hospital is concerned, in many cases the beds are entirely occupied and in many instances there are not nearly enough facilities to take care of the requirements of the Indians. Dr. TOWNSEND. In this table it is shown there were 52,631 hospitaldays treatment given; 328 major operations; 1,364 minor operations. There were 37,800 out-patient office and dispensary cases that were given 82,000 treatments. Mr. JOHNSON of Oklahoma. With respect to the major operations: Where are the major operations performed? Are they mostly performed at one hospital? Dr. TOWNSEND. The general hospital at Juneau performs a good many, and at the Anchorage Hospital operated by the Alaska Railroad, that is carried on by contract. There are hospitals at Cordova. Seward, and Fairbanks, where we send cases on a contractual fee basis. Mr. JOHNSON of Oklahoma. You say you are in need of additional hospitals. Where should the additional hospitals be located? Dr. TOWNSEND. We feel that we should have a hospital at Juneau. We should have one at Ketchikan and at Seward. That is in line with the projects planned, Mr. Dimond, which we were talking about some years ago. We need a new hospital at Kotzebue. Mr. LEAVY. Was there not some talk of a hospital at Bellingham. Wash., to accommodate patients from Alaska? Dr. TOWNSEND. That was the West Coast Phsychiatric; that was proposed some 4 years ago, I think. Mr. LEAVY. The site was actually donated, was it not? Dr. TOWNSEND. Yes. Mr. LEAVY. Has that been abandoned? Dr. TOWNSEND. Yes; it was disposed of. It was proposed as a P. W. A. project at one time. Mr. LEAVY. May I ask you another question in connection with this item? Dr. TOWNSEND. Yes. HOSPITAL AT KETCHIKAN Mr. LEAVY. Did you request the Budget for any additional funds for hospitals? Mr. GREENWOOD. Yes; we asked for $289,900 to provide a 60-bed hospital at Ketchikan. Mr. LEAVY. And you feel you really need more than that? Mr. GREENWOOD. Yes. Mr. JOHNSON of Oklahoma. That is the only one you are asking for this year? Mr. GREENWOOD. That is the only one: yes. Mr. JOHNSON of Oklahoma. That is a 60-bed hospital, costing how much? Mr. GREENWOOD. $289,900. INCREASE REQUESTED FOR 1941 HEAD NURSE FOR POINT BARROW HOSPITAL Mr. JOHNSON of Oklahoma. I notice there is an increase requested of $2,300 for head nurse at Point Barrow Hospital. Will you explain the need for that appropriation? Mr. GREENWOOD. We opened a new hospital at Point Barrow during the past year and we have there at the present time two staff nurses. The hospital really requires the services of three nurses, one of whom should be head nurse. ADDITIONAL STAFF FOR KANAKANAK HOSPITAL Mr. JOHNSON of Oklahoma. You are asking for an additional staff for the hospital at Kanakanak for 6 months. Will you explain that? Mr. GREENWOOD. We have money in the current appropriation for the construction of a hospital at Kanakanak to replace an existing hospital. The money we are requesting now will provide for an additional staff at the new hospital for a period of 6 months. The hospital will be available, it is expected, on the 1st of January next year. It will provide a greater bed capacity. The present hospital accommodates 13 patients and the new hospital will provide approximately 32 beds, so the additional staff will be necessary. Mr. SHEPPARD. You have a figure in here for one attendant at $840. Mr. GREENWOOD. Yes. Mr. SHEPPARD. Is that a white attendant or an Indian attendant? Mr. GREENWOOD. Generally they are native attendants. ADDITIONAL STAFF FOR BETHEL HOSPITAL Mr. JOHNSON of Oklahoma. And additional staff at the Bethel Hospital, $10,170. Mr. GREENWOOD. Yes. Mr. JOHNSON of Oklahoma. That is quite an increase. Mr. GREENWOOD. That is another new hospital that was opened just recently. There is in the current appropriation money to pay the staff and the cost of operation for 6 months of this fiscal year. Mr. JOHNSON of Oklahoma. So it does not seem this committee has been absolutely ignoring the requests for hospitals. Mr. GREENWOOD. No. NUMBER OF HOSPITALS IN ALASKA Mr. JOHNSON of Oklahoma. How many new hospitals have been established in Alaska within the last 6 or 8 years? Dr. TOWNSEND. Bethel, Kanakanak, Tanana, have been approved by this committee; and the one at Point Barrow. The money for that was appropriated in the deficiency appropriation following a fire in the old hospital. Mr. JOHNSON of Oklahoma. That is three or four? Mr. GREENWOOD. Three of them are really replacements. The one at Bethel is the only new hospital. Mr. JOHNSON of Oklahoma. How many beds? Dr. TOWNSEND. Forty-two beds. Mr. JOHNSON of Oklahoma. Forty-two beds; and you are requesting $280,000 for a hospital at Ketchikan. How many beds would that accommodate? Dr. TOWNSEND. Sixty beds. SUPPLIES AND EQUIPMENT Mr. JOHNSON of Oklahoma. For supplies and equipment, $18,600. Is that for supplies for hospitals? Mr. GREENWOOD. $10,000 of that is to provide for the operation of the Bethel Hospital for 6 months. We have money for operation during 6 months of the present fiscal year. The hospital was just recently opened. The committee allowed last year only enough money to carry it for 6 months. Of course it will be open for the entire year beginning July 1 and we will need to take care of 12 months' operation. Five thousand dollars is to provide for 6 months' operation of the new Kanakanak Hospital which is expected to open about the first of January 1941; $3,000 is to provide an additional sum for operating the new Tanana Hospital which is expected to be ready for occupancy about January 1, 1941 also; $600 is to provide an increase for the operation of the dispensaries and nurses' quarters at Kodiak, Tetling, and Hydaburg. Mr. JOHNSON of Oklahoma. Any further statement about this item? REPAIRS TO BUILDINGS AND TRANSPORTATION OF SUPPLIES Mr. GREENWOOD. We are requesting an additional $15,000 to make possible a little better care and maintenance of the medical buildings and utilities that we have in the Territory. Mr. JOHNSON of Oklahoma. That would be generally distributed over the Territory? Mr. GREENWOOD. Yes; that would apply to all the Medical Service buildings. An additional sum of $5,000 is requested for the transportation of medical supplies. At the present time the allotment for freight is inadequate, which means that the education appropriation is bearing the excess cost. We are asking for this $5,000 to meet the deficit in part. Mr. JOHNSON of Oklahoma. Is there any further statement with reference to health in Alaska? CAUSE OF TUBERCULOSIS AMONG NATIVES Mr. SHEPPARD. On page 152 a paragraph appears in the justification, carrying the statement that tuberculosis continues to be the most serious problem with the death rate running about 10 times the rates in the United States as a whole. Dr. TOWNSEND. The rate is about ten times that amount. Mr. JOHNSON of Oklahoma. What do you attribute that to, Doctor? Dr. TOWNSEND. I think it is the result of their mode of living, the food they eat; the fact that large families live in these small sod huts with not much ventilation. When a man contracts tuberculosis the balance of the family, the wife and children, are likely to have it. Mr. JOHNSON of Oklahoma. Are there many instances among these families where they are undernourished? Dr. TOWNSEND. Oh, yes. Mr. JOHNSON of Oklahoma. Does the climatic condition have anything to do with it? Dr. TOWNSEND. Yes; but they seem to have adjusted themselves to the climatic conditions pretty well. I think if you would put a group of white people up there under the same environment, give them the same kind of food to eat, they would have just about as much tuberculosis. Mr. LEAVY. Doctor, have the natives of Alaska always been afflicted with tuberculosis, or is it a white man's plague? Dr. TOWNSEND. I do not think so. There were some cases reported when some Russians came in there many years ago. I do not believe that there was much tuberculosis or venereal diseases among those people originally. It was introduced. Mr. LEAVY. In other words, this tuberculosis has not always existed among the Alaskan people? Dr. TOWNSEND. No, sir. GENERAL SUPPORT AND ADMINISTRATION OF INDIAN PROPERTY SUPPORT OF INDIANS AND ADMINISTRATION OF INDIAN PROPERTY Mr. JOHNSON of Oklahoma. For general support of Indians and administration of Indian property, including pay of employees authorized by continuing or permanent treaty provisions the estimates of $2,916,700 is submitted. JUSTIFICATION OF ESTIMATE Mr. GREENWOOD. The following statement is submitted in justification of that item: Appropriation, 1940__. Increases requested for 1941: 1. Additional clerical help (credit). 2. Additional mechanical personnel. 3. Transfer from Division of Investigations. 4. Transfer from Indian moneys, proceeds of labor, $2,743, 700 $14,400 3,000 47, 400 1, 440 2, 640 7,000 14, 680 7,000 20, 120 10. Transfer from "Acquisition of land for Indian tribes"- 55, 320 Total estimate, 1941. 173,000 2, 916, 700 General. This appropriation is used to cover practically all field administrative expenses and all proper needs for which no other appropriation is specifically made. It has been used interchangeably with tribal funds author ized at a number of jurisdictions for similar purposes, but the amount of tribal funds available at many jurisdictions has become so seriously depleted that it has been necessary to reduce the annual tribal fund authorizations from year to year and to increase the gratuity appropriation accordingly. There are 8 Indian agencies in Arizona, 3 in California. 1 in Colorado, 1 in Florida, 2 in Idaho, 1 in Iowa, 1 in Kansas, 3 in Minnesota, 1 in Mississippi, 7 in Montana, 2 in Nevada, 1 in Nebraska, 1 in New York, 3 in New Mexico, 1 in North Carolina, 4 in North Dakota, 6 in Oklahoma, 3 in Oregon, 6 in South Dakota, 1 in Utah, 4 in Washington, 2 in Wisconsin, and 1 in Wyoming, a total of 63. The general expenses of agency administration and of the support of Indians are provided wholly or in part from this appropriation. The Budget allowed an increase of $105.600 in this appropriation for 1940. The bill, as reported by the House committee and passed by the House, provided a lump sum cut of $25,000, to be applied at our discretion. This left a net increase of $80,600, as follows: Miscellaneous agency personnel: Field representative, salary $2.600, expenses $480_. Valuation engineer, salary $2,600, expenses $1,500 Pipestone field office_-_ Carson superintendency, salary and expenses_ Transfer from tribal funds-Agua Caliente (Mission Agency). Transfer from "Indian school buildings". Total____ $3.080 28,800 4,100 4.000 5,120 2,600 19,400 13, 500 80, 600 It will be noted that $35,500 of the above (the last three items) does not represent additional appropriations, but rather transfers to this particular appropriation from others. The sum of $10,600, representing salaries and expenses of miscellaneous law and order personnel, was transferred from this appropriation to that for maintaining law and order on Indian reservations. There follow, in the order of their appearance in the tabulation at the beginning of this justification, statements in support of the increases requested: 1. Additional clerical help (credit), $14,400.-This contemplates the establishment of 10 additional positions of junior clerk to assist in handling the .clerical work incident to the extension program in general, and the credit phase in particular. The credit work has increased tremendously on all reservations whose Indians are participating in the benefits of credit funds available under Indian Reorganization Act appropriations. Other tribes not under the Reorganization Act share in the gratuity reimbursable fund and many have special authorizations for the use of tribal funds for industrial assistance. Added to the increased credit activities has also been the additional burden placed upon the extension staffs in connection with other activities made possible by expenditures of the Soil Conservation Service, CCC-ID, new irrigation developments, rehabilitation enterprises, land purchases, the revolving cattle pool, and other activities which open new avenues of economic improvement, but which will fall short of their respective goals if help is not available to permit the keeping of adequate records, the conduct of necessary correspondence, and follow-up work in general. When a program is started which is intended to raise the standard of living of the Indian to a desirable point, and to make him financially independent by lending him money and otherwise arousing his hopes, and then the program collapses before it has an opportunity to materialize because of insufficient follow-up, leaving the Indian in debt and otherwise discouraged, the result is potentially more disastrous to the morale and economic condition of the Indian than had the program never been initiated. Appeals for additional clerical help to meet increased demands incident to the credit and extension programs are more numerous and more pressing than demands ascribable to any other activity. The present clerical forces at the various agencies are not sufficient to permit the furnishing of necessary help to these activities which explains this special request to meet this separate and distinct need. |