FAITH AND HOPE
Progress is a series of zigzags: now the individual goes ahead of the
community; now the community outstrips the individual.
The community cannot rise much above the level of the individual home,
and the home rises only by the pull of the community regulations, or
by the initiative of a few especially farsighted individuals.
The steps need to be carefully measured, for if the family begins to
rely on the State for the backbone it should have, it will not stay
up, and its fall will be lower than the stage it rose from. "When man
reverts, he goes not to Nature, but to death."
The example set by the city in maintaining clean streets and well-kept
parks reacts upon the home yards. The insistence by the police on city
regulations as to alleys and garbage educates the family as to the
general attention to be paid to such things.
The city authorities, on the other hand, are prodded to their work by
well-informed individuals who see the great gain to the community from
certain measures.
The centers of movement, civic and quasi-religious or philanthropic,
are usually the outgrowth of individual effort. The great movements
for betterment--water supply, street cleaning, tenement laws,
etc.--are carried out by community agreement with a common tax outlay.
The clean city means streets of clean houses. The clean house in the
midst of a dirty city may be the match to start a fire of cleansing.
Probably medical inspection in the public school is as good an example
as may be given of helpfulness to the community. No quicker means of
influencing both home and community life may be found, for in five
years it might revolutionize the whole.
School buildings should be so constructed and so managed that they
cannot themselves either produce or aggravate physical defects.
Departments of school hygiene should be organized, not only in every
city, but for every rural school under county and state
superintendents of instruction. The general question of physical
welfare of children involves too many considerations to be
satisfactorily treated by school physician and school nurse alone, or
by busy teachers and principals.
"New York City will spend in 1910 $6,500 for making over twenty rooms
in regular buildings, a first step in an entirely new plan of
ventilation, which will eventually give outdoor air to all children,
sick or well."[8]
[8] Bureau of Municipal Research.
Speaking generally, America is one of the last of the civilized
nations to deal with the subject of the medical inspection of school
children upon a comprehensive and national scheme. But once aroused to
the needs, it is safe to say that the nation will speedily educate
parents to correct such home conditions as reduce the child's ability
to profit from schooling, and to persuade governments to see that safe
homes are provided. It will be easy to convince the taxpayer that it
is cheaper to provide such care than to neglect the future parent and
citizen, for it is easy to prove that medical inspection in our
schools returns large dividends on small investments. Dr. Luther
Gulick says that it seems probable, though only a guess, that the
total annual expenditure for medical inspection of schools in the
United States at the present time is perhaps $500,000. The money saved
by enabling thousands of children to do one year's work in one year,
instead of in two or three years, would greatly exceed the total
expense of examining all children in all boroughs.[9]
[9] Quoted in Report on National Vitality, p. 123.
The health of all our school children should be conserved by a system
of competent medical inspection which should secure the correction of
defects of eyes, ears, teeth, as well as defects due to infection or
malnutrition.
The statistics of medical inspection in public schools tell a pitiful
tale wherever it has been tried: thirty or forty per cent of the
children are found with defective or diseased eyes, ten to twenty per
cent with distorted spines, fifteen per cent with throat and nose
troubles, all of which directly affect their intellectual proficiency.
When these deficiencies are discovered and reported to the parents,
such is the apathy of disbelief that seventy-five per cent of the
cases usually go unattended; therefore the school nurse, who follows
the case home and explains the needs and sets forth the penalties, has
become a necessity.
The parent who permits his child to go to school physically unfitted
to profit from school opportunity is not only injuring his own child,
but is injuring his neighbor's child, and is taxing that neighbor
without the latter's consent.
It would seem as if such parents had forfeited their right to the sole
care of the children, and that government would be obliged, for its
own protection, to step in and do the work while it is needed. The
author has termed this _temporary paternalism_. The providing of penny
lunches during the morning recess, the service of the school nurse and
the home visitor to teach those parents who are willing to learn all
these schemes for the saving of the child, may be carried out in a
spirit of helpfulness with a support which may be withdrawn when no
longer needed.
Although all America has not become aroused to the undoubted fact of
tendencies toward physical deterioration, it is on the verge of an
awakening. The public school is the natural medium for the spread of
better ideals, and if the teachers of cooking and of hygiene would
coöperate and use all the material which sanitary science is heaping
on the table before them, we should soon see a betterment of the
physical status. Combined with medical inspection and sanitary
construction of schoolhouses, this would raise the general health of
the community thirty or forty per cent in five years and fifty to
seventy per cent in ten years.
There has been in some quarters much objection to public effort
towards remedying evils which would not have existed if each family
had lived up to its duties. The community is a larger family, with
greater resources, and can employ investigators to find the means for
greater security. That individual is very foolish who does not
recognize this interaction between community and individual, and who
objects to taking the benefits of the larger knowledge.
To take one of the latest examples of social problems: In every
thousand children in the public schools of any city, probably of the
town also, there are perhaps fifty who are ill-nourished (not
necessarily underfed), ill-clothed, unwashed, and deprived of good air
for sleeping. What is the duty of the public? This is one of the
burning questions of the moment. Send missionary teachers to the
homes, some say, but that is costly; the selection of the suitable
missionary is difficult, and the result may be slight. Others say,
give one good luncheon at the school, for which the children pay in
part or in whole, and make that an education which, by the aid of the
school nurse, will in time affect a change in habit. In short, the
problem is this: Shall the children suffer in childhood and become a
burden on society in adult years, or shall society protect itself from
future expense by community care now? "Because _finding_ diseases and
defects does not protect children unless discovery is followed by
_treatment_, fifty-eight cities take children to dispensaries or
instruct at schoolhouses; fifty-eight send nurses from house to house
to instruct parents and to persuade them to have their families cared
for; 101 send out cards of instruction to parents either by mail or
the children; while 157 cities have arranged special coöperation with
dispensaries, hospitals, and relief societies for giving the children
the shoes or clothing or medical and dental care which is found
necessary."[10]
[10] Bulletin, Bureau of Municipal Research.
Nearly all preventive measures adopted by society and ranked as
paternalism by timid philanthropists are or may be educative and
temporary at the same time. They may be dropped as soon as the end is
gained. The attention of parents must be called to neglected duties.
Compulsory attention to such duties as affect the wards of society,
the children, may be needed for a time. Just as the wise father,
taking the child for a walk, allows him to run free as soon as his
strength and courage permit, so the paternalism of society is relaxed
as soon as its _protégées_ show themselves both able and willing to
do the right thing without its aid or command.
Compulsory school attendance places responsibility for certain care,
vaccination, decent clothing, good food, decent shelter. The thousand
and one ways in which society is now protecting itself are all
educating the newcomers to American ideals. They are all intended to
make efficient, self-sustaining citizens who do not feel the pull of
the law or the bond of outside care. It is the last conflict between
the ideals of individualism and those of the community need,
subordinating the individual preference. Much wisdom and forbearance
will be needed to secure this community ideal, but in that way
evidently lies progress. It behooves the leaders of social effort to
make all their work educational, and thus remove the necessity for a
repetition in the future.
Just as the parent in the home establishes habits while the child's
mind is plastic, so the community stands _in loco parentis_ to the
future citizen, and surrounds him with safeguards while needed.
Knowledge is needed, scientific investigation is fundamental, expert
wisdom is indispensable, costly though it is, being the product of
long research and rare brain power. This is at the service of the
nation for the good of all the people, and it is the surer the wider
the range of experience. For this reason chiefly, greater actual
knowledge and more complete harmonizing of conflicting interests is
necessary. Certain sanitary measures are carried out by the Federal
government as an education to communities, just as communities educate
individuals. Federal effort may be unwisely put forth in certain
cases, investigations of little consequence may be undertaken, but on
the whole a democracy must learn to manage its affairs by making
mistakes. The principle should not be discarded as a result of the
first mistake.
The immediate concern of this chapter is with the leaders of community
movements, the educated, sympathetic, farsighted sociologists,
sanitarians, and economists, whose concern is for the advancement of
mankind. These leaders must have courage and belief in the value of
their work, for no half-hearted means will carry the community
forward. Still more, they must have knowledge, a sure ground to stand
upon. To acquire this means both time and opportunity. To go into
betterment work without it is to set back the wheels of progress, not
to advance them.