{"@context":{"@language":"en","AggregatedSourceRepository":"http:\/\/www.europeana.eu\/schemas\/edm\/dataProvider","CatalogueRecord":"http:\/\/purl.org\/dc\/terms\/isReferencedBy","Collection":"http:\/\/purl.org\/dc\/terms\/isPartOf","Creator":"http:\/\/purl.org\/dc\/terms\/creator","DateAvailable":"http:\/\/purl.org\/dc\/terms\/issued","DateIssued":"http:\/\/purl.org\/dc\/terms\/issued","DigitalResourceOriginalRecord":"http:\/\/www.europeana.eu\/schemas\/edm\/aggregatedCHO","Extent":"http:\/\/purl.org\/dc\/terms\/extent","FileFormat":"http:\/\/purl.org\/dc\/elements\/1.1\/format","FullText":"http:\/\/www.w3.org\/2009\/08\/skos-reference\/skos.html#note","Genre":"http:\/\/www.europeana.eu\/schemas\/edm\/hasType","Identifier":"http:\/\/purl.org\/dc\/terms\/identifier","IsShownAt":"http:\/\/www.europeana.eu\/schemas\/edm\/isShownAt","Language":"http:\/\/purl.org\/dc\/terms\/language","Provider":"http:\/\/www.europeana.eu\/schemas\/edm\/provider","Publisher":"http:\/\/purl.org\/dc\/terms\/publisher","Rights":"http:\/\/purl.org\/dc\/terms\/rights","SortDate":"http:\/\/purl.org\/dc\/terms\/date","Source":"http:\/\/purl.org\/dc\/terms\/source","Subject":"http:\/\/purl.org\/dc\/terms\/subject","Title":"http:\/\/purl.org\/dc\/terms\/title","Type":"http:\/\/purl.org\/dc\/terms\/type","Translation":"http:\/\/purl.org\/dc\/terms\/description"},"AggregatedSourceRepository":[{"@value":"CONTENTdm","@language":"en"}],"CatalogueRecord":[{"@value":"http:\/\/resolve.library.ubc.ca\/cgi-bin\/catsearch?bid=1191321","@language":"en"}],"Collection":[{"@value":"History of Nursing in Pacific Canada","@language":"en"}],"Creator":[{"@value":"British Columbia. Provincial Board of Health","@language":"en"}],"DateAvailable":[{"@value":"2015-03","@language":"en"}],"DateIssued":[{"@value":"1928-04","@language":"en"}],"DigitalResourceOriginalRecord":[{"@value":"https:\/\/open.library.ubc.ca\/collections\/nursing\/items\/1.0383411\/source.json","@language":"en"}],"Extent":[{"@value":"26 pages : photographs","@language":"en"}],"FileFormat":[{"@value":"application\/pdf","@language":"en"}],"FullText":[{"@value":" ISSUED BY THE\nPROVINCIAL BOARD OF HEALTH, BRITISH COLUMBIA\nPublic Health Nurses' Bulletin\nVol. 1\nAPRIL, 1928.\nNo. 5\nPERHAPS no class of the community has to take into consideration\nthe question of view-point as often as a District Health Nurse, a\nschool-teacher, or a preacher in the rural districts. Not only must they\nreckon with the view-points of those with whom they deal, but they must\nhave a well-balanced view-point of their own.\nThe varying effects of view-point can be illustrated well by experiences of mountain-climbers who laboriously toil up to the summit of a\nmountain range. Behind them is the valley whence they came, before\nthem other landscapes of varying beauty, but all tending to distract\nthe mind from what prevailed in the valley below and to put new hope\ninto the adventurers.\nThe Public Health Nurse often feels discouragement because of surroundings and the vexations which they produce, but, like the mountain-\nclimber, she can climb up from the valley of depression through mental\neffort and from the mountain-tops of self-control see beyond the vexing\nproblems of every-day life to the great goal in the distance.\nIn the daily work of the public-health work there are many dis-\ncouragementSv it is true; but on the other side of the picture there are\nmany signs that her achievements and her efforts are bearing fruit.\nCompare the mental attitude of the public of to-day with that of ten\nyears ago, and surely there is ground for confidence. This change within\nten years justifies us in viewing our goal fifty years hence, which is ah\nAl nation composed of an Al population.\nOn the other hand, an interesting book to read, the company of\ncongenial friends, or indulgence in a meritorious picture display may be\nused as a means of driving away a feeling of discouragement or\nantagonism. With the mind once more poised the District Nurse can go\nforth to her work with a different view-point from which to deal with\nher daily problems of not only sickness but family disorders among those\nwhom she attends.\n FOREWORD.\nTraining Public Health Nurses is a fascinating business, by no means\nyet brought to the point of classical perfection. Nor Avill it ever be\nbrought to that point until public health itself is a finished product.\nThis is equivalent to saying that training Public Health Nurses will\nnever be quite perfect, because public health never will be quite perfect.\nEven approximate perfection in public health is many a long day\u2014years\nat least\u2014centuries probably\u2014ahead of us. Public health depends on\nevery other science, and all sciences are yet imperfect\u2014even mathematics.\nPublic health depends also on human intelligence \u2014 we need hardly\ncomment on its present state.\nBut the above considerations are just those which make public health\nto-day the most fascinating of all big business\u2014because to-day we have\nthe chance to build up, devise, design, direct to some extent at least, the\ndevelopment of public health at its most interesting stage. The heaviest,\nhardest, least organized, least co-ordinated work has, much of it, been\ndone. The building-stones have, many of them, been more or less well\nhacked out; some of them have been more or less well fitted to each other.\nWe may begin to see something of the ultimate thing we are erecting.\nLeaving metaphors, the more we know of public health, the better we\ncan train public-health people in general and Public Health Nurses in\nparticular. Public-health knowledge is every day increasing. Our\ncourses to-day cannot be what they will be ten years from to-day. But\nthe Public Health Nurse graduate of to-day will, ten years from now, have\nhad not merely what training we can give her now, but ten years of that\ntraining which the big world has meantime given her\u2014a training obtained\nnot under university supervision, but under the nurse's own supervision.\nOur training is but' the introduction to the larger and better, if rougher,\ntraining of the real world outside. Our most earnest desire is to so equip\nour graduates here that they will meet, equably and well, this rougher,\nsterner, more exacting training\u2014will see in all their future work, not\njust a job, but a chance for study, for construction, for the pushing\nforward of public health from what it is to what it some day will be.\nObserve, record, study, think out, all that you encounter, whether\nyou are a non-graduate, an undergraduate, or a graduate. This applies\nto real life and to the more or less inaccurate reflections of real life that\nbooks or teachers give. If all of you do this, we need have no fears for\nthe public health of the future.\nDr. H. W. Hill,\nProfessor Public Health Nursing and Bacteriology Director,\nVancouver General Hospital Laboratories.\n TABLE OF CONTENTS.\nPage.\nEditorial.    By Dr. H. E. Young  -  . -     1\nForeword.    By Dr. H. W. Hill...   .     2\nTheory and Practice.    By Frances Lyne . *      5\nProgress in Health-work in Armstrong.    By P. A. Charlton     5\nGreetings from Sayward.    By Edith M. Walls      7\nFirst Impressions of School Nursing\u2014Duncan.    By Margaret A.\nThatcher _   1 1 \\.A      8\nSchool Nursing in Nanaimo.    By Margaret E. Kerr. _     9\nPublic-health Work in Port Alberni.    By Mary E. Grierson....  10\nSchool-work in Vernon.    By Mrs. S. Martin    10\nEsquimalt Rural Nursing Service.    By Helen Kelly    11\nSaanich Health Centre.    By S. Hewerf&on     13\nChild-welfare Work in Saanich.    By N. Higgs  14\nCowichan Health  Centre\u2014Starting  Work  at  Bamberton.    By\nM. Claxton   __   _. 1 15\nPublic-health Work in Qualicum District.    By J. A. Dunbar  16\nDental Clinic in Oliver District.   By Norman R. Carter, D.D.S  17\nPublic Health in Nanaimo.    By A. Verna Beckley.  18\nKeremeos District.    By Kathleen Snowden    | 19\nSchool-work in Fernie.    By Winnifred E. Seymour..  20\nTeaching Public Health in Kamloops.    By Olive M. Garrood  21\nProgress in Rural Public Health Nursing.    By Isabell M. Gibb  23\nCowichan Health  Centre\u2014Notes for the Guidance  of Public\nHealth Nurses.    By Mrs. M. Moss   25\n J5\n1\n1\n THEORY AND PRACTICE.\nNot very long ago I was looking forward to that wonderful event\u2014\ngraduation. I thought of graduation then as the top of the hill. I think\nof it now as the gateway to a vast and interesting land \u2014 practical\nexperience. Fresh from graduation, I was full of theories and ideas and\nburning for an opportunity to apply them. Soon the chance came to\nput them to the test, and then it was that the real and practical difficulties presented themselves\u2014difficulties which the enthusiasm of the student\nhad overlooked.\nThe Public Health Nurse is very much a pioneer and an educator.\nBy patience, perseverence, and repetition she must overcome prejudice,\nignorance, and dread of the unknown. So gradually the startling fact\nthat the Public Health Nurse is at the mercy of the public came home\nto me. The beautiful theories and the splendid new ideas, I realized,\nwere useless without co-operation from the world at large. The importance of making friends became evident. Making friends is an art and\none which it is very hard for some to cultivate. But it is an essential\nin public-health nursing. Just how much can be accomplished by tact\nand friendliness came as a revelation to me. How do a Public Health\nNurse's patients regard her, I wonder. Probably as some one to call on\nin time of sickness, not as some one to instruct them in the prevention of\nsickness. A good deal of diplomacy, therefore, is necessary in the accomplishment of educational work.\nMaking friends, being tactful, co-operating with others, and gaining\ntheir co-operation in return, educating the public how, when, and where\nopportunity presents\u2014these are only a few of the demands made upon\nthe Public Health Nurse. Thus the intricacies of the work unfold themselves and as they do so the interest grows. The thousand-and-one things\nwhich no training-school and no college can teach must be learned in\nthe great school of life\u2014by bitter experience, so to speak. But it is not\nall bitter; there is much sweetness mixed with it, and the whole is\nseasoned with many a good laugh.\nFrances Lyne,\nSaanich Health Centre.\nPROGRESS IN HEALTH-WORK IN ARMSTRONG.\nIn Armstrong we have tried to improve the health of the pupils,\nkeeping in mind that the child's best health is essential to his best\nprogress in school as well as to his best work and fullest enjoyment in\nafter-life.\nAfter two years' school-work one looks for a certain number of results.\nThe evidence of progress is. healthier children. Although: the aerual\nfigures are more than gratifying, we still feel that we have a long w;iy\nto go yet.\nMalnutrition was one of our greatest problems. In September, 1925,\n28.8 per cent, of the pupils were more than 7 per cent, underweight and\n5\nM\n 2 per cent, were over 20 per cent, underweight. All sorts of schemes\nand competitions -were tried to better this grave defect, but finally we\nhave found the serving of milk at 10 a.m. to be the best of all. Straws\nare provided, a fact which seems to make the drinking of milk quite an\ninteresting incident in the day's programme. Children who could not be\npersuaded to drink milk before now drink it, apparently with enjoyment.\nMost of the children bring their own milk, but in some of the needy\ncases it is provided.\nOne little girl who drinks her pint at 10 gained more in the last\nseven months than she did the three preceding years. In one Grade\nIV., after one month's trial of milk at 10, the class average in arithmetic\njumped from 50 to 75 per cent. The average gain per pupil was over\nthree times the normal gain.\nAt noon a hot drink, soup or cocoa, is given to the underweights.\nFor a time drinks were given to all, but as there are over 300 stay to\nlunch, that is quite a problem.\nAt lunch-time the pupils are required to take a certain length of\ntime for eating. This has done away with the. | too quick lunch.\"\nFormerly some of the pupils took less than five minutes for lunch.\nIn the health classes great stress has been put on the well-balanced\nmeal. The children are taught and encouraged to eat a hot cereal breakfast, fruit and vegetables, as well as milk every day.\nAbout sixty of the pupils have been taking cod-liver oil during the\nwinter months.\nAt the end of December, 1927, 8 per cent, of the pupils were more\nthan 7 per cent, underweight.\nProbably our best results have been obtained through the dental\nclinic. In the last two years 270 pupils have received dental treatment\nthrough the clinic. The pupils of the senior grades are almost devoid of\nany dental caries. Two years ago 85 to 90 per cent, needed treatment.\nFully 95 per cent, of all pupils give their teeth daily care.\nDiseased tonsils have been other thorns in our flesh. Whether this\ncommunity is worse than the next for defective throats it is hard to say,\nbut it does seem that there are an incredible number of children with\ndiseased throats. In the last two years seventy-five have had their tonsils\nremoved.\nLast spring we had a tonsil clinic, treating a number of indigent\npupils badly in need of treatment. The cost of the clinic was $175, which\nwe raised by holding several dances. It was a lot of work, but the\nimprovement in these boys and girls has well repaid us. One little chap\nwas becoming very deaf;  now he can hear almost normally.\nIn 1926 we had an eye clinic costing about $86. As there is no oculist\nhere we had one come over from Kamloops. Besides the twenty-one\nexamined at the clinics, thirty others have had glasses fitted. There are\nstill about ten in the school who are very much in need of glasses, but\ntheir parents, although quite able, refuse to stand the expense. They\nseem to think it just a lot of tomfoolery. Educating these people is one\nof our greatest trials.\n There has been a great improvement in the pupils taking the stearo-\ndine tablets. In a great many cases the gland has subsided to the normal\nsize. In one large family in the district all the children have enlarged\nthyroids. The two oldest boys were unable to take.the treatment, but\nthe next three have been greatly benefited, so much, indeed, that the\nmother asked for treatment for the little ones at home.\nThe pupils have made a wonderful effort to improve their own\npersonal cleanliness and the school in general. This is probably due to\nthe fact of a banner being given to the room scoring the greatest number\nof marks each month. The rooms are marked for the floors, desks,\nradiators, blackboards, lobbies, pictures, plants, and pupils. It has made\na wonderful difference in the school. All of the rooms are very attractive.\nThe clean light walls are hung with pictures and athletic trophies. What\na contrast to the drab grey walls decorated with spit-balls of my day:\nThe hearty co-operation of the principal and his staff and the material\naid from the different organizations in the district have been a great help\nin our health programme.\nLook where the dawn is kindling in the Bast,\nBrave with the glory of the better days,\nA countless host, an endless host, all fresh\nWith unstained banners and unsullied shield,\nAnd great young hearts that know not how to fear,\nThe children come to save the weary world.\nP. A. Charlton.\nGREETINGS FROM SAYWARD.\nAnother year has passed since our last Refresher Course, where we\nall met to talk over our little difficulties and troubles. 1927 has been an\nanxious one for some of the residents in the valley. There have been\naccidents and sickness, some of which I have been able to help; others\nI have not.\nThe rnajority of the school-children have been free from any actual\nsickness, with the exception of one who had a very serious operation and\nhas not yet recovered. Two of the children suffering from enlarged tonsils\nhave been operated on, a vast improvement being the result.\nWe were also fortunate in getting the dental services of Dr. Youlden,\nof Victoria, to attend to pre-school and school-children's teeth, which\nservice was very much appreciated by the parents.\nAt the summer closing exercises at the Upper School a little health\nplaylet entitled | The House that Health Built\" was acted by six pupils,\neach bearing a different poster which illustrated the different articles of\nfood which should be eaten every day.\nAt the Christmas concert both schools united and gave a very good\nselection of songs, recitations, and dialogues, which were much enjoyed\nby the audience.\nWith best wishes for success to my fellow-workers,\nEdith M. Walls.\n FIRST IMPRESSIONS OF SCHOOL NURSING\u2014DUNCAN.\nV\nIn the few months' experience that I have had of school nursing it\nhas been borne in upon me very strongly that the success and value of\nthe work depends very largely upon two factors: First, the realization\nof the importance of the work on the part of the teachers and their willing\nco-operation; and, secondly, a full understanding on the part of the\nparents of what it all means and what we are trying to do.\nWhere the nurse is doing generalized work over a large district, it\nis of course impossible for her to visit every class in every school daily.\nAnd yet some sort of daily supervision seems to be necessary if health\nhabits are to be really formed and minor infections kept in check. Here\nthe teacher can help tremendously, not only by keeping the nurse posted\nup to date with names of absentees\u2014so that the cause can be promptly\ninvestigated\u2014but also, by a quick daily inspection, she can do a great\ndeal to encourage cleanliness, and can then take special note of any child\nthat needs to be referred to the nurse. In the primary classes especially,\nthe teacher can do much towards stimulating the interest of the children\nin \"health.\" Some teachers are extremely helpful in these ways, and\nthe result can be noted in their classes. Others do not seem greatly\ninterested. Perhaps they do not consider it a part of their work.\nI wonder how far one is justified in thinking that it should be.\nAnd it is not only in these concrete ways that the nurse needs the\nhelp of the teacher. Their mental attitude towards the work is bound\nto react on their classes. If the teachers think it is important, the\nchildren are more likely to do so; but if, on the other hand, they regard\nthe coming of the nurse for the monthly inspection and health talk as\na somewhat irrelevant interruption that has to be put up with as gracefully as possible, what value are the children likely to attach to it?\nIt seems as if, though personally always friendly, some of the teachers\nare not quite alive to the possibilities of the nursing service, nor to the\nclose relation between physical health and progress in school. But I\nunderstand that more emphasis is being laid on this point in normal\nschools nowadays.\nAs for the parents, their help is essential. Fortunately a great many\ndo seem to understand that we really are interested in their children,\nand are grateful for the help that they know we are qualified to give them.\nOthers\u2014either through blissful ignorance or because they are so busy\u2014\nare hard to rouse to a sense of their children's needs, but the most difficult\nmother to deal with is the one who is so complacently sure that all she\ndoes is right, and that there is no room for improvement either in herself\nor in her family, in spite of much evidence to the contrary.\nWhen parents, teachers, and nurses all wake up to the fact that,\nafter all, we are all working towards a common goal\u2014namely, the\nwelfare of the child in all its aspects\u2014and will agree to all work together,\nwhat wonders will be accomplished. In the meantime, I suppose, education is the watchword, and, at any rate, by teaching the children in the\nschools much may be done for the coming generations.\nMargaret A. Thatcher.\n SCHOOL NURSING IN NANAIMO.\nThe past year has been very encouraging from every point of view.\nParents are more keen on remedying the defects of their children; teachers, more interested in the teaching of health as a regular subject on the\ncurriculum; and the pupils, more ambitious to follow the health teachings\nwe are all expounding to them on every possible occasion.\nRealizing the value of proper nourishment to the school-child, the\nBastion Chapter of the I.O.D.E. has taken up the work of supplying milk\nto the pupils during the morning recess period. The population of\nNanaimo is composed very largely of working-class people. There is a\ntendency to exaggerate the value of such luxuries as automobiles, moving\npictures, etc., among the people. The result is that comparatively few\nchildren have anything like the proper amount of milk daily. Our scheme\nis only in its infancy so far, but it is receiving the cordial co-operation of\nparents, pupils, and teachers. About 25 per cent, of the pupils are taking\nadvantage of the service. It is too soon yet to make any predictions as\nto the bearing this will have on the health of the pupils, but we are\nexpecting real results.\nThe Parent-Teachers' Association has undertaken to support a school\ndental clinic. While we have not made much progress yet, we are hoping\nfor better things. All the energies of every organization in the city have\nbeen turned to the raising of funds to complete the new hospital. This\nhas meant the claims of the dental clinic have had to be held in abeyance.\nIts value, however, is fully realized and already a fund has been estab:\nlished.    We hope the clinic will be properly organized by next year.\nThis year I have been co-operating with the teacher of home economics\nand have given the series of classes to the | Little Mothers \" as part of\nthe routine Grade VIII. work. This has proved a much more satisfactory\narrangement than holding the classes after school. The last half-hour\nof each domestic-science period has been so used. There will be a large\nclass receiving diplomas this time.\nFor-the past four years a system of treatments for common goitres\nhas been carried on in the schools under the direction of the School\nMedical Health Officer, Dr. Drysdale. Careful measurements have been\nmade periodically and results that are both astonishing and gratifying\nhave been obtained.    Only a very few have not shown improvement.\nThe Manual Training Department has erected boards for us in the\nschools. We are using these to display the large health posters supplied\nby the Provincial Board of Health. It is very interesting to note the\nreaction of the pupils to each new display.\nWe have also had a show-case put up in the office in which practical\nexhibits are made. The first one showed the article used in performing\nthe morning toilet.    Others of equal interest are planned.\nSchool nursing has its amusing side too. The following are a few\nof the I howlers \" obtained from exam, papers:\u2014\nPasteurized milk is milk that has been very carefully detached from\ninfectious germs.\nPasteurized milk is canned cream.\nAI\n We have two sets of teeth, temporary and perennial.\nWe breathe in oxygen in the daytime and breathe out carbon dioxide\nat night.\nBefore food can be carried by the blood it must be turned into enamel.\nThe water that comes on our faces when we run is called inspiration.\nMargaret E. Kerr, R.N.\nPUBLIC HEALTH WORK IN PORT ALBERNI.\nTwo months ago public-health work was organized in Port Alberni\nand district. A generalized programme is being established, possibly a\nunique feature being a form of industrial nursing done for two large\nlumber companies, nursing visits being free to all their employees, the\ncompanies paying a substantial sum monthly towards the expenses of\nthe work.\nA home-nursing class is well attended at Great Central Lake, which\nis 14 miles from | The Port,\" where one lumber-mill is situated. Another\nclass is being formed in town.\nThere are five country schools, as well as the town grade school, all\nof which are visited every two weeks at least. A great deal of interest is\nbeing taken in the health crusade by some of the grades. Sample tubes\nof tooth-paste to those having clean hands and teeth in the lower grades\nhave aided in interesting some of the children in cleanliness. The ready\nco-operation of the teachers is of great assistance in that work.\nPrenatal and infant-welfare work is being met with sympathetic\nresponse.    Advice is asked for by phone, as well as in the homes.\nThe executive of the Red Cross Society, who are the committee here,\nare keenly interested in all phases of the health programme, and are\nworking hard to establish a baby clinic in the near future.\nI hope that when the next Bulletin is edited | The Island Western\nCoast Health Centre\" will be able to give a report of work done.\nMary E. Grierson, R.N.\nSCHOOL-WORK IN VERNON.\nThe Vernon Consolidated School District is quite large, making it\nnecessary to use three large trucks to convey children living in the outlying districts to and from school. We have approximately 1,000 children\nin the different schools. There are five school buildings, one of which is\nused entirely for manual-training classes. The School Nurse's office is\nin the largest building and all the other schools can be reached by telephone or by a short walk.\nMy work during school-hours is confined entirely to work in the\nschools, the time being spent in visiting the class-rooms, twenty-five in\nnumber, getting the names of absentees, which is done once a week;\ninspection of classes, each ciass being inspected once a month, attending\nto minor ailments and teaching health to all grades.   Each class receives\n10\n one-half hour instruction weekly, the girls of the first-year high school\nhaving a longer period and instruction on hygiene and home-nursing.\nHaving lived in Vernon for some years, I am fairly well acquainted\nwith the people and am able to inquire by telephone regarding sick\nabsentees. All actual home and follow-up visits are made after school,\nunless it is an urgent case; any extra time is spent making social service\nand child-welfare visits. There are four excellent medical men in Vernon\nand an exceptionally up-to-date general hospital, which is also a training-\nschool. I am in close touch with the medical men and the hospital staff,\nespecially during a threatened epidemic.\nIn blocking out the year's outline for the health-teaching in the\ndifferent classes, I use the | Course of Study \" as a guide, enlarging on\ncertain subjects each month so that as much as possible can be covered\nin the school-year. ~ The teacher is always present during these talks and\ntakes up that particular subject with his or her class some time later\non in the week. Health posters are made on all the important subjects,\nand practically all the teachers have such posters on their class-room\nwalls. Certain rules are given with each lesson and project-work is also\ndone bj way of health-books. In the junior rooms health-teaching is\naccomplished mostly in story form.\nDuring February of this year we had a Safety-first Week, and a\ncompetition was held in every class-room for the most original health\nposter.\nMay Day\u2014a part of the regular May Day school parade is the health\nparade, and in 1926 we were fortunate enough to receive first prize for\nour Red Cross car; the illustration does not show the health banner\nat the back of the car, and only a part of the health brigade, which was\nmade up of boys on decorated bicycles.\nA great improvement has been made in the Vernon schools since the\nevent of the School Health Nurse, my.predecessors having done the hard\npioneer-work; still there is a great deal to be done. \" Rome was not\nbuilt in a'day,\" and we are hoping for better results each year.\n(Mrs.) S. Martin.\nESQUIMALT RURAL NURSING SERVICE.\nAs one looks back a few years to the time when public health was\nfirst put into practice in the Province in the form of Public Health\nNursing Centres or Services, one cannot but be impressed with the almost\nphenomenal growth and development that has taken place.\nTo quote Dr. Young, Provincial Health Officer's own words in his\nopening renfa^ks in the 1926 Bulletin, | Progress and improvement are\nproven by the evidence of actual accomplishments.\" Years of hard work\nput in by the Public Health Nurses in the field, the man at the head,\nDr. Young, and the organizers of Public Health Services are beginning\nto bear fruit.    This is evidenced by the fact that the public are now eager\n11\n for knowledge in respect of health matters, and a much greater enthusiasm\nis shown atnong the people in this community and those other communities\nfortunate enough to have a Public Health Service organized.\nAlsOj the enthusiasm is spreading. Neighbouring communities are\nseeing the value of a Public Health Service, and our own association is\nin receipt of communications from neighbouring districts asking for information regarding the process of organization.\nDuring the past year I have conducted a course of twelve lessons\nin home-nursing for the Sooke and Otter Point Women's Institutes,\njointly, and the ladies who attended the classes took keen interest in\nthem, preparing excellent papers for the final class. Good work can be\ndone along these lines.\nIt is almost impossible to enumerate the many phases that come\nunder the heading of public health. The problems are many and varied.\nIn our own association during the past year we have taken up the question\nof sanitation of much-frequented public beaches; dangerous corners in\nthe roads in the locality; and the question of grants in respect of dental\nwork in the schools; in the hope that our endeavours will lead to\nimprovements in the near future.\nIn addition to our dental work among the school-children, which we\ncarry on continuously, children requiring treatment being taken in to\nVictoria to the dentist on any Saturday morning (we continue to hold\ntwo full examinations of all children attending school during the year),\nwe are extending our clinic-work this year to include monthly pre-school\nclinics, where mothers may bring their children to be examined by a\nphysician and receive advice regarding the correction of any physical\ndefects and bad habits.\nLast year, on May Day, we celebrated our first annual Child Health\nDay in the form of a health pageant. The Women's Institutes co-operated\nand some excellent floats were entered by the different institutes and\nBoards of School Trustees and the pageant opened with a health parade.\nFloats representing fresh air, out-of-doors, the foundations of health, the\nQueen of Health, etc., and gaily decorated cars, fell into line; and practically every one in the district turned out to witness this first annual Child\nHealth Day. The Maypole dance and other pretty folk-dances, health\nplays and exercises, sports, etc., were all enjoyed during the afternoon,\nand the only refreshments served were bottles of milk, which had previously been arranged in a milk display, and ice-cream and biscuits. In\nthe evening addresses were given at a crowded meeting by Drs. H. E.\nYoung, Irene Bastow Hudson, and David Donald, and some splendid\nhealth films were shown. Prizes were given by the association and other\ninterested people for the best health posters done by the school-children,\nwhich were all on display in the hall, and a silver cup was presented by\nR. I. Van der Byl, an ex-president of the association, as a challenge\ntrophy for the annual sports. Another cup has been promised for this\nyear. We would like to see May Day celebrated all over the Province\nas Child Health Day, and the day given up to a review of the health-work\ndone during the year among the children.\n12\n This year we shall again celebrate May Day, but in some different\nform to keep up the interest. The committee is trying to think up some\nscheme whereby it can raise some money wherewith to provide some\nsimple equipment to encourage health-giving playtime sports and exercises\nin the schools or school-grounds.\nAs each, year I am called upon to submit an article for the Bulletin;\nso each year I find an increasing difficulty in preparing an article for\npublication; not because there is less to report or write about, but\nbecause there is so much, and only a limited amount of space for each\narticle. To record all that we have done, all that we have tried to do,\nand all that we hope to do would require the whole of the Bulletin for\nourselves, which would not answer the purpose of the publication. We\nall like to read what the other public-health workers are doing and to\nlearn something from them. I will therefore content myself with concluding my effort this year with, a summary of what, from my long experience,\nI consider are a few of the very necessary and important factors in the\nsuccessful organization of a Public Health Service.\nFirst of all, service must be the keynote. Service in all things\u2014not\nmerely in nursing. A nurse in the public-health field must be prepared\nto co-operate in all things; she must be prepared to respond to any call\nupon her time; to enter into the social life of the community; to accept\ncriticism with the same grace as she would accept praise; be professional\nand ethical; make herself the parents' and children's confidante, and\nteach the doctrine of health at all times. A large order, you say ? True!\nbut not impossible. Then the committee of management must be composed of men and women who are prepared to give up a good deal of\ntheir time and talents; who have a broad outlook on life and things in\ngeneral; business-like men and women, who are keenly interested in\nthe work; who want progress and strive for it. Another important\nfactor is to obtain the co-operation of the Women's Institutes of the\ndistrict^the Boards of School Trustees, and the teachers. In conclusion,\nI am glad\\ to say that the Women's Institutes in my district co-operate\nto the full, as also do the Boards of School Trustees and the teachers;\nalso we are fortunate in having the co-operation of the Farmers' Institute.\nI have a splendid committee to work with and have no fears for the future\nof the Esquimalt Rural Nursing Service.\nHelen Kelly, R.N.\nIll\nSAANICH HEALTH CENTRE.\nThe Saanich Health Centre has seen numerous changes this last\ntwelve months. In August Dr. Berman, D.P.H., was appointed as full-\ntime Medical Officer of Health for Saanich, supervising all public-health\nwork for the municipality from the Health Centre. This is not only an\nadvantage to the public, but also to the nurses who are doing public-\nhealth work.\nMrs. Lucas, Nurse Superintendent, who, after her five years' strenuous\nwork at Saanich, resigned in October to take up public-health nursing in\nthe University.\n13\nII\n Through the School Nurse residing at the Health Centre, the generalized public-health nursing programme, which was disrupted two years\nago, has now been resumed. This spares much overlapping of work and\nunnecessary waste of time.\nThe enclosed photograph was taken in one of the Saanich schools\nof Dr. Berman, D.P.H., immunizing children of all ages against diphtheria\nwith toxoid.\nS. Hewertson, R.N.,\nNurse in Charge, Saanich Health Centre.\nimmunization for diphtheria, saanich health centre.\nCHILD-WELFARE WORK IN SAANICH.\nThe aim of all public-health nursing is education. One does not see\nthe result of educational work at once. In many branches of the work\none has to wait for several months or perhaps years before definite\nprogress is evident. It is difficult to arouse or to maintain a keen interest\nin work that does not give apparent results.\nChild-welfare and infant-welfare is a most absorbing branch of public-\nhealth nursing. Following the prenatal work it is the most important.\nConservation of infant-life is not sufficient. Promotion of health by\ncorrect routine and feeding minimize the percentage of defects discovered,\nfrequently too late, during the school-life or later life of the individual.\nThe results of infant-welfare work are apparent from the first visit.\nA list of the births in the district may be obtained monthly from the\nDistrict Registrar. Before the infant is a month old the first visit is\nmade. The entrance into a home is comparatively simple, when one\nwishes* to see the | new baby.\" After the first visit the visits should be\na monthly occurrence. It is rarely possible to visit at intervals of a\nmonth to the day.    How frequently, if six weeks have elapsed since the\n14\n last visit, we hear, \" Why, nurse, I thought you were not going to come\nany more. It is so long since you were here.\" After the first year the\nvisits are of necessity less frequent. The infant develops less rapidly and\nthe diet is more constant.\n, The ideal is to have these infants report monthly at the infant clinics.\nThe clinics are held at set times in central parts of the district. The\ninfants are weighed and measured and any advice on routine or feeding\nmay be obtained.\nPerhaps the greatest aid to the Public Health Nurse on infant-welfare\nwork is the literature. The feeding-cards supplied by the Provincial\nHealth Department are most useful. The mothers welcome all reading\nmaterial relating to the care of their baby. Very attractive pamphlets\non the care of the child are supplied also by the Metropolitan Insurance\nCompany.\nN. Higgs, R.N.\nCOWICHAN HEALTH CENTRE\u2014STARTING WORK AT\nBAMBERTON.\nThat the public is waking up to the advantages of health supervision\nfor children, not only during their school-life, but also in early childhood\nand infancy, was demonstrated recently to us bv Bamberton, the home\nof the B.C. Cement Company, Limited.\nBamberton is a compact little community of cement-workers attached\nto the factory, which can be seen close to the water's edge as one crosses\non the ferry from Mill Bay to Brentwood. Things are evidently run on\nprogressive lines there. All sorts of devices for prevention of fire and\naccidents can be seen about, and | safety-first \" posters and notices. They\nhave a very good community hall in the village and there is a pleasant\natmosphere of good-will and friendliness about the whole place.\nA short time ago we received a letter from the Secretary of the School\nBoard asking us if we could undertake a regular monthly inspection of\ntheir school-children at a certain rate per head per annum. But the\nsignificant part of the letter lay in the fact that they were most anxious\nthat all the children in the village should be included in this scheme.\nThey realized the importance of health supervision from babyhood.\nShortly afterwards I went down to talk things over with the Secretary, and drawing near to Bamberton I was struck by the thick coating\nof white dust that covers everything. They say that plants and gardens\nthrive wonderfully there, in spite of the dust, but we are wondering\nwhat effect it has on the children.\nI found the Secretary keenly interested in hearing all about the\nPublic Health Nursing Service, and he felt that greater co-operation\nwould be secured if the parents could also hear of the work at first hand.\nSo it was arranged that Dr. Stanier and myself should go down one\nevening and meet the people and tell them all they wanted to know.\nWhen the evening came the community turned out in full force\u2014fathers\nand mothers, and consequently children too.\n15\n Besides the | talks,\" a musical programme had been arranged, and\nafterwards while refreshments were being served we had the opportunity\nof meeting the parents individually. They were most interested and\nanxious that the work should be started at once. So two days later we\ngave the school-children their first monthly inspection, and followed it\nup with visits in the homes, where we found the mothers most responsive.\nNext week the doctor will examine the school-children in the morning\nand hold a preschool child clinic in the afternoon. We feel very grateful\nto the Secretary of the School Board, who by his keenness and helpfulness\nin every way has done so much to put the work on a satisfactory footing.\nWe are also lucky in having a school-teacher who realizes the close connection between the health of the children and their progress in school.\nAll nurses engaged in public-health work will realize what a splendid\nopportunity such co-operation affords, and we hope that Ave shall be able\nto make the most of it and demonstrate to the public that such service\nis of real value. m   _\nM. Claxton,\nDuncan.\nPUBLIC-HEALTH WORK IN QUALICUM DISTRICT.\nGeneralized public-health nursing in a rural district is vastly different\nfrom public-health nursing in the city or town, where everything is modern\nand convenient. This is my first experience in an entirely rural district\nand it has taken me some time to get accustomed to my new environment.\nHaving been in the district since September last, I have experienced only\nthe worst months of the year, which were bad as the winter has been an\nexceptionally hard one. As I look back on the daily troubles encountered\non snow-blocked roads in an old Ford roadster, never knowing the minute\nthe car would be sent skidding into the ditch or over tree-roots into the\nbush, I heave a sigh of relief when I realize that the winter is over and\nthere is the bright spring and summer months to look forward to.\nIn rural public-health nursing the nurse's duties are very varied;\nthere is the educational side in the schools, in the homes with the preschool and infant-welfare visits, as well as the bedside-nursing in the\nhome in the bush; there the change is startling to a nurse who has always\nbeen used to city conveniences, her resources sometimes being taxed to\nthe utmost to cope with the various conditions. I am often amazed to\nsee how wonderfully well things are utilized to meet the necessary requirements in these places and the amount of labour it necessitates. Children\nthink nothing of walking miles to the nearest store, and water has sometimes to be carried long distances; even then one wonders if it is fit\nfor use, always having to boil it before use.\nWork among the children is very interesting and encouraging, especially as I find the teachers assist greatly in their co-operation with the\nnurse, especially so perhaps in the junior grades, where the interest shown\nby the children is excellent.\nThe older girls had a Little Mothers' League last year, and this year\nwe are taking up home-nursing, covering roughly the principal bones of\n16\n the body, digestion, circulation, and now we have reached home-nursing\ncare, the making of poultices, etc. The classes are held every Thursday\nat 3.45 p.m. in the school in the most central district, pupils coming from\nthe other districts. As some of the girls have quite a distance to walk\nI always try and pick some of them up with the car, but on more than\none occasion they have walked all the way. I try also to take them\nhome, though it necessitates several trips; this is not so irksome now as\nI have the pleasure of a new Ford coupe, fate having been kind in allowing the old one, which has long ago seen its best days, to be burnt along\nwith a number of other cars in the garage.\nOur greatest difficulty is in getting the children's defects corrected,\nespecially tonsils and teeth, as we are at least 30 miles from the nearest\nhospital or dentist. It is increasingly evident, even in rural districts,\nthe marked interest shown in matters of health, and one has countless\nopportunities in the every-day contact with individuals to give helpful\ninformation, and often have the satisfaction of seeing it carried out.\nJ. A. Dunbar.\nDENTAL CLINIC IN OLIVER DISTRICT.\nDuring autumn of 1927, at the invitation of Dr. G. H. Kearney,\nresident physician at Oliver, I visited the district professionally. Finding that he had solicited this primarily with the school-children in mind,\nwe got in touch with Dr. H. E. Young, the Provincial Health Officer, and\nasked if a regular school clinic could be arranged.\nExperience shows that it takes much time and correspondence to\nprepare such a clinic. So, Dr. Young advised an immediate examination\nof the school-children; that the regular notification cards be sent to\nparents where required; that the teachers be urged to co-operate; and\nthat, where the sole reason children could not have necessary work done\nwas due to financial circumstances, his Department would aid.\nThe examinations were very happy visitations indeed. Dr. Kearney\nis a great favourite with the children. He knew each child personally,\nand as he did all the filling-in of the parents' cards, his presence acted\nas a very confidence-inspiring introduction.\nFive schools were attended. We had dentrifice literature and samples\nto distribute. Some of the former, very attractive, in the form of fairy\nstories, primers, etc., teaching the message of clean teeth in a very interesting way to the little folks.\nAs each individual was examined we had, watching us, a group of\ntwo or more classmates. We showed appropriate elation over and\nappreciation of the clean healthy mouth, and sympathetic regret where\na neglected or diseased condition was manifest. The children were very\nresponsive, anuvwe got over this lesson of oral cleanliness in a very\neffective manner.\nThe children were found to be in better than ordinary condition;\nof the 122 examined, 60 per cent, required services however, most of the\nwork being in the neglected mouths of about 5 per cent, of them.\n17\nM\n Many parents and all the teachers were enthusiastically assistant,\nand as fast as the parents' cards were signed to show that we had their\nassent, appointments were made for the children and their dental deficiencies cared for. They were invariably appreciative, and considerate and\nnearly all a pleasure to work for.\nFifty-eight pupils were attended; five others reported having been\nto their own dentists; and nine others their intention of doing likewise,\nlater.\nAnd, best record of all, in nearly all cases the parents paid promptly\nthe whole sum marked on the card as the cost of the work; in fact, only\nnine individuals asked to take advantage of the Department's aid.\nSo the children of Oliver District are in the enviable condition of\nhaving the entrance to their bodies in a state of health nearly 90 per cent,\nreasonably perfect.\nThanks, then, to the Provincial Department of Health that made\nthis possible, and to the physician, and citizens of Oliver District who\nresponded so thoroughly to the opportunity.\nNorman R. Carter, D.D.S.\nPUBLIC HEALTH IN NANAIMO.\nIt is only three months since being assigned to Nanaimo, so probably\nmy perspective of the district is a little warped. But from observation\nand actual experience in this brief time, the Public Health Nursing\nService appears to be specializing in obstetrical work, a one-sided programme indeed. Doubtless we are receiving many of the cases due to\nthe hospital here being closed. With the nearest hospital 20 miles distant\nand filled to capacity at all times, our doctors are working at a great\ndisadvantage, and were it not for the superhuman efforts put forth by\nsome of the leading physicians the mortality of the prospective mothers\nwould be deplorable. As it is, the life of the infant is the price paid in\nmany instances, and this, I feel sure, would be lessened were the hospital\nin operation.\nOur well-baby clinic flourishes. Every week sees new babies initiated\ninto the game of health, and when a mother brings in her second baby,\nonly 18 days old, to be enrolled in the same clinic that helped her with\nher first baby, we feel that our first labours were not in vain. And so\nprogress is being recorded in one phase, if not another, of our health\nprogramme.\nAt no time has it been necessary to make a diligent search for cases,\nphysicians, insurance agents, and other welfare agents all showing the\nspirit of real service in their co-operation. Work is plentiful, so plentiful\nit is bewildering at times.\nPrimarily, it is the needs of the people that must helmet, and only\nin carrying out a well-balanced programme can this be made possible.\nTo enable us to attain our goal may we be granted an increase in staff,\nand that right early!\nA. Verna Beckley, P.H.N.\nIS\n KEREMEOS DISTRICT.\nKeremeos is a little town which is hardly on the map as yet, but it\nprovides plenty of interesting experiences for its Public Health Nurse.\nThe district yvhich the nurse covers is by no means large in area. It\nconsists of the two school districts of Keremeos and Cawston and is about\n15 miles in length and 5 miles wide. Just a rather small but fertile\nvalley along the Similkameen River. To the east there is nothing except\na few ranches and an Indian reserve. West, more Indians and about\n20 miles up the river a fair-sized mine. North Olalla, which was once\none of those mad little mining towns one reads about, but is now a tumbledown collection of huts occupied by half-breeds. This, fortunately for\nthe nurse, is not in her district, but still she is expected to answer\nemergency calls here and also from any of the ranches within reasonable\ndistance.\nA train comes in and out three times a week, usually half a coach\nand two trucks, and a stage runs in from Penticton on alternate days.\nThere are only about 500 inhabitants in the valley, and financially things\nare in a bad way, as is the case in most fruit districts at the present time.\nIn spite of this, however, the people are very keen where the children\nare concerned, anxious to co-operate as far as possible, and in spite of\nthe very large percentage of defects the children, taken as a whole,\nrepresent the cleanest and healthiest little flock it has been my privilege\nto work amongst. There has not been one case of communicable disease\nwithin the last nine months, with the exception of our ever-present friend,\nthe common cold.\nThe nurse is thrown very much on her own resources. Princeton\nis 45 miles away, but connected by rail or road. Penticton is 30 miles\nby road, but at times the roads are almost impassable. During the last\nwinter there were a few days when the store-shelves were looking very\nsorry. It was during this time that the town's pet bootlegger became\nseriously ill. A slide had blocked the railway and the roads were\nimpassable. However, the phone was still working and the doctors were\nkindness itself in giving advice. We pulled him through and the town\ngave a mighty sigh of relief.\nLater I was not so fortunate, had to keep a serious case over from\nSunday afternoon until Monday morning. He died just before the train\nreached Princeton as the result of strangulated hernia. I knew when\nI was called that his only hope lay in immediate operation, but it was\nimpossible for the doctors to get in or for me to get him out.   \u2022\nRecently the liquor store opened and we had action almost immediately. I was quite alone in my little cottage one night when I was\nawakened about 2 a.m. by a loud knocking and a happy but slightly\ninebriate voice talking to my cat. I slipped on my dressing-gown and\nopened the doof^and two very tough-looking individuals came pushing in.\nThey seemed slightly offended at my hesitation in producing a light and\nproceeded to tell a very long tale about a quarrel. I left them talking\nand went out to look in the car, and found a young breed very badly\nstabbed and almost pulseless from haemorrhage.    The young dentist is\n19\n my right-hand man in trouble, so I ran down the street and threw pebbles\nat his window. 'He came and gave me help and courage. Fetched the\ntelephone-girl to connect the phone, notified the police, and telephoned\nPenticton for a doctor. The doctor, arriving at 7 a.m., found that one\nthrust had penetrated the lung, only missing the heart by an inch. They\nsutured and made him safe to move, and I turned my car into an ambulance and took him to hospital\u2014a three-hour drive.\nSince that time I have again had to turn my car into an ambulance,\narriving home on Monday morning at 5.50 a.m. These trips usually mean\nhaving to dig out of at least one snow-bank. It is never safe to journey\nwithout a shovel. My car and I have braved some very treacherous\nroads, sometimes seeming almost reckless in the attempt, but we are so\nfar from medical aid and the doctors find the trip so difficult that, when\nit is at all possible, serious cases must be sent to hospital either by train\nto Princeton or in my car to Penticton.\nA word about the Car. It is a Tudor Ford. The front seat folds\ndown and with an apple-box, plenty of cushions, and a cot mattress a most\ncomfortable bed, on which even an adult may lie at full length, can be\nmade. This is a wonderful advantage and makes the journey more comfortable and safer for the patient.\nKathleen Snowdon, R.N.\nSCHOOL-WORK IN FERNIE.\nI have been but a very short time in Fernie as School Nurse, having\ncome here at the commencement of the present term. Since taking up\nmy work I must say that I have had the most wonderful help and co-operation from the principal and staff. I am not taking all the credit to\nmyself, but imagine that it came about largely owing to the fact that\nI happened to arrive just at the psychological moment.\nThere had been no nurse here since the previous June, and when I\ncame the district was in the throes of a scarlet-fever epidemic, so there\nwas plenty of work to be done. The epidemic, I am glad to say, is very\nmild and is now well under control, but it gave me a wonderful opportunity for making the \" home contact.\"\nThere are a great many foreigners in this district and many of the\nchildren suffer from malnourishment, but I find them much more teachable than a majority of the white people.\nIn the matter of nutrition-teaching I am very fortunate in having the\nco-operation of the domestic-science mistress, and we are hoping to put\non a joint demonstration in either March or April.\nI have a comfortable and well-equipped office in the central school\nand the School Board does not refuse any request for further supplies.\nI feel that there are infinite possibilities for the work here in Fernie\nand am proud of having been given the opportunity to help.\nWinnifred E. Seymour, R.N.\n20-\n TEACHING PUBLIC HEALTH IN KAMLOOPS.\nHealth, wealth, and happiness\u2014what happy, wholesome thoughts\nthese three words convey to the mind! We all want these things. We\ncan all have them. Why, then, do we not possess what God has meant\nus to have?\nThe reason is this: Because we do not obey the laws of nature, which,\nare God's laws.   These gifts are our own birthright and inheritance.   Yet\nhow many of us possess these gifts?    The more one does school-work,\nthe more one realizes the great necessity of educating the parents as well\nas the children along the lines of natural laws of health.\nIt was certainly surprising to find in October last that out of 848\nchildren attending school 30.4 per cent, were 5 lb. or more underweight\nfor their age and height. This percentage has now been greatly reduced.\nWhen examining teeth and tonsils a large percentage of children were\nfound with soft crumbling teeth, malformation of the jaws, and enlarged\ndecayed tonsils. Parents ask me why should they pay such large dental\nbills. This question, as well as a great many others that parents ask me,\ncan be answered in two words^\u2014unbalanced diet, which has usuall}* existed\nfrom birth.\nThe importance of breast-feeding the baby for the first nine months\ncannot be overestimated. Why will not mothers learn more from our\nanimals of the fields ? In many Cases these animals act superior in their\nwisdom to ourselves in our so-called civilization and progress. The sooner\nthat mothers, who are the architects of humanity, realize their grave\nresponsibilities to our future generations, the sooner we shall be able\nto build a healthier, happier nation.\nIt is amazing to see the number of babies that are not breast-fed as\nnature intended them to be. They are weaned at the slighest excuse and\nput on cow's milk and water, which mixture is not even balanced to the\nright percentages to correspond with mother's milk. It is in these\nmixtures that we find such very high percentages of protein, in many\ncases up to from 2 to 3.5 per cent. I am sure that had nature intended\nhuman babies to have that percentage of protein it would have been\nprovided in mother's milk.    Note the following tested comparisons:\u2014\nSugar. Fat. Protein.\nMother's milk _     7.0 3.5 1.5\nCow's milk .._.    5.0 3.5 3.5\nBalanced humanized milk     6.9 3.5 1.5\nUnbalanced   cow's   milk   with\nwater and sugar added     8.6 2.0 2.5\nIt is Sir Truby King, of New Zealand, who has reduced the infant\nmortality in that country to be the lowest in the world. I am often asked\nhow he achieved this. He did it by proving that breast-feeding is the\nreally natural nielhod of feeding for a baby, and this point is the fundamental principle of his success. He has devoted twenty years of his life\nto this one great study for humanity's sake. His motto is, 1 It is wiser\nto erect a fence at the top of a precipice than to maintain an ambulance\nbelow.\",\n21\n The mothers are taught how to re-establish the milk-supply. This is\ndone by the simple method of bathing the breasts with hot and cold water\nalternately, massaging daily, and stripping them after each feed, and\nregular three hourly to four hourly feedings; no feed between 10 p.m.\nand 6 a.m. Then the babies are weaned at 9 months and are given\nhumanized milk until they are 12 to 13 months of age. The mixtures\nfor this humanized milk have been worked out scientifically to be exactly\nthe same as mother's milk. That is why it is called | humanized milk.\"\nThe protein, of course, is increased according to the babies' ages; cereals\nand fruit-juices are also added to the diet.\nYet in spite of the research-work done by Sir Truby King, and the\nscientific mixtures prepared by him, one so often finds babies fed on\nmixtures which are absolutely unbalanced, such as:\u2014\nSugar. Fat. Protein.\nUnbalanced diet     8.6 2.0 2.5\nHumanized milk I _.     6.9 3.5 1.5\nHuman milk     7.0 3.5 1.5\nMany babies are even given whole cow's milk at the age of 9 months.\nFollowing are the latest statistics, which are well worth reading carefully :\u2014\nDeaths from infant diarrhoea (under 2 years) per 1,000 births\u2014\nPer Cent.\nNew Zealand |    2.25\nDunedin (home of Plunkett system)      0.8\nNo deaths in last two years,\nAustralia  18.0\nGreat Britain    15.0\nCanada ....  24.0\nVancouver I     3.5\nUnited States  ...... j    15.0\nNew Zealand, 1907 _ 1     9.0\nNew Zealand, 1926        2.5\nInfant mortality (under 1 year) per 1,000 live births\u2014\nNew Zealand || j 1    39.8\nCanada    - 78.0\nBritish Columbia . . -  58.4\nVancouver (1925)   __  44.0\nUnited States       77.0\nGreat Britain \\ \u2014 |  75.0\nAustralia ,; | 57.0\nNew Zealand, 1907 _  ... 88.8\nNew Zealand, 1926     39.8\nOne can only realize that the principle underlying these figures is\nthat of wrong feeding. It seems to me that this high rate of infant\nmortality cannot be reduced until natural methods of feeding are both\nadvocated and established world-wide.\n22\n Great success has always been found in humanized milk when a baby\nhas been weaned at an early age. It is not only in the infant and the\npre-school child that we see the result of wrong feeding. I can only make\nthe same deduction as I daily examine the school-children. Many of\nthese children are underweight for several reasons, lack of sufficient rest,\netc., but principally from years of unbalanced diet. It is the same old\nstory\u2014too much sugar, too little fat, and too much protein. For this\nreason I advise much cod-liver oil, not as a medicine but as a food which\nwill raise the fat percentage. The high percentage of sugar which\nchildren obtain is due to candy, white bread, cakes, polished rice, too\nmany potatoes, white flour, etc. It is amazing to find I the number of\nchildren and adults who do not like whole-wheat bread, eggs, milk, nuts,\ncheese, vegetables, fruit, etc. All of these are nature's protections from\nsickness and disease; But where the value of these foods has been\nrecognized we have had wonderful results with underweight children.\nThe children themselves are so keen on gaining and I find they have\nsplendid co-operation with their parents. They really are getting more\nof these natural products of the soil, and now we are getting results.\nOne little girl gained 5 lb. in two weeks and has been gaining steadily ever\nsince. Another child, a boy of 13 years, gained 8 lb. in two months.\nTheir teachers tell me these children are improving in their school-work.\nI have started giving weekly health talks to the high-school girls.\nLater we will form Little Mothers' League classes. Home-visiting has\nbecome a great pleasure as one receives such a warm welcome from the\nmothers. I have also started evening health lectures for parents and\nadults at the high school. These are held twice a month and are well\nattended and a great joy to us all. They are really get-together meetings\nfor people who are interested in the welfare of the child, our nation's\ngreatest asset. How many of us realize that our strength as a nation\ndepends on our moulding and building of these children? The children\nof to-day are our future generation. Surely we need healthy, happy\ncitizens to carry on the progress of our Canada.\nOlive M. Garrood, R.N.\nPROGRESS IN RURAL PUBLIC HEALTH NURSING.\nProgress in public-health nursing is not noticeable from day to day,\nnor yet from month to month, but there is growth and it can be measured\nwith the years.\nThe foregoing is brought home to me when I look back over the last\nfour years, which, with the exception of the last few months, I spent at\nthe Cowichan Health Centre. On my arrival I found the nursing staff\nto be two nurses domiciled at a very second-rate hotel, though the charge\nmade should have been sufficient, in my opinion, for comfort at least.\nWell do I remember the staff nurse and myself starting out to look for\nrooms. We made a canvass, almost house to house, finally locating a\nkind-hearted woman who had two empty rooms over her shop and who\n23\n was prevailed upon to permit us to furnish the rooms and become her\ntenants. Some six months later we moved into a steam-heated apartment\nblock, which was newly constructed in a business section of the town,\nand a little over a year ago the move was made into a large house on the\nmain road, which is now the home of the Health Centre. The office during\nthis time has been on the second flood of a store building, it being possible\nto make arrangements to have the telephone answered when the nurse was\nout in the field. The move into a building of our own was to my mind\nthe most progressive step made; not only did it link all our activities\nunder one roof, doing away with the difficulty of procuring adequate\nboarding accommodation, but the effect on the public was interesting;\nthe Cowichan Health Centre became a real part of the community life,\nand I think always will be.\nThe different activities of the Health Centre have grown tremendously, and at sometimes unexpected angles; as, for instance, a Women's\nInstitute group last year asked if they might be given instruction in home-\nnursing, their request being followed by similar ones from three other\nWomen's Institutes in the district. What better opportunity is there for\nhealth-teaching than to such a group meeting for at least twelve classes.\nThe staff was increased and a second car deemed necessary in order to\nmeet the increased demand made on all branches of the service.\nCan this progress be accomplished by the nurses alone? Indeed no;\na whole-hearted effort on their part is most certainly necessary, and yet\nwe seldom pause to consider how7 little can be accomplished without the\ninterest and support of the community as a whole. In public-health\nnursing we feel that we cannot accomplish very much without the co-operation (a wonderful word, which should mean the working together for the\ncommon good) of the mothers, the children, and, in our school-work, the\nteachers. We ask them to co-operate with us in what we consider to\nbe the best interests of themselves and their children, and yet at the\nsame time do we make any great effort to co-operate with them? In\norder to get the best results we must make an effort to see each other's\npoint of view. We who have been teaching the benefits of public health\nfor years jump to the conclusion that because parents and teachers are\nnot interested at once in what wre know to be for their benefit they are\nunwilling to work with us. If, however, we proceed very slowly and\nendeavour to acquaint them with what to us is very natural and necessary\nknowledge, we will in time have results that are encouraging and often\nfar-reaching.\nI think we often take ourselves too seriously, more especially the\nnurse working alone in her district. She is very often apt to become\ndiscouraged, as progress to her seems very slow, forgetting that after all\nshe is just a part of the organization, and what may seem to her very\nlittle advancement in her particular field added to the progress made in\nsimilar districts all over the Province can be viewed as very splendid\nprogress indeed, the credit not being due to any one individual, but to\nthe staff as a whole.\nISABELL   M.   GlBB,\nDuncan.\n24\n COWICHAN HEALTH CENTRE.\nThe accompanying I Notes for the Guidance of Public Health\nNurses \" were written, on request of the Provincial Board of Health, by\nMrs. M. Moss, President of the Public Health Committee in charge of\nthe Cowichan Health Centre.\nThe success of the work as carried out in Cowichan under the guidance of the local Health Committee has been very gratifying, and it was\nthought that a statement of the plans adopted and carried out by the\nlay committee would be of moment to the nurses practising and  inr\ntraining.\nWe wish to take advantage of this opportunity of expressing our\nappreciation of the splendid co-operation we have always received from\nthe Health Committee of the Cowichan Health Centre.\nNotes for the Guidance of Public Health Nurses.\n(1.) Health Centre.\u2014A Health Centre (such as Cowichan or Saanich),\nis an. integral part of the Public Health Department and the nurses\nemployed are members of the Public Health Nursing Staff, whose head is\nthe Provincial Health Officer.\n(2.) Local Committee.\u2014These nurses work under a local committee,\nwho are responsible for the financial and general superintendence of the\nHealth Centre. The relations between the nurses, committee, and the\nPublic Health Department are analogous to those existing between\nteachers, School Boards, and the Education Department. The committee\nleaves the professional side of the work to the nurses, who communicate\ndirect with the Public Health Department.\n(3.) Appointment, Salaries, etc.\u2014All appointments and dismissals\nare made by the local committee with the knowledge and approval of the\nProvincial Health Officer. All salaries are paid by the local committee.\nOn the request of the Public Health Department, and with the consent\nof the locaK committee, a nurse may be transferred from one district to\nanother on promotion, or for the general benefit of the Public Health\nNursing Service.\n(4.) Public Health Nurse's Position.\u2014The position of a Public Health\nNurse is pre-eminently an important one in a district and calls for high\nprofessional ability, high ideals as a public servant, and infinite tact.\nThe first impressions made by a nurse on the committee and district are\nalmost indelible, and nurses should realize that professional and social\netiquette must be strictly observed in many directions if they are to\nuphold the dignity of their calling and the prestige of the Public Health\nDepartment.\n(5.) Financing of a Health Centre.\u2014So many organizations are\naffiliated in the work of a Health Centre that the wise nurse will make\nherself thoroughly acquainted with the financial side of the work. The\nupkeep of a Health Centre is financed by grants from:\u2014\n(a.)  The Public Health Department.\n(b.)  The Education Department.\n(c.) Local School Boards.\n25\n\\   !\n (d.)  City-and Municipal Councils.\n(e.)  Women's organizations.\n(\/.)  Nursing fees.\n(g.) Membership fees of the general public interested in public\nhealth.\n(6.) Taking-over qf Duties.\u2014On her appointment a new nurse should\nbe given at least one week to take over her duties from her predecessor.\nShe will meet her committee and be given a general outline of the work\nof the district. The retiring nurse should, as far as possible, introduce\nher to the local Medical Health Officer, school doctor and dentist, headmasters and mistresses of the local schools. Special attention should be\ngiven to serious nursing cases and bedridden patients should be visited\nand the new nurse introduced.\n(7.) Office-work.\u2014The office routine should be explained. All school\nrecords, Metropolitan insurance-books, account-books, etc., should be\nbrought up to date and handed over officially. An inventory of all office\nfurniture, books, paper, supplies, etc., should be. made and, if found\ncorrect, signed bj both nurses.\n(8.)  The Motor-car.\u2014The  condition,  age,   licence,   insurance,   and\ngaraging of the motor-car should be thoroughly explained by the outgoing\nnurse, and when satisfied that all is correct the new nurse should sign the\nnecessary forms provided by the committee for handing and taking over.\n(9.) A New District.\u2014In the event of a nurse opening up a new\ndistrict, she will be guided by her committee as to local conditions, but\nas soon as possible she should call professionally upon the following :\u2014\n(a.)  Medical Health Officer.\n(o.)  Local doctors and dentists.\n(c.) Headmasters and mistresses of schools.\n(d.)  Clerks to School Boards.\n(e.) Metropolitan insurance agent.\n(\/.)  Matron of local hospital.\n(g.)  Presidents and secretaries of Women's Institute and other\norganizations.\nM. Moss,\nPresident, Cowichan Health Centre.\nVICTORIA,  B.C. :\nPrinted by Chakles F.  Banfield,  Printer to the King's Most Excellent   Majesty.\n1928.\n500-428-1506\n26\n  ","@language":"en"}],"Genre":[{"@value":"Periodicals","@language":"en"}],"Identifier":[{"@value":"W1.PU2378","@language":"en"},{"@value":"WI_PU2378_V01_05","@language":"en"}],"IsShownAt":[{"@value":"10.14288\/1.0383411","@language":"en"}],"Language":[{"@value":"English","@language":"en"}],"Provider":[{"@value":"Vancouver: University of British Columbia Library","@language":"en"}],"Publisher":[{"@value":"Victoria, B.C. : King's Printer","@language":"en"}],"Rights":[{"@value":"Images provided for research and reference use only. Permission to publish, copy, or otherwise use these images must be obtained from the University of British Columbia Library.","@language":"en"}],"SortDate":[{"@value":"1928-04-30 AD","@language":"en"},{"@value":"1928-04-30 AD","@language":"en"}],"Source":[{"@value":"University of British Columbia. Library. Woodward Library. Storage. W1 .PU2378","@language":"en"}],"Subject":[{"@value":"Nursing","@language":"en"}],"Title":[{"@value":"Public health nurses' bulletin, vol.1, no.5","@language":"en"}],"Type":[{"@value":"Text","@language":"en"}],"Translation":[{"@value":"","@language":"en"}],"@id":"doi:10.14288\/1.0383411"}