Chapter 30

COÖPERATION WITH DISPENSARIES AND CHILD-SAVING AGENCIES

Scientists agree that the human brain is superior to the animal brain, not because it is heavier, but because it is finer and better supplied with nerves. As one writer has said, the human brain is better "wired," has better organized "centrals." A poor system of centrals will spoil a telephone service, no matter how many wires it provides. An independent wire is of little use, because it will not reach the person desired at the other end. The ideal system is that which almost instantly connects two persons, no matter how far away or how many other people are talking at the same time on other wires.

The school that tries to do everything for its pupils without using other existing agencies for helping children[10] will be like the man who refuses to connect his telephone with a central switch board, or like a bank that will not use the central clearing house. As one telephone center can enable scores of people to talk at once, and as one clearing house can make one check pay fifty debts, so hospital and relief agencies enable a teacher who employs "central" to help several times as many children as she alone can help.

It seems easier for a teacher to give twenty-five cents to a child in distress than to see that the cause of the misery is removed. In New York City there are over five hundred school principals, under them are over fifteen thousand teachers, and the average attendance of children is about six hundred thousand, representing one hundred and fifty thousand homes. If teachers give only to those children who ask for help, many will be neglected. In certain sections of the city principals have combined to establish a relief fund to be given out to children who need food, clothes, shoes, etc. One principal had to stop replacing stolen overcoats because, when it was known that he had a fund, an astonishingly large number of overcoats disappeared. At Poughkeepsie school children get up parties, amateur vaudeville, minstrel shows, basket picnics, to obtain food and clothing for children in distress. They are, of course, unable to help parents or children not in school. Of this method a district superintendent in New York said to his teachers and principals: "For thirty-two years I have been working in the schools of this district. I have given food and shoes to thousands of children. I know that however great our interest in a particular child when it comes to us with trouble at home, our duty as teachers prevents us from following our gift into the home and learning the cause of the child's trouble. This last winter we have made an experiment in using a central society, which makes it a business to find out what the family needs, to supply necessaries, country board, medicine, etc. We now know that we can put a slip of paper with the name and address of the child into a general hopper and it will come out eyeglasses, food, rent, vacation parties, as the need may be."

Relief at home through existing agencies was brought about by the distribution of cards like those on opposite page, which offer winter and summer coöperation.

+--------------------------------------------------------------------+ | =For School Children= | | | | Compulsory education implies the ability of all families, even the | | poorest, to take advantage of school benefits. This means that | | children should be fed properly, clad comfortably, and healthfully | | housed. | | | | The New York Association for Improving the Condition of the Poor | | aims to coöperate with school-teachers in every part of Manhattan | | and The Bronx to insure comfort and prevent suffering among school | | children, their parents, and younger brothers and sisters. On one | | day last winter we received appeals from school principals and | | teachers in behalf of twenty-nine families. Within six hours every | | family was visited, emergent aid in food and coal provided for | | many, and orders given for shoes and dresses and coats required by | | the children of school age. During the winter we gave not only | | clothing, groceries, food, and rent, but found work for older boys | | and parents, taught mothers to prepare food properly, and sent a | | visiting cleaner to make sick mothers comfortable and to get the | | children ready for school. | | | | In a word, we followed that need, the surface evidence of which | | comes to the attention of the teacher, back into the home and its | | conditions, aiding throughout the period when the family was | | unable to do justice by the school child. | | | | In many instances the home income was sufficient, but the home | | management inefficient. Probably such homes could be more | | effectively benefited through educational work emanating directly | | from the school. | | | | We can be reached by telephone (348, 349, and 1873 Gramercy) from | | 9 A.M. to 12 M. Letters or postal cards should be addressed to | | Mrs. H. Ingram, Superintendent, 105 East 22d Street. Reference | | slips will be gladly furnished upon application. | | | | The New York Association for Improving | | 1843 * the Condition of the Poor * 1905 | | | | =Teachers of Manhattan and The Bronx= | | | | _Do you know of such children as these:_ | | | | 1. Convalescent children now out of school, who would be | | benefited by a stay at the seashore in May or June? | | | | 2. Children in school whose anæmic condition would be | | greatly improved by a week at Sea Breeze during July or | | August? | | | | 3. Small brothers and sisters (and tired mothers) who may | | need outings or special help? | | | | The New York Association for Improving the Condition of the | | Poor will act promptly. Write or telephone (348 Gramercy). | +--------------------------------------------------------------------+

When these cards were first distributed several teachers went from room to room, asking children who needed help to raise the hand. In many cases parents were very angry that their children should have asked for help. But help given in instances like the following soon proved to teachers that they could afford the time necessary to notice children who appeared neglected, when so much good would ensue:

The father is sick and unable to work. They cannot get clothes for the children, who are not attending school on that account. Children were provided with shoes and clothes.

November 30, 1907, a school principal reported that six children in one family needed underwear. A visitor discovered that one of the boys who had the reputation of being unruly and light-fingered also had adenoids. He was taken to a hospital for operation, and was later interested in his school work.

A little girl was unruly and truant. No attempt was made to keep her at school, but she was reported to the Committee on the Physical Welfare of School Children. The parents could not control her. The girl was taken for examination by a specialist and found to be feeble-minded. Later she was sent to a custodial institute.

Another little girl was nine years old, but could not talk. A University Extension Society worker found that she was not kept at school because it was too much trouble. The child was taken to a physician who operated and corrected the tongue-tie.

A girl of twelve said she must stay home to "help mother." The mother was found to be a janitress, temporarily incapacitated by rheumatism. A substitute was provided until the mother was well, and all the children were properly clad for school.

After the adenoid operations in a New York school that occasioned the East Side riots of 1906, the physicians and principals who had persuaded parents to permit the operations were fearful lest the summer in unsanitary surroundings might make the demonstration less complete. Over forty children in three parties were sent away for the summer, where they had wholesome food and all the milk they could drink and fresh air day and night. When they returned in the fall the principal wrote: "The improvement in each individual is simply marvelous. We shall try to continue this condition and shall constantly urge the parents to keep up the good work by means of proper food and fresh air."

In none of these instances could the teachers have accomplished equal results for the individual children or for the families without neglecting school duties. By informing other agencies as to children's needs, teachers started movements that have since helped practically every school child in New York City. Dispensaries are setting aside separate hours for school children; fresh-air agencies are giving preference to children found by teachers or school physicians to be in physical need; relief agencies are making "rush orders" of every note from teachers; the health board is more active because volunteer agencies have added their voice to that of teacher and health officer in demanding adequate funds for physical examination of school children.

Coöperation is at present easier in New York than in any other city. Charitable societies, hospitals, dispensaries, are probably more keenly alive to their responsibilities and are at least more apt to have acquired the habit of coöperation when asked. Yet even here I have been told repeatedly by teachers: "If we have to wait for that hospital or that charitable society, our children will go barefoot." In small communities where hospital and relief agencies are for emergencies only and generally inactive, it seems that the first thing to do is to ask some friends to establish a small relief fund, just as it is easier to give a child a five-cent meal than to teach its mother how to prepare its food. But the school-teacher will find that it takes very much less energy to arouse the relief society than to maintain her own relief work. In fact, in many cities nothing could do more to strengthen hospitals and charitable societies than to put them in touch with the needs of school children. For a principal to make known the fact that school children are neglected will help the charitable society and hospital to get the funds necessary to do their part better than they are now doing it and better than the school could ever do it. Finally, one reason for a breakdown of charitable societies is not their own inadequacy, but rather the failure of the school and church to make use of an agency better equipped than themselves to give material relief. The teacher sees the child every day, while the relief society will never see it and has no reason to see it until some one calls attention to it. The very first step, and an indispensable one in relief policy, is for teachers to be on the lookout for children not adequately provided for, and then have the physical evidence discovered at school followed to the home for the cause of the child's distress.

_Coöperation_ removes the cause of distress; _doing_ may aggravate it. Teachers would do well to draw up for themselves a chart which will show exactly what part of the community's work can be best done by their school. On the following page is charted the social work now being conducted at the Massachusetts General Hospital, Boston. So far as agencies exist to deal with any individual or family problem coming into the social-work square, the hospital aims to utilize that agency. Its own direct dealing with neurasthenics, with hygiene education, with sexual deviates, is primarily for the purpose of giving adequate treatment to the needy, and secondarily to demonstrate how adequate treatment should be organized for the community. Please to note that governmental agencies are not mentioned in Dr. Cabot's chart. This does not mean that he would not emphasize the importance of those agencies, but that up to the present time, for the particular cases dealt with in his clinics, governmental agencies can be reached most effectively through the private charitable agencies in the reference square. So the teacher will frequently find that the relief bureau, children's society, public education association, or church can get better results for her pupils from public health and correctional agencies than can she by writing directly.

+-----------------------------------+ | _Work for the Tuberculous_ | | | | 1. Tuberculosis classes | | 2. Reference to other agencies | | 3. Examination of children | | 4. Stimulation of suburbs | +-----------------------------------+ | | | +--------------------------------+ | +--------------------------------+ | _Psychiatric Work_ | | | _Work for Hygienic Conditions_ | | | | | | | 1. For neurasthenics and | | | 1. Individual instruction | | hysterics | | | 2. Convalescent homes | | 2. For defectives | | | 3. Industrial hygiene | | 3. For stammerers | | | 4. Home hygiene | | 4. For epileptics | | | | +--------------------------------+ | +--------------------------------+ \ | / \ | / \ | / \ | / \ | / \ | / \ | / +-----|-----+ | | /SOCIAL WORK\ /| M.G.H. |\ / +---/|\-----+ \ / / | \ \ / / | \ \ / / | \ \ / / | \ \ +-------/-----|-----\-------\---+ | _References to Other Agencies_| | | /|1. Hospitals and sanatoriums | / |2. Associated charities |\ / |3. Societies for children | \ / |4. District and visiting nurses| \ / |5. Settlements | \ / |6. Homes--temporary or not | \ / /|7. Employment agencies | \ / / +-------------|-----------------+ \ +------------/-----/----+ | +--\-------\----------+ | _Ward Work_ | | | | | | | | _Work for | | 1. With cases soon to | | | Cases of | | be discharged | | | Varicose Ulcer_ | | 2. Cases needing | | | | | friendly offices | | | | +-------------/---------+ | +---------\-----------+ / | \ +-----------/-----------+ | +--------------\----------+ | _Work for | | | _Assistance to M.G.H._ | | Sexual Deviates_ | +---------|---------+ | Financial investigation | | | | _Assistance to | | | | 1. Unmarried but | | Other Agencies_ | |(a) of Cases asking free | | pregnant | | | | treatment | | 2. Diseased | | 1. Steering cases | |(b) of Cases presumably | | 3. Exposed | | 2. Coöperation | | able to pay a physician | +-----------------------+ +-------------------+ +-------------------------+

In country districts no plan has yet been worked out for adequate relief. Fortunately, however, the distress is generally of such a kind, and the teacher so well acquainted with all the parents of her district, that it will not be difficult to procure such attention as is necessary. Country schools should be furnished by county and state superintendents with clear directions for getting the treatment afforded in the immediate vicinity. Where teachers are alone in seeing the need for coöperation they can quickly interest young and old, physicians, dentists, pastors, health officers, in home visiting, street cleaning, nursing, helping truants, needed changes of curriculum, etc. _Getting things done_ is easy because it is human to love the _doing_; getting things done is _doing_ of the highest order.

FOOTNOTES:

[10] The importance of recognizing the family as the unit of social treatment is presented in Edward T. Devine's _Principles of Relief_, and in Homer Folks's _Care of Dependent, Defective, and Delinquent Children_.