There is one condition in the Cleveland school system which rises like
a mighty barrier against the possibility of completely fulfilling any
such program of health education as that outlined in the 10 planks of
the preceding platform. This is the fundamental fact that the
Cleveland school authorities have not yet conceived of health work as
being an integral part of education.
In this city the work of the Board of Education is divided into three
main departments. These are the executive department, the educational
department, and the department of the clerk. The executive department
is under the leadership of the director of schools and it deals with
the business activities of the Board. The educational department is
under the superintendent of schools and deals with teaching.
Under this organization the activities carried on by the Board of
Education must be assigned to one or another of the departments and
this entails in most cases arriving at a decision as to whether the
work in question is predominantly of an educational nature or of a
business nature. In dealing with health work in the public schools,
the Board of Education rendered its decision both ways. It decided
that provision for health in education was a series of business
transactions and so it placed medical inspection in the executive
department under the leadership of the director. It also decided that
provision for education in health was a teaching problem and so it
placed physical education and training in physiology and hygiene under
the direction of the superintendent of schools.
Despite its decision that provision for health in education is a
business matter, while provision for education in health is a teaching
matter, the Board realized that some sort of unity was essential if
the different sides of the work were carried forward efficiently. They
met this situation by employing a competent director of health work
and giving him an official dual personality. As the official held
responsible for health in education, he is the director of medical
inspection and is subordinate to the director of schools. As the
official responsible for education in health, he is an assistant
superintendent and is responsible to the superintendent of schools. In
one capacity he is appointed by the superintendent and receives a
portion of his salary from educational funds. In his other capacity he
is appointed by the director of schools and paid from business
appropriations. As an employee of the educational department, he is
appointed for a term of one year, but as an employee of the business
department, he is on the civil service list with an indeterminate
period of employment.
In his educational capacity, he may arrange for the organization of
basketball teams for this is held to be a matter of physical
education, but in order to have a basketball game actually played at
any time outside of regular school hours, he must get the permission
of the director, for this is held to be a business transaction.
Instruction in infant hygiene is given to the girls in the upper
grades. Part of the teaching is done by the regular teachers, the rest
by the nurses of the medical inspection department. When the
instruction is given by the teachers, it is considered an educational
activity and is under the supervision of the superintendent; when the
same class is taught by the nurse, it is considered a business
transaction and is under the authority of the director.
As chief medical inspector, representing the business department, this
official discovers a feeble-minded child whom he wishes to transfer to
a special class. Since the transfer of this child is an educational
problem, he reports the matter to the assistant superintendent in
charge of the district. Since the medical inspector is also an
assistant superintendent, these two men are co-ordinate educational
officials. The assistant superintendent of the district reports the
requested transfer to the city superintendent who deals with the
matter as an educational problem and issues an order to the chief
medical inspector in his capacity as assistant superintendent in
charge of physical education to make the transfer.
This whole situation, which arises from assigning some phases of the
health work to the business department and other phases to the
educational department, has not given rise to as many or as serious
difficulties as might well be expected. This relative freedom from
trouble and friction is an impressive tribute to the unremitting
tactfulness of the officials most directly concerned. The chief
medical inspector is a conspicuous example of a man defying holy writ
by successfully serving two masters.
Health work in Cleveland public schools is on a higher plane than in
most other cities. Its present accomplishments have carried it further
than similar work has gone elsewhere. Its future possibilities are
unusually bright because the early stages of development have been
successfully passed. The one thing that we may be sure of is that this
future development will tend toward an ever closer relationship and
more intimate intermingling of the activities which make for health in
education and those which are directed toward education in health.
Each new development and each forward step renders a separation of the
work into educational and business activities progressively difficult.
To discover decayed teeth and to teach children to care for their
teeth are intimately related matters and their separation is bound to
be theoretical and not real. To attempt to separate the testing of
vision from teaching concerning the conservation of vision is to lose
an opportunity for the most effective sort of instruction. Similarly,
if one scrutinizes all of the 10 items that have been suggested as
indicating the health activities which Cleveland should continue to
develop in its public schools, he can hardly fail to appreciate the
utter impossibility of successfully dividing the work into certain
activities which shall be educational and certain other activities
which shall be business. Sooner or later the theory that this can be
done will be destroyed by the logic of events, for health work in our
public schools is constantly becoming a more intimate and integral
part of the every-day education of all the children.
Sooner or later serious difficulties are bound to arise from an
administratively unsound arrangement in which a school official in
charge of a most important division of work is responsible to two
entirely independent chiefs. The opportunities for honest but
irreconcilable conflict of views are so numerous that they will surely
arise in time. One chief may favor vaccination and the other be
opposed to it on principle. One may deem it the duty of the schools to
have the doctors and nurses give instruction in sex hygiene while the
other may be utterly against anything of the sort. One may hold that
the only useful physical exercise is that gained through games and
athletics, while the other may favor formal gymnastics. One may
believe in school gardens, and the other deem them a waste of time
and money. One may believe that courses in infant hygiene should be
provided for the girls in the upper grammar grades, while the other
may hold that such instruction should be reserved for continuation
classes for young women.
All of these are matters on which educational authorities are sharply
divided in opinion and there are many more of the same nature. The
present director of schools, the present superintendent of schools,
and the present chief medical inspector have so far worked
successfully under the present arrangement of divided duties and
responsibilities, but a reorganization along sounder administrative
lines should be made before, instead of after, serious trouble arises.
Eventually, if not now, Cleveland must realize that health work in
education must be placed under the direction of the city's highest
educational official who is the city superintendent of schools.