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JIM tiLffiSFmmm 01 SD1 what Hca Been Dons fcnd Whnt Remains to Be Accom I plirhed Are Clearly Pointed Out in Review of Work I liich Prosrceses Ao People Are' Better Informed On Importance of Campaign. usxutn ..n. ... ... ... ... .... Born very pointed facts concerning What ba boon dono and what yet re taalng to be accomplished in the tjtaalth campaign being carried on here Bder the direction of the city, state cad government health authorities are Viry clearly set forth In a comprehen gtve open letter by Dr. O. H. Cox to the city commlaalonera and the public. lSe says: There has been brought to your atten tion In verloua ways the different health raeasures which are needed In this com zilty. It Is now desired to systematic catty present to you not only what has then done but what yet remains to be made an aocompllshed fact. .There has been found much psssinHsm and some times honest doubt as to the practicality cf methods advocated or adopted. For tis reason extra care and definite thought must be given to any measures which are to be carried out. J Motlvee For Public Health Activity. I -v. -,MAm- vh nv nubile health effort is being made at this time or any ether time. To t back to the funda mental reason remember that sanitation if being put in practice in this day and 0xo because people are generaly coming t realise that it is the civilized and decent thine; to do. This community can o no lees than hundreds of smaller or toea prosperous onee have done, to their everlasting credit and pride. Further i-wre the state board of health Is or ganised to promote, good healtn among, the people in all parts of the common wealth. It stands ready a I will continue to assist this region, as will be shown further ' on. , t The United States Public Health ser vice has a number, of reasons fOr ac- 8ve work here. It le continuing here to same as during the war emergency. When federal- military forces and the Working forces of Industrial plants needed- mors health protection than appar ently oould be afforded by local commun ity forces. This governmental force also stands as an advisor and aid to state crgsnixations. so that the efforts being pit forth here are constructive from the very beginning. Finally definite reasons must be as signed to the people so . that they will 0vm their hearty support. Their welfare the aim of all governments. Some rathorltlee have been able to estimate the results of health work in dollars and saints. - This is don to replace vague sentimental , ideas by money values so that people can grasp the idea better. For Instance, after a severe epidemic ot typhoid fever In Pittsburgh. Pa., a care, f ul investigation of It in 1908. after the 5)o1C0 FOR $4i Our Laundry Work is Second to None in the City. Our Work is Always the Best. Always Done by Experts in Their Line. We Want Every Man, Woman and Child in ' Pensacola to have Their Clothes Laundered 66 am Our Coupon System Enables You to Save 5 on Your Work. We Coupons for $4.75 and When You Have Your "Work Done Here, You Pay Us in Coupons. Order a Book or Books Today No Bundle Too Large Everywhere. Our Drivers Polite and Courteous. YOUR COUPON BOOK Can be left at our office and our cashier will take from it each week the amount of your bill. , This makes it handy for you. THE damage was done. . concluded that every case of the fever cost the community, which means the taxpayers. 1123.00 and each death ?2,26o. But even the exact business man admits that "there is much in the world which canot be measured in terms of money." !The life of a la borer may appear to have a small money value, but he Is entitled to protection by the sanitary law. ' Such laws are made for the benefit of the majority, : When (they are enforced as sanitary measures protection of the many against the few is intended. It Is conceded that there are some valid reasons why health matters have not been on a more active basis. But when we get back to fundamental facts we find only a few. I Ignorance of sanitary needs and indif- ference to them are the chief enemies of sanitary progress. This applies to citizens and officials. It is due to the , fact that one. person or group has a 11m ! ited point of view. A health officer from j tarining and purpose is the one who can I point out the needs and (he remedies. ! Every community does and should have 1 local pride. Still even this has a danger. People get the lmpressionn fostered per haps by the utterances of prominent but uniformed citizens,, that their town is one of the healthiest spots In the U. S. A., which means the world. V Every activity of a city government has some sanitary phase. All these must be harmonized. It la results which are 'demanded. When these are pointed out . as the accomplishment of a thorough pub ' lie health program cost, will cease . to ibe an objection. Cost of Public Health Work. No hard and fast figure is possible be cause local differences are many. Aver ages from many sources show that four per cent of the annual budget is not too much. Another way is to allow 50 cents per capita of population. These i are influenced by many circumstances, j most of which are, self evident. It is a ''definite fact, however, that health can be purchased. The price is paid though the channels of prevention. The people are getting better Ideas on the subject, j They demand that a fair share of their I tax money be used 'to protect them. They went their disease and death rate , kept down." Definite and sufficient ap propriation for health- work must be i taken clearly into account. This and ex- I pert service are cry In nds of the day. Surveys and Programs. Our purpose has been lo make a' sur vey of the public health situation in Pensacola and Escambia'; county, and to formulate an effective - local program. The problem has been to get a thorough survey and study of the facts. The idea PENSACOLA JOURNAL. SUNDAY MORNING, APRIL 27, 1919. of a mere passing "Investigation been carefully avoided. This Is not- a campaign. It Is Intended to be a definite, eonelee , arrangement of fundamental facts. From these the proper conclusions may be drawn. Permanent remedial ac tion Is the final need. The following part of this communication will be devoted mostly to (1) Copdltlons as they exist. (2) What has been done to remedy the undesirable ones so far. (3) What should be done In the Immediate future. 1. Conditions As They Exist. ""This Is intended a a constructive and not - deatructive criticism. At - various times it has been apparent that this city and county were not up to the average in the way they handled matters pertaining to -health. - - , (a) Infectious diseases were not report ed to hardly any extent by the majority of physicians. There was a great laxness In this important aspect. (b No provision was made for lnsoec- Jtion of schools. . ic) o xouow-up work : was ; done by doctor or nurse to attempt to check contagious diseases. '. . (d) Sanitation as applied to disposal ot human wastes was largely neglected, as was evidenced by the existence of nearly 3,000 foul. open,, surface privies within the city limits, in the areas not reached by sewers. (e Shallow . wells and driven pumps abound to numbers of 400 or. 600, and many of them I are so situated that pol lution and Infection of the water Is prac. tically a foregone conclusion. (f) Restaurants, soda fountains, confeo. ; tioneriea. markets and stands where food is handled were not up to a proper stand, ard In regard to protection of foodstuffs or general cleanliness and arrangements. This was evidenced by low scores which were made on a very thorough basis. . (g) The milk and dairy question was not on any definite or satisfactory basis'. No efficient watch was kept on sanitary conditions from the cow to the consumer. More conscientious dairy men had no encouragement. Tuberculosis of cattle which can be transmitted to human be ings abounded. Evidence of this Is made by the fact that the qualified veterinarian of the- 17. S. department of agriculture is finding herd after herd In this vicinity where 40 to 50 per cent of the cows test out as tuberculous. If there were no other objectionable features this should be cause for serious alarm. (h) The question of drainage, which to the health authorities means prevention of diseases, had been neglectd. Malaria Tever is theone greatest danger. Wet place breed mosquitoes and one species of this Insect carries' malaria. 'No mos quitoes, no malaria. Tour health department - as organized consisted of one part-time health officer, and six sanitary patrolmen under the commissioner of health. The health of ficer was too busy to give much of his j time to public matters. The four field j inspectors, each of whom had a certain section of town, had very little central di 'rection. - No matter how conscieutlou& they might be they could not. advantage ously go it alone and get many results. They could keep down gross nuisances and answer complaints, and that is about all. - The" patrolmen acting as milk inspector and market inspector, respectively, were not getting desired results as to sanita tion of the food products under their supervision. Therefore the many useful functions of a department for health of the community were being Inadequately handled or left out of consideration al together. There were ample laws on the statutes in regard to all these ques tions. , Where these did not quite cover G O U P at Our Lau ndry the state laws weer definite. - Hence- It has become apparent that the responsi bility for health conditions which is fixed by law and assumed by the community was not always aoepted in critical times. There are numbers of Instances where, when action looking towards disease pre vention should have been inaugurated, nothing definite was done. The laboratory maintained by the state for this western section Is adequate in every respect. It will continue so. and thus should be a -wonderful aid In any new orga.:atlon contemplated. U What Has Been Done So Par. - Local history- during the past three months in regard to sanitary questions is a matter of what can be found on your records.-in the press, and what may be -aeen'about town. - "- A' aanitary privy ordinance was adopt ed and Is being installed with minimum opposition-under the rection of the pue Uc health, service, aled by the city san itary patrolmen,' turned over, to the med ical officer in charge. The state sani tary officials are co-operating, mainly in the milk zone outside the city limits, and a a .i . ..... n .mv ,fVI t(TU a WWVU IUO umvj - w It will ; be noted that practically all places where Canythlng Intended for hu man food is handled have been effectually screened. It is intended that all shall do the same. v By means of scoring most places have been brought to a better condition and idea of cleanliness or sani tary order. ; Thia has been accomplished by persistent Inslstance on compliance with the law. " While there does not seem to be much progress made in milk inspection,' nevertheless most dairies have been visited and Instructed what they must do to avoid conflicting with the law. A trip through the country will reveal many improvements completed, or in the process of construction. Some milk pro ducers are anxious to comply with rea sonable regulations. Others are in need of more forceful procedure than simple instruction.. The tuberculosis situation Js being remedied as fast as thorough tests can be made. A number of cattle have been shipped away for slaughter or other wise safely disposed of. However, It is a serious menace yet to the health of .the milk using community. Considerable dis cussion of health matters "has stimulated many people to thng about the need for such things, eo that they will be In a hotter frame of mind in reeard to them. This we may call education of the peo ple. ' i " School . rnertlal Inspection. as stated shove, had not ben followed to any ex tent. In the eountrv rural schools pro vin ha been ma1e bv the district state health officer and school hoard to examine all children and then work with and for the parents to have all remediable defects corrected as far as possible. It stands to reason that tho 4,000 school children sho'ild have some supervision in regard to their health, on which so vitally depends the usefulness of their future. The Lockey school has been examined, another is undergoing the process, and this will be continued by the government medical officer until : the first of May. Then a physician under the direction of the bureau of child welfare of the state board of health will arrive to continue. It is hoped . to have a complete record of .ich h!l1 nnil thia will ha ndde! tn from t year to year as long as it is under the scnool system, v 5 ., Many serious conditions, like diseased tonsils, obstructing adenoids, decayed teeth, poor vision, and above all trachoma or "chronic contagious granulated eye-, O V-r fx' Q DR. C. Passed Assistant Surgeon . TJ. lids." have been discovered. Bad eyes are much too prevalent, and present a serious ; problem. A follow-up system conducted by vis iting nurses is the logical sequence to all thla work. Allusion is made all too fre quently now to the fact that "once upon a time" medical inspectons were made but nothing' came of it. Support from all quarters would be more hearty if more permanent efforts were assured. Confi dence must be restored. The reporting of contagious diseases ty the physicians is being more definitely ar. ranged. The state .1 v did require each case to be reported to Jacksonville head quarters. Recently it has been changed so that if some one responsible locally will collect these morbidity reports and then transmit them on it will be satis factory. Here again is shown the need for a full functioning department. Col lection of facts about cases means so much locally in handling contagion whilo there is yet time. It also gives a closer touch to those reporting, and will help to make returns more thorough and ac curate. s In many ways then progress along pub lic health lines has been made. It is more apparent to those active in the work. Sti'l It Is evident to anyone who thinks and looks. To have the majority of the people know these things and to act intelligent ly in conjunction to further matters woulj UNO None Too Small. H. COX. S. Public Health Service. be an accomplishment greatly to be de sired. Pensacola and . Escambia county must proceed with the spirit of the times. III. An Organization For Future Needs. In the light of what has existed and what has been done so far there appear several reasons why something definite must be organised which will promote the health of the community. Let us enumerate these: (a) It is the sign of progress to so or ganize. (b) The times drMd more thought on the part of those ui authority for those who elect them. (c) When a town becomes a city stricter regulation of individual action becomes necessary. You have had it demonstiated to you that sanitation pays. ; - The people who have borne the cost and trouble of certain Improvements will now demand protection by a definite re sponsible organization. The center and driving force of your needed oarganization will be a V'Hh of ficer in the shape of a man wno knows what to do and how and when to do it. He should be the "sanitary expert" on whom you can depend for advice on all ciylc affairs into which the question of health enters. This means that he will need to give all his time to the af fairs of his department. You may think that such a peraqn cannot be found. Cre Sell You a $5., Our Wagons Go YOUR COUPON BOOK Can be left at our office and our cashier will: take from it each week the amount of your bin.- -.yy: This makes it handy for you. ate the position and then the nan found. : Once he haa authority to ncs indicated personnel can be found I trained under him. The quetslon of pense enters here. As has been she above, the percentage system can be tr aa applied to annual income, or you settle on the 50 cents to $1 per capita the need seems most indicated. -A desirable health officer could hex' be found for less than $3,000 PC"N y with maintenance of car In addltlc 1 bear in mind that the state boiJ I appropriated 11.000 toward this In ev that he may serve the health needs Escambia county. In addition there n possibly be another source to bear sac of 'the expense. The Item of sanUr; inspectors need to be no heavUy thsa I la now. Five, or six good raenean lac after the maintenance Of the bog-and-cc privy system, correct nuisances, and spect milk and food supplies it is quite evident that several vtsir nurses should be employed. -X i recommend not less 'than two from t tlrst. The scope of thetr duties car be the subject of , special paper. I trith school inspection and Infant w: wcrk; visiting cf practically all conta oua eases to see that all precautions a. taken to prevent infection of others; vt Itlng of poor and destitute Sick under t: city physician; and , assisting at a clhA for those who can come out for treatmerjt. there will be found much needful werx to do. 1 There wiy be other expenses neorj- sarlly charged to theae activities. Sot; of these will be printing, office asstd ance, and upkeep of equipment. ; t ' One very important item whloh fortuaM ately will not loom large in this cor- munlty will be mosquito control. Tt m.ia-ia t- ni and this is taken vp by a? special report by. the.atate sanitary en gineer after a survey-made on April is. 17 and 18. ,Ue finds that the former., natural courses and ditches which have t been allowed to become choked up frost neglect can bo opened . adequately at ) small expense. ; The small amount of water which may remain can be so rest. I ed with oil that mosquito breeding wW J be nothing compared to the present. W ) must look at this from the standpoint or; ! disease prevention. Malaria ; Is always With . "r I stw is not) a remote possibility. ; jjj,-, It lias been stated that the health -anA1 sanitation touch nearly every phase of city activities, at; least In advisory ca parity. With the department W streets and public utilities-is shared an interest' in garbage disposal, the sewerage sysi tern, the water system. th - iinin..,. problem, plumbing inspection, and build-' ing Inspection. The question of license to food handlers and especially to mllftu dealers should certainly be approached, from the health side. ; The' police depart 5 ment has many things In common wlJf the health department. It is not always ' easy to decide whether a person has com 4 I mined a crime under the criminal o-f 1 sanitary code. At all events the goof 4 of.tlfo many has eben harmed by tlu action of the liw. 4 1 Departments which guard the welfar- ' cr tlie iwipit certainly shoulj stand to- ' gether. You health department certainly' merits close consideration and definite thought. V. , , Respectfully, . f . ' O. IL COX, " : P. A-Surgeon. SEE PASTIME AND LIBERT THEATRE ADD OX PAGE 18,' WOM AN'S SECTION,, , v i Book of FOR ? 210 n : 1' . x PHONE 114 Ve Apprecinte Yczr Bcsizsss PHONE 114 1 1