Organization.—In order that the members of the church in which
it is proposed to organize the branch league may understand thoroughly
the objects of the league, the minister or other competent
person should explain clearly the purpose of the league and what it
is expected to accomplish. He should inform them that relatively
many more colored people die of consumption than white people;
that very few colored people get well of the disease, partly because
they do not know how to take care of themselves and partly because
many neglect to do so; and that the object of the league is to teach
the well how to preserve their health and prevent their contracting
consumption and other diseases, and the sick how to regain their
health. If too poor to take the necessary treatment, it is the purpose
of the league to help its members to do so.
After the foregoing has been thoroughly explained, the church
branch of the state league should be formed by the adoption of the
constitution and by-laws given for church leagues in the plan of
organization published in the Public Health Reports of May 28, 1909.
After this has been done, the officers required by the by-laws should
be elected.
The secretary then takes the name and address of each of the members,
and as soon as a member has paid his dues he is given the certificate
of membership, properly filled out, and signed by the president
and secretary of the church league.
The certificate of membership given to each person joining the
league has printed on it information and instructions which, if followed,
will tend to protect the individual from consumption.
An attempt has been made to make the certificate large and
attractive, and it is expected that the members will value it to such
an extent that they will frame and hang it in a prominent place in
the home, where it can be frequently seen, and that the sanitary
maxims that it contains will be learned and followed.
In organizing the church league it is well to have a number of the
certificates on hand to supply the members as soon as they pay their
dues. The form of the certificate will be found in the plan of organization
for these leagues. The certificate can be printed at a local
printing office, but if this is not practicable, or it is preferred to buy
them, very handsome certificates printed in black and red, with a
large red seal, and the name of the state and church branch league,
can be bought for about 6 cents each, by the hundred.
The amount of the annual dues to be paid by each member can be
changed by each league to suit the necessities of the community.
The dues should be so small that no one will be kept out of the league
by not being able to pay them. However, as the dues will be the
chief source of revenue with which the league expects to do its work,
they should not be made smaller than is actually necessary.
The money paid into the league as dues goes to form a fund that
is disbursed by the church league collecting it to help those of its
members who contract consumption. How much this help will be
will depend upon the amount of money the league has at its disposal
and the needs of the individual. But whether this help is
much or little the having the certificate of membership and belonging
to the league will give information that will teach one to protect
himself and his family from disease. This means less sickness, consequently
less loss of time from work, therefore more money, more
comforts, and more happiness for all concerned.
The vice-presidents and organizers should see that the four standing
committees required by the by-laws of the church leagues are
promptly appointed and that they understand their duties.
As the work of each church league will at first consist largely of
educating its members as to the cause of tuberculosis and the way
to live to keep from getting it, the committees, and especially the
ones having charge of “sick,” “sanitation;” and “information”
should be especially active. They should learn all that is possible
about their respective subjects so that they can teach the other
members.
In joining the church league one also becomes a member of the
State Colored Antituberculosis League. Members of the state
league and church branch leagues wear a button showing their
connection with the leagues.
Membership.—Membership in the church leagues should not be
confined to the members of the church organizing the league. As a
rule it is better that the members of each church join their own
church league, but if for any reason their church has no league there
should be no objection to their joining the league of some other
church. Those who are not members of any church should also be
allowed to join the league.
Details of the work of a church league.—As soon as the church
league is organized the president should appoint the four standing committees
required by the by-laws to serve for one year, viz: “Finance,”
“Information,” “Sick,” and “Sanitation.” The details of the work
to be done may then be considered. One of the first of these is to
ascertain how many of the members have or are suspected of having
tuberculosis. This duty devolves upon the committee on the sick,
which should get from the secretary a list of the members, giving the
name and address of each. This list should be gone over and every
member carefully considered. It is probable that the greater number
of the members are personally known to the committee, and thus
it can be told at once whether they are sick or well.
The committee is not expected to decide whether these members
have tuberculosis. Their duty is to make out the list of the sick and
ailing. The physician will decide the nature of the sickness.
It is desirable to find cases of consumption in the earliest stages,
for these may be cured, and if all members who are not strong and
healthy are examined by the physician it is possible that cases of
early consumption will be found.
Each ailing member should be visited by some of the committee
and more careful inquiry made as to the nature of the trouble and
the member urged to go to a physician or a dispensary for examination.
This is especially true if the member has been losing flesh, or
has had a cough for some time, or has throat trouble, or is sickly and
frail. If upon examination the physician finds that the member has
consumption, the patient should get a certificate stating that fact.
The physician will also tell the patient what treatment is necessary.
The certificate will be presented to the committee by the patient,
and the committee will make more careful inquiry into the condition
of the patient, the treatment considered necessary by the physician,
the patient’s means, the number of people he has depending upon
him, etc., so that the facts may be presented to the executive board
in accordance with the requirements of Article VII of the by-laws.
The list of the sick should be most carefully guarded and no one
allowed to see it but the officers of the league and the health officers.
This knowledge should be regarded as a sacred confidence that should
not be divulged except to the persons mentioned above, as many
might object to having it known that they have tuberculosis.
Under no circumstances should the list be allowed to fall into the
hands of “patent medicine” concerns which might urge their nostrums
on the patients, much to their annoyance and also to their detriment,
if they become induced to take the “patent medicines.”
The measures necessary for the treatment of a patient who has
tuberculosis must be determined by the physician, but it is the duty
of the executive board to decide how much and what kind of help
the league can give the patient in carrying out this treatment.
It is not proposed to discuss here the question of treatment in a
sanatorium which is the ideal way of handling all cases of tuberculosis,
for in a sanatorium the sick cease to be a menace to the community
and can be under supervision and treatment all the time.
Unfortunately, at present sanatoria are not available for the great
mass of the people; and even if they were, many would be unable to
go to them.
There is a class of patients who have to depend upon their daily
labor for the support of themselves and their families. If they
stop work, their support is cut off. For such as these treatment
in a sanatorium is out of the question, and any treatment they can
get must be given in their homes and frequently while they are
working. To this class belong the great majority of the negroes;
therefore the work of the church leagues must be directed to such
help as can be given under these circumstances. What is necessary
in each case will depend upon the condition of the patient, the stage
of the disease, and the financial circumstances of the individual.
For the purposes of the league, consumptives may be divided
into three classes:
First. The patients who are in the earlier stages of the disease
and are able to go about their work while taking treatment.
Second. Cases in which it is necessary to stop work and remain
quiet if they are to get well.
Third. Cases in which the disease has progressed so far that it is
hopeless to attempt a cure, but for which much can be done to make
the patients comfortable and prevent them from scattering the
germs of the disease.
As stated above, what is necessary in each case will depend upon
the condition of the patient and his surroundings. Much also
depends upon the means the league has at its disposal to help the
individual. Most church leagues find that they have very little
money; therefore the help given must be limited. However, there
are certain things that can be done even by the poorest leagues.
Information as to the way in which the disease is spread; the
means to prevent it; what is necessary to get well if one has it, etc.,
is all printed on the certificate. When the member gets the certificate
and has learned all that is printed on it, the first step has been taken
in the education of the individual in regard to tuberculosis, so it
should be the aim of the officers of the leagues to get the certificates
in the hands of the members.
The officers of the league can see that the instructions on the
certificate are understood and carried out. Many individuals are
careless and must be constantly watched to see that they do not
neglect important precautions. Probably the most difficult thing
the league will have to do will be to induce its members to keep
their windows open and let fresh air and sunlight into their rooms.
The officers and committees of the league should urge the members
to keep the windows of their rooms open, especially at night, and to
avoid overcrowding their sleeping rooms. Whenever a dark room
or closed window which should be open is found, the danger should
be pointed out, and the member urged to correct it.
The practice of sleeping with the head and face covered is so deeply
rooted in the negro race that it seems almost hopeless to attempt to
eradicate it in the present generation. It is a most pernicious habit.
The dangers of the practice should be pointed out, and the members
urged to abandon it. Children should not be allowed to contract the
habit.
The careless spitting of consumptives in their homes is a practice
dangerous to others. The careless at times spit on the floor, the
walls, the hearth of the open fire, or on the stove if one is used. The
sputum of the consumptive dries and is carried into the air as dust.
This is drawn into the lungs when one breathes. The dangers of this
should be emphasized, and the proper way to dispose of sputum
shown. The consumptive should catch all of his sputum and burn it.
There are cheap cups made of paper that can be had at small cost,
and these should be used to spit in, and when they are full they
should be burned. The better cups have covers to them, so that the
flies can not get at the sputum. While consumption is a dangerous
disease, the careful consumptive is not dangerous to live with. The
careless consumptive, however, is dangerous to live with and a menace
to those around him.
The minister and the officers of the leagues should consult frequently
with the health officer of their community. Working together they
can accomplish much more than by working alone.
The minister and officers of the league can teach their people to
be careful and not produce unsanitary conditions, and the health
officer can remedy conditions that the people can not correct. The
leagues should urge the members to beautify their homes, no matter
how humble they may be. If the home is made more attractive,
interest in it will grow, and an improvement in the sanitary conditions
will naturally follow. Teach the members to have grass
and flowers in their yards. See that there is no dirt, trash, or litter
scattered about; that the loose paling of the fence is nailed on,
and the sagging gate has a new hinge. Pull the dirty rags from
the broken window pane and burn them. Let them put their bed-clothing
out in the sun occasionally, and sweep the dust from under
the bed and furniture. Open the window and door and let air and
sunlight into the rooms. All of these things tend to improve the
sanitary conditions, which means health and happiness.
Members should be taught that remedies advertised as cures for
consumption are not to be relied upon, and that the only known
way to get well is to live in the open air as much as possible, both
day and night, and to eat nourishing food at regular intervals. The
consumptive when possible should go to a physician or a dispensary
and follow exactly the instructions given.
Aside from the help that can be given the individual consumptive,
which will be discussed later on, there is much that the leagues can
do by concerted action to improve the conditions under which the
negro lives. Probably one of the most important factors in the
spread of tuberculosis, aside from his habits, is the manner in which
the negro is housed. The negro as a rule is a renter. The houses
that he can rent are usually located in the poorest and most unhealthy
part of the city. They are often poorly constructed, badly
lighted and ventilated, and frequently in bad repair. The rooms
are usually small and dark, having but one window, and the top
sash is seldom arranged to be lowered. Many houses are built on
poorly drained ground, and water stands under them after each rain,
making the rooms damp and cold. These houses are seldom provided
with bathing arrangements or water-closets, thus necessitating
the use of privies, or the back alleys, with all the dangers attendant
upon such conditions. For such houses, or more frequently for one
or two rooms in such a house, the negro pays proportionately more
rent than the white race does for better houses in the same community,
either because better accommodations are not available, or
because he can not, or will not, pay for better. The family, usually
consisting of father, mother, and several children, and often friends
or relatives, all live, eat, and sleep in these two or three rooms, frequently
with the windows and doors tightly closed, and in winter a
stove going at full blast.
In the negro section of the city the streets are usually either badly
paved or not paved at all. The sidewalks are either in bad repair or
missing. The streets are badly lighted at night, garbage cans are
not emptied regularly, and the scavenger service is poor.
“There is a reason for these things,” say the landlords, the municipal
authorities, and others who have dealings with the negro. The
landlord says: “Negroes are destructive; they pull down, but they
never improve property. A house rented to negroes will depreciate
from 25 to 50 per cent in a year. If you put in plumbing they break
it, they deface the walls, they tear off the shutters and the doors,
they break and burn the fences. It is useless to give them good
houses as they neither appreciate them nor take care of them.”
The municipal authorities say that negroes make no effort to
keep their surroundings clean and sanitary. They throw things into
the street, choke the plumbing, drains, and sewers with old rags,
trash, and dirt, and make no effort to help the authorities keep things
in order; therefore it is useless to try to help them until they learn to
help themselves. They say that there are exceptions to these
statements, but that they are true so far as the great mass of the
negroes is concerned. Reference is made to the subject here to
draw attention to the fact that the leagues can do much to change
these conditions, thereby bettering the condition of the race.
If the things that are said about the negro by the landlords, the
municipal authorities, and others are true, then it is necessary for
the negro to change these conditions before there can be hope for
much betterment. If they are not true, steps should be taken to
convince the landlords, municipal authorities, and others that they
are false.
It is in this way that the leagues, though aimed at tuberculosis,
may be the means of bettering the conditions along many lines. If
the negro can demonstrate that he is not destructive, and that he
can and does take care of the house in which he lives; if he will keep
his surroundings neat and clean; if he shows that he is clean and
sanitary in his practices, and that he feels his responsibility as a citizen
by trying to keep up the sanitary conditions and the appearances
of his home and his city, he will find that many of his troubles will
disappear. If a landlord finds that his property is being cared for
by his negro tenant, the yard, fences, etc., being kept in order, the
rent promptly paid, and tenant is desirable, he will be only too glad
to keep him, and to make such alterations in his house as he may
desire. If it is demonstrated to the municipal authorities that the
negro is as careful of his section of the city as the whites, his wants
will receive consideration. The educated negroes succeed in getting
surroundings that are far better than those of the average because
they have learned to appreciate the above facts, and have put them
into practice.
When the leagues have taught their members that it is not healthy
to live in dark, damp rooms, with bad sanitary surroundings, and
have educated them to the point where they will refuse to live under
such conditions, then the landlords will build proper houses for them.
The leagues working in conjunction with the health officer can get
the city authorities to so frame the building ordinances that only
sanitary dwellings will be erected in the city.
What a church league can do for the individual consumptive.—In
addition to supplying the members of the league with information
in regard to tuberculosis and sanitation, which is the work of the
committees, and trying to induce the members to follow the instructions
given them, there are other things that the league can do for
the individual consumptive.
The chief difficulty that will be encountered by the leagues is the
lack of money to help their sick members. It is hoped, however,
that as the league demonstrates its value to the community more
money will be available, and the work of helping the sick members
can be extended. This work contemplates the “class method” of
treating patients at their homes, the establishment of dispensaries,
and ultimately sanatoria and “tuberculosis farms,” where a patient
can earn a living by working on the farm and at the same time be
under medical supervision. It is realized that these things are for
the future, but it is well to keep them in mind as one of the ultimate
aims of the leagues.
Now let us consider what can be done for the members who have
consumption. The league should buy a number of the paper spit
cups mentioned above, and distribute them to their consumptive
members, and urge their use. These cups are cheap and therefore
can be burned after being used. If every consumptive can be induced
to use these cups and then burn them much will be done toward
stopping the spread of consumption.
Whenever a case of consumption is discovered the officers of the
league should apply to the health officer to disinfect the rooms occupied
by the consumptive, in order to protect the other people in the
house from the disease. Then if the consumptive is careful he is
not likely to reinfect them. Also when a consumptive dies the health
officer should be asked to disinfect the rooms.
Consumptives should spend most of their time out of doors, and
if possible should sleep on a porch, or in a shed, or tent. All one
needs is something to protect against the weather and keep off the
rain and snow, but let in a great deal of fresh air. Patients live out
of doors all winter in the north, with the thermometer below zero,
and many have been cured of consumption in this way, including
negroes. The league may help to provide the shack, shed, or tent,
or it may furnish sleeping bags, blankets, etc., and in this way help
the patient.
If the patient is very poor it may be that the league can see that
he gets proper food which he might not otherwise have. The committees
of the league will doubtless find many other means for helping
the patient at small expense. The minister in making his pastoral
calls can be of the greatest help both to the patient and to the community
by seeing that the patient is properly carrying out his instructions,
and that he has the proper facilities for doing so.
Dispensary.—As soon as the church league is formed, some physician
should be designated who will examine all members referred to
him, to decide if they have consumption. Usually there will be
found one or more physicians who are members of the league, who
will probably act in this capacity. If practicable a tuberculosis dispensary
might be established at some convenient point, possibly in
one of the rooms in the church, where the physicians could be found
on certain days at stated hours, say, twice a week. Here they could
see the consumptives, and examine and advise them as to the treatment
necessary. They could also examine other members referred
to them to decide whether they had consumption or not. Records of
the dispensary work should be kept.
It is not practicable at this time to go more minutely into the
details of the work of these leagues, which are now in their formative
stage.
The writer will be glad to lend any aid in his power to any state or
church league that may desire it, and all persons who are interested
in this movement are invited to write to him, expressing any views
they may have for the advancement of the work. He will be glad to
have any aid, advice, or criticisms that may be offered.
