FIGHTING THE SCOURGE: AMERICAN INDIAN MORBIDITY AND FEDERAL POLICY, 1897-1928
AbstractBecause the Indian health service in the first decades of the twentieth century was unable to correct the economic and political origins of the "Indian health problem," the vigorous and progressive campaigns conducted by that service failed to eradicate significantly disease from among Indian people in the United States. At the turn of the century, the federal Indian schools spread tuberculosis among the children in attendance. Although made aware early in his administration that the schools were "death traps" and "charnel houses," ignorance of the etiology of the disease prevented Commissioner of Indian Affairs William A. Jones from acting decisively to curtail the contagion. As bacteriologists and public health officials disseminated information about tuberculosis, Commissioners of Indian Affairs Francis E. Leupp, Robert G. Valentine, and Cato Sells launched vigorous health campaigns, which were patterned after the anti-tuberculosis crusade of the National Association for the Study and Prevention of Tuberculosis. A significant decline in Indian tubercular mortality did occur from 1915 to 1920. The National Tuberculosis Association mistakenly attributed the decline to the Indian office's efforts to provide sanitarium care, better housing, health education, and pure milk supplies for Indians. In fact, the thousands of Indians who turned to farming as a means of livelihood were responsible for the decline in tubercular mortality. The Indian office's campaign against trachoma, an insidious and prevalent eye disease, was successful in the schools, but made little progress on the reservations, where the family was the foci of the disease. In response to agitation from white reformers in the 1920s, the Indian office launched the Southwest trachoma campaign, but poor planning and mismanagement doomed the campaign from the start. Other progressive health projects included a "save the babies" campaign and a dental hygiene program. By upholding the goals of traditional Indian policy and by shaping policy to conform with programs designed by progressive urban reformers, Commissioners Leupp, Valentine, and Sells gave new respectability to the Indian policy created by the Christian reformers of the nineteenth century. Surprisingly, after Commissioner Jones had prevented the Indian service physicians from creating a professional medical corps, the physicians themselves made no united effort to improve the health of Indians. World War I with its concomitant inflation had a detrimental effect on the Indian health service. Following in the war's wake, the devastating Spanish influenza pandemic swept the reservations and killed 2 percent of the Indians of the United States. In the 1920s Commissioner Charles H. Burke's tolerance of an incompetent physician as his chief medical supervisor, and his cowardly suppression of the extraordinary Red Cross report of 1924 contributed to his administration's dismal record, compared with those of the commissioners prior to World War I. By 1928 the Indian office could show little achievement in its fight against the scourge of disease. Unfortunately, the health section of the prestigious Meriam report was flawed and offered ineffective solutions to the persistent problems of tuberculosis, trachoma, and infant mortality.