OUR DISCUSSION OF THE epidemic of influenza derives a particular and immediate importance from the fact that a recrudescence of the disease in many communities is likely to occur in the near future, and we are all keenly anxious to learn how best to meet the situation should it arise.
What counts even more, however, than the development of a plan of action which will help us to deal effectively with the epidemic should it be rekindled, is the ultimate good which this frightful tragedy may be made to yield. There are those here who will give adequate attention to the purely scientific aspects of the epidemic. It is my desire to call attention to the more general features so that we may learn certain lessons from the events of the past 3 months. Each of us should go back to our respective communities and urge and plead with all possible emphasis that the 350 000 and more deaths caused by the now waning epidemic in this country shall not pass from memory without leading to a drastic reorganization of public health work in every town, city and state, and in the Federal government as well. Let us make it known that we were not properly prepared to meet the emergency, and let us not permit the significance of the facts revealing our handicaps and shortcomings to be minimized.
Let it be known that our hospital facilities were not organized to meet the situation, and that the lack of proper governmental control over these agencies caused no end of confusion and suffering. We should frankly point out that the lack of control over doctors brought sharply into focus the commercial aspects of a profession whose protective and healing missions are so sacred and so vital to the lives of people that we must not allow its members to degenerate into independent and competing agents under a competitive system of medical practice. It should be made clearly known that the Federal Health Agencies lacked adequate powers and organization to assume leadership in guiding and coordinating health activities throughout the country, and that, instead, their work resolved itself largely into feverish and oftentimes futile efforts to summon detachments of doctors in the manner of the minute men of Lexington, to battle with the disease as well as they might in stricken and undefended communities.
Shall we permit the spectacle to be forgotten of doctors and visiting nurses who crossed each other's tracks, several visiting the same districts and even the same buildings, while in such houses men, women and children were dying for want of medical care, because under the present system of medical practice, the doctors were responding to calls from homes where a financial return could be expected? Shall we blame the doctor for this condition of affairs, or rather the lack of governmental control which would assure medical care to every person in the community, and give a decent recompense to doctors and nurses so as to free them from the necessity of commercial and degrading competition and enable them to devote themselves to ministering to the sick and to the protection of the well?
The socialization of the medical and nursing professions to place them under governmental control and direction should not be longer deferred. We should not be halted in our efforts to secure such a change by those who would seek to dam every such attempt by branding it as socialism.
The salvage of human life ought to be placed above barter and exchange. Shall we not in our reorganization provide so as to be prepared to meet a recrudescence of the epidemic or the development of a new emergency? Shall we, as a nation who have unstintingly given billions for the conduct of war, plead economy and withhold the much smaller sums needed to make possible the protection of human life on a decent scale?
We should take the lessons of the epidemic to heart and go back to our respective communities and demand the apportionment of money for every justified expenditure for the organization of preventive measures, medical care and relief. We should demand that the morale of every local and state organization be raised to the highest standard possible and be safe from political, personal or other petty disturbance, so that public health service shall offer a secure career to those who make it a life work and invite the best medical men and women from a scientific, social and humanitarian point of view, to dedicate themselves to it. We should reorganize health work so that the health officer shall no longer deem it necessary when he meets his professional brethren to say, apologetically, “I am a health officer,” but it shall become an honored as well as an honorable career.
Public health protection is not the work of a day, and only by appropriations for an adequate personnel and equipment, and by guaranteeing security of position and of the morale of health organizations, will communities be better prepared to cope with disease and to extend the province of preventive medicine. These observations apply to the present situation.
The Federal Health Department, instead of dissipating its energies in attempts to provide medical and nursing attendants in cases of emergency–a task that it cannot hope to fulfill adequately–should be the leader and guide in public health work. It should serve as the clearing house whose agents, scattered about in this country and abroad to the far corners of the earth, should serve notice without delay of dangers that threaten from various sources, so that we may not be taken by surprise. It should serve as a pacemaker, not attempting the hopeless effort to be the nation-wide medical servant and sanitary police corps, but rather as a center from which authoritative judgments and guidance shall issue to every health agency, large or small, to stimulate them to greater effort. The Federal Health Department should be the coordinating body, a pacemaker and a model for all other health departments. It should be the unifying agent that brings about team work between departments and laboratories throughout the country, and the advocate and friend of every weak and struggling health organization. Finally, every nurse and doctor now in military service should be released as soon as possible for community service in case of necessity.
I am purposely avoiding the citation of experiences of purely local interest. I am hopeful that every person here present will become a missionary to carry back a message that will make for radical reorganization so that we will be better equipped to deal with routine and emergency conditions.
Louis Israel Harris, New York City Commissioner of Health.
Source. The New York Academy of Medicine
In any scheme of reorganization the American Public Health Association ought to play an important part. This body should likewise be a clearing house for authoritative opinions on matters of immediate importance; and all information gathered from the papers that have been presented here and from the discussions that have taken place, should be disseminated promptly, and not filtered through after the lapse of months. This Association should set standards in public health work for the guidance of all of us, and should make its influence felt in aiding the work of every local, state and other governmental health agency which may need a champion, and it should be unrelenting in opposing everything that tends to weaken health organizations. Let this night mark the beginning of a persistent and unremitting propaganda carried on by this Association to bring home to every community the need of increasing its appropriations and its personnel, to the end that human life may be better protected. In this way only may some measure of good be derived from the tragedy out of which we are apparently just emerging.