Issued by the
PROVINCIAL BOARD OF HEALTH, BRITISH COLUMBIA
Public Health Nurses' Bulletin
OCTOBER, 1924
V.
/     >t-©.    /
IT is the purpose of the Provincial Board of Health to assist the Public
Health Nurses to issue a bulletin which will be a medium for the
exchange of ideas in connection with their daily work.
We all profit by experience gained when applying our theoretical
knowledge to problems that arise and which may be classed as purely
local. Yet similar conditions in other districts may have to be met, and
one nurse's experience when told through the bulletin may be of great
help to others.
With this object in view the nurses have been asked to send in from
time to time an account of their trials and tribulations, giving or asking
for advice.
Such an interchange of ideas will be of great benefit to all; not only
to the nurses, but to the women's organizations, who are so much interested in the work and who are the main support of the service.
We wish the public to understand and appreciate the difficulties
which the nurses have to contend with and we also wish to have the
bulletin be a means of educating the public to the fact that a nation can
only exist and progress on a firm foundation of health.
We owe such-4. service to the rising generation.
Miss Jeffares, Public Health Nurse at Duncan, has kindly edited the
present issue.
We have reserved material, from centres not mentioned, for a later
issue.
SPEAKING OF RESULTS.
The actual figures are often beyond our greatest hopes, which is
another way of saying that the report of my first year's school-work in
Nanaimo surprises even myself. |p|
The results from bur dental campaign are very gratifying; the
teachers and the parents, as well as the members of our medical staff,
have united in making dental work and the routine care of the teeth the
popular thing. In two classes one-half the pupils have already been to
the dentist, and in a school of 146 pupils we could only find two boys
who did not have perfectly clean teeth. , •
 The children were asked to sign lists in the class-rooms, giving the-
date they began and the date they completed dental treatment.    Class
rivalry was stimulated by the promise of a star on the longest list.   This
also gave me an excellent record of the dental work.
M. J. Woods (Nanaimo).
COMMUNITY SERVICE.
Miss McClung, Kelowna, reports that she is a" member of a Relief
Committee, the object of the committee being to raise sufficient money
to enable Miss McClung to make arrangements for the necessary medical
and surgical attention required by children whose parents cannot afford
it. We must ask Miss McClung to let us have a report of the work of
her committee and the result of their general appeal to the public for
funds.
SCHOOL-WORK IN VERNON.
There are four schools in the town, with about 1,000 children in
attendance. The majority of the children are suffering from defects
which have been reported on by the previous nurse, and are still uncorrected.   The great difficulty seems to be a financial one.
I found the Women's Institute very helpful, and through them was
able to get a dental chair installed in one of the schools, with a view to
arranging for a dental clinic shortly.
In visiting the homes of the children, I find the parents are very
pleased to get any advice with regard to the health of the children I am
able to give them.
Jean A. Dunbar (Vernon).
COLWOOD.
• In a large district, such as the one in which I am operating as nurse
in charge of the Esquimalt Rural Nursing Service, the service necessary
to bring about the desired results of educating the people to a realization
of the benefits derived from supporting such a service in their midst is
very varied.
Apart from the usual aims and objects of a Public Health Nurse,
which include the dissemination of all information tending to check the
spread of infectious and contagious diseases, and the inculcation of habits
of right living amongst the people, child-welfare, etc., social service must
play a very important part in the daily life of a nurse in charge of such
a service.
If all the work accomplished by a Public Health Nurse could be made
public, there would be no difficulty in obtaining the vote of the people at
the annual ratepayers' meetings for the extra small assessment towards
2 I
 the upkeep of the service in their midst, but much of her work has of
necessity to be kept confidential, and therefore much of the benefits of
the service are known to only the few.
I will quote one case of many, withholding, of course, names and
anything which may lead to identification, whereby the State has been
saved, potentially, many thousands of dollars; the State, and thereby the
people.
The case deals with the Social Service Branch of the work. I
learned of a family living away back in the bush, where there were three
boys who, owing to them living outside the 4-mile limit, had never attended
school. Accompanied by the vicar of the parish, I went to investigate
the case. Taking my little car up miles of rough trail with barely room
at times to pass, we eventually located the place where the family in
question were living. There we found a shocking condition of things in
general. The three boys, ages 6, 8, and 10, had not only never been inside
a school, but were unable to speak properly, owing to the fact that the
father was almost stone-deaf and the mother on the verge of a mental
collapse through loneliness and lack of association with her fellow-
creatures.
Within two weeks we had the family moved to the village of ,
and very soon after that had collected sufficient clothing for the boys to
attend the school there. This was some months ago, and the boys are
now doing well at their studies and show fine promise, and the mother,
though still suffering more or less from her terrible experience of loneliness in the bush, shows great improvement, and no reason at all why
she should not become a normal healthy woman. The father, a good
workman, but severely handicapped by his extreme deafness, will have
the chance to become a useful self-supporting citizen, as I succeeded in
interesting the local Women's Institute and the Nursing Association to
the extent of procuring an ear-trumpet for him.
That is oiilyybne case from one portion of the district; but it will
serve to show how necessary it is for a Public Health Nurse, when in
charge of a district, to give and have a wide view of the opportunities of
service, and for the people to realize this service and support it liberally,
and thereby save themselves increased taxation in the future. It will
not require a very vivid imagination to realize what a burden such a
family would have become to the State eventually had they been left to
their own devices.
With regard to the progress of the Nursing and Public Health Branch
of the work, we have by. dint of perseverance, and with the co-operation
of the Public Health Department and the Saanich Health Centre,
to whom we are indebted for the loan of a dental chair, established a
dental clinic for children of school age and under—a service which has
proved itself to be of undeniable benefit and which is greatly appreciated
by the parents. We held our first clinic during the Easter holidays and
are continuing the work to completion during the midsummer vacation.
There is no better foundation for health than in a clean mouth, with
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 well-preserved teeth that will masticate the food required to build up a
healthy child, and ensure a good digestion and assimilation of the same.
Of my pre-natal work, first-aid work, etc., I need say very little, but
it is very gratifying to note the growing confidence with which mothers
will appeal to the nurse for advice regarding the slight ailments of their
children, and the welcome extended when making those numerous " home "
visits, which mean so little to the casual observer when reading of the
number of | home 1 visits made in the monthly report, but which mean
so much to the nurse and to the parents and to the future realization
of the achievement of the aims and objects of the public-health movement. ^
I have Girls' Health Clubs established in several of my districts,
and hope before very long to have Boys' Health Clubs established 'as
successfully. My dreams for the future include a real health centre,
where boys and girls and men and women and babies will come to
"play" and learn to be healthy; not come because they are sick, but
come to learn how to keep well; space will not permit of detailed descriptions of my " dream health centre," but in time I hope to achieve my
object. A Public Health Nurse's object and that of a Nursing Service
should be that of promoting public health; not merely the attending of
sick people at so much per visit, but by giving advice privately, and
in public-health talks show them how to keep well so that they won't
require the services of the nurse for sickness, but be glad to pay for her
upkeep in their midst because they recognize their need of her.
I have a splendid committee to work with, one whose motto is
" progress," for which I am very thankful, and who are, one and all,
in absolute sympathy with the movement and who encourage and do not
hinder.
Helen Kelly.
DUNCAN.
Cowichan Lake School Fair.
I had accepted an invitation to attend the School Fair at Cowichan
Lake, our most rural school, about 20 miles from) the Health Centre headquarters, and present the prizes for the Health-book Competition, which
were given by the Provincial Board of Health. Cowichan Lake School
is in the centre of a logging community and most of the children come
from the different camps.
On arrival at the school we found the judges were busy in the
school-house with the exhibits, and sports in progress on the grounds; a
group of about forty parents being accommodated on roughly put-up
benches or on the desks from the school-house.
In the school-house the different exhibits were arranged attractively,
our interest, of 'course, being centred on the " Health Books." Last
February it had been suggested to the teacher that, if she cared to take
the matter up, a prize would be given for the best essay, poster, or book
on any health topic taken up by the School Nurse during the term.
4
 About eighteen books and several posters were sent in competition; some
of them were a great surprise. The majority of the books were illustrated with cut-outs, while some had little pencil or water-colour sketches,
all of them being made to look as much like a book purchased in a shop
as possible. One clever little book on " Milk " had an amiable-looking
cow on the front cover and a very tiny milk-bottle in the centre of the
back cover.
After the sports had been run off and the judges had completed their
task, the pupils put on a little health playlet, in which there was paraded
before a little, pale, thin | City Boy " all the good things he could procure
more easily by living in the country. The children were dressed to look
the part of the article they represented; for instance, " Egg " was a tiny
golden-haired girl, carried in a large basket covered with white crepe
paper. When all the 1 Good Things " were arranged around the little
boy and he was considering their real value, in walked a procession of
his old-time I Enemies," headed by a large § Coffee-pot," and followed
closely by | Pie " and "Candy." It was not very long, however, before
the superior strength of 1 Milk " and his faithful supporters was felt,
the | Enemies " chased afar off, and thin, little 1 City Boy " left to his
new friends.
I. M. Jefpares (Duncan).
Good-health Competitions in Rural Schools.
Realizing that it was possible to arouse interest in health-teaching
in rural schools by way of a good-health competition, We decided to put
on this year a competition among all the rural schools in our district.
The rules of the competition are simple and as follows:—
Between the rural schools visited by the Public Health Nurses from
the Health Centre, Duncan, this year we are going to have the most wonderful competition for the best HEALTH POSTER, HEALTH BOOK,
and for the best ESSAY on any HEALTH TOPIC.
There, arevgoing to be SIX PRIZES offered, as follows:— .
Prize for the BEST POSTER made by a girl.
Prize for the BEST POSTER made by a boy.
Prize for the BEST HEALTH BOOK made by a girl..
Prize for the BEST HEALTH BOOK made by a boy.
Prize for the BEST ESSAY written by a girl.
Prize for the BEST ESSAY written by a boy.
The poster is to illustrate a I Health Talk " given by the nurse.   The
essay may be upon any | Health Topic " taken up by the nurse during the
school term.   The " Health Book " must tell and illustrate the story of
I Good Health."
Special Prizes.—A special prize will be given in each school for the
BEST POSTER,  HEALTH  BOOK,  OR  ESSAY,  the  age and  school
standing of the competitor to be taken into consideration by the judges.
Competition to close May 31st, 1925.
The Provincial Board of Health has kindly offered to see that we
have prizes and we are looking forward to a great many entries.
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 In order to conduct the competition with as little confusion as possible, we drew up the outline of " Health Talks," given below, for the year,
so that all the children will receive the same instruction and have an
equal opportunity to send in the best poster, health book, or essay.
Month. Topic. Story.
Sept Cleanliness, fresh air, and sunshine The Pig Brother.
Oct Proper food and drink The Milk-bottle.
Nov Teeth Old Grouchyman Toothache.
Dec Proper clothing, posture, and exercise..The Crooked Man.
Jan School ventilation and common cold Mary had a Little Cold.
Feb Germ-life—common    cold    and   sore
throat Billy's Pal.
March .The need of green vegetables and fruit,
also neatness and cheerfulness The Two Houses.
April Talk on annual physical examination,
the reason and why defects found
should   be   corrected,   leading   up,
especially with interest to the older
children, to the need of a healthy
race physically, mentally, and morally in Canada.
May Flies, home and school sanitation !.The Diary of the F,ly.
June General   review   and  presentation  of
competition prizes. ;
I. M. Jepfares (Duncan).
PERSONAL ITEMS.
When a nurse is making a change from one district to another, it is
very pleasant to be able to carry away the knowledge that the people of
the district appreciate your work among them, not only professionally,
but from the community standpoint as well. Such must be the knowledge
of Miss Gawley when she looks back on July last, when the people
of the Malakwa District met together to make her a presentation, and to
say I Farewell" to her on the eve of her departure.
*****
Miss Ada Benvie has resigned her position on the staff of the
Cowichan Health Centre, as she finds it is necessary for her to remain
with her mother, who is ill at her home in Nova Scotia.
Miss E. Naden, B.Sc. (Nursing), U.B.C. '24, has been appointed to
Cowichan Health Centre.
*    *    *    *
Miss E. N. Bodenham has left Keremeos for the " Old Country,"
where she expects to remain indefinitely.
6
 CONVENTION NOTES.
During the past summer there have been several conventions held
in the East of interest to Public Health workers, and being fortunate
enough to obtain a copy of notes taken by a Public Health Nurse attending three of the conventions, I thought perhaps some of the other nurses
might enjoy reading'them also, as it is surely interesting for us to have
an idea of what the leaders of our profession are thinking and of the
work that is being carried on elsewhere.
At the Biennial National Nursing Convention held in Detroit in
June, Dr. Lockwood, of the Pasadena Hospital, spoke on " The Role of
the Physician in the Education of the Nurse," after which there was a
very heated discussion, at which it was admitted that more and more the
education of the nurse should be turned over to the nurse. Dr. Lock-
wood said that medical men were too busy to properly prepare their
lectures, and consequently the lectures were often either too advanced
and technical or too elementary to be of much value. He admitted that
many doctors felt that the pupils should receive only such teaching as
they chose to give them, but he felt that the nurses themselves should be
equipped to give most of the teaching, and he felt sure that the doctors
would very soon realize the value of such a step and would be glad to
relinquish the teaching to the nursing profession.
*****'
In giving an address on | Communicable Disease " at a general session, Dr. Chas. Emerson, Dean, Indiana University School of Medicine,
said he thought it was the duty of every Public Health Nurse to teach on
every possible occasion to individuals and to groups the value of serums,
vaccines, and antitoxins as preventive measures against communicable
disease. He also felt that, unless the nurse herself was a firm believer
in all preventive measures, she should not pretend to be teaching preventive medicine as a Public Health Nurse. He felt that a nurse who
could not believe thoroughly and implicitly in preventive measures that
had proved to be successful should find some other line of work.
At the Child Welfare Section of the National Organization of Public
Health Nursing, the general thought of the meeting was that in most
cases too little attention was being paid to the pre:school child. While
realizing that at present the school-child needed a great deal of care and
attention, it was felt that most organizations should lay more stress on
the necessity of allowing more time for work with the preschool, and
that much of the health-teaching in the schools would need to be given
by the teachers, thus leaving the nurse free for more intensive pre-natal
and preschool work.
The question of continued visits to mothers who failed to co-operate
with baby clinics and welfare organizations came in for lengthy discussion, some of the nurses maintaining that after a period of two or
three months such mothers should be dropped and the nurses' time and
energy given to those willing to co-operate.   Finally, however, the meeting
7
 decided that this was not the wisest course, and that the mothers who
would not co-operate were those who were most in need of education,
and that there should be no limit to the time of carrying such patients.
It was also suggested that a change of nurses visiting a particularly non-
co-operative individual might bring about the desired results, as very
few of usin this world can deal satisfactorily with every question.
At another meeting, Dr. Haven Emerson, speaking on 1 Meeting the
Demands for Community Health Work," emphasized the thought that
community health is, after all, primarily an individual problem; that
we must seek to educate people to their responsibilities towards maintaining the health of themselves and their children and of guarding
against communicable disease by the preventive measures that are now
available. When this is done, community health will be cared for to a
great extent by the people themselves. Dr. Emerson felt that this should
be the end towards which we should all strive, to make people realize and
admit their individual responsibility for the health of their community.
Miss Crandall, of the American Child Health Association, took a
view almost opposed to Dr. Emerson, and laid the responsibility for the
community health almost entirely on the State or Federal Government.
She advocated communistic methods of obtaining medical and hospital
aid and of pensions, etc., for old age, sickness, unemployment, etc. She
did not feel that the individual was primarily the one to undertake the
work of raising standards of community health.
Mr. William J. Norton, Secretary of Detroit Community Fund, said
that so often Public Health Nurses and doctors'were so interested and
enthusiastic about their work that very often they failed to realize that
the public at large did not understand clearly just what they were trying
to accomplish with the money they asked for.
He said that we should remember that, after all, it is the lay people
who provide the money, and we should take greater care to see that they
understand just what we are trying to accomplish before we ask for
money, and we should invite their co-operation in the spending of their
money more often than we do.
Dr. Dixon, Director of V.D. Clinics, Detroit, spoke on 1 Milestones
in Progress, of Social Hygiene from a Medical Standpoint." He emphasized the fact that venereal disease can be both cheaply and satisfactorily treated if we can only educate people to the necessity.
He said that in his opinion sex education should be given in the
home, but deplored the fact that so few people have a vocabulary which
is at all adequate for such teaching. Dr. Dixon said he made it a practice
to ask the mothers and fathers who came to him for some considerable
period just what they knew about such matters and what they could
tell their children, and he said very few of them had words which could
be used without embarrassment. Dr. Dixon said he felt it was the duty
of every physician to teach parents in simple dignified English what
 they hand on to their children, and maintained that such teaching could
y never be undertaken until the people were provided with a vocabulary of
simple dignified words.
*    *    *    *    *
Efforts to prevent crime among foreigners should be along lines of
showing them the opportunities the new land has in store rather than
endeavouring to make them forget their own national traditions and
ideas.
The Employment Service in Canada was reviewed by Professor Jackson, Toronto University. In 1923 about 377,000, or about one-eighth of
the working population of Canada, obtained work through this service.
Stabilization of employment by public expenditure was complicated by
the fact that the Federal Government does not consider unemployment
primarily its problem, although willing to help the municipalities to a
certain extent. Up to the present, Professor Jackson said, the method
has been haphazard and in future must be considered on broader lines.
Conference on Social Work, Toronto, June 25th to July 2nd.
At a luncheon of police-women, Mrs. Wooley, of the Merrill-Palmer
School, Detroit, spoke on 1 Pre-delinquency," emphasizing the fact that a
great many of the -lasting impressions are recorded on a child's mind
before the age of 5 years. She is convinced that the seeds which later
bring a harvest of disgrace are sown very early in life and are planted
sometimes by parents, who are not evil-minded but merely injudicious,
and are ignorant of methods of wisely training children. She believes
that back of every crime lies a mistake in training and that the innocent
beginning of many an evil habit lies in mistaken training methods of
parents.
The telling of diplomatic lies was strongly denounced. Many parents
consider it an (easy way of dealing with children, but it is unsafe, particularly in dealing with the ages of 3 and 4, when the imagination is
apt to run riot.
m
Mr. K. C. McLeod, of Edmonton, was the principal speaker at a
meeting when the problem of the underdeveloped child was discussed.
He was of the opinion that the time had come for drastic measures. He
thought that many of the children could be socialized and if put in the
right kind of home could be taught certain routine duties. Those incapable of being taught should, in his opinion, be chloroformed. Mr. McLeod
thought that a country which was already overburdened with taxation
should not be asked to provide expensive institutional care for such
cases. He also maintained that all definitely feeble:minded persons
should be sterilized, thus cutting off at the source the supply of feebleminded children.
Two resolutions were adopted at this meeting:—
(1.) To the effect that the association strongly disapproves of any
newspaper publishing any details of any criminal offence by children
§1111! 9
 before such a time as their cases have been disposed of by the Juvenile
Court; the theory being that the notoriety of any case injures the child
and adds to the possibility of future delinquency.
(2.) To advise the various Provincial Governments that they should
harmonize and co-ordinate as far as possible those branches of the public
service dealing with the supervision and inspection of children in foster
homes, and the inspection conducted by the school, health, and other
organizations, to avoid undue multiplication of expenses.
*****
Dr. Bernstein described the development of the last thirty years in
the care and education of the feeble-minded as carried out by the institution at Rome, N.Y. All of the inmates (as far as possible) are trained
for some manual work. On some of the farms where the boys are taught
they are entirely self-supporting, and the simple environment of the farm
is the best possible for them. Considerable success has been attained in
starting some homes for girls in small cities where they can go out and
perform domestic duties during the day and return to the home at night.
Dr. Chas. Johnson was another speaker at the same meeting. He
deplored the feeling of antagonism which had arisen between many public
and private agencies. He urged all social workers to go back with the
resolve to educate legislators out of the belief that posts of responsibility
in welfare-work should be regarded as
political plums."
At the meeting of the Immigration Session, Dr. Barnes in his address
said the immigrant should be taught English, but should also use their
mother-tongue, and the best customs of their own land should be maintained and blended with our customs.
VICTORIA, B.C.:
Printed by Chakles P.  Banfiebd, Printer to the King's Most Excellent Majesty.
1924.
1M-1024-7638
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