Part 12

The city of Pittsburgh at the time of this survey possessed six private relief societies which dealt with more than 1,000 families a year each; three which dealt with between 500 and 1,000 families, and a Department of Charities whose cases numbered over 1,000. In addition, relief was given to a number of individuals by some of the settlements, by the probation officers, and by private groups. The number relieved or the amount of material relief were not ascertained and could not be in less than from one to three years. It has developed also that other associations, whose original purposes were of a different character, some purely educational, have had smaller or larger funds to use for relief. In the summer of 1908 requests for information were sent to 422 churches. Of these sixty-one replied and of this number sixty reported that they gave relief. The more one went into this investigation, the more one appreciated the impossibility of concretely recording the number of organizations dealing in material relief. Without in the least attempting to theorize, but drawing the obvious conclusion, it may be said that Pittsburgh's primary charitable impulses to give to the poor were being disintegrated because there was no sufficient relation between the groups and no feeling of joint responsibility.

In presenting a rough picture of the whole charitable field in Pittsburgh it is doubtless necessary to remind those who read this that, if the survey had been undertaken in another city, conditions similar in many respects would have been found. Though in certain directions better co-ordination would be found, and in certain other directions developments which are not here present, the fact remains that in all our cities charitable societies simply "grew." Taken in the large there are gaping rents and holes, discordant colors and bad cloth in the fabric of each city's garment. Without the repression of a single individual impulse of the right sort, the writer seriously questions whether eventually we shall not have to apply the rigorous precepts of town planning to the work of proper co-ordination and systematization of charities.

Coming to medical care and nursing, the city on October 1, 1908, had fourteen general and seven special hospitals, including two supported by the city for contagious diseases. Fourteen of these reported a total property valuation of $6,848,339; nineteen a bed capacity of 2,268. Thirteen reported their number of free patients for the previous fiscal year as 10,135, the cost of maintenance of these free patients as $339,518. The capacity will soon be increased. Twelve of the above hospitals maintained dispensaries. In addition there were three dispensaries independent of hospital management. One of the three reported patients to the number of 1,955 for one year, another 5,647, the third, a state dispensary for tubercular patients, at the time of the Survey, had not completed a year's work. A valuation of the property could not be obtained. Not included above is the tuberculosis camp maintained by the Department of Charities at the county institutions at Marshalsea.

Nine agencies provided nurses to visit the homes of the poor. Of these three were distinct organizations, one only being chartered; two were carried by settlement house associations, two as departments of church work, one by a religious order, and one by a school alumnæ association.

So far as observations go the specialized work itself was well done. Yet the nursing associations may be specifically accused of such failure of co-ordination that the nurses were constantly crossing one another's tracks, visiting the same families, instead of having worked out, jointly, a district plan.

The welfare of children is of course involved in the agencies named above. In addition there are no less than forty and possibly more institutions for their care. For the especial oversight of children within family circle influences, there is the Juvenile Court Association, two playground associations, and the Children's Aid Society of Allegheny County. These, and other agencies are described in the special article on children.

For the joint care of mothers and children there are six fresh air homes and six day nurseries.

There are ten institutions to provide temporary shelter, principally, for both men and women. The general intention of these agencies is to set upon their feet people who are without immediate home ties and so return them to normal conditions.

Coming to the aged where the fair chance may consist simply in providing suitable institutional care, we find for them no less than eight homes, exclusive of the care provided in the city institutions of Pittsburgh located at Marshalsea and Claremont (formerly a part of the municipality of Allegheny).

Six rescue homes for unfortunate women next come into the field of observation.

Outside of the necessary care provided by public moneys, there would seem to be very little private provision for the care of defectives, there being for this class only one institution, a home for epileptics.

A public wash and bath association, as well as a widows' home association, provide other forms of self-help to women particularly. The former furnishes women with tubs and driers to use for the washes which produce income. The latter lets nineteen houses with a total of 110 rooms at a small rental to the families of widows with limited means, thus providing pleasant sanitary quarters in a good neighborhood. It is significant of the confusion prevailing that even this last association has developed special relief funds of its own.

A legal aid society has lately been organized.

To this point we have been enumerating associations which, while possessing social purposes, have embodied in their fundamental aims some form of direct relief, material or otherwise, to the individual. There are other agencies purely for social reform which should be cataloged. These associations are primarily concerned with certain forms of so-called preventive philanthropy. The Civic Club, the Chamber of Commerce, the six settlements, the tuberculosis league, the child labor association, have all dealt with specific social problems, to say nothing of the endeavors of the Health Bureau in fighting improper drainage, bad housing and preventable disease and of the city administration in struggling for a better water supply and the diminution of typhoid fever.

While both the child agencies and the social reform agencies last cataloged find their proper positions in other lines of the Survey, it is necessary that they be included in this bird's eye view of the whole charity organism.

Drawing closer now to the organism from our bird's eye view, we observe four plainly marked divisions. The classification here made is not one which appears in any directory of charities but it is one which is peculiarly adapted to a survey of a field. A different analysis would be required for other kinds of study. We find then four lines of activity: (1) Treatment of Families in their Homes, (2) Neighborhood Aid, (3) Indoor Relief, (4) Social Aid.

By (1) we refer not only to material relief but also to all other forms of aid, medical, legal, advisory, in fact to any dealing with individual families in their homes, whether the treatment be mental, moral, physical or environmental. It is with this group that this study deals. By (2) we refer to the satisfaction of the needs of neighborhoods rather than of individuals: to the general activities of settlements, of bath houses, etc., so far as those activities are not manifested in direct civic and social reforms. Of course (3) refers to all forms of institutional care, temporary or permanent,--for children or adults. Number (4) refers to all agencies or activities for civic or social reform. The last three groups are considered in detail by other contributors to the work of the general survey.

In Pittsburgh as in other cities the philosophy of individualized charity still holds strongly its position. Individualized charity as against social charity involves the idea that what one does concerns only the doer and the "done to." That necessarily associated with charity is the function of umpire and director has occurred only to the larger societies. In the three last fields of our classification everything tends towards organization of a public character. The very end to be obtained, whether it be to provide hospital care, baths or child labor legislation, requires the co-operation of many people and with co-operation and the more or less resultant publicity the organizers must inevitably sense some sort of public responsibility. In the treatment of families in their homes, however, no such fundamental need of publicity exists. Therefore it is that many people, having perceived human suffering, without thought of the importance of co-relation, of adequate knowledge, or of umpiring, took the easy means of giving money and food and clothing without recognition of anything beyond. Thus, possibly hundreds of individuals and groups are serving simply as distributors of material things. It is true that one of the relief associations maintained a registration system by which people might learn what others were doing for a family, but the information was concerned mostly with the giving or withholding of material relief. More than that, it can scarcely be said that this registration system was sufficiently advertised or advertised with sufficient continuity. Even in communities where a charity organization society continuously advertises its registration system, there is still revealed a wide crudeness of thought which is crippling to any sort of decent social progress. In the city where the confidential exchange of information between societies has been best developed it is a fact that scarcely more than a score of churches register regularly. By not doing so the churches everywhere have put themselves in the wrong, they have not recognized the very sacred and high social function which is involved and which so vitally concerns the social welfare. For it will be observed that there is nothing in the recognition of the high social function which favors the centralization of relief work of any sort. It means only that there shall be a working out together of the family problems and an estimation of the remedies to be applied.

Both with the smaller groups and with the larger societies the lack of co-operation has resulted in rather confused umpiring and in the application of wrong remedies. For instance it has been revealed that able-bodied men, with families, have been aided through the public charities department. What they needed and should have had was the careful attention of some private society which would bend every energy to provide work for them. Whatever conditions were responsible for the unemployment of these men (at a time when there was no particular industrial depression) there was only one way of treating them so that their own sense of initiative would not be lost. That was through one of the several private agencies to provide absolutely necessary amounts of relief to each man while pushing him into work. But with certain striking exceptions each one of the agencies was working along irrespective of the activities of others.

Few societies felt that to be brought in touch with a family should mean the acceptance of the responsibility for furnishing or securing the total necessary amount of relief, material or otherwise, which might be required.

As a field investigator has written:

Previous to the organization of the Associated Charities in February, 1908, no center of information existed, and there was practically no attempt at co-operation among the different relief agencies. Indeed, it was tacitly understood, if not openly expressed, that families applying for aid to any agency would go to others. One city official expressed the feeling when he said, "Of course, they go to other societies; we don't give them enough to live on." The shape of the city made communication between the different districts often very difficult in the days before the telephone, and habits formed then are not wholly outlived. The main thoroughfares follow the general direction of the two rivers. These become widely separated by high hills as they extend back from the business district on the "Point," and often one must either go a long way round or climb over to get from one section to another. It was very easy for a family to have its rent paid by a church, to get groceries from the city charities, to secure a nurse if needed, besides miscellaneous aid from one or more societies and charitably inclined individuals without any one of these organizations or persons knowing that another was helping.

From May 1, 1908, to September 20, 1908, the Associated Charities investigated 216 families. Of these thirty were "out-of-town" cases and twelve were false addresses, leaving 174 cases tabulated for comparison. The following shows the number of these cases duplicated by different societies and is probably a fair sample of the overlapping constantly going on:

No. of cases helped by 11 societies 2 No. of cases helped by 7 societies 2 No. of cases helped by 6 societies 3 No. of cases helped by 5 societies 17 No. of cases helped by 4 societies 12 No. of cases helped by 3 societies 20 No. of cases helped by 2 societies 23 -- Total 79

A more thorough investigation than was possible with the limited number of workers would have shown that many of these cases were also receiving aid from one or more churches or individuals.

It should be remembered that this comparatively small list of duplication, only covers the cases where actual investigations were made by the society itself and not the many duplications revealed in the registering of from 7,000 to 9,000 cases. The reason why no tabulations were made of these was that, owing to the incomplete registration, the returns could represent but a very incomplete set of facts much less than in the case of the families actually seen.

Duplication of relief without thorough investigations, it need hardly be said, may mean one of two things. It may mean in one instance the dowering of a family which needs something else than financial aid, or it may mean, in another, the inadequate dowering which compels an otherwise decent family to beg from different quarters, thus inculcating the begging habit. It is not an unjustifiable theory to advance that it probably meant the one just as often as it meant the other in the Pittsburgh field because there had not been, previous to the coming of the Associated Charities, those frank and informal conferences between workers in the different societies, which alone can bring about that joint planning for the same families which is not only economic but just and not only just, but humane.

Every charity organization society in the country can match these stories of the evils resulting from the lack of a feeling of complete responsibility, which means inevitably unfair umpiring and often no direction at all. For how can there be direction when not all that is being done is known, and when the manner and the character of the remedies are held secret. The Associated Charities workers do not claim that with their presence the uncooperative effects disappear as at the touch of a wand, but that means to bring about complete and, if need be, joint responsibility for doing the right and complete thing for each family is furnished through their offices as meeting places and neutral ground.

The great weakness in the treatment of families in their homes, other than in medical and nursing care, is in the lack of thorough knowledge regarding the individual causes of conditions, the individual characteristics and connections and resources (other than material) of families, and a planning upon this knowledge. There is no need to draw illustrations from the Pittsburgh field because they can be drawn from every city, even where a greater degree of co-operation has been developed.

There is the instance of the aged mother, once a successful boarding house keeper, assisted by a society to re-establish herself in this business though her increasing infirmities doomed the project to failure. This failure brought not only the mother but her widowed daughter (herself in poor health) and two children into the direst of situations. Then it was found that the money had actually been thrown away because a certain well-to-do-relative in another city had not been followed up. The clue which led in his direction had been covered up during a hurried investigation. When he was informed through correspondence of the situation he immediately made provision for the mother in his own home and for the temporary care of the others until the daughter recovered her health.

There is the instance of a man and wife, the man apparently recovering from tuberculosis. No careful physical examination was made either of the husband or wife. Various attempts at finding employment for the husband were made but he began to fail. Then suddenly the wife's condition became alarming and it was discovered that she was in a more advanced stage of the disease than her husband. Meantime the couple had not been assisted in tracing the whereabouts of the husband's parents, supposed to be well-to-do. In the end, fortunately, the couple themselves received word from the parents who were in California prepared to receive the family (which included three young children) and to provide care for the sufferers and if the worst came to give a home to the children.

There are the many instances, where material relief has been given to sickly families and the improper sanitation of the neighborhood or the imperfect disinfection of the houses, the causes of the conditions, have not been investigated and rectified.

There are the instances where a family, left as the result of an industrial accident without its male bread winner, has not had the kind of assistance which would enable it to secure the proper settlement with the particular industrial plant in which the death occurred.

There are the instances where the wayward boy has not been given the specialized training which might have turned him into an interested workman with a constantly increasing salary.

There are the instances where widows have been allowed to carry too heavy burdens and where, unknowingly, children have been put illegally to work, through holes in the laws which should be blocked up.

There are instances where with the failure to see the male bread winners the whole moral and physical condition of the families has rotted because shiftlessness and intemperance have been allowed to run riot.

There are the instances where endless evil has developed when the most hardened of beggars, because of their very vociferousness, have been permitted to set an example of easy living to the honest and toiling people in a whole community.

There are the instances where material relief has not been followed by agencies for the development of a better family life: better cooking, better home keeping, a larger fund of recreation, more harmony, better individual development, more thrift. In other words, such a development that there need not again be descent below normal living.

In Pittsburgh as elsewhere there has been too much reliance upon visits to the families and upon a superficial sizing up of conditions. As a result there has been too little development of treatment beyond the mere giving or withholding of material relief and of medical and nursing relief. Notable exceptions there are, but on the whole it can but be said that material relief alone, and that in many instances by no means adequate, has bulked too large. The same must be said of outdoor relief everywhere. To-day it requires as much attention for its right development as any other field of social effort.

It cannot be said that the outdoor relief agencies of Pittsburgh have been as effective as educators of the community and directors of its charitable impulses as they would have been with proper co-operation. On their own initiative they are now putting an amount of effort, and brains, and heart into the work of co-operation which assures far more definite results when the new order has established itself. For instance, it would have been possible, with proper co-ordination, for the relief agencies to gather a vast mass of data regarding dependency wrought or deepened by two social evils to which Pittsburgh is prone, the prevalence of typhoid fever and the number of uncompensated industrial accidents.

It was not possible for those engaged in this survey to obtain any satisfactory data as to the approximate number of applications for aid, due, superficially at least, to these two causes. They have also been unable to obtain reliably complete data regarding the prevalence of tuberculosis in the families to which a helping hand has been extended. Nor could data regarding centers of infection and probable inciting causes of this disease be obtained. It was not possible to ascertain in how many instances physically weakened young men and women could trace as one of the causes of their condition, too early labor for wages. It was not possible to learn in how many families the mental backwardness of the children could be traced to physical condition. Nor, it must again be re-emphasized, do the relief agencies of other cities live up to their responsibilities in this direction. There have been many cities visited by the writer where long established charities, with fairly complete records and with a covering of practically the whole field, have not held in compact shape the illustrations to furnish the background which might cause people to hearken more quickly than anything else. A society, which among other activities, maintained a tuberculosis committee, was unable even to state the number of families, with whom it had come in contact, in which cases of tuberculosis had been discovered. Another city, where there was tolerably good co-operation, and where there had been considerable interest manifested in the housing problem, could not tell from its records, just where in certain specified neighborhoods the most unsanitary houses were located. The writer in this case felt personally responsible so that his position as critic must not be misunderstood.

To put it plainly the Survey has only revealed again that in the whole field of outdoor relief there must be a deeper realization of the fact that as umpires in the discrimination of causes, as workers in the right forms of treatment, and as educators in revealing true conditions, there is a very heavy responsibility which all who in any way deal with the dependent or neglected in their homes, must feel. It is because their work brings them into the homes that the responsibility is the greater.