Photograph taken in the yard of a Day Nursery, where the babies are
left during their mothers’
absence at work.
]
Wherever possible, then, I believe that the effort of society should be
to keep the mother in the home with her children, and where pensions are
necessary in order that this result may be attained, they should be
given, not as a charity, but as a right. It would be a very good
investment for society, much more profitable than many things upon which
immense sums are lavished year by year. In the meantime, much good might
be accomplished by the establishment of municipal _crèches_ or day
nurseries in all our industrial centres, so that babies and young
children could be properly cared for during the absence of their mothers
at work. Something is already being done in this direction by private
philanthropy in many cities, but it is exceedingly little when compared
with the magnitude of the need. In saying that these institutions should
be provided by the municipality, or by the state, I do not mean that any
attempt should be made to prohibit private philanthropic effort in this
direction, nor that such effort should be in any way lessened; but that
the municipality or the state should accept final responsibility in the
matter, and provide them wherever the failure of philanthropy makes such
a course necessary. In all our great cities, as well as in many of the
smaller manufacturing towns, there should be such a _crèche_ or nursery
in the neighborhood of almost every primary school, until it is found
possible to enable the mothers to remain with their little ones instead
of going to work. With trained nurses in charge of such institutions, it
would be easy to control the dietary of the infants and to see that they
were not given pickles, candy, or other unwholesome things. Yet such a
system, no matter how perfected, can only be regarded as a makeshift, a
rather uneconomical substitute for the humane system of keeping the
mother with her child.
The heavy death-rate in most foundling hospitals, despite all scientific
care and the most elaborate equipment, have been accounted for by the
lack of maternal interest and affection. In the splendidly appointed
Infants’ Hospital on Randall’s Island New York City, little lonely,
mother-sick foundlings pined away at an alarming rate and died like
flies until the Joint Committee of the Association for Improving the
Condition of the Poor, and the State Charity Aid Association,
investigated the matter. The Joint Committee wisely decided that every
one of the bits of human driftwood was entitled to one pair of mother’s
arms, and that no institutional ingenuity could ever take the place of
the maternal instinct. They instituted a system of placing-out the
children with foster mothers, and the results have been highly
gratifying.[162] That is the human way, answering to the universal
child-instinct for a mother’s love and presence. The same objection
applies to _crèches_ as to foundling hospitals; the difference is only
one of degree. These institutions are far better for the children than
the neglect or the ignorant handling of “little mothers” from which they
now suffer, but they can never compare in efficiency with the personal
attention of the mother. There are few mothers, be they ever so
ignorant, who would not attend their own children with greater
efficiency than any institution nurses could do. In the ultimate result
I am convinced that the pensioning of mothers to care for their children
adopted by the French municipalities where the Socialists have obtained
control is much more economical and effective.
V
The importance of impure milk as a contributing cause of infant
mortality is now pretty generally recognized. The splendid work of Mr.
Nathan Straus has done much more, perhaps, than anything else, to
emphasize this fact. In view of some rather caustic criticisms of
charity in the preceding pages, it may be well if I embrace this
opportunity to explain my position somewhat more fully. No one, I think,
recognizes more fully than I do the important experimental work which
has been done by philanthropic enterprise. Such work, of which that of
Mr. Straus is a conspicuous example, has blazed the path for much
municipal and state enterprise. It would be impossible to overestimate
the value of the work done by social settlements and such bodies. For
the charity which denies justice and seeks to fill its place, I have no
sympathy, but for the charity which adopts as its motto the fine phrase
adopted by the ablest journal of philanthropy in America,[H]—“Charity
to-day may be Justice to-morrow,”—I have nothing but praise.
[Illustration:
A “CLEAN MILK” DISTRIBUTING CENTRE IN A BAKER’S SHOP, ROCHESTER, N.Y.
]
I have long held the opinion that the milk supply of every city should
be made a matter of municipal responsibility. Some ten years ago, while
residing in England, where the subject was then beginning to be
discussed and agitated, I devoted a good deal of time to the propaganda
of the movement for the municipalization of the milk supply. In view of
the splendid achievement of the _gouttes de lait_ in France, it was
natural that we should have attached much importance to the
sterilization of the milk, and I remember with what enthusiasm some of
us hailed the introduction of the system into St. Helen’s, Lancashire,
the first English city to adopt it. I am convinced now that
sterilization is unnecessary and a grave mistake. Undoubtedly it is well
that dirty or impure milk should be sterilized, but it would be still
better to have clean, pure milk which needed no sterilization. The
testimony of Dr. Ralph M. Vincent before the British Interdepartmental
Committee[163] and, more emphatically still, the splendid results of the
Rochester experiment under the leadership of Dr. Goler[164] show that
this can be attained. Every municipality in America could adopt, and
should adopt, the plan. “Now that the way has been shown, upon ‘city
fathers’ indifferent to the childhood of their cities, upon health
officers and departments warped into unbudgeable routine, upon
near-sighted charity workers and unknowing givers who care for the
suffering, but do not get at causes, will rest the responsibility for
the continuance of a part of that fearful tally of dead babies which
each summer’s week jots down on a town’s death-roll—your town and ours.”
In these direct, unequivocal words _Charities_ sums up the whole
question of responsibility.
The purely experimental work of such philanthropic efforts as that of
Mr. Straus has been done. The practicability and value of municipal
control of the milk supply has been abundantly proven, and there is no
longer need of private charitable effort and experiment. There lurks a
danger in leaving this important public service to philanthropy, a
danger well-nigh as great as in leaving it to private commercial
enterprise. The dangers arising from the amateurish meddling of
“near-sighted charity workers and unknowing givers” is much greater than
is generally recognized. Many of these charitable societies drag out a
precarious existence, their usefulness and success depending upon the
measure of success attending the efforts of the “begging committees.”
Generally speaking, they are less economical, and, what is more
important, less effective, than municipal enterprises, besides being
based upon a fatally unsound and demoralizing principle. I know of one
large city in which a number of public-spirited citizens have for some
years interested themselves in the supply of sterilized milk for
infants. Notwithstanding that they receive each year in subscriptions a
much larger amount of money, in proportion to the milk supplied, than
Rochester’s deficit, they charge the parents more than twice as much as
the latter city for the milk.
Nor is this all; there are other, weightier objections than this. There
are no regular depots for the distribution of the milk, under the direct
supervision of the Committee, but it is handled by drug-store keepers
and others. No sort of control is exercised over the sale. Any child can
go into the store and buy a bottle of milk. This is what happens: small
children, sometimes not more than four or five years old, are sent by
their parents to buy the milk. These little children are, naturally,
ignorant of the importance which the medical advisers of the charity
attach to the subject of modifications of the milk to suit the age of
the child to whom it is to be given, with the result that babies less
than three months old are given milk intended for babies eighteen months
old, while the latter are half starved upon the modified milk intended
for the former. Another evil, not, I am told, peculiar to this
particular charitable society, is the selling of milk irregularly and in
single bottles. When the mothers have the money, or when they are not
too busy to go for the Pasteurized milk, they buy a single bottle, but
at other times they send out to the grocery store for cheaper milk, or
else feed the babies upon ordinary table foods. Of course, there should
be a system of registration adopted; every child’s name should be
enrolled, together with the date of its birth, and no less than a full
day’s supply should be sold. That is the custom where the matter has
been taken up by the municipal authorities. The result is that the
children can be weighed and examined more or less regularly; facilities
are offered for the periodical visiting of the homes of the infants and
their inspection; mothers can be taught how to care for their little
ones; and, instead of leaving it to chance, or depending upon the word
of an ignorant mother, or a child, the attendants in charge are able to
regulate the supply so that at the proper time each child gets milk of
the proper strength and richness. How far the abuses I have named are
prevalent in philanthropic experiments of this kind, I do not know, but
I am convinced that there should be no room for such well-intentioned
but disastrous muddling. The whole milk supply of every city should be
the subject of municipal management and control, and special
arrangements should be made for dealing with the milk intended for
infant consumption. Personally, I should like to see the principles of
the Rochester system extended to cover the entire milk supply of the
city, and, in some one of our great cities, the further experiment of a
municipal farm dairy for the supply of all milk necessary for hospitals
and similar institutions upon the most hygienic principles possible.
This has been done to some extent in Europe with success.